Hartford Business Journal

16 Hartford Business Journal • November 30, 2020 • www.HartfordBusiness.com By Liese Klein lklein@hartfordbusiness.com L ook up. Look down. Walk in a straight line. Can you tell me what day it is? Can you tell me who the president is?" (OK, that one might be tricky.) Dr. Stephanie Allessi-LaRosa, a sports neurologist at Hartford HealthCare, asks a standard set of questions when she examines a patient who may be suffering a con- cussion. In her role as a physician for teen athletes as well as MMA fighters and boxers at Mohegan Sun, she treats many head injuries. Lately, however, her questions and basic examinations often hap- pen over Zoom, with her patient following along via phone or laptop. "I can give them different com- mands, giving them a target on the left and right of the screen," Allessi- LaRosa said of her new diagnostic routine. "It doesn't completely replace in-person assessments, but we definitely have made it work." Allessi-LaRosa is one of thou- sands of Hartford-area physi- cians who have pivoted quickly to videoconferencing technology for patient visits since the onset of the COVID-19 pandemic. So called "telehealth" or "virtual health" technology has been adopted by both patients and providers with astonishing speed since earlier this year, after decades of lagging in its acceptance. Now, months into the pandemic, local healthcare providers say they are eyeing new and expanded uses of telehealth as it becomes a normal part of their operations. But that doesn't necessarily guarantee the long-term growth of the service, as some insurers begin to balk at the higher-than-usual reimbursement rates they've been offering provid- ers since March. "The pandemic has served as a catalyst, ... one of the silver linings is virtual care," said Dr. Syed Hus- sain, chief clinical officer for Trinity Health Of New England, which operates St. Francis Hospital in Hartford. At the start of the pandemic, Trinity had only a basic virtual- care platform in place, which saw very little activity. When the first lockdown hit, the health system quickly deployed several videocon- ferencing software products for use by patients and providers. Virtual health visits peaked during the first COVID-19 surge in April at 32,454, and average monthly visits hovered around 26,700 from May to July. "This is our phase 1.0 of virtual care, but we would like to take it to the next level, which is even more access and ease for the patients we serve," Hussain said. Primary care and mental health services have been at the forefront of deploying virtual tools at Trinity Health, Hussain added, due to high demand from patients and relative provider shortages. The service was then expanded to cardiology, with the help of biometric devices that patients can take home to help doc- tors remotely monitor their vital signs. The next level for Trinity is hiring "virtualists," physicians and other providers who specialize in using videoconferencing tools to diag- nose and treat patients. St. Francis is the first hospital in the region to start hiring for this position, Hus- sain said. "I think it's here to stay," Hussain said of virtual health. "We want to get ahead and leverage this tool to be able to provide those services to the community." Crisis innovation Hartford HealthCare had been working with a virtual health pro- gram integrated with its Epic medi- cal records system for several years when the pandemic hit. Virtual health visits went from a handful to 100,000 in a few months, now totaling more than 300,000 since COVID-19 arrived. "This to me is sort of quintes- sentially about what a crisis does to accel- erate innova- tion," said Dr. Barry Stein, Hartford HealthCare's vice president and chief clinical innovation officer. The quick surge in virtual health was made possible by interest from both patients and providers and the relaxation of state rules and insurer restrictions on reimbursement, Stein added. "We had demand on both sides and the other constraints both regula- tory and payer were relaxed," Stein said. "That really unleashed this incredible transition from in-person to virtual, literally overnight in a blink of an eye." Virtual health has changed how providers do their jobs, Stein added. "Very quickly what we used to believe was essential for a visit was challenged. Legacy thought processes about how to take care of patients were challenged, not because of anything other than out of necessity," he said. The upsides of the technology come with some downsides, in- cluding the potential to widen the digital divide between those with access to devices and those without, said Susan Ma- rino, Hartford HealthCare's vice president and chief nurs- ing information officer. "It's critical for us — we can't leave out a huge component of our population of pa- tients, especially here in Hartford," Marino said. Hartford HealthCare has imple- mented programs to get devices to needy patients and ensure that Top 5 telehealth diagnoses in the Northeast in August 55.8% Mental health conditions 3.5% Joint/soft tissue diseases and issues 2.8% Developmental disorders 2.1% General signs and symptoms 1.9% Substance use disorders Source: Fair Health Virtual Care 2.0 Hartford area doctors eye expanded use of telehealth, even as some payers balk Sports neurologist Dr. Stephanie Allessi-LaRosa has adapted her examinations to videoconferencing technology. PHOTO | STEVE LASCHEVER Dr. Syed Hussain Dr. Barry Stein Susan Marino

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