A medical assistant is reviewing discharge information with a patient who is postoperative
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The entity (BonaCura Children’s Hospital) referenced in this illustrative case is fictional. Individuals, businesses, events and scenarios referenced are influenced by interviews and review of publicly available literature. Any resemblance to actual individuals, entities or events is purely coincidental. BonaCura Children’s Hospital is a large pediatric specialty hospital serving a broad catchment area covering both urban and rural geographies. The BonaCura Urology Department has decided to adopt video visits to provide postoperative care, particularly for patients located in rural areas. BonaCura conducts approximately 1,200 urological surgeries annually. A claims analysis conducted by the hospital’s research department found that a significant proportion of BonaCura’s patients were not coming back to the hospital for postoperative follow-up visits. The analysis revealed that a greater percentage of rural patients were experiencing postoperative complications and returning to the hospital for subsequent postoperative care compared with urban patients. To address this disparity, BonaCura has decided to implement a re-engineered, technology enabled discharge protocol. Before discharge, the patient’s physician assesses whether the patient’s family member or caregiver has the necessary devices and broadband connection to participate in post-discharge video visits for follow-up care. If they can participate, the physician initiates consent and scheduling for the follow-up video visit. Those who lack the necessary technology to participate in virtual care will be provided with a connection to local resources that can support their efforts to acquire needed technologies Two or three days after discharge, a nurse or medical assistant will reach out to the family member or caregiver via telephone to review discharge instructions, remind them of the patient’s upcoming video visit, and answer any technology related questions. During the video visit, a clinician will assess the patient’s postoperative status with the help of a family member or caregiver and address any issues or complaints related to the surgery. After the video visit, the physician will contact the patient’s pediatrician to update them on their patient’s status. Strategic goals Strategic goalsBonaCura Children’s Hospital will utilize postoperative video visits in order to:
Program impact on health care value streams Program impact on health care value streamsClinical outcomes, quality and safetyClinical quality and safety outcomes; clinical processes
Access to careAffordability of care; availability of care
Patient, family and caregiver experienceClinical and/or technology experience
Clinician experienceTechnology experience
Financial and operational impact Financial and operational impactOperational efficiencies
Health equityEquity in clinical outcomes, quality and safety
Examples of virtual urological posoperative follow-up programs Examples of virtual urological posoperative follow-up programsArkansas Children’s Hospital: The Arkansas Children’s Hospital Urology Department delivers postoperative follow-up telehealth visits for patients located in Springdale, Jonesboro, Texarkana and Fort Smith. Mayo Clinic: At the onset of the COVID-19 pandemic, the Mayo Clinic Center for Connected Care launched a program to enable video and telephone visits for pediatric urology. Mount Sinai: Mount Sinai’s Department of Urology conducts telehealth primarily for postoperative follow-up and has scaled up the program during the COVID-19 pandemic to address select other visit types. Relevant literature supporting illustrative impact estimates Relevant literature supporting illustrative impact estimatesAccess to care
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