By Peter Bigler, MD, MS, Chief Medical Officer at Baylor St. Luke’s Medical Group, and Robert Forrest, MBA, Performance Improvement Director at Baylor St. Luke’s Medical Group

 

For St. Luke’s Health, as for every other health system in the U.S., ensuring appropriate access to care for every community and patient group we serve is central to our mission—and one of the foremost challenges we face. The reasons are a combination of universal and unique circumstances: a mismatch between the available supply of clinicians and the demand for their services due, in large part, to a well-documented physician shortage; the affordability of care; Texas’ population boom; and—in a positive development—an increase in patients’ desire to pay more attention to health and wellness.

Technology is transforming health care, especially in the access-to-care realm. From virtual visits to remote treatment monitoring to data-driven scheduling optimization, St. Luke’s Health is using the power of ever-evolving technology to help solve one of health care’s most stubborn problems.

Telehealth Takes Off

One of technology’s most valuable capabilities is how it enables us to meet people where they are, literally and figuratively. At Baylor St. Luke’s Medical Group, the COVID-19 pandemic turbocharged our use of telehealth, which, in early 2020, was limited to a small number of primary care physicians. Now, all of our physicians (in every specialty) and advanced practice providers offer virtual visits.

We’re caring for multiple generations, and there are significant disparities between these patient groups regarding how they prefer to interact with clinicians. Some favor in-person care, and indeed, a face-to-face visit remains preferable, if not requisite, in many situations. Other generations, though, are eminently comfortable receiving as much care as possible virtually. For patients with mobility or transportation issues, or those facing the unique challenges of accessing health services in rural areas, telehealth brings care within reach. Whether motivated by preference, convenience, necessity or a combination of these factors, many patients are turning to virtual visits to ease access to health care.

Telehealth doesn’t just enhance access to care. It also helps us adjust when we need to be nimble in responding to the flow of events. Over the past few years, we’ve used telehealth to care for patients during local or regional COVID-19 flare-ups. When an outbreak occurs and we need to restrict in-person exposure, we avoid major disruptions to care by transitioning as many appointments as possible to virtual visits.

We know patients want to be able to turn to a single, unified platform for scheduling appointments and communicating and having virtual visits with clinicians. As an organization, we’re working toward a single-source solution for all electronic interactions between patients and clinicians. 

Beyond Virtual Visits

We’re using virtual care technology to do far more than enable remote visits between patients and clinicians. At some of our locations, technology is helping patients receive much-needed care via remote monitoring.

How and when are patients using their asthma inhalers or CPAP machines? Remote monitoring allows physicians to easily track this data to gauge patient compliance. In addition, remote glucose monitoring allows for closer collaboration between clinicians and patients as they manage diabetes. 

Telehealth technology takes our clinicians’ expertise where it’s needed most. Project ECHO, for example, brings together Baylor St. Luke’s Medical Center specialists and primary care clinicians from throughout Texas in videoconferences to discuss patients’ chronic disease cases and create treatment plans. Through our Neuroscience Telestroke Network, BSLMC neurointensivists and clinicians at community hospitals and clinics in southeast Texas meet virtually to discuss the most appropriate care paths for patients with stroke.

Speeding Access Through Data-Driven Scheduling

At Baylor St. Luke’s Medical Group, we know access to care hinges, in part, on seamless appointment scheduling. That’s why we use data to help ensure appointment availability matches demand.

Over the past five years, we’ve optimized the scheduling footprint for all of our clinicians by using data from previous years and anticipated growth statistics to understand the volume capacity for which we need to prepare. As a result, we’ve been able to optimize physician schedules so we have an appropriate number of the various types of appointments patients require.

Each month, for both our primary and specialty care clinics, we monitor the median number of days for scheduling new patients and getting established patients on the books. We compare these data points to our internal metrics and industry standards to get a clear picture of how we’re doing.

Promoting Growth and Maximizing Resources

What does the future hold for our efforts to improve access to health care? We’ll continue addressing the problem from a variety of angles—and technology will play a key role.

We’re part of CommonSpirit Health, which is making a significant financial investment in expanding our technology footprint and infrastructure, as well as increasing interoperability within Baylor St. Luke’s Medical Group and between the medical group and me. This investment will allow for more seamless care throughout East Texas.

In the years ahead, we anticipate adding more clinics, physicians and advanced practice providers to our team. We’re doing our part to reduce the clinician shortage through efforts such as our East Texas Family Medicine Residency. Finally, we plan to get the most out of our resources by, for example, using our EMR to help relieve clinicians of some of the burden of documentation during patient visits—a step that will increase efficiency and allow us to see more patients.