Health Without Borders

Expanding the Telehealth Program at Children's Hospital Colorado

Often the financial burden of ill health weighs as heavy on a patient as the physical symptoms and side effects. Taking time off work, travelling long distances to unfamiliar locations and paying for accommodations can all result in a stressful and expensive experience.

This is never more evident than in pediatric medicine. In Colorado, there are few specialists beyond the Front Range and families living on the Western Slope may need to take three days off work and school for just a short visit to a specialist in Denver.

Fortunately, the team at Children’s Hospital Colorado are coming up with a solution. Their telehealth program​has extended the reach of 25 health departments, putting them on track to reach more than 3,000 patients in 2018, over a seven-state region.

Christina Olson, MD​, (pictured at right) is a pediatric hospitalist and the telehealth medical director for Children’s Colorado. Her role is to help implement new service departments and ensure the programs meet and maintain high standards.

Dr. Olson has experience of working in general pediatrics in a remote area, and so understands the challenges associated with rural practice.

“Telehealth is a two-location project,” she explained. “It needs to be based on mutual respect and mutual commitment to the relationship. We don’t want to take over care in a community; we want to augment what the community is able to provide to its people. We want to help patients get the best care, as close to home as possible.” 

This goal is admirable, promising to reduce patient costs, boost satisfaction and, of course, improve the lives of people across the country. But providers benefit, too, through increased efficiency and the ability to serve more patients, with rural providers able to extend their scope of care.

The hospital medicine group at Children’s Colorado, for example, has recently started covering the hospital pediatric service at Vail Health. Patients are still seen in-person at the hospital by a nurse practitioner or physician assistant, but the team has access to a pediatric hospital medicine physician at Children’s Colorado via telemedicine.

“It’s an innovative model that’s not largely being used around the country,” Dr. Olson said. “We’re finding it really is an optimal way for us to expand rural health coverage.”

Dr. Olson and her team are also working on partnerships with other hospitals such as Cheyenne Regional Medical Center in Wyoming. “We’re aiming to have our neonatologists provide NICU consults to their patients,” she said. “It’s a novel service for us but if we can keep more newborns closer to home, we’ll be pleased.”

But ensuring that telehealth care meets all compliance and regulatory standards is not straightforward and, with some concerned about the security of remote medical care, Dr. Olson has her work cut out.

“I’ve learned a lot about health care systems and the nitty gritty details for providing out-of-state medical care through telehealth,” she said. “From DEA regulations to hospital privileging to even financial models, it’s my role to make sure we’re in compliance with all these standards for any new service line using telehealth.

“We accomplish this as a team and patients are always at the forefront. We want to make sure we don’t compromise quality of care with unique care models. The last thing we want is to make our patient encounters less efficient, and we also remain sensitive to finding the right balance between telehealth and in-person patient encounters.”

This attention to detail and commitment to putting patients first appears to be paying off. Daniel​ Hyman, MD​​, is chief medical and patient safety officer at Children’s Colorado and says Dr. Olson’s leadership has helped push the telehealth program forward. 

“We are fortunate to have Dr. Olson,” he said. “Her commitment to providing outstanding service to the providers here at Children’s Colorado and the patients, families and referring providers at remote sites has been unwavering. There is complexity to the regulations and agreements necessary to host these consultations and Dr. Olson has become expert in ensuring we meet those requirements.”

Through Dr. Olson and her team’s efforts, Children’s Colorado are working to ensure they can offer health care for everyone, no matter where they live. Although the expansion of telehealth may be complicated, with a reported increase in long-term conditions and a move to value-based care, it’s certainly a step in the right direction.

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