Case Study: How ITEX Improved Resident Outcomes With Integrated Virtual Care
About ITEX
ITEX is the family-owned operator of Glenview Terrace, Harmony, and Whitehall of Deerfield. They are the market leader for post-acute rehab in the Chicago area. They are also in the preferred provider networks for some of the largest health systems in Illinois (Advocate Aurora Health, NorthShore University HealthSystem, and Northwestern Medicine). Third Eye Health’s telehealth solution has helped both ITEX and its network of skilled care centers keep patients in the same health system and avoid leakage.
Pre-Third Eye Health Challenges
Known for delivering exceptional care in Chicago and throughout the North Shore, ITEX sought to improve provider availability during nights, weekends, and holidays. Their skilled nursing facilities were affiliated with a large, clinically integrated network in Chicago and struggled to treat ITEX’s residents across a wide geographic area. This was especially true as the 2020 pandemic set in and human resources became even more scarce. As a result, newly presenting changes in condition during nights, weekends, and holidays often delayed care or transfers to the ER, which in turn led to unnecessary readmissions. Timely care is essential to patient satisfaction, clinical outcomes, and minimizing the cost of care. In most scenarios, these readmissions were preventable if a provider had properly assessed the patient and treated them in place. ITEX understood that while their care was highly regarded, there were still opportunities to ensure residents received the highest level of care possible. Because unnecessary readmissions significantly drive rising healthcare costs, the provider group collaborated with ITEX to find a solution to reduce these readmissions and their associated costs. After-hours readmissions were rising, and providers were spread thin and on call, delaying access to the EHR, documentation, and/or orders, delaying care, worsening outcomes, and driving transfers to the ER. Often, transfers became readmissions that could have been prevented if a provider could have treated the patient in place. Ian Crook, Chief Operating Officer for ITEX, remarked, “Adopting a system-wide telehealth solution with the support of our providers was key to the success we experienced in increasing the quality of care for our residents.” Having used their services in other local SNFs throughout Chicago, the provider group was familiar with the impact of a well-known post-acute telehealth provider, Third Eye Health, and recommended ITEX consider adding their services for night, weekend, and holiday provider coverage.
Why Third Eye Health?
Many ITEX providers were already familiar with Third Eye Health, the nation’s leading virtual care provider for post-acute. They had seen firsthand the benefits to patients, providers, and entire health systems when their services and technology were in play. One of the greatest benefits observed for providers was that high-acuity patients had access to quality care at all times of the day, with Third Eye Health’s board-certified physicians taking call on nights, weekends, and holidays. Through their telehealth technology, a Third Eye Health physician can consult with the bedside nurse and resident within minutes. EHR-integration capabilities give Third Eye Health physicians visibility to patient medical records and the ability to add notes and signed orders. Secure video, text, and image sharing capabilities enable the Third Eye Health physicians to lay eyes on the patient, have in-depth conversations with both nurse and patient, assess lab reports and additional paperwork all with the use of a simple app on an iPad.
Additionally, with Third Eye Health’s Care Coordination services, we review and summarize documentation from every encounter, then share it with the primary provider and nurse leaders, creating a warm hand-off before the next day begins. For the provider group, bringing on Third Eye Health meant offering relief to their providers on nights, weekends, and holidays. In many instances, Third Eye Health physicians can respond faster and provide a much more thorough assessment using the secure, integrated technology than a provider could over the phone. Patients can receive high-quality care from board-certified physicians without being transferred to the ED. By treating them in place, patients do not risk exposure to additional infections, worsening conditions, or being moved to an entirely different facility after discharge. They remain in the same care, and Third Eye Health’s Care Coordination Managers ensure that a full summary is provided after every encounter. Another factor making Third Eye Health the ideal candidate to support ITEX’s clinical team in caring for residents was its ability to integrate with ITEX’s EHR, PointClickCare. Third Eye Health is unique in that it develops all its technology in-house. By aligning with EHRs such as PointClickCare and MatrixCare, Third Eye Health can quickly and easily implement its services, which facilitate bi-directional EHR integration and enable ITEX’s clinical team and Third Eye Health physicians to access medical records.
Implementation
ITEX saw many advantages in bringing on Third Eye Health as their virtual care provider. The implementation process was highly efficient and quick. Within weeks, every center was up and running. Several factors contributed to Third Eye Health's quick-start capabilities. “Third Eye Health’s technology and physician services fit within our pre-existing workflow, making it easy for our clinical teams to initiate virtual care consultations,” said Crook. As mentioned, Third Eye Health has an in-house development team and a pre-existing partnership with PointClickCare, which expedites EHR integration into Third Eye Health’s proprietary telehealth technology. Next, Third Eye Health uses iPads to conduct their virtual bedside visits. Whereas most telehealth solutions use third-party carts, iPads are easily accessible and highly mobile, making it easy for nurses to move from room to room as they conduct rounds. And since most nurses are familiar with using iPads, the technology was easy to learn. Third Eye Health works directly with nurses and leadership at each center and offers training from experienced post-acute nurses. With iPads in hand, nurses could confidently begin consultations with Third Eye Health that same day. The iPad technology is simple to use. With a tap of a button, nurses saw they could connect with a physician within minutes. They could text, share photos, and video chat with physicians. With the PointClickCare integration, all notes and orders were readily available in the EHR after each encounter. Each center has a dedicated Third Eye Health Care Coordination Manager whose day begins at the end of the day shift by receiving a report from the center informing Third Eye Health of high-risk patients, new admissions, or any pertinent information the Third Eye Health physicians may need if they are called. Bringing the care full-circle, the Care Coordination Manager reviews each encounter. He sends a summary immediately following a coverage period, ensuring proper attention continues once the primary provider returns the next day.
Impact
Once implemented, Third Eye Health’s services had an immense impact on ITEX patients, providers, and clinical staff. Patients could see physicians with access to their medical records at any time, day or night. They were treated in place, often preventing further complications and improving clinical outcomes. Because patients could see a physician when needed, patient satisfaction rose even higher. Nurses had access to Third Eye Health physicians through easy-to-use mobile technology. They no longer had to wait for physicians to call back or for orders to be signed. Third Eye Health physicians answered consultation requests in under two minutes on average. Physician notes and orders were available directly through their EHR. Administrators and Directors of Nursing benefited from the quality assurance of the Care Coordination Manager reviewing each encounter and from the detailed analytical reports made available through Third Eye Health’s technology.
For them, this added an extra set of eyes on regulatory matters and reduced risk. For ITEX, treating more patients in place meant fewer patients returned to the hospital. More beds were full, and mandatory bed holds decreased. Fewer transfers to the ER meant fewer unnecessary readmissions and a lower likelihood of patients being discharged elsewhere. As clinical outcomes improved, local health systems regarded them highly for their ability to provide high-quality care, making them a leading partner for post-acute care. The provider groups serving ITEX also reported higher satisfaction because they no longer had to take calls. They gained much-needed time to focus on their own health and well-being and, in turn, performed better at the bedside. Their Medical Director (who had been with ITEX for over 30 years) valued these benefits and used them as a large recruiting tool for the provider group, promising nights, weekends, and holidays off – an anomaly when it comes to post-acute medicine. From Ian Crook’s perspective, “Physician satisfaction rose once Third Eye Health began covering nights and weekends for multiple reasons. Fewer residents returned to the hospital, sustaining care continuity within our communities and reducing leakage back into the health system. With the opportunity to finally rest, interactions between providers and nurses improved, positively impacting the overall quality of care for our residents.
Most importantly, our providers had peace of mind knowing their patients have access to a dedicated group of physicians watching over their care on nights, weekends, and holidays.”Lifetime Impact 4384 Consults95% Treat In Place Rate Treat in Place by Encounter Type: 100% treat-in-place rate for TOP 10 encounter types. The exception: high-acuity conditions that should warrant a transfer to the ED in many cases, such as: Fall with Injury: 84%; Hypoxia: 59%; Chest Pain: 65%
Summary
It’s not surprising that Third Eye Health remains the leader in virtual care in the post-acute world. Their technology is easy to implement and even easier to use. With PointClickCare and MatrixCare integration and dedicated care coordination, it eliminates guesswork and supports the primary clinical team through seamless transitions in care. The quality of care received from Third Eye Health physicians complements that of the primary providers. By treating patients in place, clinical outcomes and quality measures improve. What sets Third Eye Health above any other post-acute telehealth provider is its ability to provide integration at scale, essentially becoming a force multiplier in delivering high-quality post-acute care: as care quality increases, so do outcomes, patient satisfaction, staff and provider satisfaction, as well, all while reducing the overall cost of care.