RACER: Successful 18-hour Emergency Telemedicine Implementation at Onslow Hospital

When Hurricane Florence made landfall in South Carolina in mid-September, it left over 150,000 residents without power and caused lingering disruptions in essential services, including medical care. One particular hospital, Onslow Memorial Hospital, was hit hard by Hurricane Florence’s destructive force. Flooding was so severe that hospitalists were unable to get to the hospital, while the number of patients more than doubled the day immediately after impact. SOC Telemed (SOC) used its RACER (Remote Acute Care Emergency Response) protocol to provide Onslow Memorial with expedited remote acute care during the response and immediate recovery phase. Jack Spradley, VP of Operations, and Jennifer Guilmette, VP of Project Management and Implementations, explain how SOC worked hand-in-hand with partner Sound Physicians to bring this rapid response emergency telemedicine initiative to fruition within 18 hours.

“In our core business, SOC regularly monitors and reacts to inclement weather events that can disrupt our service for clients in impacted regions. The idea for the RACER initiative and the expertise required to execute on it came out of this internal process,” explains Spradley.

How was SOC able to deliver a complete emergency telemedicine implementation in 18 hours?

Spradley: The situation was critical. Because of wind and water damage, access to the hospital was basically shut off. Tired, fatigued hospitalists couldn’t leave the hospital; new staff couldn’t come in to relieve them; a backlog of patients was building with many more expected in the near future. Bottom line: the hospital still needed to function. Our initial connection to this project was through Sound Physicians, which is not only a partner of ours but also provides physicians to Onslow Memorial. It was through this connection that we learned of Onslow’s need and were brought in to help with a solution. Guilmette: Sound and SOC have a great partnership. Prior to this project, we have worked very closely together, going live on multiple sites with them and building a trusted partnership between the two organizations. We collaborated and diligently worked together to get this monumental task done in less than 24 hours. A standard implementation can take 90 to 120 days but SOC has done many implementations in less time especially if there is an urgent need. There are so many things we must accomplish to ensure the systems are in place and that there is no impact to patient care. Some of the implementation activities can happen in parallel while others must occur sequentially. But through it all, we must ensure there are no glitches that could impact patients.  In this case, our successful working relationship with Sound made it possible for us to compress our timeline even further.

What did the process of rolling out emergency telemedicine services in less than a day look like?

Guilmette: Our preexisting relationship allowed us to not only truncate the time to launch but also condense the activities and deliverables that normally go into an implementation. Physician training, for example, is something that can take up a lot of time during an implementation. Because we had already stood up two facilities with Sound, they had approximately 30 physicians already trained in acute telemedicine delivery through our Telemed IQ telemedicine platform. In this scenario, having that baseline set was crucial. From there, for our part, it was about updating our teams and systems with clinical and operational information, making sure we had scheduled physician coverage for three to five days and coordination from the site (Onslow) and from Sound so that we had all needed data to input into our systems. A key and often lengthy element in all implementations is privileging, making sure that all physicians using the Telemed IQ telemedicine platform have the right credentials to be able to see patients. Here, it took a meticulous and remarkable effort between all three groups—SOC, Sound and Onslow—to ensure all implementation activities were in place to begin delivering care. Concurrently, Sound saw to the quick training of Onslow’s onsite staff, with all training taking place remotely. It took all hands on deck to bring this rapid-fire telemedicine implementation to go live. We all met together; we talked through everything; we made sure we had all the key criteria and assignments in place. We sent revised action plans two to three times that day, making sure things were being checked off and updated. Here at SOC, the Consult Coordination Center team was instrumental in making sure that the call team was ready, that all parties were trained, and that the mock consult went off without a hitch. We also had a designated team at the ready to support Sound throughout the life of the project. Spradley: A key factor that helped SOC accomplish an 18 hour implementation was that Onslow already had a cart onsite and was familiar with the use of telemedicine. We were able to utilize the existing cart and this eliminated the need (and time) of having to ship one in.

What was the outcome of the temporary Sound-Onslow RACER effort??

Spradley: Our Onslow emergency response provided remote acute care for three days during the response and immediate recovery phase, a time which can have a marked rise in injuries and illnesses from storms and floods, exacerbated chronic conditions, and an increase in acute mental health symptoms. Three unique physicians provided care, each covering a 12-hour night shift. This implementation translated to critical care for 16 patients, including a newborn, in those three days. Looking back, it’s incredible what we were able to accomplish. Everyone really came together to make this happen and most importantly provided much needed patient care. The collaboration between SOC, Sound Physicians, and Onslow Memorial was impressive and we’re happy and proud to have played a part in its success. ***** Read more about SOC’s Remote Acute Care Emergency Response (RACER) protocol.