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An interview with Dan Herbstman
Chief Strategy and Product Officer, Co-Founder
Third Eye Health

Editor’s Note: Third Eye Health is a Healthbox Portfolio Company

The onset and acceleration of the COVID-19 pandemic forced many healthcare organizations to shift priorities, delay new pilots and investments, and ultimately, reduce appetite for longer-term opportunities. Within some healthcare settings, however, the resultant pandemic response created a perfect storm for rapid implementation of new technologies and mechanisms of value creation.

One such setting was long term and post-acute care facilities, whose immediate need for remote, highly skilled physician access became increasingly vital to their operations. For Third Eye Health, a virtual urgent and emergent care provider in post-acute care settings, this market demand was a major catalyst for their business and evolution. Here we talk with Dan Herbstman, Co-Founder, Chief Strategy and Product Officer at Third Eye Health, to understand the complexities of managing a business through a pandemic and virtual health renaissance, as well as how to plan for the future in a volatile regulatory environment.

COVID-19 changed our world, as far as the implementation of virtual care. For those unaware/ on the outside, can you give some perspective on how much/ how fast things changed?

The world changed rapidly in March 2020. Where telehealth had been a solution for more forward thinking, early adopter health care organizations, it suddenly became a necessity for almost all to embrace. Before March 2020, CMS reported that approximately 13,000 Medicare beneficiaries were receiving telemedicine services on a weekly basis. Fast forward to the last week of April 2020, close to 1.7 million were recorded receiving telemedicine services – moving the market for telehealth forward five years in just a matter of weeks.

In our core focus area, skilled nursing homes, there was a giant need for telehealth for a few reasons. First, physicians and other providers were not able to get into nursing homes to see their patients, or could not do so safely. Also, physicians were exhausted from treating COVID patients and needed support from telehealth providers. We were there to help them cover nights, weekends and emergencies.

We found ourselves in a unique position to service larger nursing home chains and health system preferred post-acute networks, given Third Eye Health’s established market leadership in post-acute telehealth.

Was technology already in place that helped make this shift?

We had spent the past six years creating a robust telehealth solution, specifically for post-acute, including a deep understanding of optimal workflow and integrations with the leading electronic health records systems. Because our platform is mobile-based, it offers quick after-hours physician access to nurses through an iPad. This makes our telehealth platform easy to implement and use. At the height of the public health emergency, between March and June of 2020, when so many skilled nursing facilities were adopting telehealth solutions for the first time, and as many as 26% of the visits in nursing homes were conducted through telehealth according to CMS, this was especially important.

On the topic of long-term care facilities and nursing homes, they seemed to be in the headlines quite often throughout the pandemic, and not for positive reasons. As an organization that explicitly serves those populations, do you think the attention they received was warranted? And do you think there are any changes that nursing homes should make coming out of this crisis?

Overseeing the care of some of the sickest and most vulnerable patients, they quickly came under scrutiny as the pandemic hit. An early scramble to organize COVID-only centers in anticipation of capacity-constrained hospitals highlighted any deficient areas in post-acute care. As contact restrictions were put in place and illness ensued, the lack of medical professionals also became apparent. It was the perfect storm and amplified any issues that already existed.

That being said, while some post-acute operators were facing increasing hardship and scrambling under the public eye to recover, those who were able to quickly pivot actually fared much better than the headlines at the time led us to believe. Strategies that included the quick adoption of telehealth, integrating it into daily workflows, actually found that their overall care quality improved. SNFs were seeing better outcomes with patients being treated in place, readmission rates decreased, and in some cases, they were able to earn additional revenue from site origination fees.

Looking ahead, SNFs need to continue to find ways to improve the standard of care. Human capital is an ongoing issue. Medical Directors and attending physicians are spread thin and are really feeling the effects of burnout heightened by the pandemic. With more patients and less time, high quality care is often not always available when changes in condition are first recognized in a SNF setting. Telehealth changes that scenario, creating processes to conduct virtual visits and begin treatment without delays. We’ve seen firsthand that the most successful programs in driving quality measures have the full backing from SNF leadership and Medical Directors and frequently rely on their telehealth provider for support.

What were the key drivers of growth for the business over the course of those months, and, coming out the other side, were there any meaningful changes to the product?

Implementation at the enterprise level was something we were already achieving, which was helpful as we were asked to quickly roll out services for new operators during the height of the public health emergency. By shifting from an in-person to virtual process, we were able to synchronize the implementation of hundreds of buildings, immediately supporting more nurses and skilled nursing leaders.

We were also able to expand our services and technology beyond skilled nursing facilities to large health systems and provider groups. This was important, given clinician burnout and resource constraints, and enabled us to extend value across the health care value chain. Providers were able to use our mobile-based telehealth solution on their own smart devices to consult with their patients and then pass the baton to the Third Eye Health physicians during after-hours. More patients were treated in place, reducing the risk of further complications or unnecessary exposure to illness, while reducing medical spend (lower readmission rates) and improving provider satisfaction.

To the extent telehealth utilization continues to expand, where do you think we will start seeing the largest opportunities arise?

Telehealth is breaking down barriers and cultivating health equity by enabling immediate access to care. While COVID-19 and the public health emergency accelerated its adoption, we continue to look ahead at what’s next across all transitions of care in the post-acute sector, including home health.

Additionally, as value-based care becomes more prominent, ensuring that providers, health systems, post-acute operators and payers align operationally is important to drive optimal outcomes. The use of a single telehealth solution ensures cost savings from treating patients in place and reducing readmission rates, funnels patient data through one designated EHR via integrated technology, and embraces coordinated transitions in care.

If we take a step back, from a regulatory perspective, what sort of changes enabled the rapid scaling of telehealth, and are they here to stay? What do we need to continue to the adoption of these services and telehealth technology moving forward?

When the public health emergency was declared, temporary regulatory waivers eased patient access to immediate medical care because physicians were not restricted to practice in their licensed state(s). Additionally, these waivers permitted telehealth visits to be conducted in lieu of in-person visits for nursing home residents, beyond just rural settings. There were also modifications to the frequency of visits, allowing for better patient care.

Incorporating telehealth into care processes, especially under the public health emergency waivers currently in place, has become essential to all parties involved. With 24/7 access to physicians, patients are receiving higher quality care, providers are getting needed support and healthcare costs are decreasing through reductions in unnecessary returns to acute care and hospital readmissions. We believe that many of the public health emergency waivers will become enshrined in new federal and state laws going forward, cementing the telehealth gains.

For Third Eye Health, retaining these regulatory waivers will enhance our ability to deliver high quality post-acute virtual care. Permanently removing geographic restrictions will continue to optimize provider access during critical moments of need. We realize there is no true replacement for in-person care, but the pandemic was revealing as to how influential and an integrated telehealth solution can be. Not so long ago it was optional, now telehealth is a necessity for adding value across the post-acute spectrum.

To learn more about virtual and emergent care, or to connect with the Third Eye Health team, email hello@thirdeyehealth.net

Third Eye Health provides world-class virtual urgent and emergent care in post-acute care settings. They extend bedside care beyond the physical walls of the skilled nursing facility, connecting patients with a medical team specializing in acute-level care. Through accessible, integrated technology, nurses immediately connect to board certified physicians with the simple touch of a button.

Healthbox, a HIMSS Solution and healthcare advisory firm, drives innovation from the inside and out, helping organizations build internal innovation programs, assess the potential of employee-led projects, and look to the market to find solutions to implement or invest in.

Leveraging Telehealth to Improve the Future of Facility-Based Care

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