Evaluation of a Virtual-Only Program for Specialty Care

Transforming Specialty Care: Evaluation of a Virtual-Only Program Cortney Belton, MBA, BSN, RN Medical University of South Carolina

Medical University of South Carolina (MUSC) Source: Medical University of South Carolina , web.musc.edu, accessed 4/10/25

Our History Telehealth for efficient, effective care MUSC Center for Telehealth Center of Excellence State of South Carolina telehealth investment. MUSC Center for Telehealth founded Designated by Health Resources & Services Administration (HRSA) as a national Telehealth Center of Excellence 2002- 2009 Healthcare Redesign Integration of telehealth into existing healthcare delivery models and culture 2020 2014 2013 2023 2017 Early Years Telehealth Expansion Explosive growth of telehealth in ambulatory space due to COVID-19 SCTA Founded Telestroke, TeleICU, TelePsych, Maternal Fetal Telemedicine South Carolina Telehealth Alliance founded. Headquartered at MUSC

Background Problem: Patients in South Carolina Patients often have difficulty accessing in- person care, which results in delays and poor health outcomes Context: In South Carolina has 41 of 46 counties are designated as Health Professional Shortage Areas (HPSAs), leading to delays in accessing in- person care. Solution: A Virtual Specialty Service Line was developed to increase access to specialty providers, reduce wait times, and improve patient outcomes

Background Program Features: 100% virtual care for high-demand, low access specialties Dedicated clinical support team to enhance pre and post visit experience Coordinated local referrals for lab work, imaging, and pharmaceuticals Goals: Reduce wait times for specialty care Increase access to care in rural and underserved areas Successfully recruit specialists for our growing system and state needs

Methods We employed the RE-AIM framework to assess key program elements and outcomes. RE-AIM is a popular framework for guiding evaluations, RE-AIM enhances the sustainable adoption and implementation of interventions and services. We selected outcomes in the following RE-AIM dimensions Reach: the number of participants & their characteristics Effectiveness: impact of the program Adoption: the providers and service lines who adopt the program Implementation: consistency and adaptions made to the program Maintenance/sustainment: extent the program becomes routine and institutionalized Data: EPIC electronic medical record data and Andor telehealth virtual visit platform data Methods: Data are aggregated and trended over time Business intelligence dashboards are also used to enable leadership real-time access to key metrics by provider, program and compare new vs. returning patient types Source: https://re-aim.org/learn/what-is-re-aim/

Results Reach As of Jan 2025, Virtual Specialty has completed over 21,350 visits Caring for over 10,170 unique patients Effectiveness 2024 Average new appointment within 7 days: 45.8% 2024 New visit appointment wait times: Family Medicine 3 days Rheumatology 6.9 days Hematology/Oncology 10.6 days Endocrinology 21.6 days Patient experience ratings are consistently higher compared to hybrid in-person/virtual care.

Results Adoption Sleep Medicine is consistently the highest volume service each month, followed by Rheumatology Implementation Additional providers are added per specialty based on access metrics. Additional specialties are added based on system access needs.

Results Virtual Specialty patients are spread across the state, saving considerable time and travel costs Returning patients made up 58% of visits Support team navigates patient needs for ancillary services close to the patient s home

Conclusions Access & Integration: Regulatory Barriers: Patient Impact: Program Growth: Early results show- Increased access to timely care Improved patient experience Lower no-show rates than national benchmarks Establishing a highly accessible digital front door remains a challenge, when integrating Electronic Health Record (EHR) tools. South Carolina regulations on Schedule II & III medication prescribing limit care options. Geographic requirement for overseeing physicians regarding APPs Continued expansion will involve innovative partnerships, cross-specialty collaboration, and coordination with trusted affiliates.

References and Special Thanks The Team- Robert Borowski, DO, Marjorie Paul, NP, Haley Walter, MD, Sallie Giblin, DO, Nicole Houde, PA, Daniel Landau, MD, Thomas Schriefer, MD, Marri Horvat, MD, Abigail Dy, MD, Hina Chaudhry, MD, Jessica Brown, PA, Janee Carter, FNP, Mary Sue Brewton, DO, Mellissa Sargent, RN, Sonja Muckenfuss, RN, Katie Hurley, RN, Rebecca James, LPN, Donna Rosado, Shakeia James. References- HRSA. (2025). Find Shortage Areas. Retrieved from https://data.hrsa.gov/tools/shortage-area RE-AIM. (2025). What is RE-AIM. Retrieved from: https://re-aim.org/ SolutionReach (2025). Which wins? The national average No-Show rate or yours? Retrieved from: https://www.solutionreach.com/blog/which-wins-the-national-average-no-show-rate-or- yours-1

THANK YOU! browcort@musc.edu