Stephen Kropp, Physician Resource Liaison, Saint Luke's Health System
Headquartered in Kansas City, Saint Luke’s Health System spans the state line that divides Kansas and Missouri, along what was once America’s western frontier. In this Midwestern region, the Kansas City metropolitan area has a dense population of 2.3 million people. But drive outside the metro area, and the landscape quickly turns to the Northern Plains. In fact, 97 percent of the state of Missouri is primarily classified as rural.
"As reimbursement has evolved, Saint Luke’s has focused on the inpatient telemedicine solutions with an electronic intensive care unit, virtual hospitalists and remote specialty consults"
As a health system with its first hospital based in the urban core, it is easy to focus on providing exceptional care to patients living in the metropolitan area. However, our faith-based roots require us to look outward to deliver the same excellent standards of care to our rural patients. With 16 hospitals based in primary and secondary markets throughout the region, we are continually identifying new and innovative ways to provide care to rural patients where they live, and deliver world-class care to the population living in rural America.
How do we assess the need? Saint Luke’s closely monitors the transfer patterns from several regional locations in relationship to:
• Available resources in their home community
• Average daily census in the local facility
• Travel distance to the next level of care
• Wait times for the next available appointment
At Saint Luke’s a team of physicians, administrators, legal and accounting professionals determine if the available resources meet the immediate and anticipated needs of the patients in rural communities. Then we consider telemedicine.
Saint Luke’s has made it a priority to incorporate technical tools, which allow us to provide the highest levels of care to patients wherever and whenever they are. By creating a focus on telemedicine, the technical tools are in place at each facility within Saint Luke’s Health System – both rural and urban – to allow physician and patient encounters to take place virtually, saving time and cost for patients, their families and providers by avoiding travel.
Saint Luke’s meets the specialty needs of patients in outpatient virtual clinics for Neurology, Pulmonary, Wound Care, Endocrinology, Infectious Disease, Hospitalist services and more. In fall 2017 Saint Luke’s took a huge leap forward by upgrading all our regional and rural facilities to the EPIC electronic health record used throughout the health system. This step alone mitigated the challenges of archaic communication via fax, which was previously required to efficiently share clinical information between providers.
A patient who received care at Hedrick Medical Center in rural Chillicothe, Missouri for challenging health conditions including stroke, diabetes, bleeding and a wound and experienced difficulties traveling for appointments with specialists now is able to remain in Chillicothe and receive the exact care with his same specialists through telemedicine, allowing him more efficient means to navigate his multiple health issues. During a patient interview, he expressed gratitude and satisfaction, saying, “through telemedicine, I met a physician who brought me hope close to home.”
Saint Luke’s conducts nearly 10,000 provider to patient encounters each year from our metropolitan locations. As reimbursement has evolved, Saint Luke’s has focused on the inpatient telemedicine solutions with an electronic intensive care unit, virtual hospitalists and remote specialty consults.
Engaging providers in a virtual experience for patient care requires technology that is reliable at the point of patient care. Saint Luke’s has refined and evolved the telemedicine tools since our first physician to patient encounters in 1998.
A great cost-saving measure for Saint Luke’s was the development of our ePharmacy service to meet overflow demand within our health system and engage facilities outside our health system as clinical partners. Saint Luke’s ePharmacy program electronically reviews 48,000 to 50,000 orders each month with an estimated savings of nearly $1.2 million annually.
Since we began telemedicine in 1998, Saint Luke’s has proven that physician-patient encounters can be as meaningful through telemedicine, as in person. The future is bright for telemedicine, as emerging reimbursement models focus on remote patient monitoring for chronic and post-acute patients, and licensure and site requirements are beginning to soften. Saint Luke’s patients are confident as well in choosing convenience over travel as they consider their health care options.