SNF Spotlight

The Evolution of TeleHealth

These days, the words social distance, quarantine, and telehealth are a new addition to our daily vocabulary. For Mordy Eisenberg, he has been using telehealth for much longer. 

Mordy Eisenberg, NHA, is the co-founder and Chief Operating Officer ofTapestryHealth, a full-service medical provider for nursing homes. TapestryHealth started out specifically servicing very small and remote nursing facilities across the country by providing them with remote access to nurse practitioner services. 

In the last three years, though, that model has evolved. Eisenberg says, “We now include the entire spectrum of 24/7 care for nursing homes, and that would include everything from medical directors on down through specialty services, including psychiatric care.” 

Their services include on-site care as well. Depending on a facility’s needs, TapestryHealth will serve them remotely, in person, or in a hybrid combination. 

“It’s really a full service, medical infrastructure that we can bring to skilled nursing facilities, no matter where they are. Whether they’re small, remote, rural, or a large urban building, we really fill gaps in care or services to be that kind of one-stop-shop for medical providers,” says Eisenberg. 

Telehealth Before COVID-19
When Dr. David Chess, president and CMO, and Eisenberg founded the company, at a time when a third of the country’s nursing homes were eligible for telemedicine payment. However, they didn’t have this kind of physician services. “There was a tremendous need for physician services. These were buildings that had a doctor come in once a week or sometimes once a month and nothing else in between,” says Eisenberg. “And then also there was a payer for it. Medicare was paying for telemedicine services in those buildings.” 

Eisenberg says their initial model was to offer each facility consistent access to a nurse practitioner, who could be available virtually, especially to rural facilities. 

Then, the company began growing and implementing their hybrid model of today. Eisenberg says, “It was always virtual, and then as we started growing and realizing there were some buildings that were larger. Plus, we partnered with small rural buildings. Telemedicine wasn’t reimbursed in all those markets, but they wanted our services. We then put the NPs physically in the building during the day, but then we’re able to wrap around telemedicine at night, so that way they truly have a 24-hour coverage model.” 

Having the virtual and remote option with the NP dedicated to specific buildings gives this model continuity. The nurse practitioner gets to know the residents and is an integral part of those buildings. 

“Our only agenda has been completely in line with what the facility needs. You’re trying to fill beds and take care of patients? Take whoever you want. We’ll see whoever you feel comfortable seeing, and we’ll take care of them, so that’s kind of how that ended up evolving where we are now. We named the company Tapestry because it really is a safety net around the patient by being able to provide that tapestry of care,” says Eisenberg. 

Telehealth During the Pandemic
Although TapestryHealth has been using a remote option for years, COVID has enabled the company to expand services even more. “Unfortunately, the word telehealth is kind of thrown about, and people think of telehealth as a service. Telehealth is not a service. Telehealth is a delivery method, and that’s what we see it as, and that’s what we’ve always seen it as. For us, telehealth is kind of just how you can get services somewhere that you otherwise couldn’t,” says Eisenberg. 

He continues, “We’ve obviously been doing this for far before the pandemic started, but, it definitely allowed us to kind of step up our game for facilities where maybe we were there in person, and now because of the pandemic, we couldn’t be there. For example, we had some facilities where we had an onsite or a physical nurse practitioner based in the building, and now that NP either contracted COVID herself or the facility wasn’t so keen on bringing in outside staff. We were able to quickly transition her to telemedicine.” 

TapestryHealth employs medical directors and physicians as well. Eisenberg shares, “We have one physician who sees patients in multiple buildings. We really didn’t want those people going from building to building because of the possibility of infection, and so we were able to transition a lot of that to virtual care.” 

To help lessen the spread of infection at facilities that have a COVID unit, Eisenberg says,” We were able to step up with the virtual clinicians and take on that care. All of this can only be enabled by telemedicine. It’s a huge component of the way we see healthcare evolving in this space.” 

Changing Strategies
The pandemic has changed many aspects of healthcare. Eisenberg says, “First, it’s kind of moved telemedicine as a delivery method, or even as a service from a luxury to a necessity. You really need to offer this now and have somebody that’s available to deliver services over telemedicine.” 

Telemedicine provides new opportunities to support seniors. “The skilled nursing facility of today is the community hospital of yesterday, and the assisted living of today is the skilled nursing facility of yesterday. Everybody’s been moving up that ladder,” says Eisenberg. 

With the way things have been changing, Eisenberg says, “We’re now able to offer services in assisted living facilities, which is extremely important. They’ve never had the ability to have that. Now because we’re able to do some of these things via telemedicine and get reimbursed for it, we can essentially bring the same services that we had in skilled nursing into the assisted living facilities. They absolutely need these services.” 

These changes are a major contributor to bringing meaningful, lasting change to the industry. “Skilled nursing’s goal is to keep people out of the hospital. You go down the chain to the assisted living, and their goal is to keep people out of skilled nursing. The longer you can treat people on site, and the longer you can keep people in whatever setting they’re in, the better it is both financially for the operator and from a patient outcome perspective,” says Eisenberg. 

Patient-Centered and Proactive Care
Facilities benefit greatly from the services provided by TapestryHealth. Eisenberg says, “It becomes a selling point for the facilities where first, they’re selling to their local hospitals and sending the message that they can take a much higher acute patient than ever before because we now have round the clock support by a clinician.” 

Patients benefit the most from the model that allows for more time with a provider. Eisenberg says, “From a patient perspective, we spend a lot of time with families and in the room with the patient.” 

It’s an approach that is patient-centered and proactive, as well as data-driven. “We have a number of tools that share daily clinical reports that we run, including remote patient monitoring and transitional care. There’s a bunch of things that we do to identify when people are getting sick or to get ahead of the curve. We’re looking for patients that are having signs and symptoms of something that is brewing, so that doesn’t become a three o’clock in the morning call three days from now. That’s a very fundamental difference for us than some of the others,” Eisenberg says. 

The service that TapestryHealth provides is invaluable, especially now. They are bringing a level of care for their buildings that sets them apart. Their innovation in telehealth has undoubtedly been a huge asset before, during, and certainly will continue long after the pandemic. 

 

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