How an FQHC uses telemedicine for primary care, behavioral health and addiction treatment
The Harbor Care Health and Wellness Center in Nashua, New Hampshire provides primary care, behavioral health and dental services to a population that is either homeless or at risk of homelessness.
Harbor Care Health is a Federally Qualified Community Center (FQHC). FQHCs were established to provide affordable medical services to those in need, regardless of their ability to pay.
As a non-profit organization, investments in information technology are sometimes challenging, said Henry Och, chief operating officer. Maintaining basic IT services and advancing innovative technologies are difficult with a small technology budget, he added.
“As the COVID-19 pandemic increased in early 2020, we put significant strain on our already stretched technology infrastructure,” he recalled. “Furthermore, even without COVID-19, our patient population can be transient and often difficult to maintain in care, posing many risks to their overall health.
“Technology can help address this challenge, using mobile and web-based platforms to access our patients’ care teams,” he continued. “We quickly deployed multiple telemedicine solutions, including Doxy.me and Zoom, to set up multiple communication channels for our patients.”
These telemedicine products rely on great internet connectivity. Harbor Care Health’s network infrastructure required significant upgrades to accommodate the demands of mobile devices, computing equipment, and server traffic.
In addition, existing telecommunications technology was not designed to take advantage of modern unified communications platforms.
“As we developed our project proposal and plan, we realized that as we increased the use of telemedicine services, our network deployments needed to be addressed,” explained Och. “We have upgraded our point-to-point, Internet and VoIP systems.
“We have integrated our new WildIx web-based VoIP system into our Office 365 platform,” he added. “The tight integration with all our communication systems allowed us to offer telemedicine services in a consistent and powerful way.”
The workforce also benefited from the investments, since they can now be productive regardless of their location. Telemedicine – and teleworking for employees – quickly became a core part of the service offering.
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TO ACCEPT THE CHALLENGE
After implementing telemedicine technologies, Harbor Care Health needed to train both staff and patients. Those were the two main interest groups.
“We used the telemedicine solution to provide services to both adults and children,” said Och. “These services included primary care, behavioral health and addiction treatment. Delivering behavioral health and addiction treatment via telemedicine has had a major impact on the lives of our patients navigating the unknowns of the COVID-19 pandemic.”
Telehealth services are now part of the provider organization’s service delivery model.
“In calendar year 2021 we provided 15,207 virtual visits, while we did not provide any in 2019,” reported Och. “In 2019 we treated 3,194 patients. In 2020, that number dropped to 2,573 patients. Due to improved access to care via telemedicine and adjustments to surgeries, we have expanded access to 2,681 patients.
“We have yet to recover to where we were before the pandemic,” he continued. “However, we are confident that with continued use of technology and innovative solutions, we will continue to provide access to quality care.”
USE OF FCC PRIZE APPROPRIATIONS
Harbor Care Health and Wellness Center received $801,768 from the FCC telehealth grant program to obtain computers and telecommunications equipment and improvements to their network and network security to provide enhanced telehealth services to patients, 75% of whom self-identify as homeless identified .
“We have used FCC telemedicine award funds to ensure the technology that supports our healthcare professionals and support workers can meet the needs of our patients,” Och said. “We have upgraded the infrastructure, end-user equipment and treatment rooms.
“One of the concepts we’ve implemented is telemedicine ‘phone booths,'” he concluded. “These areas can be used by our staff to connect patients to their provider, regardless of where the provider is located. We hope to use this platform to virtually connect patients with their specialty providers or other healthcare professionals.”