According to Rogove, "in order for the implementation to be successful, you need buy-in at the highest executive level." In the case of this hospital, there was a growing need for the hospital to become a comprehensive stroke center, which in turn would increase patient revenue. Hospital leadership (physician, nursing and administrative) realized that the diversion of stroke patients by the County EMS system, which also required a hospital stroke designation, would not be consistent with the hospital's goal and would result in patient loss.
Identifying the opinion leaders and change agents and involving them in planning is important. In this case, the strongest opinion leader turned out to be the hospital CEO, who understood the value of the program to patient care and physician buy-in.
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Resistance to change and the fear of losing patients did exist among local neurologists in the beginning, but they soon understood that the telemedicine program served as a partner for providing emergency care to their patients. The remote team of physicians was available to see their patients in emergencies or when they couldn't break away from their office practice or get to the hospital.
Motivation from the external organizations also proved helpful. In this case the American Stroke Association's quality metrics and the Joint Commission's performance measure reporting and feedback mechanisms helped gain physician compliance.
About the C3O Medical Group:
C3O Medical Group provides virtual care solutions using telemedicine technologies and assists hospitals, clinics and other providers with the development of their telehealth program and network. This virtual medical group is lead by Herb Rogove, DO, FCCM, FACP, President and CEO, who has developed multiple ICU, Hospitalist, and Emergency Medicine programs.
About the American Telemedicine Association 2011 Annual Meeting: The ATA Annual Meeting is the largest international meeting and tradeshow focusing exclusively on telemedicine, telehealth and remote medical technologies. It is the premier educational and networking event for individuals involved in health technology and remote medical services and anyone using telecommunications solutions for healthcare. ATA 2011 is the world's largest gathering of telehealth professionals--over 4000 researchers, clinicians, administrators, technicians and entrepreneurs, all focused on the development of telemedicine.
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