INDIANAPOLIS-There was a time when doctors came to the homes of patients so often that the term “house call” effectively entered the language during the early decades of the last century.  In fact, Jason “JD” Duigou, the chief information officer at Indianapolis-based Medxcel, says that nearly half of all doctor visits during the 1930s and ’40s were for home-based care. 

The practice practically ceased to exist by the close of the 20th century, but thanks to internet technology and the rise of video conference apps, virtual remote care is rapidly becoming the wave of healthcare’s present. Whether it’s telemedicine in psychiatry or virtual check-ups, virtual remote care is here to stay.

“Now, instead of opening a door, patients simply need to open an app,” Duigou said in a recent writing.  “Telehealth is putting a 21^st century spin on the old-fashioned house call [ensuring] patients receive the best care at the right time and right place by increasing accessibility to doctors, physicians and specialists.”

“Telehealth” isn’t meant to replace traditional medicine, Duigou said, since accidents and emergencies still require in-person care to properly diagnose and treat, but virtual consultations can assist with an array of non-emergency problems ranging from anxiety and depression to the common cold and even post-operative follow-up discussions.

Telehealth also allows doctors to “travel” to patients who might be otherwise immobile.  Duigo said the process is also a cost-saver, allowing more patients to be diagnosed in a shorter time frame rather than queuing in a doctor’s office or emergency room. 

“The University of Pittsburgh Medical Center found that, on average, $86.64 is saved each time a patient receives their care online versus in a clinic or ER,” he said.  “When multiplied by hundreds of patients each day, the fiscal benefits of telehealth programs alone are astronomical.”

Furthermore, beds in an emergency room setting are often in short supply, and Duigo estimates that nearly three-quarters of ER or urgent care clinic visits could just as easily have been handled virtually. 

“Although telehealth is emerging at a fast pace, healthcare as we know it has been undergoing a major shift to population health with smaller, community-based healthcare facilities,” he said.  “This requires a shift in mindset for facilities management leaders where they should be developing a mobile workforce strategy that will take those same facilities management services provided within the walls of a large hospital and become equipped to service smaller ambulatory centers.”

Duigou reiterates that telehealth cannot fully replace traditional in-person care, especially for specializations like heart and lung care that require constant monitoring.  However, more specialized centers of care, called “boutique hospitals,” will become more of the norm in this newer virtual sphere. 

Technology will also play a crucial part in this new paradigm.

“Wearable technology such as Fitbits or heart rate monitors will continue to inform patients about healthcare data in real time and allow them to share with their doctor,” Duigou said. “Doctors can be linked in to patients’ ongoing health and can utilize telehealth’s applications should an issue arise. … Already, we’re seeing elderly patients with cognitive reasoning and communication issues operate virtual reality headsets to help foster their interactions.

“As the telehealth revolution continues to boom, facility managers must adapt to the virtual changes,” he said.  “While hospitals will never be truly nonexistent, telehealth is paving the way for a new era of care.”

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INDIANAPOLIS-Medxcel Vice President, Program Development, Support and FM Compliance Officer Larry Lacombe is quick to stress the importance of regulatory compliance in the healthcare field.  Lacombe is in charge of developing and implementing compliance programs for Medxcel to ensure that his firm’s nationwide network of hospitals is survey-ready, anytime of the day or night, for the Indianapolis-based company.

However, just being ready isn’t enough, Lacombe emphasizes.  Rather, continuing staff education to ensure they are up to date on the latest developments in regularly compliance is key to heading off potential problems later on. Particularly for new staff, utilizing onboarding buddies, or something similar can be a good way to ensure training is up to date.

“When it comes to maintaining regulatory compliance, education is oftentimes the most difficult part.  Particularly in situations when staff are accustomed to doing things in a certain way, it can be tough to persuade the team to adhere to new compliance-related procedures,” Lacombe said in a recent letter sent out by Medxcel.  “However, with more than 629 discrete regulatory requirements across nine domains, it’s apparent why compliance education is so crucial. With so many regulations, there’s a lot to consider.”

Lacombe believes that because regulatory compliance is such a complex organism, training should be fluid and ongoing and not left until it is too late, i.e., after a problem has already manifested itself.

Staff can sometimes be slow to adapting to new rules and regulations, but Lacombe said that with proper training, healthcare staff and facilities will more be better able to comply with newer and expanding requirements. 

“Healthcare leadership should implement these education programs as soon as possible to ensure its success,” he said.  “Programs should also be developed with intent in mind.

“Of course, the ultimate objective is to comply with all requirements; however, healthcare facilities should also consider the education’s other purposes. This will help to develop curriculum and provide staff with fine-tuned programs.”

The executive believes that compliance procedures must be internally standardized so that the entire staff follows the same guidelines during training and beyond, and that is up to management to ensure that guidelines are explained to staff in a way that is easy to understand and implement.    

“Regulatory compliance is complicated.  In order to safeguard a facility against errors and subsequent fines, an important part of regulatory compliance education is remaining open-minded and shifting plans as needed,” Lacombe said of the need to evaluate how training implementation is proceeding.  “Sometimes after a process is set in place, facilities later find out there’s a more efficient way of operating. The important thing is to remain flexible.

“Leadership should always evaluate any sort of process or educational program following implementation and adapt as necessary.  Furthermore, adapting plans will help to increase transparency within facilities.”

A better way to ensure that regulatory compliance training holds up is to include staff in the decisions and implementation, said Lacombe.  This means staff-and, ultimately, the facility-are more apt to remain in compliance as they feel they have something at stake as well. 

Medxcel’s business operations entail savings and efficiencies for healthcare organizations in the belief that this improves the environment for patients and staff in the long run.

“As you develop your regulatory compliance education, remember how important it is to properly educate staff and adhere to all regulatory requirements,” said Lacombe.

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INDIANAPOLIS — Hospitals are commonly regarded as a safe place among patients and caregivers, where services never cease, and staff is continuously effective — but what happens when disaster strikes? Hospitals are needed to operate under standard-to-severe conditions, maintaining quality care and protection for patients, visitors and associates alike in the event of a natural disaster.

According to Scott Cormier, vice president of emergency management, environment of care, and safety at Medxcel, weather-related catastrophes are responsible for nearly 500 deaths and $15 billion in damages. In his recent publication, Cormier focuses on tornadoes in particular, which typically occur during the months of spring and summer. As hospitals stand as a crucial asset in the response and recovery of a community following a disaster, it’s imperative that these facilities are prepared and protected. Cormier explained how a hospital can prepare and protect during the event of a tornado by following three separate steps. These steps comprise implementing a comprehensive emergency management plan, developing communication infrastructure and following the plan.

In 2017, the Centers for Medicare and Medicaid Services updated emergency management requirements for 17 providers and suppliers of healthcare including hospitals, long term care, home health, and outpatient services. Through this, Medicare and Medicaid providers are required to create comprehensive emergency management plans in place that account for their patients, associates, and communities for all natural, man-made and technological disasters.

If a facility is determined unsafe, the hospital must work with local emergency management and public safety agencies, as well as contracted partners, to evacuate the facility.

There are three methods of evacuation: horizontal (moving patients from one side of a building to another that is safer), vertical (evacuating a floor of the hospital to another floor), and total (evacuating the entire facility.  Each department should have a specific evacuation plan that considers the type of patient being evacuated, such as a newborn, critical care patient, or patients attached to specialized equipment. The Hospital Command Center coordinates the evacuation, connecting patients with transport assets and open beds at other facilities, while patients are transported from their rooms to a staging area, and those patients that require rapid transportation are evacuated first, while making sure to provide the patient’s chart for any specialized medications so they can continue care.

Tornado safety features include special windows to withstand flying debris, underground wiring to prevent power outages, and a reinforced roof. For existing structures, the facility team should create safe zones characterized as windowless, reinforced rooms placed throughout the facility where staff, visitors, and patients can shelter during a tornado. The Federal Emergency Management Agency (FEMA) has a grant program called the Hazard Mitigation Grant Program, in which healthcare facilities can partner with local and state governments to apply for safe room grants.

Cormier urges hospitals to create a plan that reinforces areas to make the building safer, stating it should be a part of a multi-year capital improvement program. Further protections include investing in warning equipment like weather alert systems, and subscribing to a private meteorological service that has the exact coordinates of hospitals to receive specific forecasts and warnings based upon those locations, which is more accurate than the general warnings broadcasted in the media. It is also vital to train staff on how to react during a tornado watch and warning, which includes preparation of patients and visitors, keeping emergency equipment accessible in all areas of the facility, and having a checklist to quickly determine if the building is safe to stay after the tornado passes. Finally, confirming memorandums of understanding (MOU’s) for staffing, transportation and evacuation sites are up to date.

“Since tornadoes appear with little warning, unlike hurricanes, there is little that can be done when a tornado warning is issued. Natural disasters are one of the top hazards a healthcare facility will face, so it makes sense that they invest in preparation, response, and recovery supplies and equipment,” said Cormier. “If you are in a tornado risk area, it’s important you understand your facility, your vulnerabilities, and where safe areas are located in the building.”

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