How asynchronous telemedicine saved SSM Health 18 minutes per visit

SSM Health, a health system that serves Illinois, Missouri, Oklahoma and Wisconsin, is always looking for ways to reduce the cost of healthcare while increasing access for the patients it serves.


As most in healthcare know, many of the low-acuity conditions for which patients seek treatment do not necessarily require an in-person visit.

As a result, the health system wanted to find a telehealth system that would enable it to provide patients with an option for a visit that would be really convenient and also reduce costs to below those of a typical telemedicine video visit.


Telemedicine vendor Zipnosis proposed collaborating with SSM Health on a virtual visit solution. The solution would be unique in that it would give the health system the flexibility for an asynchronous adaptive interview, which would give patients flexibility and improve provider efficiency.

“A typical visit – even a video visit – would take a provider much longer to complete and therefore cost more,” said Grady Brimley, vice president of health transformation at SSM Health.

“With Zipnosis, our providers can review the clinical information and provide a response often taking less than two minutes of the provider’s time,” he said. “The patient has a better experience, too. Rather than waiting while the provider processes all the information, the patient is notified to return to the platform once a treatment is recommended.”

“With the virtual visit platform, we average provider work time of just one minute and 50 seconds for an asynchronous or online interview visit, a fraction of the time of an in-person or video visit, which is usually closer to 15 or 20 minutes.”

Grady Brimley, SSM Health

Most virtual visit solutions focus solely on connecting a patient and provider via video, but there are several others that have a similar focus as Zipnosis on making the visit more efficient, Brimley added.

“We found that some vendors made big promises to use AI and be able to treat an even wider variety of cases with machine help,” he said. “In our exploration, the technology wasn’t advanced enough to provide a consistent experience. I hope it gets there in the future, because we need to find ways to lower costs and improve access, and providers are a finite resource.”


There are many vendors on the market today offering telemedicine technology, including American Well, Avizia, GlobalMed, MDLive, Novotalk, SnapMD, Teladoc, TeleHealth Services and Tellus.


SSM Health launched the telehealth virtual visit technology as a direct-to-consumer offering. Anyone within the health system’s four-state footprint of Illinois, Missouri, Oklahoma and Wisconsin can take advantage of a virtual visit for $25 with no insurance required.

Now, more employers are coming to SSM Health to set up a reduced price or free visit as a benefit for their employees.

“Clinical care notes from the virtual visit will be uploaded into our Epic EHR through an HL7 interface,” Brimley explained. “We recently went through an instance upgrade so we put off the integration for a few months but that should be completed shortly. We are and will continue to explore how we can create even more integration between Epic and Zipnosis.”


Brimley noted that the program is still young so there will be a lot more to measure with time in the marketplace.

“However, in these early months, we have been focused on a few key metrics around patient utilization and provider efficiency gains, as well as overall patient satisfaction,” he reported. “Patient visits is one of the highly visible and tangible metrics we are monitoring and within the first few months of launching the platform we have been averaging about 600 visits each month.”

However, as SSM Health expands advertising to build awareness and enters the cold and flu season, staff expect that number to grow. This metric is important to staff as it helps the organization deliver on its goal of greater access to care.

“Another metric we’re looking at is provider efficiency gains,” Brimley said. “With the virtual visit platform, we average provider work time of just one minute and 50 seconds for an asynchronous or online interview visit, a fraction of the time of an in-person or video visit, which is usually closer to 15 or 20 minutes. This not only enables us to see more patients, but to do so in a way that better meets their needs and preferences.”

Further, the health system is monitoring patient satisfaction with the service.

“Once again, with just a few months under our belts, we already have achieved a Net Promoter Score of 53, which is well above average,” Brimley explained. “This tells us that patients are extremely happy with the experience of using our virtual care solution, and that is exciting.”

In addition to the external patient audience, the health system also provides the service as a benefit to its own SSM Health employees. They can complete a virtual visit for a reduced price of $10, which the health system expects will reduce health expenditures for its employees by avoiding urgent care or other visits to brick-and-mortar locations.


“First and foremost, telehealth solutions, like virtual visits from SSM Health, must focus on the patient,” Brimley advised. “In our research, we found that patients are looking for a more convenient way to meet their health needs, not necessarily a video visit. In fact, the majority of patients prefer a phone call or a message-based system to a video visit.”

Second, these days, healthcare provider organizations need to do whatever they can to lower the cost of healthcare, he added.

“At SSM Health, we drew a line in the sand, adopting the policy that any new virtual or telehealth offering must reduce the total cost of care before SSM Health will consider purchasing it,” he noted. “Having that guiding principle has provided a great direction for us as we evaluate new opportunities.”

Twitter: @SiwickiHealthIT
Email the writer: [email protected]
Healthcare IT News is a HIMSS Media publication.

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