Hybrid Care Innovation at UMass Memorial Health

Digital innovation is a cornerstone of UMass Memorial Health’s strategy, garnering the health system impressive accolades including HIMSS Stage 7 certification for EMR adoption, CHIME’s Most Wired Level 8 certification, and Epic Gold Stars Level 10 status.

Dave Smith, Senior Director of Digital Innovation for UMass Memorial Health, attributes his organization’s competitive edge to a physician-led leadership team that truly embraces digital transformation. UMass Memorial has been delivering hybrid care for the better part of 20 years through its flagship eICU and tele-stroke programs. The throes of the pandemic and ensuing challenges related to patient safety, capacity management, patient flow, and staffing shortages reignited interest in hybrid care innovation, leading the health system to pursue additional programs like hospital at home, remote observation, and remote patient monitoring (RPM) in recent years.

In the enlightening session “Hybrid Care Innovation: The ROI of Bedside Virtual Care at Scale,” part of Becker’s Healthcare’s 2024 Digital Health and Telehealth Virtual Event, Smith sat down with Caregility President and COO Mike Brandofino to share compelling insights into the transformative hybrid care initiatives his organization is pursuing, how his team approaches ROI, and what it takes to scale new hybrid care models.

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Hybrid Care’s Return on Value

UMass Memorial’s Hospital-at-Home program is a great example of how health systems are bringing resources to bear to improve outcomes, efficiency, and the experience for patients and clinicians. Patients receive twice-daily visits at home, supported by EMS partners working in collaboration with UMass doctors and nurses. They also have immediate access to virtual nursing support. The health system employs a four-to-one ratio for field nurses and a 30-to-one ratio for virtual nurses.

By bringing acute care to the patient’s home, the team has been able to expand capacity. “In our first year of operation, we saved over 3,000 bed days at our busiest hospitals,” shared Smith.

“With our eICU program, we monitor 150 critical care beds around the clock with intensivists on any given shift and the aid of a pharmacist at night,” Smith said. Since its inception in 2006, UMass’s eICU program has seen a 27% reduction in patient mortality and fewer patient complications, reducing care costs.

“For programs like tele-stroke and tele-psych, the ROI is really about improving access,” Smith continued. “But also, community hospitals see the ROI because they don’t have to hire and retain a full-time specialist. Instead, they buy professional services from a tertiary health system like UMass Memorial.”

The health system’s remote video monitoring (RVM) program has shown the strongest direct labor-cost ROI by enabling a single care team member to support six patients instead of conventional one-on-one observation ratios. “To take advantage of the full 12-patient panel, we assign each observation tech six primary patients and six backup patients for a total of 12,” Smith shared. “For every remote observation tech, we save $300,000 a year in direct labor costs.”

The health system is also leveraging AI solutions for radiology, ophthalmology, and ambient dictation to save providers valuable time. “I don’t think AI is going to replace doctors anytime soon, but I do think the ones who embrace it will probably surpass the ones who don’t,” noted Smith.

Scaling Hybrid Care Innovation

Smith sees digital health innovation as “the cost of doing business for healthcare systems that want to innovate and remain competitive.”

“We're in the process of building a new 72-bed inpatient facility that will open about a year from now and every bed will be wired with Caregility technology. We'll use the technology for a variety of use cases like virtual rounding, remote observation, specialty consults, patient/family communication, and even tele-ICU level care. And the funny thing is, it was an easy sell to hospital leadership because they understand the importance of hybrid care and balancing staffing demands. I just think hybrid care is the new standard.”

Dave Smith

Senior Director of Digital Innovation, UMass Memorial Health

Smith champions platforms that can be leveraged across the enterprise over point solutions. “To do anything at scale, it cannot exist in silos and pockets that are scattered throughout the organization,” he shared. “A good example is our commitment to building a digital medicine hub. We’re taking most of our virtual services and putting them under one roof. By doing so, not only will it be a showcase for our health system of the future, but we’re expecting to find operational synergies by having these virtual care teams collaborate in the same physical space. So, teams like eICU, transfer center, RVM, RPM, interpreter services, and virtual nursing will all be working alongside each other.”

“We’re also investing in a new digital innovation team to support rapid scalability. Digital health and especially AI is evolving so quickly that we need to operate at a faster pace to keep up. I’ll be leading a new multidisciplinary team to focus on emerging technologies that support our system initiatives and foster collaboration with our care teams. The whole idea is to identify opportunities, experiment with proofs of concept, fail fast, if necessary, iterate, and then deliver a solution or look at alternatives.”

“People are embracing technology in ways never thought possible and it’s making hybrid care models not only plausible but also practical.”

Watch the full session recording:  Hybrid Care Innovation: The ROI of Bedside Virtual Care at Scale