Telehealth will remain an important part of healthcare post-pandemic

This week BRI Network hosted its 6th National Telehealth Summit and it included sessions that spanned a range of topics including: the logistics of implementing a telehealth program, use cases and best practices for remote patient monitoring, how telehealth can be used to reduce care disparities and prevent readmission, and more.

Telehealth remains a timely topic for healthcare providers as it’s been one year since the first coronavirus patient was identified in the United States and the country is still struggling to contain the virus, slow its spread as more contagious variations emerge, and deliver vaccinations to hundreds of millions of people. It seems virtual care models are going to be essential to delivering comprehensive healthcare for the foreseeable future and furthermore, expected by consumers who have grown to appreciate its convenience.

Alleviate the growing demand for providers and facilities with technology

While telehealth is certainly not new to healthcare, its use skyrocketed in 2020 as a result of the pandemic and subsequent public health emergency. The rapid expansion and adoption of telehealth changed the way many organizations view telehealth and as a result they perceive the acceptance and growth of virtual care as a rare bright spot in the pandemic. They see opportunities to fill gaps in traditional healthcare, expand digital tools to engage patients in their care, and safely care for patients in a way that’s convenient for them. 

One important and interesting use case for virtual care is home monitoring. In a session titled “Telehealth and Patient Safety,” Sherene Schlegel, RN, Executive Director, Telehealth Clinical Operations at Providence St. Joseph Health, shared how her organization has approached home monitoring during the pandemic to address capacity and staff challenges.

As COVID-19 cases surged and facilities approached capacity, Providence St. Joseph Health got proactive, leveraged partnerships and resources, and developed an innovative program to care for non-critical COVID-19 patients at home. If patients were COVID-19 positive or presumptive positive, but did not require hospitalization, they were enrolled in the home monitoring program, sent home with a thermometer and a pulse oximeter and instructed to check-in three times a day via the portal for 14 days.

"Adding Twistle was a game changer"

During this session, Providence’s Executive Director of Telehealth Clinical Operations shared how adding Twistle to their COVID-19 home monitoring program boosted engagement from around 5% to over 90%.

Getting resourceful

To help staff the program, Providence reallocated nurses in departments where they were not being used, like day surgery centers. To monitor patients, they took over computer labs that were also not in use due to the pandemic. They also looked at their technology-based resources, including their EMR and patient portal, to streamline the program.

Fine tuning and iterating

After initially launching the program, it quickly became apparent that expecting patients to go to a computer, log into their portal, answer a short survey and enter their vitals three times a day was not realistic and engagement was very low. They then turned to Twistle to help them quickly deploy a text-based program that was integrated with the EMR. Patients would be prompted via text to check-in and report their vitals and that information would be automatically added to a dashboard where nurses could quickly see “red” or “yellow” patients who may be at risk and require follow up. Schlegel described the addition of Twistle as a “game changer” for their home monitoring program. Patient engagement skyrocketed from around 5% to over 90% – and the nurse to patient ratio went from 1:20 to 1:85, allowing Providence to scale this program to a large patient population.

Lessons learned

The program is live in over 90 facilities in six states and accommodates 12 languages, and Providence continues to learn and iterate on the program.

Keep it simple. Patients will not engage if accessing the program is complicated or difficult. The user experience is key to success. Providence leveraged a text-based care pathway and easy to access education and resources to keep patients engaged.

Integrate technologies as much as possible. Providence was able to automatically initiate home monitoring via an order in their EMR, and used a tool called Xealth so that enrollment was automated and information was pre-populated into Twistle.

Be flexible. Providence adjusted the program as they heard feedback from patients and learned more. If a patient was “green” – recovering just fine – the cadence of messages now goes from three times a day to two times a day, and the original 14-day protocol has been shortened per CDC guidance.

Planning for the future

As healthcare leaders continue to think about ways to safely deliver care, home monitoring – even for patients who may require more acute care – is a promising model when combined with a tool like Twisle that is configurable, flexible, and can be integrated with other technologies to ease the burden for staff and patients and automate communication and customizable alerts.

Are you interested in learning more about how Twistle can help you manage patients safely at home? Contact us today at

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