Lāna’i Community Health Center (LCHC) has one of the largest telehealth programs in Hawaii. We provide tele-ophthalmology (DM retinal imaging), tele-derm and tele-ultrasound (OB and abdominal) using technology. Tele-echocardiology will begin shortly.
LCHC has a ZOOM license and provides tele-psychiatry and tele-consultation for other specialists including post-op care. Users are only required to have communication technology with a camera. LCHC has been instrumental in introducing multiple providers to their first telehealth experience. All consultations are billable at the same rate as a face-to-face visit, as per Hawaii State law, which means no lost revenue to the providers.
LCHC utilizes an ongoing contract with UH Department of Psychiatry to provide behavioral health integration (BHI) with SBIRT. LCHC’s full-time psychologist supports this program, and as the island has limited behavioral health services, LCHC provides care to Straub Lāna’i Family Health Center patients, as well as LCHC patients.
Our home BP monitoring program is now 2 ½ years old, one of few mature programs in the country. For both hypertension and diabetes, LCHC is migrating patients to off-the-shelf Bluetooth-enabled CVS BP cuffs and One Touch Glucose meters. Our cloud based care management system allows integration with our EHR data and access to the care plan for our pharmacist partners. LCHC Community Health Workers (CHW) provide community-based self-management support and care coordination.
LCHC provides prenatal care including ultrasound and non-stress testing, using ‘store and forward’ technology. We coordinate high risk patients with providers on Oahu and Maui.
Our use of telehealth technology has generated local and national recognition:
- LCHC is a site for the CMS CVD Risk Reduction Model Research in the intervention arm (https://innovation.cms.gov/initiatives/Million-Hearts-CVDRRM/). The program is one of the alternative payment models for CMS and we are able to use the resource to reduce CVD risk for all of our patients over 40, but only report those that have Medicare and meet study criteria. The program is built into our chronic care program. LCHC is the only site in Hawaii.
- LCHC is participating in the Hawaii DOH 1422 CDC grant focused on prediabetes and hypertension. This past year we increased the number of patient managed for hypertension by 43%. And, included is a pilot telehealth program with ABCDiabetes, an East coast certified diabetes education center, coupling diabetes education and our CHW.