How a mental healthcare practice switched to telehealth
In early March the COVID-19 pandemic caused thousands of skilled nursing homes across the US to close their doors to visitors and outside medical staff, including clinicians from Los Angeles-based Executive Mental Health (EMH), a medical practice that specialises in clinical psychology and neuropsychology.
Clinicians from the practice had regular sessions with elderly residents in nursing homes, many of whom were dealing with heightened stress and disorientation due to coronavirus. When these visits were abruptly cut off, residents became more vulnerable to the effects of the pandemic, including being at a greater risk of depression and anxiety.
This meant that in just a matter of hours, the immediate mental healthcare needs of thousands of people were put on a backburner, awaiting a solution that did not involve in-person therapy.
EMH faced a challenge. How could they move from face-to-face care to something more tech-forward, abiding by social distancing guidelines? In the end it took the practice under 3 weeks to switch to telehealth for over 100 nursing homes.
"As of March 1, EMH was providing no remote care, had not purchased any equipment to offer this service, and had not conceptualized the logistics of delivering an effective telehealth model" explained EMH’s CEO and president, Dr. Ari D. Kalechstein. "In just three weeks our team had set up the system protocol and launched it to over 100 partner facilities.”
For Dr. Kalechstein, the way to this was simple - find the right software and hardware, and train the team appropriately. “The team sourced HIPAA-approved teleconferencing programs to optimize the communication between patients and doctors, purchased tablets and stands for facilities and set up wifi contracts with service providers.”
The nursing homes supported by EMH were given newly created materials on telehealth, including set-up instructions.
Additionally they created a new position - that of Device Technician, someone who reduces the chances of a device becoming a vector for disease transmission, by being the only person using it. This eased the burden on clinicians to focus on providing mental health care to those who needed it most. A Device Technician training handbook was also created with procedures and safety guidelines.
Overall, the transition was a success. “In March, it was do or die" Dr. Kalechstein said, "specifically, as facilities closed their doors to outside visitors, EMH decided to reinvent operations to provide mental health services remotely via telehealth. Had EMH not made that existential decision, up to 60 per cent of the EMH staff could have lost their livelihood."
"Fortunately, the launch of EMH Telehealth was a success: By July 31, EMH had completed over 11,000 sessions and transitioned fully to telehealth with over 85 per cent of all psychotherapy and neuropsychological assessments carried out using the new technology. EMH also sourced, trained, and managed a team of 25 DTs, whose efforts are integral to the implementation of telehealth."
Zoom enters the healthcare market - a timeline
Since the pandemic began Zoom has become an integral part of daily life for people working from home, as well as a vital tool for families and friends to communicate. However it's also been eyeing up the healthcare space since 2017, and following the boom in telehealth the company has been rolling out additional services. Here we chart Zoom's move into healthcare.
2011 - 2013
Zoom is founded in San Jose, California, by Eric Yuan, formerly of Cisco. He got the idea to create a video calling platform from his visits to his girlfriend while he was a student, which would take 10 hours by train.
A beta version is released in 2012, which can host up to 15 participants. In 2013 this rises to 25. By mid-2013, Zoom has 1 million users.
2014 - 2017
Zoom attracts investors, including Sequoia Capital, Emergence and Horizon Ventures. By January 2017, Zoom has a series D funding worth $100 million.
2017 - 2019
Zoom for Telehealth launches, including an integration with EHR system Epic. It has cloud-based video, audio, and content sharing features, a "waiting room" for patients, and can easily be integrated into healthcare provider's workflows.
In 2019 Zoom goes public, with its IPO rising 72% in one day.
As a result of the pandemic, Zoom gains 2.2 million new users, more than in the whole of 2019. On the 23rd of March alone - the day the UK lockdown was announced - the platform was downloaded 2.13 million times around the world.
Share prices rise to around $150, and founder and chief executive Eric Yuan becomes one of the world's richest people, with an estimated net worth of $7.9 billion.
Early security issues are addressed by encrypting data with the Advanced Encryption Standard (AES). By now the the platform allows 99 people to be on a call simultaneously
New features launch, including Zoom Home and Zoom for Chats. Throughout the year the platform is used to replace most kinds of real life events: work meetings, online classrooms, church services and social events.
Renamed Zoom for Healthcare, users can share secured video, audio, and content through desktops, mobile phones, and conference devices. As well as Epic, it can be integrated with Strmr, IntakeQ, and Practice Better.
It can also be used with diagnostic cameras and other point-of-care devices, including digital stethoscopes.
In an interview with Korea Biomedical Review, Zoom Global Healthcare Lead Ron Emerson said: "Our service is not simply a virtual care and telemedicine platform but a multi-purpose platform that can satisfy the needs of healthcare institutions."
"It can be used for administrative tasks, including telemedicine, medical team meetings, recruitment, medical education, employee training, and disease prevention. Analysing electronic records managed by Zoom could provide meaningful insights into patient care."
Phoenix Children's Hospital, Belfast's Hospital Services Limited, Butler Health Services and the global Project ECHO are among Zoom for Healthcare's current customers.