New telehealth chief uses expertise to address health issues
Published on Tuesday, September 8, 2020
By: Ruth Cummins
Dr. Saurabh Chandra remembers well when COVID-19 arrived in the intensive care unit at Northwell Health, with 23 hospitals New York’s largest health system.
“My boss sent me a text that said, ‘Saurabh, your first patient is here,’” said Chandra, a board-certified critical care physician and until recently Northwell’s telehealth program medical director. “At the time, we weren’t at all expecting what was about to unravel over the next few days and weeks.”
Thus began a day-to-day relationship with a worldwide pandemic, and inspired thinking that Chandra will use in his new role as telehealth chief of the Center for Telehealth at the University of Mississippi Medical Center.
“We went from one patient to thousands of patients in the Northwell health system, and a lot of them were in critical care,” Chandra said. “If I remember correctly, we probably had the largest cohort of patients with COVID-19 seen by a health care system in this country, and probably in the world.”
The swift surge of patients in the fast-growing pandemic was overwhelming for the critical care world. It called for creative solutions. Chandra devoted himself exclusively to increasing availability of critical care by using telehealth innovation.
“We placed mobile (telehealth) carts in the ICUs and the units that were now housing critical care patients – the PACU, the ED holding areas,” Chandra said. “The mobile carts supported non-critical care trained providers who had been rapidly deployed to take care of patients with COVID. We set up an external collaboration with a health system in Seattle and tapped into their bandwidth so that their providers could help give care in our ICUs and the new units we set up.”
Northwell telehealth nurses trained in critical care rallied around stressed nurses in the ICUs, plus nurses with little critical care experience pulled in for bedside COVID care. “They helped reduce exposure risk for the nurses, helped them with documentation, and provided education on things like how to prone a patient with a bedside team,” Chandra. “They also gave them emotional support.
“It was an amazing experience to increase those capabilities in a very short period of time, and we did it uniquely.”
Chandra re-imagined the structure of Northwell’s telehealth program to save lives during a health crisis never before seen in modern medicine. That’s just one reason UMMC leaders sought him to lead the Center for Telehealth.
“Dr. Chandra brings a highly sought-after combination of experience that is directly relevant to the times we are living in,” said Dr. Alan Jones, assistant vice chancellor for clinical affairs. Jones served as the Center’s interim chief telehealth officer.
“In his previous institution, he championed the clinical development and successful implementation of various telemedicine programs for areas such as critical care, hospitalist service and stroke, to name a few,” Jones said. “When you couple Dr. Chandra’s innate passion for telehealth with the surge in demand for telehealth services brought on by COVID, then layer in a unique regulatory environment of loosened telehealth restrictions and increased funding sources, the opportunities are endless.”
When UMMC began its search for a chief telehealth officer, Jones said, “we knew candidates with demonstrated success in the clinical implementation of various telemedicine programs would offer the most desirable experience for the position.”
Chandra’s work at Northwell included leading the clinical implementation of the first tele-ICU program in that system, which expanded over five years to provide remote monitoring of more than 170 critical care beds at 10 sites, with plans to expand to 250-plus beds by year’s end. He led implementation of tele-stroke and tele-hospitalist programs in multiple Northwell hospitals, and also of a telehealth program providing physician coverage at skilled nursing facilities during off hours.
“Dr. Chandra not only possesses this unique experience, but is also a practicing clinician board certified in both internal and critical care medicine, two specialties with an abundance of telehealth opportunities,” Jones said. “We are very fortunate to have someone with Dr. Chandra’s skill set and caliber in this vital role at a crucial time for our institution.”
Chandra “brings us a new perspective that possibly we haven’t had before,” said Dr. Richard Summers, the Medical Center’s associate vice chancellor for research. “He brings that in a timely way.”
The critical care aspect of telemedicine “is probably one of our greatest needs during this pandemic,” Summers said. “We need someone who can reach out to rural areas of the state, because our critical care areas are full. Dr. Chandra can help us develop an infrastructure to allow us to engage hospitals across the state in taking care of their patients with COVID.”
It’s that opportunity, coupled with the desire to work with a nationally recognized telehealth program, that attracted Chandra to make the move down South.
“In the field, we know about the Centers for Excellence and how good the program is in Mississippi,” Chandra said. The Center for Telehealth in 2017 was designated one of two Telehealth Centers of Excellence by the federal Health Resources and Services Administration. Summers is principal investigator for the Center of Excellence, which received an initial $600,000 in funding, with the opportunity for an additional $1 million in grant funding per year for three years.
The Center for Telehealth serves thousands of patients annually, offering adult and pediatric care in multiple specialties, remote patient monitoring, telemergency services and urgent care. Since March, the Center and UMMC have joined the Mississippi State Department of Health in coordinating statewide COVID testing, with the Center screening those who seek testing and scheduling appointments at dozens of testing sites.
The Center has dramatically increased virtual visits during the pandemic using its UMMC 2 You platform, and in March alone, patients used it a total 4,723 times, a 286 percent increase over the 1,230 appointments in February 2020.
“UMMC is the only academic medical center in the state. You have a Center for Telehealth and a population lagging behind in health care,” Chandra said. “If I am truly passionate and believe in telehealth as a modality for health care delivery, this is the perfect place to demonstrate the value of telehealth.”
Chandra has four tenets that guide him: Deliver great clinical outcomes, do that at a reduced cost, enhance the patient experience, and enhance the provider experience. “I will be chasing those tenets vigorously,” he said. “But more than that, I see our Center for Telehealth aligned with the mission and vision of UMMC to deliver high quality patient care.
“The Center for Telehealth should drive programs that embed telehealth into the different schools here. We are nationally regarded as the creator of a telehealth center, and we should maintain that preeminent position.”
“We need someone who has a dedicated focus on telehealth every day that will help bring us to the next level,” Summers said. “Dr. Chandra is a very collaborative person, and as someone who works in telehealth to bring specialties together across institutions, that skills set will be particularly valuable.”
Chandra received his medical degree from MLN Medical College in Allahabad, India, and his Ph.D. from the Department of Life Sciences at Indiana State University. He completed an internal medicine residency at The Christ Hospital in Cincinnati and a fellowship in critical care medicine at the University of Pittsburgh Medical Center. He also was a research fellow at Cincinnati Children’s Hospital.
Jones and Summers “have given me a free hand to learn and to vigorously pursue ideas,” Chandra said. “In the last two weeks I’ve been here, I’ve had amazing support from all of the team members. I’m having a ball.”