Supporting the Health of the Fargo Community with Telehealth

July 29, 2021

Prior to the pandemic, telehealth capabilities were uncommon for many medical practices, especially nonprofit community health centers. The reliance on providing in person, face-to-face medical and dental care was prevalent. Family HealthCare (FHC), our 2020 Resourcefullness Award winner in North Dakota, developed a sustainable, revenue-generating initiative which allowed them to quickly adapt to the new COVID restrictions in order to safely care for their patients remotely.

About Family HealthCare

Family HealthCare is a Fargo, North Dakota clinic that provides affordable, quality healthcare for all patients, even if they don’t have insurance or ability to pay. At FHC, medical and dental care is accessible to anyone who needs it. They treat a diverse population of people, and every patient is treated with respect and dignity.

The professionals at FHC recognize the importance of preventive medicine, early intervention and management of disease. Improving overall community health is extremely important to FHC. Providing preventive medicine and the consistent management of disease for the most vulnerable in the community—those with low incomes and diverse cultures—helps minimize unnecessary hospitalizations, emergency room trips and complications from untreated health problems.

Services offered at FHC include onsite dental care, labs, x-rays, radiology, behavior health assessments, vision care, physical therapy and a full-service pharmacy. They also help patients better manage chronic health conditions, such as diabetes and heart disease.

"The safety of Family HealthCare patients and staff is our number one priority. Telehealth has allowed us to limit exposure to COVID-19 while providing patients the care they need and deserve. Telehealth has also helped in reducing the "no-show" rate of our patients, allowing them to access the care they need and deserve without barriers such as unreliable transportation. Telemedicine makes it easier for people to access preventive care that will improve their long-term health. People who may not have sought medical care before will consider telehealth."

-Patrick Gulbranson, CEO, Family HealthCare

Campaign Initiative: “Overnight Pivot to Telehealth”

Family HealthCare’s Resourcefullness Award campaign initiative - “Overnight Pivot to Telehealth” - was developed in 2020. While telehealth is not new to the medical industry, it was completely new to FHC. They used their ingenuity and resources to implement telehealth services for their over 17,000 patients in less than 24 hours. The flexibility of adjusting to the rapid change of providing virtual patient care highlights the organization’s resilience and ability to adapt to change.

With the CDC guidance released in late March of 2020, FHC rapidly implemented emergency operating procedures to effectively achieve the objectives as set forth by the CDC. They focused their efforts on reducing transmission of the COVID-19 disease, providing access and directing patients to the appropriate level of care and decreasing the burden on the healthcare system.

Through this process, FHC made substantial changes to nearly all patient flow and clinical interaction processes. They undertook an immediate transformation from in-person patient care to the use of telehealth capabilities/systems/processes, from home office locations to the several clinics themselves. They invested in the necessary tech equipment and updated computer systems, and healthcare providers were set up to work from home.

In coordination with the two large health systems in the community, FHC closed down all scheduled, elective and non-urgent medical and dental care. As a result, FHC saw a drastic reduction in medical and dental visits and a corresponding loss of revenue, with dental seeing a 60% visit reduction and medical visits reduced by 40%. This difficult decision was made in order to “bend the curve” and protect the critical resources of the hospital systems for the surge of COVID-19 patients.

FHC’s migration to conduct telehealth appeared to be the only means of avoiding a financial disaster. With little or no available funding or technical telehealth capability, FHC undertook a clinic wide paradigm shift toward full telemedicine service. This shift, for a nonprofit community health center with little financial means, is organization-changing. This community health center was able to rally administrative staff, clinical teams and some generous community organizations to be able to ensure patient access during an unprecedented, challenging time. The fact that they were able to remain financially viable throughout is a testament to the creativity and perseverance of FHC and the generous individuals that support the organization.

Goals of the Revenue-Generating Initiative

FHC’s goals were to replace the lost in-person visit revenue by increasing revenue through a drastic increase in telehealth visits. Additionally, goals included restoring the in-person visit revenue to pre-COVID levels while increasing the volume of telehealth visits at the same time. At the outset of the COVID-19 pandemic, federal and state government directives were published to ensure healthcare systems’ capacities were adequate for diagnosis, treatment and monitoring of suspected and confirmed COVID-19-diagnosed patients.

FHC complied with those directives and intentionally discontinued in-person medical and dental visits as well as elective medical and dental treatment. With revenue substantially reduced and no financial reserves available, in order to deploy telehealth technology and continue to ensure patient access to their medical providers, FHC explored a number of no-cost/low cost solutions by cobbling together the necessary equipment to facilitate the video and telehealth capabilities. Administrative and clinical staff began using their own personal computers and equipment. In addition, an urgent request was sent to community stakeholders asking to borrow webcams and other necessary peripherals.

From March to August of 2020, FHC generated 6,246 telehealth visits, with an average reimbursement of $93 per visit. This resulted in an increase in gross revenue of $580,878 that would not have been realized had FHC not quickly and successfully implemented this shift to telehealth capabilities.

Lessons Learned from the 2020 Resourcefullness Awards

In a year full of disruption, nonprofits were forced to be agile, flexible and innovative. Despite all the complexities and obstacles, the nonprofit community learned how to better use technology and public generosity was more than ever. Watch our “Lessons Learned in Resourcefullness” webinar recording to learn how our award winners rose above the challenges.

Creativity and Sustainability

Implementing telehealth services to support patients in less than 24 hours was a remarkable feat in a high-pressure situation. FHC utilized creative problem solving that showcases the resourceful ingenuity of all staff as well as demonstrates the generosity of its community members.

As a result of the development of processes, procedures and capabilities of telehealth services, FHC intends to make this a permanent, alternative option for patients who have anxieties about returning to a physical healthcare facility, or for those who simply feel that telehealth offers a more convenient option.

The organization intends to make further investments into expanded telehealth capabilities, such as monitoring of patient vitals and treatment compliance through wearable technologies, etc. They believe that the future will be significantly different in how medical and dental services are delivered going forward.

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