Digital Health

Beyond COVID-19: Making Telehealth More Accessible & Equitable

Posted on Sep 1, 2020 in Digital Health, Scroll Images

COVID-19 has provided us with many important lessons, but among the most significant for Sutter Health is how valuable expanded telehealth has been in reaching traditionally underserved communities in new and meaningful ways.

Sutter serves one of the most demographically and geographically diverse regions in the nation. Through our not-for-profit mission we work to ensure every patient gets the care they need, when and where they need it, regardless of their circumstances or ability to pay. We are committed to finding innovative ways to provide all of our patients with high-quality, accessible and affordable healthcare.

Like most U.S. health systems, the policy changes enacted to expand telehealth options to address COVID-19 made it possible for us to significantly expand our telehealth services. In our case, video visits increased by 32,000% – yes thousand – with patient satisfaction ratings right on par with in-person visits. As incredible as they are, what these numbers don’t tell you is how impactful these policy changes have been for vulnerable populations who otherwise may struggle to access the treatment they need.

Read this full article by Sutter Health President and CEO Sarah Krevans on the American Telemedicine blog.

Video Visits by Flashlight: Telehealth Keeps the Doctor ‘In’ Even When the Power is Out

Posted on Aug 25, 2020 in Digital Health, Scroll Images

When the next heat wave causes power outages or the next round of wildfires prompt evacuations throughout Northern California, chances are the global COVID-19 pandemic will still be unfolding. Under any or all of these conditions, we want to remind patients how and when to seek care, even during displacement or power loss.  

First: Make Your Smart Phone Smarter with the My Health Online App.

There is no question that mobile phones have become essential to our lives, and that reality has been underscored during the current emergency. Your phone may already receive alerts, including air quality reports, evacuation announcements or planned power shutoff notices, but is your phone optimized for your personal health needs?

If you haven’t already, we encourage Sutter patients to download the My Health Online smart phone app from the Apple App Store or Google Play. The My Health Online smartphone app helps connect you with your care team – even if you lose power or are displaced – provided you have wireless or mobile internet access and a charged phone battery.

“When we created the My Health Online patient portal we knew we would need a mobile phone option, but I don’t think we realized how important it would be in the context of natural disasters,” said Albert Chan, M.D., chief of digital patient experience at Sutter Health. Within the app you can send a message to your care team, view lab and most test results, securely access health records and schedule and complete a video visit.

“While we previously saw the app as a convenience, we now know that it’s a necessity; in fact we have a dedicated support team at (866) 978-8837 to troubleshoot any issues that patients have activating the app,” said Dr. Chan.

Second: Know that Severe Weather Can Cause Symptoms to Worsen, Quickly.

The smoke from wildfires, the heat in late summer and the stress of evacuation or a power outage can compromise your immune system and put stress on your body. “People who already have heart or lung-related illness, and some who don’t, may need personalized medical care to manage through this period,” said Chan. Video visits can often help doctors determine the severity of symptoms, provide medical advice and guide someone to in-person care as needed; providing reassurance in a very uncertain time.

“Bottom line, if you experience new or worsening symptoms we encourage you to schedule a same-day video visit with your doctor or another provider in the Sutter network – don’t ignore your body’s signals.”

You can also use the “symptom checker” that is integrated into Sutter Health’s website and My Health Online patient portal. Originally launched in February 2019, the self-led symptom checker is a kind of online survey that helps patients decide whether to engage in self-care or to seek care, if they need an in-person appointment or a video visit, and if they need to be seen now or soon.

As always, call 911 or go directly to the nearest hospital emergency department if you are experiencing chest pain or having difficulty breathing.   

Third: Don’t Let an Evacuation Erode Your Health.

“Often, when people are ordered to evaluate they are in such a great rush that they leave medications, medical equipment, or medical instructions behind,” said Chan. “We recommend preparing a ‘go bag’ for each member of the family with medications and any needed medical supplies, just in case.”

But if you have to evacuate without medications, remember an often- overlooked value of video visits is their role in enabling physicians to authorize new prescriptions or call in short-term refills of existing medications to pharmacies near a patient’s temporary relocation spot. “We will do everything in our power to assist with your medication or medical device needs, so please remember to reach out as soon as you are somewhere safe.”

Clearing a Path to Care

Posted on Aug 13, 2020 in Digital Health, Scroll Images

When Sutter Health adapted its operations to continue caring for patients while responding to COVID-19, it meant leaning heavily on its integrated network and technology and innovation teams.

During a recent Sacramento Business Journal podcast, Albert Chan, M.D., M.S., Sutter Health’s chief of digital patient experience and Chris Waugh, Sutter Health’s chief innovation officer discussed the rapid expansion of virtual care and telehealth to help support patients and improve their experience.

Albert Chan, M.D.., M.S.

“Our telehealth expansion was originally planned for 2021 and estimated to take 18-24 months. But in response to COVID we rolled out that expansion within six weeks,” said Dr. Chan. “We trained thousands of new physicians on using the technology … and saw a 32,000% increase in telehealth visits in just two months.”

But it’s not just an increase in virtual appointments that drives Sutter’s innovation-focused dynamic duo, it’s the important access that telehealth offers to a wide range of patients who otherwise might not have received the care needed.

Chris Waugh

“We had [patients] who would not have used this technology previously, now willing,” said Waugh.

Dr. Chan shared the story of a patient in rural Northern California who was concerned after finding a lump. Dr. Chan was able to diagnose the lump as a hernia and instruct him on how to recover at home — all through the safety and convenience of a video call.

“Normally, this patient would have had to come in person for an appointment, and he lives a four-hour round-trip from the facility he would need to get to,” Dr. Chan said. “Patient access has been truly transformed … and this is especially important for our remote and rural areas.”

Dr. Chan says the goal is to take a thoughtful approach to implementing technology and look at every step in the patient journey to make it simpler and more efficient. He emphasized that the aim with telehealth is to create better health outcomes at a lower cost.

And better health outcomes are made possible by what Waugh calls the ability of technology to “reduce friction” — or obstacles to accessible care.

“Whenever we can use technology to make the experience more human, not less, therein lies the silver-lining” said Waugh. “We want to create a more human exchange from beginning to end — between the healthcare system and the patients they’re serving — with the goal of creating better relationships and therefore better [health] outcomes.”

Care Coming into View

Posted on Aug 4, 2020 in Digital Health, Scroll Images

Arleen Beviacqua-Enriquez

Arleen Beviacqua-Enriquez noticed two things about her body in the fall of 2019. First, an irregular mole, which the 65-year-old had already developed a trained eye to spot. Its irregular edges told a familiar tale. Moles are a hereditary condition passed down for generations in her family.

The second? A lump in her breast.

Beviacqua-Enriquez set the mole aside in her mind to focus on what she felt in her heart was the more critical issue: the lump. Working with the support of her Palo Alto Medical Foundation primary care doctor, Rebecca Ashe, M.D., Beviacqua-Enriquez went in for a diagnostic mammogram where it was confirmed she had breast cancer in November 2019. Surgery followed in December. The turn of the calendar—and the ushering in of a new year—brought the beginning of chemotherapy in January 2020.

Beviacqua-Enriquez remained focused on her breast cancer treatment for the next several months even as COVID-19 tore through the U.S. While the world grappled with the implications of this global health crisis, she navigated through her own. Despite being immunocompromised—not to mention feeling fatigued and vulnerable—her care team kept her medically necessary treatment on schedule. Once May finally arrived, she could see the finish line to her chemo.

But now that mole. It had started to tell a different story. It grew ugly—jagged, inflamed, painful. It bled.

“I knew I had to get back into the saddle about that dermatology appointment,” she said.

Rajiv Bhatnagar, M.D.

When she first contacted the dermatology office in May, Beviacqua-Enriquez learned the first in-person appointment wasn’t until September. Rajiv Bhatnagar, M.D., a dermatologist with Palo Alto Medical Foundation, suggested a video visit, which could happen as soon as the next day. Video visits have increased at an astonishing rate across Sutter’s not-for-profit integrated network since the outbreak of COVID-19 in California—providing a safe and convenient option for care. She accepted a video visit for the upcoming Monday. While she admits she isn’t the most tech-savvy person, she has familiarity with the format. Beviacqua-Enriquez, who works in sales for the airline industry, often conducts meetings with her colleagues via video.

In preparation for the visit, Dr. Bhatnagar suggested Beviacqua-Enriquez send pictures of her moles. The digital photo upload option was a new feature aiming to enhance the virtual care experience. She took nine photos from various angles, and after a few clicks, the images were securely off through the online patient portal.

“It’s a good feature,” she said.

When Dr. Bhatnagar previewed the images that Sunday before, plans dramatically shifted. He examined the photos and knew immediately that Beviacqua-Enriquez needed treatment. The video visit was cancelled. Instead, Dr. Bhatnagar spoke with a dermatological surgeon and oncologist, and arranged for the patient to come in the next day for an excision of her melanoma.

“Once you get past the shock, you learn to trust,” she said.

“We very rapidly learned how to deploy video and other telemedicine visits across every specialty within Sutter Health’s network, and saw immediately, as in Arleen’s case, how impactful this can be,” said Dr. Bhatnagar. “We’re continuously learning and improving upon how we deliver both traditional and telemedicine care. Access has taken on new meaning, and we know it can only help enhance outcomes and the overall care experience.”

Beviacqua-Enriquez continues her healing journey this summer. The native Northern Californian, along with husband and college-age son, will remain close to home. When the timing is right, they will hit up some of their favorite walks and trails around the peninsula.

Their quality time together is precious and not taken for granted. While Beviacqua-Enriquez’s video visit may have never happened, it opened the door for her to get immediate care she needed—to make these moments with her family a reality.

“These are changing times. Our lives will not be the same as before COVID. It’s changed everyone’s perceptions on many things,” she said. “You have to be open to different techniques and processes. We have to have other options and thank God we have it.”

The Future is Now: Video Visits Explode in Light of COVID-19

Posted on May 11, 2020 in Digital Health, Scroll Images

Whether at home or in the hospital, patients getting the support they need


“It is transformative—I don’t think we’ll ever go back to practicing medicine in the same way we did B.C. — before coronavirus.”

Albert Chan, M.D.

SACRAMENTO –In what may herald a cultural shift in how patients and their doctors interact, video visits have increased at an astonishing rate across Sutter’s not-for-profit integrated network of care since the outbreak of COVID-19 in California. According to Albert Chan, M.D., Sutter Health’s chief of digital patient experience, video visit volume has grown by 350-fold since the pandemic.

“Our digital health initiatives are critical to Sutter’s efforts to respond to COVID-19,” said Dr. Chan. “As we shelter-in-place, digital health enables the human connections that we need to care for our community.”

Video visits, also called telemedicine, offer an alternative way to get care from home for respiratory illness, as well as everyday concerns such as minor injuries, infections, chronic disease management and palliative care. With many clinicians in the Sutter network now offering video visits, patients can book a video visit directly with their provider through their My Health Online account or by calling their clinician’s office.

Read more about Telehealth at Sutter Health.

From Great Challenges Comes Great Opportunity

“Telemedicine is perhaps the only silver lining of this horrible pandemic,” says Aarti Srinivasin, M.D., an internal medicine physician with Sutter’s Palo Alto Medical Foundation. “It is transformative. I don’t think we’ll ever go back to practicing medicine in the same way we did B.C. — before coronavirus. Each and every day will be shaped by the way we practice medicine A.C.—after coronavirus.”

To further expand access to video visits and other digital innovations, philanthropy teams across the Sutter Health network pooled resources to make $1.5 million available for a system-wide purchase of iPads. So far, 950 iPads have been deployed to patients and clinicians in isolation while about 2,000 units have been provided to physicians to conduct video visits. Through this continued philanthropy partnership, 1,000 additional iPads will soon support telemedicine efforts, with a goal to ultimately equip thousands more physicians in Sutter’s integrated network of care.

Video Visits Inside the Hospital?

But the shift isn’t just for those who are following stay-at-home orders. Video visits have now branched beyond clinical support to patients who are hospitalized. Connection with loved ones can have a profound impact on the human spirit. In these difficult times however, it can be easy to feel isolated. The Centers for Disease Control and Prevention (CDC), continues to recommend maintaining a connection with loved ones, even if just digitally, throughout this pandemic.

To bring some comfort to hospitalized patients, Sutter’s Emergency Management System assembled a work group to lead the charge in securing iPads for Sutter hospitals. In about two weeks, the work group provisioned nearly 1,000 iPads to hospitals across the Sutter network. The iPads allow hospitalized patients to connect with family and friends, helping to improve their overall care experience.

“I had the honor of helping the son of a patient visit with his mom via FaceTime on the new iPads,” said Caryn Brustman, R.N., a clinical manager who works at Sutter Roseville Medical Center. “The son was in full military uniform and was deploying soon, but wanted the opportunity to say goodbye to his mom before he left.”

In addition to allowing patients to keep in touch with their loved ones, these iPads help frontline teams save valuable PPE. The care team can check in with a patient before entering the room, eliminating visits before a patient is ready. This also allows support staff like chaplains and social workers, who aren’t typically allowed in these rooms during the pandemic, to connect face-to-face with patients.

Grants Accelerates Video Visit Access to Palliative Care

This new era in healthcare is now also broadening the reach and potential for other means of telemedicine. A $225,000 grant from the Stupski Foundation is enabling Sutter clinicians to bring vital palliative care services via video visits to Bay Area patients facing serious illness or end-of-life. The grant will provide mobile-enabled iPads to enhance patient care and improve planning for inpatient and ambulatory palliative care teams at California Pacific Medical Center, Alta Bates Summit Medical Center, Eden Medical Center, Palo Alto Medical Foundation and Sutter East Bay Medical Foundation. The technology provides added capacity via virtual visits and will also expand access to an advance care planning (ACP) video library to facilitate patient and family engagement, virtual ACP discussions for advance health care directive, and Physician’s Orders for Life-Sustaining Treatment (POLST).

“Through the generosity of the Stupski Foundation, we will now be able to share important ACP tools at our hospitals as well as our ambulatory palliative care, Advanced Illness Management and care management programs—which could not access these resources prior to the COVID-19 outbreak,” said Beth Mahler, M.D., vice president of clinical integration at Sutter.

“We have been inspired by the pandemic response across the Bay Area, in particular from healthcare providers like Sutter Health that are expanding telehealth to deliver care,” says Dan Tuttle, Stupski Foundation director of health. “Thanks to their quick and thoughtful responses, our communities facing the greatest challenges from COVID-19 are receiving the safe, high-quality care they need locally now, and into the future.”

Community members interested in helping these efforts can visit www.sutterhealth.org/give-covid19.

Volunteers “HELP” Elderly Patients Through Virtual Visits During COVID-19

Posted on Apr 22, 2020 in Digital Health, Scroll Images

SAN FRANCISCO – National Volunteer Week (April 19-25) is an opportunity to recognize the impact of volunteer service and the power of volunteers to tackle society’s greatest challenges, to build stronger communities and be a force that transforms the world.

California Pacific Medical Center (CPMC), part of Sutter Health’s not-for-profit integrated network of care, has more than 850 volunteers that help provide companionship and emotional support to patients and their families in the emergency department and elsewhere, guiding people around facilities, explaining procedures, helping patients eat, playing music, performing clerical duties and so much more.

To help reduce the risk of coronavirus transmission, CPMC volunteers are currently sheltering in place but that hasn’t stopped them from participating in the hospital’s Hospital Elder Life Program (HELP). This unique program allows volunteers to engage elderly patients to help prevent episodes of delirium and increase their functional independence.

Instead of meeting patients at the bedside, CPMC volunteers are conducting phone and virtual visits to help keep their patients mobile and alert, with the goal of them getting well faster and going home sooner.

“When we knew our HELP volunteers couldn’t continue to visit our patients at the hospital, we immediately looked at digital alternatives and whether our volunteers could still make a meaningful connection through a virtual visit,” said Clara Rubin-Smith McKie, CPMC Volunteer Coordinator/Elder Life Specialist. “The answer was yes, and we’re excited that our volunteers have committed themselves to engaging patients remotely.”

HELP Volunteers are now using their mobile phones and tablets to communicate with patients. They engage and stimulate patients through activities such as guiding them through range of motion and breathing exercises to reduce stress and encouraging them to walk.

“The HELP program at CPMC has helped reduce falls for older patients by 22 percent and readmission by 25 percent,” says Wendy Zachary, M.D., CPMC hospitalist and HELP physician-champion. “It’s vital during the COVID-19 pandemic that we continue to help support these fragile patients and I applaud our volunteers for their dedication during this difficult time.”

Wendy Zachary, M.D., CPMC hospitalist and HELP physician-champion.

Patients Appreciate the Conversations

Melissa Ann Im, a HELP Volunteer had a lovely conversation last week and passed along the following comment from a patient:

“I’m not a great fan of the human race… but the people who work at the hospitals are the kindest people on the planet… working all their days to alleviating pain and saving lives. They do it because it is what they want to do. They are the most caring and professional people… I am in awe.”

“I appreciate you volunteers so much. You don’t have to do this, but you do… if you could see me right now, I have a big smile on my face.”

Building relationships are the key. HELP volunteers are taught about using a healing touch to establish a trusting relationship with the patient. Amidst the current stress of the pandemic, for many volunteers, it’s the highlight of their week.

“I’m so grateful to our volunteers for continuing to do this great work during this extremely challenging time,” says Frances Huang, CPMC Volunteer Coordinator/Elder Life Specialist. “The significant improvement in the level of care our patients receive from the HELP program is immense and I’m glad that our volunteers continue to bring smiles to so many faces.”