The Rita Langworthy Foundation Board of Directors, with input from the Advisory Board, unanimously voted to award a $5000 grant to St. Mary’s Healthcare System for Children. The grant will be used to support telehealth services to medically complex, economically disadvantaged children in New York who are at a high risk of further health complications.
St. Mary’s Healthcare System for Children’s mission is to improve the health and quality of life of children with special needs and their families. Established nearly 150 years ago as New York City’s first children’s hospital, St. Mary’s has since evolved into a robust continuum of care that serves medically fragile children in inpatient, community and home care settings.
Each year, our healthcare system provides intensive rehabilitation, specialized care and education to thousands of children, of all ages, and of diverse cultural, economic, and religious backgrounds, and regardless of a family’s ability to pay. With our beneficial programs and our dedicated team of physicians, skilled nurses, therapists, nutritionists, social workers and many other trained pediatric specialists, St. Mary’s helps kids with special needs achieve a better quality of life.
Ongoing advances in medicine, technology, and training are helping children live with illness and injury previously thought to be impossible to survive. These advances have helped to create an emerging population of children with medically complex conditions who require ongoing specialized care and rehabilitation throughout their lives. As the number of children with special needs continues to grow, so too does the need for the services provided by St. Mary’s Healthcare System for Children.
St. Mary’s provides much-needed services that are unique to our region. Our 103-bed pediatric inpatient facility is New York City’s only rehabilitation hospital for children, and our Certified Home Health Agency (CHHA) is the only Special Needs CHHA of its kind in New York City, specializing in pediatric healthcare services for medically complex children.
As a vital safety net provider in New York City, St. Mary’s provides care to some of the city’s most economically disadvantaged families. A majority of our patients live in impoverished households, as evidenced by a 97% enrollment in Medicaid.
St. Mary’s Healthcare System for Children’s current programs includes a broad array of specialized services for medically complex children, including skilled nursing, physical therapy, occupational therapy, speech therapy, medical social services, nutritional services, and telehealth services. Additionally, we provide the kids in our care with enriching and educational activities that further contribute to their health and well-being, such as art therapy, music therapy, animal-assisted therapy, an early education center, and our new “Toddler Story Time” literacy program.
In New York, when children with special needs are ready to be discharged from intensive care facilities like New York-Presbyterian Morgan Stanley Children’s Hospital or Steven & Alexandra Cohen Children’s Medical Center, physicians and families often turn to St. Mary’s Healthcare System Children for further support. We differ from those other agencies, in that we are the only post-acute children’s hospital in New York City, specializing in getting children with medically complex conditions safely back home and keeping them healthy once they’re there.
The Telehealth Program is essential to getting children with special needs transitioned back to their homes and keeping them healthy once they get there. Using advanced telehealth technology, the program provides preventative care to medically fragile children who are living in a home setting, ensuring that the child’s health is being maintained outside of a hospital setting. Through regularly scheduled automated calls to the patient’s family (in conjunction with regularly scheduled home visits), our team of pediatric specialists remotely monitors changes in the child’s clinical status and medication adherence – allowing our team to identify potential health complications and intervene before the problems escalate to ER visits or hospitalizations.
The population served by St. Mary’s Telehealth Program includes children of all ages who have serious and potentially life-limiting medical conditions, including but not limited to Asthma, Diabetes, HIV/AIDS, Seizure Disorder, Hydrocephalus and Cerebral Palsy.
The objectives of St. Mary’s Telehealth Program are: to provide preventative care to children with special needs that will decrease the risk of ER visits and avoidable re-hospitalizations; increase medication adherence; and increase patient/family satisfaction – via the use of telehealth technology that provides remote patient monitoring to medically fragile children who are living in a home setting with their family. This technology enables clinicians to identify children who need care between visits and to quickly intervene before an issue develops into a major health concern.
Through regularly scheduled automated calls, St. Mary’s Telehealth Program monitors changes in a child’s clinical status, medication adherence and identifies potentially adverse events before they escalate to ER visits or hospitalizations.
Our Telehealth Program involves the use of an Interactive Voice Response System (IVR). Automated IVR calls will request very basic information from the children’s parents/caregivers. Calls will solicit yes or no responses from parents/caregivers who are asked a series of questions on their child’s medication adherence, occurrences of major medical events, and changes in condition. Responses to these automated calls take 2-3 minutes to gather.
Based on these calls, reports will be generated automatically, flagging responses that indicate the need for follow-up. RN Telehealth Nurse Managers will monitor alerts and make follow-up calls to further assess flagged calls. If an urgent need is identified, our Telehealth Nurse Manager will coordinate with the child’s assigned home care nurse to make a follow-up visit, thus facilitating a preventative intervention days and maybe even weeks earlier than previously possible. This technology enables our clinicians to identify children who need care between visits and to quickly intervene before an issue develops into a major health concern.
St. Mary’s is uniquely qualified to deliver these telehealth services to children in the New York City area, as we are the only special needs Certified Home Health Agency (CHHA) in New York City specifically devoted to the care of children with special needs. We are well-positioned to deploy telehealth preventative care support that will reduce avoidable hospitalizations and avoidable ER visits for these at-risk children.
St. Mary’s home care division is staffed with 96 full-time employees, 90 part-time employees, and 15 per diem employees. This includes a broad array of pediatric healthcare specialists comprised of skilled registered nurses (RNs), therapists, social workers, care coordinators, nutritionists, and managed care liaisons, who collectively provide interdisciplinary, specialized home health care services to children and young adults with medically complex conditions and special needs.
St. Mary’s Telehealth Program was implemented in 2014, and is continuing on an ongoing basis.
A core belief of our organization is that home is generally the most ideal setting to provide health care to a sick child. It contributes to the health and well-being of a child to be in their familiar home setting and with their family instead of an institutionalized setting such as an inpatient facility. In the less restrictive home setting, a child with a special need is able to embark on a richer life filled with family support, education, recreation, and long-term rehabilitation and care. As such, St. Mary’s always strives to safely discharge our patients from our inpatient facility to a home care setting whenever it is possible to do so without compromising their quality of care.
Of all the services provided by St. Mary’s home care division, our Telehealth Program is inarguably one of the most essential components to reducing the risk of further health complications amongst medically complex children living at home. Telehealth helps to ensure that our dedicated team of pediatric specialists can remotely identify and prevent a health complication in a child before it becomes a reality.
St. Mary’s evaluates the success of our Telehealth Program by the improvements that occur within our patients’ individual rehabilitative and therapeutic goals. We are committed to rigorous data and outcome tracking. Our staff is trained to identify and document the notable improvements that occur as a result of our programs and services. Our telehealth program has had numerous positive outcomes for children with special needs and their families. Over the course of just one year, we found that the telehealth program resulted in a 39% reduction in hospitalizations (567 total enrolled patients). With substantial grant support in place, we expect to achieve similar or greater results over the period of the requested grant.