From the Hospital Into the Home: How Butler Health System Scaled Telehealth During COVID-19

Rich in history and heritage, the small town of Butler, Pennsylvania, is also home to innovation. Butler Health System (BHS), an independent healthcare organization that has been serving patients for more than 120 years, is known throughout the region for its state-of-the-art technology and commitment to providing top-notch care.

BHS has embraced telehealth in recent years to increase access to care in rural communities. But prior to the COVID-19 pandemic, telehealth options were limited and required patients to travel to a special location for their appointment for their visit to be covered by insurance.

BHS implemented Zoom for Healthcare in rapid response to COVID-19-related facility closures, expanding its telehealth program to serve patients at home. Zoom enabled providers to recreate much of the clinical experience for primary, specialty, and urgent care appointments, resulting in improved access to care for those who need it.

Key priority: Expand telehealth program

Like many hospitals and health providers, BHS closed its doors to outpatient care during the height of the pandemic to limit exposure and conserve resources for COVID-19 patients.

BHS needed to expand its telehealth program quickly to enable its network of 200-plus physicians and care providers to continue serving patients.

Cynthia Esser, BSN, MHA, MBA, director of emerging technology at BHS, got the call from IT to implement Zoom’s healthcare plan as a telehealth solution. “We were no longer able to see patients face to face, but we still needed to provide care to all our patients. Zoom made the most sense.”

Secure platform for patients

In a matter of days, Esser and her team provisioned 200 new licenses to BHS’ network of physicians, advanced practice providers, and administrative personnel across western Pennsylvania. “We went live in 30 physician offices and saw our first patient in three days in their home over Zoom,” she said.

The team created a customized workflow using Zoom’s Scheduling Privilege feature, which allows office staff to schedule appointments for multiple providers at the same time while still giving providers host capabilities. Seamless integration with Microsoft Outlook enables providers to join their appointments with a simple click. All patients have to do is click on the meeting link sent via email to start their virtual visit.

To simulate an urgent care setting, the team developed a workflow that leverages personal meeting IDs (PMI) and Zoom’s Waiting Room feature. “We call our on-demand virtual visits ‘Faster Care NOW,’” Esser explained. Patients with more acute symptoms who can’t wait for a scheduled appointment are given a meeting link to a physician’s PMI and placed into a waiting room queue on entry. Physicians can admit patients, one by one, from the waiting room into the virtual “doctor’s office” for a private telehealth consult and lock the meeting for extra security.

Security and privacy are top priorities for BHS, and Esser said they never hesitated when it came to evaluating and implementing Zoom. “We felt we were offering a secure platform for patients.”

Reduced no-shows and cancellations

“Before COVID, we had a handful of telehealth visits a week,” Esser said. “Through Zoom, that became thousands of visits. That’s how we were able to keep our providers in business during COVID.”

Esser said many patients have found telehealth to be a more convenient, efficient option than in-person exams. She shared an anecdote from a mother who had a child with ear pain and was facing a three-hour wait at a nonaffiliated urgent care clinic.

“She’s sitting in her car with a screaming child, and she says, ‘I’m going to give BHS’ virtual appointment a try,’” Esser said. The team set her up with a Faster Care NOW virtual appointment, and she had a prescription over Zoom in 15 minutes. “She had a great experience. I was happy to hear that she was impressed with the entire process.”

Esser believes telehealth will remain an essential tool for BHS’ physicians, providers, and patients. By removing certain barriers to care that are common in rural areas, like long travel times and lack of access to specialists, BHS can increase access to its services for those who need them most. Additionally, BHS has seen a reduction in no-shows and appointment cancellations as a result of virtual visits into patients’ homes.

Telehealth can also help patients take the reins to improve their health by focusing on lifestyle management. BHS’ in-person classes on healthy lifestyle, weight management, self-care, and meal planning have gone virtual during the pandemic, and enrollment has increased.

As an independent health system, “it’s important for us to be competitive and differentiate ourselves,” Esser stressed. Leveraging the convenience, access, and efficiency of Zoom for telehealth allows BHS to serve patients beyond the four walls of a hospital and provide the most appropriate care in the most appropriate setting.