Outcomes of a military regional multispecialty synchronous telehealth platform and the importance of the dedicated patient presenter.

Implementing a successful multispecialty synchronous telehealth program requires identifying and overcoming numerous barriers. One key aspect of synchronous telehealth involves the telehealth presenter; however, the impact that a dedicated patient presenter has supporting routine multispecialty synchronous telehealth is unknown.

Methods: We conducted a retrospective review of telehealth encounters conducted from a single regional medical center over a two-year period to 12 outlying health clinics which provided one of 3 levels of patient presenter support: category 1 locations had a dedicated telehealth registered nurse, category 2 locations had a nondedicated registered nurse or licensed vocational nurse, and category 3 locations were supported by an Army medic (military occupational specialty 68W).

Results: A total of 4,032 telehealth encounters occurred from January 2014 to December 2015 involving 26 distinct specialties located within a single regional medical center and 12 outlying health clinics which supported 60,232 beneficiaries. The 3 category 1 locations (3/12, 25%) supported the most telehealth encounters per month compared to either category 2 or category 3 locations (P<.0001). Category 1 and category 2 locations averaged a 239% and 122% year-to-year growth, respectively. Category 3 locations averaged a year-to-year decline of 11.7%.

Comment: This is the first study of which we are aware that has compared different patient presenter levels and evaluated its effect on telehealth activity. Regional medical centers initiating a multispecialty synchronous telehealth program should strongly consider hiring, educating, and placing dedicated presenters at patient originating sites.