Avera eCARE

Mission
Avera is a health ministry rooted in the Gospel. Our mission is to
make a positive impact in the lives and health of persons and
communities by providing quality services guided by Christian Values.
History
Avera’s roots stretch back to the frontier medicine of the
Benedictine and Presentations Sisters, who began providing health
care in Dakota Territory in 1897.
32 Hospitals
21 Nursing Homes
2.7 M Outpatient & Clinic Visits
110,000 Home Health Visits
1,000,000 People Covered
$3.3 Billion in Revenue
Purpose
Better Access to Care
Better Care & Better Outcomes
Lower Costs
Rural Workforce Sustainability
Telehealth
Network
Virtual
Hospital
Avera eCARE
eConsult
Avera eICU
CARE
ePharmacy
eEmergency
eAccess /
Long Term
Care
eAccess /
Correctional
Facilities
133 Sites
29 Sites
62 Sites
97 Sites
30 Sites
4 Sites
Jan 2012
Apr 2012
Nov 1993
Aug 2004
Nov 2008
Oct 2009
Purpose
Better
Rural Workforce
Access to Care
Support
Better Care & Better Outcomes
Lower Costs
Rural
BetterWorkforce
Access to Sustainability
Care
Rural Physician
2015 Job Description
• 13,000 Diagnoses
• 6,000 Medications
• 4,000 Procedures
• On Call: 25% – 50%
of the time
Know it all, No Mistakes
Gawande, A. (2011). Cowboys and Pitcrews. Harvard Medical School Commencement
Address. May 26,2011.
Rural Workforce Challenges
•
•
•
•
National Primary Care Workforce Shortages
Difficulties recruiting
Many burnout factors
Greater reliance on
Advanced Practice
Providers
• Lower case volumes =
less confidence
Real Time Support
eCARE was designed to provide 24/7, realtime access to:
• A ready network of peers
– We had an adverse outcome here … It was just nice for our
provider to get the phone call from the [hub] folks, the docs and
the nurses who said ‘you know, you guys did everything possible
that you could do’. (Hospital CEO)
• Specialty consults
– ‘I’m not a cardiologist, I’m not a neurologist, I’m not a trauma
surgeon…in a small town you are asked to be all of those things
and more…It’s nice to have that backup of people who are used
to dealing with those things on a daily basis.’ (Hospital
Physician)
• Nursing Support
– ‘This gives us that little extra time to be a nurse, and that’s why
we are all here’ (Hospital Nurse)
Emergency Physicians
Emergency Nurses
Intensivists
Critical Care Nurses
Pharmacists
Geriatricians
Advanced Practice Providers
Long Term Care Nurses
Education
• Interactive Video Education
– 200 nurses a month
– 40 providers a month
– CME and CNE
• Very popular
• Most attended sessions – Pediatric topics,
trauma, low-volume cases, sepsis, stroke,
Ebola, emergency airway management
Becoming Part of the Team
• Daily video contacts
• “We’re here for whatever, whenever”
• Ongoing mentoring and support:
– Policy sharing
– Quality projects
– Disaster drills
– Onsite skills labs
Results: Recruitment & Retention
Conclusion: Results indicate that, all other factors being equal, tele-emergency
increases the likelihood of physicians entering and remaining in rural practice.
The availability of tele-emergency helps with
recruitment and retention of healthcare professionals
in my hospital
285 Respondents
150
100
50
0
104
47
33
66
12
14
9
Hospital CEO: I've got to admit, the two
docs I've got on right now, […] both have
made the statement to me directly that if
it wasn't for [tele-emergency], they would
not have come out here because they
were not comfortable with it.
We Make a Difference
240,000+ patients touched
224 hospitals and clinics served
2,200 providers impacted
545,000 square miles covered
8 States
$157M in health care costs saved
Virtual
Hospital
Partners
Collaboration
Technology
Efficiency
Innovation
Proven, Predictable, and Sustainable Results
Questions?
Mandy Bell, MHA
Avera eCARE eQuality & Innovation Officer,
Mandy.Bell@avera.org