Nashville-based Alive Hospice expanded the scale of its telemedicine programming as tornadoes and the coronavirus pandemic took the area by storm this spring. Technology has become an essential tool for many providers to continue caring for hospice patient populations at highest risk of coronavirus infection.
Alive Hospice launched the Henry Hooker Alive Connect telehospice program in 2018 after receiving donations from a patient’s family after their passing. The funding was instrumental in creating virtual programming that helped to sustain operations when the hospice had limited hands-on access to patients and families during the COVID-19 outbreak. Also early this year, telemedicine played a key role as supercell thunderstorm systems simultaneously sprouted destructive tornadoes across Tennessee.
“We had a gentleman patient several years ago that passed under our care and his family wanted to give back,” said Alive Hospice’s president and CEO Kimberly Goessele. “They made a donation to do something in his memory and as a gift to Alive to thank us for the care that we gave. Alive Connect really took off when Nashville was hit by a tornado during week one of March. We had a lot of patients in areas that were difficult for us to service, meaning that the roads and neighborhoods might have been closed to thru traffic. Alive Connect allowed us to stay in touch with family members and patients. By week two of March we were seeing our first cases of COVID-19, and that’s when it really evolved.”
Founded 45 years ago, the non-profit hospice serves more than 3,600 patients and their families annually and provides grief support services for nearly 600 adults and children in Tennessee. Alive Hospice’s service regions include 12 counties across the state’s middle region. While the hospice provides care in facilities and hospitals throughout the area, more than 90% of its patients receive care in the home. Telehealth capabilities played a key role in the provider’s ability to continue reaching into these communities virtually this past spring.
“During a tornado and a pandemic, Alive Connect gave us the comfort to know that we could still see our patients and that gave our patients and family comfort knowing that they could see us,” said Goessele. “We use it as an ‘and’ and not a replacement of hands-on care, it’s in addition to it. We rapidly were able to deploy more iPads into the community. It’s been a lifesaver for us.”
Tennessee was among the nation’s hardest hit states by an EF-3 tornado that spanned across 60 miles of the Nashville area in March, according to the National Weather Service. Damage to Alive Hope’s service regions across the state’s middle region created literal roadblocks to patient homes. When the coronavirus outbreak hit the state shortly after with the need to socially distance to minimize spread, the hospice provider’s telemedicine programming grew in response.
Seniors 65 years and older account for roughly 17% of Tennessee’s overall population, according to the U.S. Census Bureau. The National Hospice and Palliative Care Organization reported hospice utilization among Medicare decedents in the state at 44.9% during 2018. Utah ranked highest nationwide at 60.5%.
Telemedicine programming doubled Alive Hospice’s virtual reach with as many as 450 users since the pandemic’s onset, giving continued access to the provider’s medical and non-medical services. As Goessele shared with Hospice News, the program’s growth during COVID-19 served as an indicator of its long-term sustainability.
“What the pandemic has shown us is that having Henry Hooker Alive Connect was the right thing to do,” Goessele said. “It’s put our focus toward how we do more with it now. We talk about a lot about things we’ve learned during the pandemic that should have survivability, and this is definitely one of those things that is really heightened. It’s proven our hypotheses that if you put the right support tools in play along with compassion and care, that it can change the experience. That’s really how we look at technology: How can we help improve and change that experience for the family? Patients and families felt so much closer to their care team even when their care team wasn’t in their home with them.”
Patient and family satisfaction with telehealth is a growing industry-wide priority among hospice providers as the U.S. Centers for Medicare & Medicaid Services (CMS) plans to make permanent a number of temporary flexibilities for expanded telehealth in response to COVID-19, though which of those rules would impact hospices has yet to be determined.
“At the time when we started this telehealth was not a service that could be reimbursed through CMS reimbursements, so it’s difficult to make decisions like that when you know the value it offers to the family and the patient, but none of a reimbursement is supported,” said Goessele. “We’re hoping that telehospice and telehealth as a whole is being considered for reimbursement and that they look closely at how the hospice industry has utilized it.”
As Alive Hospice continues expanding telemedicine programming, associated costs to consider involve a heavy focus on technical updates for devices and the ability to sustain technological advances as products evolve over time, along with ensuring secure data sharing with patients and family members.
With continued funding support and fundraising efforts over email and social media campaigns, Alive Hospice is strategizing to further expand telemedicine with different technology capabilities in operational areas such as admissions and patient goals of care.
“There’s a whole lot of information that comes along with the hospice admission and we’re looking at how we can streamline that paperwork process as much as possible but not take away from the human touch,” Goessele told Hospice News. “As we start our next generation of telehospice programming and change some of the features and functionalities, probably the biggest thing is just improving our communication with the patient and their family.”