Henry Ford Health’s effort to ensure that patients 65 or older can communicate with their physicians and care teams was recognized by the Association of American Medical Colleges (AAMC) for demonstrating a “commitment to addressing barriers associated with telehealth and health technology across clinical delivery and medical training” particularly for historically under-resourced communities and populations.
“The purpose of telehealth is to provide connection,” said Denise White Perkins, MD, PhD, chair of the Henry Ford Health’s family medicine department.
“We're connecting with the patient and we're connecting with their data and that will allow us to manage their disease better,” added Dr. White Perkins, whose research and quality-improvement work has focused on addressing patients’ social determinants of health and chronic disease self-management, including diabetes, hypertension in Black men, and improving the virtual care experience for older adults.
The AAMC highlighted Henry Ford Health’s survey of older adults to learn about their digital needs, connectivity, devices and barriers. This was followed by hosting focus groups to “better understand the barriers, facilitators and perspectives of older adults regarding digital tools.”
“Henry Ford Health identified a lack of access to and use of digital tools among the system’s older patients,” the AAMC stated in its publication, Digital Health Equity: Current Practices and Approaches of Academic Medical Centers. “In contrast to other organizations with whom we spoke, Henry Ford Health is engaging peer digital inclusion coaches and leveraging existing community collaborations to codesign a curriculum that will facilitate peer coaching to support older adults who want to use telehealth.”
Dr. White Perkins, however, said this type of activity is not new for the health system.
“Henry Ford Health has always been focused on innovation and trying to make sure that we're doing things in better and newer ways,” she explained. “That's in our DNA as a health enterprise.”
In partnership with Michigan State University College of Human Medicine and with funding from the Michigan Health Endowment Fund, the Henry Ford Health team is also training physicians and other health professionals to better connect during telehealth visits.
Henry Ford Health is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
“Over the last several years, as health care has become so very excited about telehealth, we focused a lot on building all the technological infrastructure and workflows and training the physicians and staff to make sure the healthcare team connects to the telehealth encounter,” Dr. White Perkins said, explaining the health system’s outreach approach.
“But we may not have been doing as good of a job focusing on what needs to happen to get that patient in that virtual room in a way that's going to meet their needs,” she added. “That connection point is critical, and also the steps it takes to get the patient to that connection point is what we need to focus on a bit more.”
Telehealth is critical to the future of health care, which is why the AMA continues to lead the charge to aggressively expand telehealth policy, research and resources to ensure physician practice sustainability and fair payment.
Telehealth is for everyone
“Telehealth is for everyone,” but patients without adequate access or digital health literacy are missing out on the benefits the technology offers, according to Alexandra Hunter, MPH, a virtual care consultant for Henry Ford Health. That is especially true for adults 65 or older who have chronic health conditions.
“At Henry Ford Health, this is something that we’re heavily invested in, specifically in our older adult population,” Hunter said during a presentation at this year’s Healthcare Information and Management Systems Society (HIMSS) Global Health Conference in Orlando, Florida.
Dr. White Perkins cited U.S. Census statistics showing that broadband connectivity remains lower in Detroit at 79.4% than the rest of Michigan, which is at 87.8%.
While some may not view an 8% difference as that significant, Dr. White Perkins noted that it represents one more thing that economically and socially marginalized communities have been deprived of.
“The difference is compounded by the fact that often the same neighborhoods that have less access to safe walking spaces, grocery stores with healthy food options—all those social and built environment elements that help someone be healthier—tend to also be the neighborhoods where there's less access to broadband,” Dr. White Perkins said.
“People are getting a double whammy, so to speak, in terms of the difficulty that they're having in getting what they need to be healthier,” she added.
Making the magic happen
In addition to focusing on innovation, social determinants of health concerns are also being addressed.
“We've been very intentional about bringing an equity lens to the work that we do every day to ensure that, as we develop these innovations and practice-changing ideas, we’re providing the same quality of care to all our patients,” Dr. White Perkins explained.
“Nationally, we know that there are inequities in health and inequities in the quality of care that people get—and that this is particularly true among those who are in groups that have been minoritized, marginalized or historically underserved,” she added. “Henry Ford Health is committed to being brave enough to look at our own data and to see if we have some of those concerning patterns, and where we do, to then step up with interventions to close those gaps.”
One such gap that was discovered was the poor connection between older adults and the use of digital health tools.
“When you think about the essence of a clinic visit, it's about connecting the physician and the patient so that we can address their needs,” Dr. White Perskins said.
“When that happens in the exam room, we take it for granted because the patient enters the room and is seated, the physician enters the room as and is seated, and then the magic happens,” she said. “But when we're talking about a virtual visit, there are different kinds of steps necessary in order to get those two connected for that magic to happen.”
Outreach efforts are identifying older adults can train their peers to better use their patient portals and have effective virtual visits. This operates on the understanding that, while a patient’s grandchild can help them connect, little training takes place in these encounters.
“A lot of times—and I've experienced this myself—the teen will come over and say, ‘Just give it to me,’ and they press a bunch of buttons, hand it back to you and walk off,” Dr. White Perkins said. “And you're thinking: Well, thanks. But that really doesn't equip me to do it myself the next time. So we value the younger generation for their technological savviness, but sometimes they may not be helping the older adult in the way that's going to be most effective for them feeling comfortable the next time they have a need.”
The AMA Telehealth Implementation Playbook offers a twelve-step plan to effectively integrate and operationalize telehealth into your practice.
