Pivoting to Telehealth: the HSS Experience, Value Gained, and Lessons Learned
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RESPONSE TO COVID-19/COMMENTARY
Pivoting to Telehealth: the HSS Experience, Value Gained, and Lessons Learned M. Jake Grundstein, PT, DPT, MBA
& Harvinder
S. Sandhu, MD, MBA & JeMe Cioppa-Mosca, PT, MBA
Received: 2 June 2020/Accepted: 28 July 2020 * Hospital for Special Surgery 2020
Keywords telehealth . orthopedics . musculoskeletal health . rehabilitation . healthcare . innovation . COVID-19 Introduction Healthcare innovations are continually being introduced, but the arrival of the coronavirus disease 2019 (COVID-19) pandemic caused providers and payers to rapidly reassess delivery methods and push telehealth to the forefront of patient care. Despite uncertain times, the healthcare industry has responded with flexibility, collaboration, and quick action to the urgent need to provide care while keeping patients and providers safe. During the pandemic, hospitals have been uniquely challenged to care for patients with acute and chronic conditions, despite the limited access to practitioners imposed by social distancing and shelter-in-place measures. Prior to the pandemic, institutions were slow to implement telehealth. The hesitancy was in part due to lack of reimbursement models, limited comfort with virtual services and technology, legal concerns such as state licensure laws, and socioeconomic barriers [5]. COVID-19 abruptly shifted the care model from in-person to telehealth visits. Patients at high risk for severe COVID-19, such as individuals with comorbidities and those over the age of 65 years, were suddenly confined to their homes with no access to traditional care options [1]. The Centers for Medicare and Medicaid Services and most commercial insurers responded by temporarily allowing reimbursements for telehealth [2], and many states temporarily eased licensure requirements or Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11420-020-09788-y) contains supplementary material, which is available to authorized users. M. J. Grundstein, PT, DPT, MBA (*) : H. S. Sandhu, MD, MBA : J. Cioppa-Mosca, PT, MBA Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA e-mail: [email protected]
administered temporary licenses for telehealth to ensure continued access to care [8]. Since then, hospitals that adopted telehealth have reported a substantial increase in virtual visits [4, 10, 21]. Here, we describe how the Hospital for Special Surgery (HSS) physician and rehabilitation community addressed the challenge of providing continued orthopedic care to patients by rapidly expanding its nascent telehealth platform. We explore the value telehealth added to our patients’ care and the lessons we learned along the way. Pre-COVID-19 Era HSS is an orthopedic teaching institution that addresses a range of simple and complex orthopedic and rheumatological diagnoses. A leader in musculoskeletal health, the institution’s purpose is to help people get back to what they need and love to do better than any other place in the world. In 2019, HSS had 421,095 ou
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