Virtual visits: Health care meets tech

A Mercy technology program launched in St. Louis this summer has moved to Springfield’s Mercy Technology Distribution Center to scale up.

Called Engagement at Home, the program serves high-risk patients by keeping them at home as much as possible through the use of technology kits. Once enrolled, patients receive an Apple iPad Air II, a pulse oximeter, Bluetooth scale, blood pressure cuffs, a stylus and instructions.

“This gets them direct physician and nurse contact. They’ve just got to turn on the iPad,” said J.P. Peltier, Mercy’s technology services logistics supervisor.

The patients, who have difficulty leaving home for health care visits, are coached on the technology and check-in with heath care workers every day.

Mercy Technology Distribution Center plays a major role with the program in working with Mercy’s Virtual Care Center in St. Louis. Engagement at Home is scheduled to begin in Joplin early next year, with a plan to expand throughout the entire network in two years.

Peltier said his nine-person team in Springfield creates all the kits.

“We are already in the business of assembling kits and providing all the IT equipment for the entire health system,” Peltier said of the south-side distribution center. “We are really the only distribution center for Mercy for IT equipment. It’s here in Springfield.”

Mark Saxon, executive director of Mercy virtual ambulatory medicine, said the kits and virtual care services are creating at least 35 percent savings for the patients and cutting in half emergency department visits by chronically ill patients.

“The top 5 percent chronically ill spend 50 percent of the health care dollars. They are spending the most money but also need the most help,” he said. “We are avoiding those unnecessary visits.”

There currently are 80 patients in Springfield with a potential for 1,500 more, Saxon said.

“We are about to grow significantly in Springfield soon,” he said.

He said each patient has a navigator – a liaison between the doctor, the technology and the patient. The daily interaction with the patient and checking of vitals reveal shifts in health that would otherwise go unnoticed – a three-pound weight gain in a day, for example.

The technology both eliminates the need for urgent care and emergency room visits for aches and pains and basic health visits, and it lets the doctor and patient know when something more serious is happening and an in-person visit is required.

Mercy Technology Services also is co-developing the triage software for the iPads with a Kansas City company called Lifescience Technologies.

“It has the power to do spoken request, as soon as they touch the button. Everything is Bluetooth. We can share all labs, all appointments and full education videos,” Saxon said.

Although sticking with Medicare Advantage patients in Springfield right now, officials plan on expanding to the entire population.

Mercy neurologist Dr. Scott Duff has participated in Mercy’s Telestroke program the past three years.

“I can actually zoom right into their pupils and see the iris of their eyes,” he said of the technology.

Assisted by in-room nurses, Duff helps patients with neurological emergencies in rural locations. These cases require fast action, he said. The speed in which they receive treatment results in better outcomes and less side effects.

“It’s really similar to our emergency room scenario, just that I’m coming in over a camera and a microphone,” he said.

In a philosophical sense, the work is no different than the work Duff does every day.

Additionally, he said there is an extreme manpower shortage among neurologists.

“This is up to us, this is about pushing technology and pushing system management as hard as we can,” he said. “It’s extremely rewarding work to help these people in these remote areas.

“It’s what I dreamed about when I went to medical school, helping people in need and doing it to a high standard.”

Most Telestroke doctors still provide bedside patient care.

“We are not exclusively virtual doctors. That is probably the most appropriate model to have,” Duff said. “It keeps your skillset there.”

Saxon said the program was not created to replace anyone in the system, rather to augment and help in an effort to be proactive with care.

“Our average patient has 27 different diagnoses and are on 17 different medications,” Saxon said. “We want to make sure we meet the needs of the patient.”

Duff said this is the future of medicine – using the natural ebb of workflow in hospitals and clinics to their advantage, by allowing physicians to be accessible virtually and closing the gaps.

“While we may not actually touch a patient, we make it easier for our doctors, nurses and other caregivers to do their jobs every day. That’s what keeps us going. That’s our goal in life,” MTS supervisor Steve Becker said.


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