Streamlining Emergency Care

Illinois Telehealth Network Uses Technology to Triage, Deliver Behavioral Health More Efficiently
April 2021

The Illinois Telehealth Network (ITN), led by HSHS Good Shepherd Hospital (Shelbyville, IL), is a 28-member organization consisting of critical access, rural and urban hospitals and healthcare partners, rural clinics, FQHCs, an ACO, physician groups and medical homes, mental health services and a school district.

The ITN is a rural health network development project that increases rural access to specialty health care by collaboratively developing telehealth and telemedicine to facilitate encounters between patients and providers. The ITN provides support to its members with education, training and counsel. HSHS St. John’s Hospital, based in Springfield, Illinois, is directly responsible for assisting eight HSHS Illinois hospitals with telehealth implementation and acts as a hub for many ITN members.

Although ITN members have been offering some telehealth services over the past several years, the onset of the coronavirus pandemic accelerated implementation and boosted provider interest. “One of the biggest benefits during this time has been the increased interest in telehealth,” said Katie Mueller, ITN network director. “It’s always been a bit of a challenge to get the buy-in we needed, and now we have many providers coming to us with new ideas of how to implement telehealth.”

Implementing Non-Contact Behavioral Health Services

Before COVID-19, the emergency departments at network hospitals shared the services of an area mental health provider. When patients arrived in the emergency room, either with a mental health issue or an acute problem that had behavioral health implications, the hospital used to contact this counseling group who would physically send a licensed social worker to the hospital. The region encompasses six counties: Christian, Macoupin, Montgomery, Jersey, Greene and Calhoun. As a result, these counselors might spend 40 to 50 minutes driving from one hospital to another.

“We started doing these crisis assessments by telehealth, which lessened the drive time and allowed for faster response.  It also helped keep both providers and patients safer,” said Alison Rhodes, ITN project director. “We had some initial hesitation about how patients might react, but we’ve had nothing but great reviews. The counselors love being able to stay in their hub locations as well.”

Besides being able to provide non-contact care and reducing wait times, telehealth has reduced crowding in the emergency departments. “The counselors will work with the local hospital and the patient to determine whether inpatient care is needed,” Mueller said. “If the patient is stable enough to be released, they set up next steps and follow-up care together.”

Establishing Non-Contact Triage Services

Currently, St. John’s is working on setting up a more efficient, non-contact triaging system using telehealth technology. Eventually, they would like to have one nurse practitioner handling triage for multiple hospitals. Incoming patients would be escorted to a room where they would immediately be triaged by a telehealth provider. After this initial step, the patient would be taken to an exam room for the in-person portion of the appointment.

“The triage nurse would evaluate the patient, order any blood draws or labs needed, and manage the initial documentation,” Mueller explained. “This process would help us better manage workflow and keep our physicians focused on the higher levels of care. We expect our waiting rooms would be kept clearer and reduce the number of patients leaving before being seen.

“In addition, we may be able to manage more low acuity cases through telehealth alone, being able to see and discharge patients more quickly,” Mueller added.

Benefits Abound, Raising Telehealth Expectations

ITN already had an established history of successful telehealth initiatives, including St. John’s telestroke program that began eight years ago, a teleNICU service, and others.

“One other benefit we saw during COVID was using the technology to help patients connect with their families,” Mueller said. “Our members really put so much time and effort to make that available for patients who were isolated. It just shows this is not always about medical care, but helping people as a whole. That was so inspiring to me.”

As healthcare moves into the future, Mueller expects telehealth is here to stay. “I think with all the conveniences associated with telehealth, people will come to expect it,” she said. “It has now been proven with positive outcomes. Telehealth is so beneficial for both patients and providers; it’s a great option.”