virtual care at ochin 2019 - himss chapter
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Virtual CareAt OCHIN2019
Who is OCHIN?
OCHIN Supports Over 500 Organizations Nationwide and Growing
OCHIN Epic111 Organizations
OCHIN Services400+ Organizations
OCHIN Billing26 Organizations
OCHIN Broadband 164 Organizations
OCHIN Research35 Partners; 40 Clinics
14 1
2
34
14 549
11
29
90
26
3
3
1
6
3
2
6
(DC)
3
4
12
OCHIN NextGen44 Organizations
4
3
OCHIN Offerings
2
1
2
5
4
1
2
1
1
1 2
11
1
1
1
1
2
1
31
1
3
10
4
1
1
1
1
1
2
1
1
1
1
2
2
The numbers indicate the states in which member organizations are based, though they may operate in
additional states (represented with unnumbered circles).(May 2019)
Medicaid Expansion States
Non-Medicaid Expansion States
1
1
7
1
1 1
3
1 1
1
1
1
1
11
1
Our National Impact
500+ Organizations in 47 states
10,000 Providers
5.1M Patients served
33M+ Records exchanged past 12 months
As of April 2019
5.1M Active Patients
70% Female | 10% Children
46% At or Below Federal Poverty Level
Diversity
42% Racially Diverse | 27% Hispanic
29% Best Served in a Language Other than English
Chronic Conditions
70% Have at Least One Chronic Condition (3.5M)
52% Have Two or More (2.6M)
The Population We Serve
46%
7%
21%
26% Medicaid
Medicare
Private Insurance
Uninsured
Payer Mix
Migrant/Seasonal Workers
Homeless
Incarcerated
School-Based
Veterans
Foster Children 13K
22K
37K
43K
41K
40K
What is Virtual Care?
$$$ (Resources/Encounter) ACCESS (Specialist Encounters)
• SMS Appointment Reminders
• Portal modules (targeted education)
• Planned Parenthood HIPAA-compliant texting
• Smart symptom algorithms
• The Ideal: Implants and Wearables (Closing the Loop)
AUTOMATED CARE
JMIR Diabetes 2018;3(4):e15. URL: https://diabetes.jmir.org/2018/4/e15
JMIR Diabetes 2018;3(4):e15. URL: https://diabetes.jmir.org/2018/4/e15
JMIR Diabetes 2018;3(4):e15. URL: https://diabetes.jmir.org/2018/4/e15
• Patient portal (MyChart) features
– My Preventative Care
– Care Companion
– Symptom Checker
• Electronic Referrals (eConsults)
– Partnership Health
– Care Oregon
ASYNCHRONOUS CARE
eConsultPartnership:
Open Door Community Health Center & Partnership Health Plan
Any referral that meets the following criteria WILL be sent to eConsult:
eConsult availability
Telemed2U Specialist
The patient is on MediCal (PHC)
Standard operating procedure: send
eConsult
Open Door CHC eConsult Data
Total e-Consults
Patients Needs Addressed
Average Days Patients needs
addressed
referred for face-to-face visit
average days referred for face-
to-face visit
Dermatology 270 59% 7 30% 1
Neurology 75 63% 7 12% 3
Endocrinology 73 44% 8 47% 2
Rheumatology 94 31% 7 54% 2
Urology 28 68% 8 11% 1
Infectious Disease 7 57% 6 43% 1
Gastroenterology 52 6% 11 87% 1
Pain Management 2 100% 11 0% NA
eConsultscost 25% less than
face to face visits
(includes travel costs)
7
333
507
601
0
100
200
300
400
500
600
700
2015 2016 2017 2018
Total eConsults completed year-over-year at Open Door facilities
eConsultPartnership:
Care OregonLocal Community Health Centers
• 85.9% Improved Care Plan
• 71.0 % Educational
• 40.7% Avoided Referral
• 41.7% Avoided Diagnostic
• 2.5% No Effect
Reported outcomes
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
% o
f eC
on
sult
s
Avoided Referral Avoided Diagnostic/Service
79%Outcomes reported
1,095eConsults submitted
58%Avoided Service Rate
Reprinted with permission of Tanya Kapka, MD
• Language Interpretation
• Phone Consults
• Video Visits
– Open Door, Telemedicine
– Winding Waters CHC, MyChart Video Visits
SYNCHRONOUS CARE
17
133
775
1232
1434
0
200
400
600
800
1000
1200
1400
1600
2014 2015 2016 2017 2018
Total video visits completed year-over-year at Open Door facilities
• Expanding Virtual Care is hard.
• OCHIN is committed to offering this to the Safety Net anyway.
• OCHIN is committed to sharing its findings and helping others achieve success in Virtual Care.
WHAT WE’VE LEARNED SO FAR
Thank You!
Dave Boston, MDSr. Clinical InformaticistMedical Director of Virtual Carebostond@ochin.org
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