Valley-Wide Health Systems is a community health center with 15 primary care clinics serving multiple rural counties in Southern Colorado. Recently, Janelle Lucero, R.M.A., the nonprofit organization’s chronic care management coordinator, spoke with Healthcare Innovation about a new partnership with TimeDoc Health, a Chicago-based provider of virtual care management, chronic condition management and remote patient monitoring.
During the initial pilot with TimeDoc, which has since been expanded, virtual care services were tailored to the needs of specific patients with comorbidities or social determinants that can complicate in-person medical appointments. TimeDoc Health’s team of patient care coordinators oversaw day-to-day treatment plans and vital screening needed to assess and address individual risk factors.
Lucero leads a team that spends time on the phone with patients with chronic diseases as well as their clinicians, talking about upcoming appointments and reconciling medications. “I currently have 27 patients on my particular panel,” she said. “In February of this year we started having TimeDoc come in and take over some of our patients and help with other regions, help with the language barrier. They started enrolling patients throughout our organization and helping serve both the English- and Spanish-speaking populations, and right now, I believe we have 900 patients on the panel.”
TimeDoc Health said it has supported Alamosa-based Valley-Wide with four care coordinators, with plans to add more staffing resources in the coming months as enrollment grows. The care coordinators are trained nurses and bilingual to meet the needs of Spanish-speaking populations, a key demographic in Colorado. The team shares a “two-way” dashboard with the patient receiving care, outlining health priorities and capturing longitudinal health data that can show the ebbs and flows of symptoms and chronic conditions. Many of those who are enrolled in the program suffer from illnesses like diabetes, hypertension, and asthma.
The virtual care that TimeDoc helps provide is critical in a rural setting, Lucero said. “For some of our clinics, it's 50 miles to the nearest emergency room,” she said. “We do serve the underserved population.” She adds that if they can increase the frequency of connections with patients, Valley-Wide will be able to make more accurate decisions about their long-term care needs.
Lucero said that Valley-Wide looked at several third-party companies as potential partners for virtual care services. “What we liked the most about TimeDoc was the integration between our EHR systems because a lot of other service lines didn't have that. We were thinking: How can you really manage the patient well if you're not able to review the last chart notes from the provider, and understand what their goals are and just keep better track of them? TimeDoc has access to our EHR so they'll send over messages that are needed for the provider or for the nursing staff and maybe do some care coordination in between their visits with the patient as well.”
Lucero said that although the early results are promising, they will need more time to do a complete assessment of the partnership. “We love the fact that we've had so many patients enrolled, but we haven't yet received too much feedback from patients themselves, and we're still trying to help our providers understand the service line,” she said.
“We’re finding, through partnerships like Valley-Wide, that our technology can increase adherence with routine screenings and ensure that the healthcare experience is more inclusive than it has historically been,” said TimeDoc Health Vice President of Clinical Strategy Sarah Cameron, in a statement. “Sometimes the trip to the doctor’s can be stress-inducing and intimidating. So, it’s our goal to empower Valley-Wide with the tools that strike the right balance, understanding that no one knows their patients better than they do.”
TimeDoc said it is focused on expanding its work with rural FQHCs, community health centers, and medical practices that struggle with digital chronic conditions management, patient engagement, and staffing shortages.
During the pandemic, the company said, it helped providers increase their bandwidth and overall quality of care for more than 70,000 patients, while also delivering significant revenue for reimbursable remote patient monitoring and chronic care management services.
The company has worked with organizations such as Premier Health Associates, Southwest Community Health Center, Rainelle Medical Center and Transitions Care.