Intermountain Healthcare has launched an Infectious Diseases TeleHealth program to provide virtual consultations to patients at its small hospitals as well as antibiotic stewardship program support to the local staff.
The program is now live at Alta View Hospital, Logan Regional Hospital, Park City Hospital and Riverton Hospital. However, by April, Intermountain’s goal is to have the system running at all 16 of its small hospitals.
This is a far cry from the situation the health system experienced in 2014, when only one of its small hospitals had access to an infectious diseases physician and only one had a formalized antibiotic stewardship program designed to optimize the use of antibiotics.
“There’s a huge need for infectious disease consultations,” says Edward Stenehjem, MD, an infectious disease expert at Intermountain Medical Center. “We’re able to go in and speak with the patient and look at them with our high-definition cameras. And we’re all on the same electronic health record, so we can look through all of the data.”
According to Stenehjem, 72 percent of all U.S. hospitals have less than 200 beds, and the majority of these hospitals do not have access to antibiotic stewardship programs or infectious disease physicians.
“We know that infectious disease consultation improves care in terms of clinical outcomes, decreased length of stay and reduced costs,” he adds. “Up to this point, our small hospitals didn’t have access to infectious disease providers.”
Started in October, the Infectious Diseases (ID) TeleHealth program includes homegrown technology capabilities developed in-house by Intermountain. Stenehjem notes that infectious disease physicians conducting the consultations remotely can zoom in with a high-definition camera to examine patient rashes and wounds as part of the doctor-patient interaction.
“The only thing I can’t do is physically touch the patient,” he says. “If I need a physical exam, I’ll have either a physician or nurse onsite to help me with that patient exam. Then, I’ll make recommendations and place orders—in short, everything that a full ID consultation would do. We, then, see the patient the next day and follow-up just like we would if we were in the hospital right there with the patient.”
In addition, Intermountain is instituting antibiotic stewardship programs at each of its small hospitals. Antibiotic stewardship programs, which become mandatory at all U.S. hospitals under new Joint Commission regulations that take effect January 1, optimize antibiotic use by a number of methods, including providing feedback to providers on antibiotic prescribing in an effort to slow the development of antibiotic-resistant bacteria.
Stenehjem contends that antibiotics are frequently prescribed incorrectly and that most of the common diagnoses seen in primary care and urgent care (bronchitis, colds, ear aches, and many sinus infections) are caused by viruses, upon which antibiotics have no impact. As a result, widespread use of antibiotics has led to antibiotic resistance, producing bacteria that can survive and continue to cause harm in the presence of antibiotics.
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