Integrated Health System Adopts Telemedicine with High Patient Engagement & Satisfaction

September 9, 2020

When the rate of COVID-19 infections in New York started to skyrocket, Guthrie’s nursing homes, like many nursing homes across the country, were hit hard. Using a new tool they had come to rely on in the pandemic, the organization sprang into action.

“Very quickly we purchased additional Eko CORE stethoscopes, hooked them up to iPads, and created a workflow where our providers could take care of patients without having to go into the physical building,” said Alison Bidlack, IT Application Manager of Virtual Care at Guthrie. “We sent the digital stethoscopes to caretakers at the nursing home within 36 hours, set them up, instructed them, and they were ready to go, lock stock and barrel.”

David Hall, Associate Vice-President of Guthrie’s Operations & Virtual Care explained that partnering with Eko allowed them to respond to the pandemic with agility, speed and confidence.

“The organization was able to flex and pivot so quickly. Working with a partner like Eko, that could give us the tools we needed to ensure that we delivered safe, effective care to our patients quickly, was so important,” he said.


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Guthrie had explored telehealth options before the novel coronavirus reached pandemic proportions. The problem was the technology they encountered wasn’t mobile, wireless, or user friendly. Dr. Jagmeet Singh, Chief of Nephrology and physician lead for telemedicine at Guthrie, piloted each attempt to allow providers to see patients remotely.

Eko was the fourth solution we tried, and it has been a very good experience. I’m really impressed with the quality of auscultation sounds. And my efficiency in virtual exams is as good as in-person visits, Singh said, adding that he prefers the CORE digital stethoscope over his traditional stethoscope, even when he isn’t doing telemedicine.

The Missing Piece of the Puzzle


Many telehealth platforms are video only. While this allows patients to connect with a provider from the comfort of their own homes, it leaves out the physical examination. Other telehealth solutions rely on a nurse at a local clinic doing the physical exam while the provider watches remotely. In this model, providers must rely on what the nurse relays to them. Many, including Dr. Singh, feel that relying on second-hand information is a handicap. 

Before the CORE, I thought we were missing something,” said Singh. I need to listen to the patient’s heart and listen for crackles in the lungs. The CORE stethoscope completes the telehealth visit. It helps me make a clinical judgment. The patients were feeling it too,” added Singh.

Eko gives patients that faith, that trust in the provider, that they are checking their heart and lungs. Sometimes I share the screen so they can see their heartbeat. They are very impressed. Eko bridges the gap in a telemedicine visit.

Nurses perform telemedicine exams with Eko stethoscopes.
Nurse auscultates with Eko CORE Digital Stethoscope & iPad while Dr. Singh directs exam through videoconference.


Bidlack refers to Eko’s digital stethoscope and telehealth platform as “plug and play.” In other words, it’s a solution that works like a puzzle piece, fitting into an array of health care platforms with minimal setup and stress. 


“We had a situation where the provider couldn’t come into the office and was quarantined for 14 days,” recalled Bidlack. “We very quickly set up Eko for the office, where patients could still come in, use Eko for vital sounds, and stream it to the provider at home for those 14 days. We were able to set that up overnight because it’s a plug and play mobile device.”


Guthrie’s Great Virtual Migration


When COVID-19 hit the East Coast, it was uncomfortably close to home. Guthrie is an integrated health care system that operates five hospitals, 32 regional clinics, and several skilled nursing facilities in New York and Pennsylvania. The non-profit’s team of leaders was faced with a daunting task. How would they shift hundreds of providers into a new telehealth setting in the middle of a pandemic?

“When you’re doing up to 1.3 million outpatient visits a year, a pandemic could vastly impact our ability to continue care,” explained Hall, who is responsible for Guthrie’s Virtual Care Division. “We were able to shift about 400 providers in 10 days to a virtual environment. Out of those 400 providers, about 335 of them we would consider active within those first 10 days, seeing patients immediately.”

The “plug and play” nature of Eko’s platform helped Guthrie rise to the immense challenge. We wanted something simple for our nurses to use and we wanted providers to be able to click a link, hear vital sounds, and know what they’re doing. That’s what we got Bidlack said.

Organization was also key to the mass virtual migration. Ryan Hewitt, a leader on Guthrie’s telehealth team, described how easy it was to set up users through Eko’s online portal.

“The Eko portal made everything streamlined. Being able to bookmark the URL for each provider and show them how to get right to it, we were off and running. Being able to have that set up for them has been one of the easiest parts of transitioning to Eko,” Hewitt said.

Now, after recovering from the peak of the pandemic, Guthrie continues to rely on telemedicine for many visits, averaging anywhere from 150 to 200 patients per day. Before COVID, Guthrie was averaging only about 40 virtual visits per month.

“And now that we’ve shifted a large percentage of our practice to that virtual environment, we’re seeing the sustainability start to kick in. We’re seeing patients who really value the access and convenience of telehealth,” Hall shared.

Today, Guthrie is using Eko both inpatient and outpatient. Patients in nursing homes are being seen by providers remotely. And patients who visit primary care clinics in their home towns are being seen by specialists at Guthrie hospitals through telemedicine.

Dr. Singh has done about 400 nephrology telemedicine visits in the last six months. According to his estimates, 60-70% of his work can be handled through the technology. He too, recognizes how valuable that is.

“Some of my patients have to travel 90 miles just to spend ten minutes with me, so this is very good for them. I’m a big fan of telemedicine,” he said. “This is the future.”

Dr. Singh directs telehealth exam.
Dr. Singh is able to direct telehealth exam by speaking to nurse and patient through videoconference and listen to patient's heart through the CORE stethoscope.

Unexpected Insights


Millennials may have a tech-savvy reputation, but Guthrie’s move to virtual technology revealed an unexpected tension among younger clinicians.

When we first launched our ‘Guthrie Now’ telehealth platform, we thought our younger physicians would really buy into it and be able to pick it right up,” explained Hall. “But actually, they wanted nothing to do with it! It was our older physicians who had been practicing for twenty years and had seen certain symptoms a thousand times who had the confidence to diagnose through telemedicine.

That confidence gap between clinicians with varying levels of experience is something Eko has picked up on as well. It’s one of the reasons why Eko has developed ‘Eko AI’, artificial intelligence screening algorithms. The CORE and DUO stethoscopes can detect heart murmurs, and the DUO can also detect atrial fibrillation.

Another insight is that patient satisfaction with Guthrie’s model of telehealth is astronomically high. “In a survey of our patients who experienced telemedicine, more than 99.5% of our patients would recommend telemedicine to their family and friends. That is a huge quality indicator for us,” said Hall.

Eko is proud to partner with Guthrie. To learn more visit them at: www.guthrie.org

Interested in learning telehealth best practices from Guthrie? Register for our upcoming webinar here →

Want to learn how Eko partners with health systems like Guthrie? Visit the Eko Platform page to learn more.

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