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Virtual CareAt OCHIN2019
Who is OCHIN?
OCHIN Supports Over 500 Organizations Nationwide and Growing
OCHIN Epic111 Organizations
OCHIN Services400+ Organizations
OCHIN Billing26 Organizations
OCHIN Broadband 164 Organizations
OCHIN Research35 Partners; 40 Clinics
14 1
2
34
14 549
11
29
90
26
3
3
1
6
3
2
6
(DC)
3
4
12
OCHIN NextGen44 Organizations
4
3
OCHIN Offerings
2
1
2
5
4
1
2
1
1
1 2
11
1
1
1
1
2
1
31
1
3
10
4
1
1
1
1
1
2
1
1
1
1
2
2
The numbers indicate the states in which member organizations are based, though they may operate in
additional states (represented with unnumbered circles).(May 2019)
Medicaid Expansion States
Non-Medicaid Expansion States
1
1
7
1
1 1
3
1 1
1
1
1
1
11
1
Our National Impact
500+ Organizations in 47 states
10,000 Providers
5.1M Patients served
33M+ Records exchanged past 12 months
As of April 2019
5.1M Active Patients
70% Female | 10% Children
46% At or Below Federal Poverty Level
Diversity
42% Racially Diverse | 27% Hispanic
29% Best Served in a Language Other than English
Chronic Conditions
70% Have at Least One Chronic Condition (3.5M)
52% Have Two or More (2.6M)
The Population We Serve
46%
7%
21%
26% Medicaid
Medicare
Private Insurance
Uninsured
Payer Mix
Migrant/Seasonal Workers
Homeless
Incarcerated
School-Based
Veterans
Foster Children 13K
22K
37K
43K
41K
40K
What is Virtual Care?
$$$ (Resources/Encounter) ACCESS (Specialist Encounters)
• SMS Appointment Reminders
• Portal modules (targeted education)
• Planned Parenthood HIPAA-compliant texting
• Smart symptom algorithms
• The Ideal: Implants and Wearables (Closing the Loop)
AUTOMATED CARE
JMIR Diabetes 2018;3(4):e15. URL: https://diabetes.jmir.org/2018/4/e15
JMIR Diabetes 2018;3(4):e15. URL: https://diabetes.jmir.org/2018/4/e15
JMIR Diabetes 2018;3(4):e15. URL: https://diabetes.jmir.org/2018/4/e15
• Patient portal (MyChart) features
– My Preventative Care
– Care Companion
– Symptom Checker
• Electronic Referrals (eConsults)
– Partnership Health
– Care Oregon
ASYNCHRONOUS CARE
eConsultPartnership:
Open Door Community Health Center & Partnership Health Plan
Any referral that meets the following criteria WILL be sent to eConsult:
eConsult availability
Telemed2U Specialist
The patient is on MediCal (PHC)
Standard operating procedure: send
eConsult
Open Door CHC eConsult Data
Total e-Consults
Patients Needs Addressed
Average Days Patients needs
addressed
referred for face-to-face visit
average days referred for face-
to-face visit
Dermatology 270 59% 7 30% 1
Neurology 75 63% 7 12% 3
Endocrinology 73 44% 8 47% 2
Rheumatology 94 31% 7 54% 2
Urology 28 68% 8 11% 1
Infectious Disease 7 57% 6 43% 1
Gastroenterology 52 6% 11 87% 1
Pain Management 2 100% 11 0% NA
eConsultscost 25% less than
face to face visits
(includes travel costs)
7
333
507
601
0
100
200
300
400
500
600
700
2015 2016 2017 2018
Total eConsults completed year-over-year at Open Door facilities
eConsultPartnership:
Care OregonLocal Community Health Centers
• 85.9% Improved Care Plan
• 71.0 % Educational
• 40.7% Avoided Referral
• 41.7% Avoided Diagnostic
• 2.5% No Effect
Reported outcomes
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
% o
f eC
on
sult
s
Avoided Referral Avoided Diagnostic/Service
79%Outcomes reported
1,095eConsults submitted
58%Avoided Service Rate
Reprinted with permission of Tanya Kapka, MD
• Language Interpretation
• Phone Consults
• Video Visits
– Open Door, Telemedicine
– Winding Waters CHC, MyChart Video Visits
SYNCHRONOUS CARE
17
133
775
1232
1434
0
200
400
600
800
1000
1200
1400
1600
2014 2015 2016 2017 2018
Total video visits completed year-over-year at Open Door facilities
• Expanding Virtual Care is hard.
• OCHIN is committed to offering this to the Safety Net anyway.
• OCHIN is committed to sharing its findings and helping others achieve success in Virtual Care.
WHAT WE’VE LEARNED SO FAR
