In just a matter of weeks, “virtual healthcare” delivery to older adults became one of the safest, most effective alternatives to face-to-face healthcare during a pandemic.
Ordinarily, Landmark brings medical, behavioral, and palliative care into patients’ homes via house calls for older adults with chronic conditions. Those house calls are still happening for patients who need face-to-face medical care, but the company is also leveraging technology to address ongoing preventive care needs via telehealth visits.
Over the final 16 days in March 2020, Landmark saw a 1,267% increase in the company’s telehealth (video and phone) visits across 14 states.
“We pivoted quickly for the safety of our patients and providers. Within four days of CMS relaxing the rules regarding telehealth services, we shifted a majority of face-to-face visits to phone and video visits,” said David Hirota, MD, Landmark’s Senior Medical Officer, and Infectious Disease Specialist. “And in-person urgent care is still available with all the careful protections in place for patients who need high-touch medicine.”
While the need for in-home healthcare models existed well before the current pandemic, social distancing to reduce the spread of the COVID-19 virus has further validated the industry movement. During this crisis, frail seniors in particular should limit travel to traditional care settings whenever possible, like clinics and urgent care centers, to access primary care services. Nationally, more than 100,000 seniors have access to Landmark’s home-based services and could be receiving house calls and telehealth care.
DURING THE PANDEMIC PATIENTS CONTINUE TO REQUIRE ROUTINE AND URGENT CARE
Not all Landmark’s telehealth visits include concern over COVID-19. With tens of thousands of patients who rely on Landmark for regular in-home medical visits, the company continues to treat and triage patients for everything.
“Our patients’ chronic conditions, including diabetes, heart disease, high blood pressure, lung disease, and cancer, still require preventive and urgent medical care,” said Dr. Hirota.
Landmark is leveraging both in-home visits and scaling up telemedicine capability to touch as many patients as possible. The company has quickly deployed virtual visits to bring physicians, nurse practitioners, physician assistants, behavioral health specialists, social workers, pharmacists, and dietitians to its patients safely.
The healthcare company is currently conducting video visits via commercial applications, and is looking to launch proprietary provider and patient apps that will include telemedicine capability, for both Android and iOS devices, in the coming weeks.
Just like an in-home, face-to-face visit, a video visit can offer a meaningful glimpse into a patient’s environment and needs:
- Are the patient’s chronic health conditions well maintained?
- Does the patient have the necessary medications?
- Is the patient experiencing anxiety or stress related to social isolation?
- Does the patient have a support network to lean on?
ISOLATION SYMPTOMS AND SOLUTIONS
Landmark’s medical professionals must consider fallout risks of COVID-19 even when not treating the virus specifically. Landmark providers and nurses are trained to spot the consequences of social isolation in their regular patients.
Along with medical care, Landmark brings social services to individuals where they reside, and this may include nutrition and mental health support. During COVID-19, Landmark teams are watching for social services and resources that may have been discontinued.
“Our patients are experiencing the loss of family visits and community-based support such as meal and grocery delivery, church friends and caregiver support,” said Dr. Jeremy Berman, Landmark Medical Director in Seattle. “Landmark is reaching out to our patients to prioritize who has the greatest needs right now, and help find solutions.”
ALTERNATIVE HEALTHCARE DELIVERY MODELS IN THE LONG-RUN
While remote healthcare is being quickly deployed by many healthcare provider groups and highlights remarkable successes, Landmark maintains that regular, in-home visits are critical for the long-term care of patients.
Many clinics have moved most of their care to telemedicine. Landmark is one of the few provider groups who can also visit patients where they reside.
“Telemedicine and video triage are one of the best ways to reduce this virus transmission rate in the short term,” said Dr. Berman. “But we know that for the chronically ill older adult population, the phone and video-based platforms can be limited. Landmark will continue to provide care in the home, ultimately preventing avoidable ER visits and hospitalizations.”
EXTENDING LIFE, REDUCING ADMISSIONS, LOWERING PATIENT COSTS
Landmark’s research shows that for patients who receive Landmark’s care, mortality rates are significantly lower than those who do not receive Landmark’s care.
Patients engaged with Landmark have a 26% lower risk of death. Hospital admissions for Landmark patients are reduced by 28%, and Landmark’s interventions (including a focus on palliative care at the end of life) are associated with a 20% reduction in healthcare costs in the last 12 months of life.
“We’re not just doing work that improves the lives of patients,” states Dr. Michael Le, Landmark’s co-founder and Chief Medical Officer, “we’re doing life-saving work.”
About Landmark Health
Since 2014, Landmark Health and its affiliated medical groups (Landmark) have delivered comprehensive in-home medical care to older adults, 24/7 – 365 days a year. Specialized in complex chronic care, Landmark’s physician-led multidisciplinary teams work with patients’ existing healthcare networks to bring medical, behavioral, and palliative care, along with social services, to individuals where they reside. As one of the nation’s largest value-based healthcare companies, more than 100,000 people across 14 states and 46 metropolitan communities can access Landmark’s care at no cost. Most critically, Landmark is bending the cost curve in health care by reducing avoidable ER visits and hospital admissions while extending lives of patients. www.landmarkhealth.org