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Telemedicine Case Studies

Bon Secours Hampton Roads: Teleneurology Brings Better Outcomes, More Profitability

Like all health systems, Bon Secours Hampton Roads (BSHR) continually seeks ways to improve its competitive advantage. However, developing a growth and differentiation strategy is challenged by the fact that its southeastern Virginia and northeastern North Carolina catchment area is right in the backyard of a large, $3.5 billion, fully-integrated, non-profit health system.

BSHR’s flagship hospital, Bon Secours Maryview Medical Center, is a 346-bed acute care hospital located in Portsmouth, VA. It’s the largest hospital within the Bon Secours Hampton Roads health system, which also includes Bon Secours DePaul Medical Center, Bon Secours Health Center at Harbour View, Bon Secours Mary Immaculate Hospital and Bon Secours Health Center at Virginia Beach. With a patient population that suffers a high incidence of cerebrovascular disease, Maryview Medical Center was the best choice for initial rollout of a new neurosciences service line that the health system decided to launch. The first step: making Maryview a Joint Commission-certified primary stroke center.

Finding the Best Coverage Option

To obtain primary stroke certification, Maryview needed to provide 24/7/365 emergency neurology coverage. Although fortunate to have one local neurologist taking call, providing round-the-clock on-call coverage was becoming an overwhelming burden for one neurologist to sustain. Like many hospital administrators around the country, Smith found few local neurologists willing to take call. And those that did required that the hospital pay them $800 a day, or approximately $300,000 annually. This extra line item made the service line pro forma less compelling, especially in the start-up phase.

Looking at the traditional alternatives of recruiting neurologists or hiring locum tenens, Smith quickly dismissed the latter since it was not optimal. The recruitment process was not immediately fruitful either and Maryview required a minimum of one or two additional neurologists to provide 24/7 emergency neurology coverage to achieve primary stroke center certification. Conversely, while $300,000 for stroke stipends seemed exorbitant, locum tenens would actually have been more expensive and only a temporary solution, not the foundation of a new stroke center.

Selecting Teleneurology

Fortunately, another hospital in the Bon Secours network previously overcame these challenges as it sought stroke center certification. After extensive due diligence, Richmond Community Hospital (RCH) had selected the Specialists On Call teleneurology solution to solve its coverage challenges.

RCH reported that even in the first year, Specialists On Call decreased costs and improved care quality. Satisfaction among RCH physicians, staff, and patients was high. With a ringing endorsement from RCH, Maryview also implemented Specialists On Call’s emergency teleneurology consultation service.

Raising Care Quality, Creating a Bottom Line Impact

Before partnering with Specialists On Call, ambulance services handling stroke patients routinely bypassed Maryview. Since implementation, the hospital’s stroke volume has steadily increased. Within the first 12 months of go-live, Maryview experienced numerous benefits, including the following:
  • 39 percent growth in admissions
  • $486,000 increase in contribution profit—not factoring any cost savings from the elimination of $300,000 annual stipends
  • 0.5 day decrease in the average length of stroke patient stay
  • $200-plus decline in cost per case
  • More than triple the number of cases in which tPA was administered

Setting the Stage for Future Growth

When using the teleneurology service, the hospital’s emergency department physicians are now guaranteed a 15-minute response by Specialists On Call’s top-quality neurologists. Patients and staff alike appreciate their quick response, evidence-based treatment recommendations and quality service.

Maryview’s hospitalists no longer need to cover the ED for neurology patients, and they can contact Specialists On Call with any followup questions. Local neurologists, too, are relieved of the disruption of emergency calls, which gave Maryview the ability to more easily recruit and employ three additional neurologists to support the growth in
the neuroscience program. 

Within the first year of partnership, Specialists On Call helped the stroke program at Maryview grow volume and profit by 35 to 40 percent, along with an across-the-board improvement in quality outcomes.

“Specialists On Call delivered on everything I expected. And the physicians feel that way too, which is even better yet,” explains Smith. “We were a little concerned about patient perception, but it turns out they love it! It’s new and modern healthcare.”

As a result of the benefits Specialists On Call has brought to Maryview, Smith is now implementing the service in other BSHR facilities.

For more information about this case study, please contact:
Kathleen M. Plath, SVP, Sales and Marketing, Specialists On Call; 866-805-1513,