Skilled nursing facilities face a severe shortage of workers. As it is there is a documented shortage of primary care physicians and the gap keeps getting wider.
On top of it, SNFs have been known to have a shortage of direct care workers. Add to this, the primary care shortage – makes matters even worse.
The fact that a majority of baby boomers are above 65 and will soon be entering into the purview of skilled nursing facilities, this acute shortage needs to be addressed.
One way to deal with this is to provide primary care providers on call. This is exactly what one telemedicine company wanted to do – they had a roster of USA licensed physicians that were ready to provide on-call services.
This is not a new business model per se, as primary care providers have been provided on an on-call basis for a while. However, in this particular case, the telemedicine company wanted to provide video and voice calling facilities to the skilled nursing facilities.
The basic idea was that when the SNFs would face a volume of patients without having enough primary care providers on site, they would immediately book an appointment with these on-call doctors. Each provider would have VPN access to the EMR of the skilled nursing facility hence would have the ability to look at patient records as well as update with diagnosis and treatment/care plans.
How it was executed
The idea was executed quite simply – the nurse would create appointments on available providers’ calendar. The provider being on call, would always have their calendar up to date. At the time of the call, the provider would read the nurse’s note for the upcoming patient video call, login to the SNF’s EMR, read the patient chart and thereafter, start the video call.
While on a video call with the patient, the provider would take as many notes as needed and as part of the after-call-work (ACW), they would update the patient’s record on the SNF EMR to reflect these notes.
At all times, these recordings needed to be available for audit and security reasons, stored on a HIPAA secure infrastructure.