AirStrip ONE OB

The massive Catholic Health Initiatives health system, with 87 hospitals in 18 states, is ramping up its digital health efforts while also getting ready to establish a distinct business unit dedicated to what the Englewood, Colo.-based organization calls "virtual health services."

(Correction: The original version of this article incorrectly described the unit as a standalone company that was spinning off from CHI.)

CHI will soon move its virtual health services into a wholly owned subsidiary with a new name the organization isn't ready to divulge yet, according to Proteus Duxbury, whom the organization brought on at the beginning of the year to be director of technology strategy for virtual health services. The category includes not only traditional telemedicine and telehealth, but also mobile, social media and elements of gamification.

The new subsidiary will market these services to employer groups and payers, a departure from earlier telehealth efforts that concentrated on hospitals.

CHI has already commercialized its ePharmacist Direct telepharmacy services, which grew out of a statewide project in North Dakota that started in 2004 to aid critical access hospitals and other rural facilities that can't afford on-site pharmacists around the clock. Nearly a third of the 25 hospitals on the telepharmacy network are outside the CHI system, Duxbury said.

The virtual health services group – which, interestingly, is part of CHI's clinical services division, not the IT department – is slowly expanding into medication therapy management and tele-mental health with various digital technologies. "We see there is a huge desire for mental health services in America," Duxbury said.

That one of the first two phases in a four-stage strategy. "Our initial focus is on consolidating our core telehealth platform." Duxbury said. CHI is trying to standardize its telehealth services with Polycom telecommunications equipment and Microsoft Lync software.

"We don't just dive into things," Duxbury explained. "We have to make sure we're doing the right thing nationally."

Later, Duxbury wants to move into home monitoring for disease management and, eventually, crunching data in the cloud for real-time and predictive analytics.

The plan is to provide a suite of integrated products and services, part of a desire to break down silos that currently exist in telehealth and digital health and also to address care coordination, Duxbury said. Someone who has been diagnosed with congestive heart failure, for example, not only needs to stay on prescribed medications, but also might be depressed because of the diagnosis, according to Duxbury.

Already, CHI is starting to move into home monitoring. CHI and Adventist Health Services jointly own Centura Health in the Denver area, which has had some success with remote patient monitoring, Duxbury noted. The Catholic health system also is beginning to use AirStrip OB, an obstetrics app from San Antonio-based AirStrip Technologies, he said.

Most of the technology the new subsidiary will offer will come from third parties and, preferably, be white-labeled. "We want to find solutions that work well and we will become an aggregator," Duxbury said. "The key thing is, they have to have the ability to scale, we have to be able to brand them and they have to be integrated." 

Data collection and data reporting have to be automatic and not disruptive to patients. "Automation is key here," Duxbury explained. If a device is intrusive and stressful to a patient, it could throw off readings.

Automation includes integration with clinical information systems. "EMR integration is key for us and it is a conundrum for us," Duxbury said, because the massive healthcare organization has multiple vendors across the country, and many systems are being upgraded to meet Meaningful Use requirements.

Among CHI hospitals, the group is turning to Orion Health's Rhapsody Integration Engine, which follows HL7 standards, for interoperability. "With non-CHI organizations, it becomes a little tricky," Duxbury said.

Ease of use is another consideration. "Especially with nurses, you really have to make it seamless," according to Duxbury. He expect to rely on what he called "skinning" to put a clear user interface on top of complex technology.

"On the patient side, you really just have to have one button," Duxbury continued. Interventions don't even have to be high-tech, Duxbury said. Sometimes, interactive voice response is sufficient, as CHI is finding with automated follow-up calls for recently discharged patients.

The technology also has to be secure to win the trust of physicians and patients. "Physicians are going to have to be our champions," Duxbury said. His group will be relying on them to "prescribe" appropriate technology, and clinicians want things that are easy to use. "Patient engagement is key to this, but our view is, this has to be driven by healthcare professionals," added Duxbury.