How Northern Light Health is using hybrid care to improve access

Enhancing health equity and accessibility

Northern Light Health (NLH) is Maine’s only integrated health system, consisting of 10 hospitals, over 10,000 staff, eight nursing homes, 37 primary care locations, and five emergency transport centers. NLH averages 2.47 million outpatient visits, 129,000 emergency room visits, over 140,000 home and hospice visits, and over 290,000 virtual visits annually.  

The health system’s journey into hybrid care was limited before the pandemic, encompassing programs in tele-stroke, virtual urgent care for employees, and behavioral health. Once the pandemic hit, NLH launched a standalone virtual care solution at scale, but overtime recognized the need for a comprehensive platform that could integrate with its other infrastructure and digital systems and provide a more strategic, streamlined partnership to meet growing hybrid care needs.  

Acknowledging hybrid care as a key driver for patient access and care delivery, NLH launched a strategic partnership with Amwell in 2021, integrating hybrid care directly within its EHR to better serve its patients.  

Challenges 

More than 60% of Maine’s population lives in rural areas, and many of these areas have limited broadband and internet access. In fact, 85,000 homes in Maine are without high-speed internet.  

“Poor broadband quality due to lack of affordable access has been a major issue with my ability to see pediatric cystic fibrosis patients. Rural lack of quality broadband, often paired with socioeconomic factors, leads to an inability to participate in remote visits. Many attempt to participate on phones instead, bypassing the need for broadband. This leads to poor quality images, excessive movement, frequent breaking up or delay in transmission, and interruptions or dropped transmissions when calls come in.” 

^{Dr. K Suchari Rutledge, Pediatric Physician, Northern Light Health} 

In addition to poor broadband and connectivity concerns, many patients lack access to reliable technology, have low technological literacy rates, and must drive significant distances to receive care in person, often through mountainous terrain.  

The limited number of providers available to serve patients, especially for more specialty concerns, is a significant challenge in Maine, so NLH needed a partner that could help improve staffing challenges and allow clinicians time to focus on the most critical, in-person care needs. NLH also needed a reliable hybrid care platform that would improve virtual care experiences for patients and providers and align to their strategic goals and growth needs.  

Strategy and solution 

Beginning in 2021, NLH partnered with Amwell to launch an on-demand virtual urgent care solution integrated within its Oracle Health EHR, giving existing and new patients a digital front door for remote access to care. With no other health systems in Maine providing an offering like this at that time, NLH stood out as an early innovator and driver of virtual care access, particularly to rural communities.  

In the fall of 2022, NLH expanded to scheduled virtual visits, and embedded these workflows directly into the EHR for patients and providers. This increased opportunities for care, enabling patients to remain more engaged in their health and optimizing the experience for patients and providers. Patients can easily access visits from their health system patient portal, with no other downloads, logins, or passwords needed. Providers can join a visit with a single click within the EHR without losing access to important patient records.  

In addition to these outpatient programs, NLH utilizes Amwell Carepoint® carts to enable provider-to-provider synchronous consultations in inpatient settings. These remote consults allow patients to stay in local communities to receive care, reducing costly transfer rates, protecting limited bed availability at their tertiary care centers and increasing financial stability to the local hospitals. This program also helps keep beds open at NLH’s largest medical center for the most critical patients.  

Outcomes 

By partnering with Amwell, Northern Light Health has better met patient care needs in inpatient and outpatient settings and allowed more patients to receive the care they need with less travel time and fewer medical transfers. Through the partnership, NLH has seen: 

• Over 351,000 receive care virtually 
• 600 clinicians adopt the technology 
• 90% patient and provider satisfaction rates 

NLH’s hybrid care strategy has been crucial to its ability to enhance health equity and expand access to care, especially to rural populations. Virtual care now accounts for 10-12% of all scheduled visits at the health system with an average 90% patient satisfaction rate, and more than 600 clinicians have adopted the technology with a 90% satisfaction rate.  

“I was impressed with how seamless the process was and how easy it integrated with the patient chart. So far, the audio and video have been great. I’m relieved the transition has been so smooth.” 

^{Dr. Kris O’Connell, DO Family Medicine Physician, Northern Light Health} 

Since moving to the Converge platform, NLH has given more than 351,000 patients access to virtual care, averaging over 14,000 scheduled visits per quarter, which has helped avoid extended wait times in brick-and-mortar settings.  

For their inpatient consults, the system averaged over 125 consults a month in 2023 for its tele-ICU program. NLH has served over 400 patients with its tele-stroke program, helping over 330 of those patients to remain at their local hospital rather than be transferred.  

Looking to the future, NLH is launching more hybrid care programs focused on orthopedics, NICU, palliative care, and infectious diseases. Recognizing the critical position the system holds in advancing health equity and breaking down barriers to care access, they are dedicated to making healthcare more accessible and straightforward and improving the health of the people and communities they serve.