In the lobby of Mercy Virtual, Mercy Health’s $65 million investment in the future of healthcare, is a reflecting pool. Every so often a stream of water pulses up from the centre, sending ripples across the pool when the stream hits the surface. The symbolism is clear: Mercy Virtual, the first large-scale virtual care centre in the US, can impact nearly every aspect of the US healthcare system.
The ripples could also extend beyond the borders of the US. During our visit, we learned that Rwanda’s Ministry of Health would be visiting the centre in the next couple of weeks. Potentially, Mercy Virtual could hail the beginning of a global platform for healthcare delivery.
Telemedicine isn’t new. Many health systems, hospitals and physician practices have deployed ranges of teleservices. What’s new with Mercy Virtual is its scope – when fully deployed, it could be like an Amazon of healthcare, linking different providers and patients on one platform, and coordinating and deploying resources to support patients anywhere and everywhere.
It’s a very large bet. Right now, virtual care delivery isn’t reimbursed by health plans or payers; Mercy delivers these services free to hospitals in its network and sells them to non-Mercy facilities across the US (and beyond).
The scope of teleservices offered through the platform is extensive. The most common include
- An eICU – this provides 24/7 monitoring of intensive care unit (ICU) patients by teams of physicians and nurses. The service covers 28 ICUs in five states, including a non-Mercy facility in South Carolina. Mercy estimates that 2,000 lives were saved through this service between 2012 and 2013 alone.
- TeleSepsis – Sepsis is an extremely dangerous infection that commonly affects the elderly, recently sick and recently hospitalised. In fact, it is one of the most common hospital-acquired infections, so keeping the sick out of hospital is important to prevent susceptibility. Mercy Virtual has remotely assessed nearly 47,400 sepsis patients, leading to a 45% reduction in deaths from septic shock, and a 60% reduction in deaths from severe sepsis.
- eSitting – One of the most common accidents that occur in hospitals is a patient falling when getting out of bed. This leads to serious injuries and longer lengths of stay for many patients. eSitting deploys nurses and other health workers to monitor patients and talk to them if they are uncomfortable and need assistance.
- Home monitoring – Mercy Virtual monitors 3,800 patients in their homes. Patients using this service often have a range of complex chronic conditions that can result in unnecessary emergency room (ER) visits.
Integrating virtual care, disruptive technologies and supply chain
What’s so exciting about Mercy Virtual is its potential to integrate the digital with the physical supply chain. The supply chain organisation has a direct conduit into the patient’s home, which makes replenishing needed therapies that much easier and more efficient. The information feed for last mile delivery is fully integrated within the supply chain.
Moreover, this could alter the role supply chain practitioners have traditionally played in the value chain. Since many issues that patients have stem from behavioural, social or environmental risk factors, supply chain service providers can morph into assessors of these situations.
According to Vance Moore, President of Business Integration at Mercy Virtual: “We’ve got to start looking up the channel to understand the behavioural and environmental issues that need to change. We’ll never be able to address a condition like chronic asthma unless there’s a behavioural or environmental change”.
Outside the home care setting, the telematics used to link the virtual care site to the network of hospitals holds tremendous promise. In clinical scenarios, the cameras used are so accurate that they can register the dilation of a patient’s pupils.
In an operational setting – a supplies storeroom on an ICU floor, for example – the cameras are equally as powerful. Certain cameras and analytical horsepower associated with them can determine the product a nurse pulls from a storeroom shelf simply by the shape and configuration of the packaging. This can trigger the supply chain to replenish the product, thus removing the nurse’s responsibility to manage supplies.
This is a win for the patient as well as for the value chain overall.
The bottom line
Virtual care needs to be reimbursable – the potential for cost-savings and better outcomes is vast, and it’s already been proven. The fact that it isn’t right now is more a matter of gamesmanship between payers and providers. In this instance, we need to throw our weight behind the providers to get this platform humming as it should.