Telemedicine at the Ready: Scaling Technology and Training to Meet Systemwide Needs

By: Alex Nixon and Teagan K. Maguire

Due to COVID-19, analysts at Forrester Research revised their predictions for 2020 virtual care in April, suggesting virtual health care interactions are now on pace to top 1 billion by the end of the year. Another research group recently released data showing telehealth visits surged by 50% in March 2020 alone.

UPMC, which has experienced a similarly dramatic increase in the utilization of its telehealth technology, was prepared for the surge. Last year, UPMC expanded its telemedicine capabilities to surgeons and other clinicians who perform medical procedures. And this year, UPMC quickly provided telemedicine capabilities to the vast majority of its primary care physicians. These strategic decisions prepared the system for a rapid escalation of telemedicine, which has enabled UPMC to continue to provide quality care, safely, during the pandemic.

A Strong Network
Even with a strong foundation, various departments and teams across the health system quickly responded by getting devices, applications and training in place. Yet, one important aspect of the equation needed to make the technology work, UPMC’s network infrastructure, was already equipped. It has been the recipient of significant investment in recent years as UPMC has grown.

“We were ready,” said Chris Carmody, senior vice president, UPMC Information Services Division (ISD). “Our network wasn’t specifically designed to deal with a pandemic, but we did intentionally configure and build it to be scalable, flexible, resilient and secure, as UPMC has adopted more and more technology into the daily care of patients and Health Plan members. We have always viewed telemedicine as a strategic part of the future of health care.”

To respond to the sudden demand for telehealth services, UPMC expanded its capacity for video visits. As of early April, the system could run up to 700 video visits simultaneously, and plans are in the works to build upon that even further.

While many outpatient providers already had the equipment and training necessary to perform telemedicine, workflows and training guidelines were created to expand inpatient rounding and consults. ISD ordered and deployed 800 additional laptops to clinicians to support video visits, and UPMC’s revenue cycle, legal and compliance teams also were integral to handling the rapid scaling.

“Telehealth at UPMC could not have scaled as rapidly as it did without the support of many employees from across the health system,” said Carla Dehmer, UPMC’s director of telemedicine. “I am honored to work at an organization that was able to react and expand so rapidly because everyone jumped in to help. And everyone did it in a kind, respectful and thoughtful way.”

The Work from Home Shift
In addition to accommodating telemedicine, UPMC’s network simultaneously needed to handle an influx of staff working from home and signing on to the network to access email, files and applications. Previous investments in a new data center, cloud computing, cybersecurity and other capabilities helped employees and clinicians continue to support patients in an unprecedented situation, when staff and patient safety were paramount.

With four internet service providers each serving UPMC with 10 GB of bandwidth per second, the system was able to accommodate a record 76,000 remote users on the network in a single day in March, Carmody added. “The most I’d ever seen at one time before that was 10,000.”

This is the second article in a four-part series about the impact of telemedicine at UPMC during the COVID-19 pandemic. Click here to read the first story and check back each Friday for the upcoming installments.