TeleEM helps patients find most appropriate care

Intermountain Health’s new Telehealth Emergency Medicine program is helping patients answer a common question: Do I really need to go to the ER??

For many patients, the emergency room may not be the best choice. A consultation with an emergency medicine provider can outline options, refer people to the appropriate level of care, or even make TeleEM the focal point for their care.?

TeleEM focuses on fee-for-value patients and supports all InstaCares in Utah, ConnectCare, the Patient Service Center, and Health Answers. Once referred to TeleEM, patients are managed as outpatients, with a focus on prioritizing lower-cost resources such as Castell, Tellica, and Hospital Level Care at Home.??

This is mutually beneficial for patients and Intermountain. For patients, getting the appropriate level of care helps them avoid unnecessary expenses. For Intermountain, our capacity at our EDs can be opened up to more quickly and efficiently treat patients who need that level of care.. For example, a computed tomography (CT) scan that might cost $1,500 out of pocket at a hospital might cost only $350 at a Tellica care site.?

“We want to be a support to patients to help them navigate the system better,” said TeleEM medical director Joel Taylor, MD. “We’re helping a lot of people access more appropriate care and lowering their costs of care while doing it.”?

Participation is limited to proactive care patients. The system is set up to encourage providers to reach out regarding patients who may be eligible, and often reduces the burden on InstaCare facilities as well as emergency rooms.?

“It’s a model that works to save money for patients,” said Kelcie Douglas, Telehealth operations manager. “It often allows them to avoid a costly ED visit.”?

Recently, a patient who was homeless and eating only once a day was referred for care. Through TeleEM, the patient received a voucher for food and was connected with a Castell team for further care.?

“Providers can’t keep up with everything, so we’re there to help guide the patients to the resources they need and be the glue for all these resources,” Dr. Taylor said.?

In the past, there was often little communication between InstaCares and emergency rooms, which sometimes led to double billing and expectations that were not met when care was transitioned from one location to another. TeleEM alleviates those problems.?

Interactions with TeleEM begin with a referral call. If the patient qualifies, the next step can be a video consultation to determine the best course of treatment. If it is determined that the patient needs further evaluation but can be treated on an outpatient basis, TeleEM continues to manage their care. That can involve having labs drawn at InstaCare or assigning workups to various resources.?

“It really is a model that makes sense compared to a silo-based model where no one’s talking to other caregivers,” Dr. Taylor said. “We’re there to guide patients to the best care possible as soon as possible.”?

A referral is required for patients to be considered to receive Telehealth Emergency Medicine. Please reach out to our partners, IntsaCare, ConnectCare, PSC, or Health Answers, for information about transfer of care.

TeleEM is currently staffed from 10 a.m. to 8 p.m. Monday through Saturday, with plans to expand soon to 24/7 care. The program is currently active only in Utah but will eventually cover Intermountain’s entire footprint. In the past year, TeleEM caregivers have recorded 1,200-plus interactions, with 550 patients admitted to TeleEM care. More than 95% of the time, they are able to avoid an ER visit.?