"We have recently been discussing how to best obtain information from this population regarding the technology that they have access to and what obstacles, if any, they face. This effort is still in the formative discussion phase, but we felt it to be necessary to accurately design an approach to this group in an effective and sensitive fashion," he says.
Intermountain's alternative to the ACO model, known as shared accountability, is leading to interface cost reduction (admission to discharge) and is allowing the system to invest in telemedicine infrastructure in every single inpatient room and ambulatory exam room, which will allow consultations among any physicians in the system.
"We decided to take those cameras and point them inside first," Valdes says. "By doing that, and looking at the infrastructure and process that would require that, we started to realize additional cost savings and additional efficiencies that we previously couldn't have realized without that infrastructure. For example, if I were to run a monitor and microphone and speakers in a room, sure I can bring a consultant into that room virtually, but I can also bring an interpreter into that room, a case manager, a pharmacist, a nutritionist, a chaplain, and I could leverage these resources across my system very efficiently."
Intermountain also realized that when the infrastructure was not in use by staff, patients could use it. "Grandpa comes out of hip surgery and wants to chat with the grandkids, say, 'Hey, doing okay.' We'll let him do that. We can make that available."
The interactive patient room design now in progress at Intermountain includes a touchscreen-enabled device that allows the patient to request interpretation services or other video services, Valdes says. "Patients have a better idea of when they need an interpreter than we do.
"This infrastructure is the exact same infrastructure that the organization was looking at to roll out patient entertainment to all the rooms," Valdes says. "That was about a $12 million to $14 million investment. It's also the same infrastructure that they were looking at to roll out patient education to all the rooms. That was about an $8 million investment. So by committing to this infrastructure, we were able to roll all those projects into one and save the organization about $22 million of proposals right off the bat."