New frontier: Telemedicine is here to stay

Photo by Tima Miroshnichenko:
Photo by Tima Miroshnichenko

If you need an indicator that health care at home is here to stay, look no further than Cole Nardi’s title: Director of Telemedicine at Rochester Regional Health.

Telemedicine – or telehealth – allows health care providers care for patients without an in-person office visit via technology tools like video visits.

The American Medical Association estimates that before the COVID-19 pandemic’s widespread arrival in March 2020. telehealth represented less than 1% of the total health care volume in the United States. In March 2022, 22% of Americans had utilized some type of telehealth services in the past four weeks, according to U.S. Census Bureau Household Pulse Survey data.

Telehealth boomed during the pandemic out of necessity, but today local health care providers and the technology experts who support them are seeing the service continue due to a myriad of factors including better comfort with the technology and increased benefits for patients, providers and support staff alike.

Rochester Regional Health: More patient-led technologies

At Rochester Regional Health, Nardi leads the team that makes the technology of telemedicine possible for its patients and providers, like on-demand video visits.

Cole Nardi

The large health system began piloting on-demand video visits before the pandemic to employees and their families, but in March 2020 quickly amped up and broadened its video visit reach. By the close of 2020 Rochester Regional Health had logged over 230,000 video visits between patients and providers, Nardi said.

This March Rochester Regional Health launched a new service called Express Care, which offers patient-initiated on-demand video visits for non-emergency issues. The service is available from 9 a.m. to 9 p.m. during the week and 9 a.m. to 5 p.m. on weekends. Anyone with the HIPPA-compliant app MyCare through Rochester Regional Health can utilize Express Care.

The way it works: You open your app, choose “On Demand Video Visit – RRH Express Care” from the menu and wait in the queue for an available local provider from Rochester Regional Health. You can choose between a general video visit or a TytoCare video visit.

TytoCare is a small, handheld digital device with attachments – like an otoscope – that lets health care providers guide patients through medical exams remotely. It can capture heart sounds, lung sounds, body temperature, heart rate and videos and images of the inner ears, skin and throat. These high-quality readings, sounds and images are immediately sent to the provider on the other end of the screen for evaluation.

Rochester Regional Health has begun giving TytoCare medical exam kits to select, qualifying patients from some of its pediatric, primary care and internal medicine practices, along with a quick start guide and materials to help them learn to use the device. The kits are also available for purchase on the Rochester Regional Health website and are Health Savings Account / Flexible Spending Account eligible.


“It’s a pretty intuitive tool,” said Ryan Peterson, a physician assistant with Rochester Regional Health, who notes the biggest challenge of TytoCare is convincing some patients it actually does what it’s touted to do. Some patients have a hard time believing such technology actually exists and is accurate but are amazed once they trust it.

Peterson says that the ability to use TytoCare opens up more opportunities for patients to access care without barriers like finding childcare, inclement weather and other obstacles for those that may have a hard time leaving the home.

Leslie Dintruff MD

Leslie A. Dintruff, a family nurse practitioner with Rochester Regional Health, is one of the providers whose primary patient care role is telemedicine via Express Care. She calls the program “pretty unique” in this region and views it as an excellent way to streamline care for patients with providers from this area (as opposed to some telemedicine apps which are staffed with providers outside of the area who do not have access to patients’ medical records.)

Finger Lakes Health: Asynchronous care amps up

In July 2019 Lifecare Medical Associates in Seneca Falls – part of Finger Lakes Health – began trialing video appointments for their patients who range in age from newborn to over 100.

“At first people were skeptical,” said Dr. Elizabeth Osborn, MD, a family medicine physician at the practice. “Once the pandemic hit, the uptick in users was really fast and people were very grateful it was an option.”

Now, people expect the technology to be there, Osborn said, and a good number of her patients prefer video visits when they need to be seen outside of their annual in-person wellness check due to the flexibility and ease of access.

Elizabeth Osborn MD

“It’s the way healthcare is going and we have to adapt, be proactive and innovative to offer the best healthcare we can to our patients,” Osborn said. “A lot of concerns can be handled on a video call. It’s actually amazing how much information you can get from a video visit.”

Another way the practice uses technology to enhance the patient experience is via asynchronous care, which Osborn says has “become a bigger part of our practice in the past two years.” The term refers to self-service abilities for patients that are not real-time with their health care providers, such as sending a message and photo with a non-urgent question within the patient portal.

Online pre-check-in for an appointment is another example. Not only can it decrease the amount of time a patient needs to spend filling out forms in the office waiting room, but it has helped considerably with the workflow for office staff, Osborn notes.

Trillium Health: Technology increases access

At Trillium Health — a Community Health Center that provides equitable, judgment-free and affordable care for all people — the ability to use telehealth has greatly reduced barriers to healthcare, like childcare, transportation and geographic distance, according to Dr. Sarah Bolduc, the organization’s chief medical officer.

Trillium operates five sites throughout Rochester, offering services that include: a Transgender Center of Excellence, primary care, pediatrics, gynecology and harm reduction.

Some patients at Trillium’s Transgender Center of Excellence live up to two and a half hours away or are at colleges out of state and the ability to check in with their healthcare providers virtually removes the travel barrier.

Other patients may live close by, but don’t want to use their paid time off to drive to Trillium, be seen and then drive home or back to work – preferring instead for a quick virtual visit during their lunch break.

Bolduc notes that some patients accessing mental health services with Trillium seem to do better with video visits and find it easier to connect with their providers by screen.

“A big part of what we do is meet patients where they’re at,” Bolduc explained and technology helps them do that.

Overall, Bolduc says telehealth can often lead to greater access for all patients.

“If it’s done well it’s a lot more efficient for everyone including the providers and the office staff,” she said. “Increasing efficiency can increase access because you’re saving time and can connect with more people.”

Caurie Putnam is a Rochester-based freelance writer.

Searles to join Trillium Health leadership team

Joseph Searles has joined Trillium Health as its vice president and chief community engagement officer. He starts his new position on Oct. 25.

Searles previously served as corporate diversity relations director for Excellus Blue Cross Blue Shield. He has been a member of Trillium Health’s board of directors since 2017.

“I’m thrilled that Joseph will be joining our executive leadership team at Trillium Health,” said Trillium President and CEO Andrea DeMeo. “Joseph brings a wealth of experience and dedication to fostering diversity, equity and inclusion; he is well acquainted with our mission, vision and values; and he shares our commitment to barrier- and stigma-free care. Joseph will serve as an important adviser to me and our entire executive and operational leadership teams as we work together to achieve diversity, equity and inclusion both within our culture at Trillium Health and in our efforts to address health equity within the community.”

Searles has nearly 15 years of experience in community relations; diversity, equity and inclusion; strategic planning; and organizational development. A native of Rochester, he has cultivated a broad network of influential leaders in the community, including government officials, municipalities, business leaders, higher education leaders and community-based health and human service organizations.

Joseph Searles

“It excites me that Trillium Health continues to evolve as a premier organization for healthcare, LGBTQ advocacy, diversity, equity, inclusion and access in our communities,” Searles said. “I am equally energized to be joining an organization that has a legacy of serving the LGBTQ community’s health and well-being.”

Searles has been a member of many boards and task forces for local professional organizations, including Trillium Health, the United Way of Greater Rochester and the Finger Lakes, Common Ground Health, YWCA of Rochester Monroe County, Ibero American Action League, Out Alliance, Big Brothers Big Sisters and the Rochester Gay Men’s Chorus.

In his new role, Searles will be responsible for strategic leadership, development and oversight of Trillium Health’s community engagement, DEI and LGBTQ health and education initiatives. Searles and his team will be responsible for building bridges with like-minded organizations and developing and facilitating the implementation of DEI strategies that are aligned with the organization’s mission and strategic plan, with a focus on addressing needs in underrepresented and marginalized communities to achieve health equity.

[email protected] / 585-653-4021
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Trillium to lose millions in 340B carve-out

Trillium Health on Tuesday said it stands to lose more than $5 million annually if the state proceeds with its carve-out of the 340B program on April 1.

The resources in jeopardy are related to the 340B prescription drug discount program. Pharmaceutical companies that participate in Medicaid are required by the federal government to provide discounts to some types of community health centers like Trillium and their pharmacies.

Trillium and other safety net providers are required to use the savings to fund critical programs and services that address needs such as food insecurity, housing stability and transportation for underserved communities, in addition to providing low-cost prescription drugs to clients.

Gov. Andrew Cuomo in his state budget proposal wants to effectively create a price ceiling for certain high-cost prescription drugs reimbursed under the Medicaid program by requiring a 100 percent supplemental rebate for any amount that exceeds a benchmark price recommended by the state’s Drug Utilization Review Board.

More than 40 lawmakers statewide, including several in Rochester, immediately reached out to the governor opposing carving the pharmacy benefit out of Medicaid and replacing it with a fee-for-service (FFS) model, as advanced by the Medicaid Redesign Team and passed in the Fiscal 2021 budget.

“These savings are provided directly by drug manufacturers as a condition of their participation in the Medicaid program and, as such, do not use any state or federal taxpayer dollars. Eliminating these savings will have a significant impact on chronically ill patients, communities of color and low-income individuals that have already been disproportionately impacted by the COVID-19 pandemic,” according to the letter.

The letter also cites a recent Community Health Care Association of New York State survey that shows the carve-out will result in an estimated loss of $100 million per year for community health centers statewide, and 32 centers would be forced to close their doors. A new analysis also found that the carve-out will result in $154 million in additional costs during the first year of implementation and a total increase in costs of $1.5 billion over the next five years.

Rochester-based Trillium said the $5 million it will lose annually as a result of the carve-out will cause an immediate disruption in services to hundreds of thousands of the most vulnerable New Yorkers and a loss of jobs. It would impact COVID-19 testing and vaccinations, HIV treatment and prevention and harm reduction programs aimed at addressing the opioid epidemic, the Federally Qualified Health Center said.

“Black and brown people are at highest risk for severe illness, hospitalization and death from COVID-19. Likewise, these same communities are most at risk for contracting HIV and not receiving adequate treatment to sidestep its life-threatening symptoms. Quietly eliminating 340B funding in service to ‘recovery’ from COVID-19 is merely trading one epidemic’s negative impacts for another’s, with black and brown communities drawing the shortest straw,” said Urban League of Rochester President and CEO Seanelle Hawkins. “We must seek alternative approaches to COVID-19 economic stopgap measures if we are to interrupt racism’s deadly health impacts in New York State.”

Trillium has vaccinated thousands of community members in the last several weeks – many of whom are older, on a limited income and are persons of color. Officials said these efforts, in addition to many vital community health programs offered by Trillium Health and other health centers statewide, will not be able to continue if the funding cuts go through as planned on April 1.

Andrea DeMeo
Andrea DeMeo

“People will suffer. And make no mistake— these are the very same people that have been disproportionately affected by COVID. And all the progress to address the opioid and HIV epidemics – which are now further exacerbated by the pandemic—will be undone. The governor needs to understand that this will be Armageddon,” said Trillium President and CEO Andrea DeMeo.

[email protected] / 585-653-4021
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Coalition formed to help strengthen North Clinton neighborhood

Three area nonprofits have partnered in an effort to strengthen and clean up the North Clinton neighborhood.

The Father Laurence (Larry) Tracy Advocacy Center, Ibero-American Action League and Trillium Health have formed C.A.R.E. Rochester, which stands for Community, Action, Resources and Education. The partnership was established in consultation with the North Clinton neighborhood block clubs, Rochester City Councilmember Michael Patterson, County Legislator Vince Felder and others in the community.

Trillium Health has hired two full-time employees who will be dedicated to cleaning up used syringes in the North Clinton neighborhood. Residents will be able to see where cleanups are schedule and can suggest locations that need attention at the partnership’s website. The website is offered in English and Spanish and the C.A.R.E. team will respond to inquiries within a day or two.

“Ibero looks forward to co-creating a new vision for this neighborhood with all our partners, one of investment and opportunity,” said Angelica Perez-Delgado, president and CEO of Ibero-American Action League. “I am proud that this collaboration has honored and lifted the voice of a once victimized neighborhood.”

The C.A.R.E. partnership was established earlier this year and represents months of work to strengthen the North Clinton neighborhood. It comes amid excitement for the opening of La Marketa International Plaza, which is planned for later this fall, and the groundbreaking for new housing in the El Camino neighborhood.

“¡No Más! Change has arrived; we will not go back. ¡No Más!” said Rudy Rivera, executive director of the Father Laurence (Larry) Tracy Advocacy Center.

Another neighborhood initiative, Project HOPE, recently was a catalyst for Rochester receiving the distinction as a 2020 “All-America City,” officials noted.

“Trillium Health has been fighting the opioid epidemic since 1994, and the HIV epidemic since we first opened our doors to the community in the 1980s,” said Trillium President and CEO Andrea DeMeo. “We are so proud to work with the Father Laurence (Larry) Tracy Advocacy Center, Ibero-America Action League, Rochester City Council and the residents of the North Clinton neighborhood to help ensure the revitalization of a vibrant community rooted in rich history and culture.”

Trillium is a Federally Qualified Health Center whose mission is to promote health equity by providing affordable primary and specialty health care to all. The agency serves the nine-county Rochester region.

“Getting to this point of collaboration hasn’t always been easy. We all have felt the frustration and as residents, it’s sometimes easier just to give up,” said Ida Perez, chair of the Scrantom Street Block Club. “Yet the persistence in all of us has helped us find our common goal, which is the improvement of quality of life for all involved. Today we are working together towards that common goal.”

The Father Tracy Advocacy Center is an advocate for the community of North Clinton Avenue and helps residents access addiction treatment and offers other supports.

Ibero-American Action League was established in 1968 and is a dual-language human services agency that serves individuals and families of all ethnic backgrounds through educational programs, health and social support and more.

[email protected] / 585-653-4021
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Trillium joins coalition to protest health center cuts

Trillium Health Inc. has joined a statewide coalition to protest cuts to community health centers.

The Protect the Safety Net campaign, led by advocates and Medicaid patients, seeks to reverse a provision in the New York state budget that strips a critical federal benefit from health care providers and patients statewide. Campaign leaders said the “carve-out” provision harms all safety net providers in the federal 340B drug discount program and further jeopardizes the health of some of New York’s most vulnerable Medicaid recipients during the COVID-19 pandemic and economic recession.

The provision, which was recommended from the Medicaid Redesign Team II and advanced by Gov. Andrew Cuomo, would require the New York Medicaid program to carve out the pharmacy benefit from the state’s Medicaid managed care program and shift payment of drugs covered under that benefit to fee-for-service reimbursement.

Coalition members say that if the provision is implemented it would harm federally qualified health centers, safety-net hospitals and other safety net providers in the 340B drug discount program and adversely impact the financial stability of health care clinics across the state.

Clinics rely on the funding to operate food pantries, provide transportation assistance, offer sexually transmitted infection testing and run harm reduction programs, services they say are “grossly underfunded” by the state.

Andrea DeMeo
Andrea DeMeo

“In the rush to approve this year’s budget, a little-noticed provision was adopted that would devastate community health centers across New York State. The same clinics that have been fighting COVID-19 will be forced to eliminate services or close – leaving people living in poverty without access to testing, food pantries, transportation and housing assistance, STI screening and treatment and programs to fight the opioid epidemic,” said Andrea DeMeo, president and CEO of Trillium Health. “In addition, clinics that have been battling HIV/AIDS for decades will be financially devastated, reversing all of the progress that we’ve made in the fight against HIV. Therefore, we are calling on the governor and state legislators to reverse this harmful carve-out.”

The federal 340B Drug Discount Program is a lifeline that allows safety net providers, including HIV/AIDS clinics receiving support under the Ryan White CARE Act, to obtain prescription drugs at below-retail prices. The program was established with bipartisan support as part of the Veterans Health Care Act of 1992.

“Without this benefit, there’s no way I can afford my medicine. We have been struggling to make it through the pandemic, but this is the breaking point. I would welcome whoever came up with this terrible idea to come to my clinic and see the people impacted by this heartless decision,” said Annie Brooks, a patient at Trillium Health.

The Governor’s Medicaid Redesign Team II made budget recommendations that were approved by the Assembly and Senate and signed by Cuomo in April. The budget, including the carve-out provisions, is set to go into effect at the start of the next fiscal year beginning on April 1, 2021.

[email protected] / 585-653-4021
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Trillium to cut 33 positions

Trillium Health Inc. plans to eliminate 33 jobs as a result of the recent economic upheaval brought on by the COVID-19 pandemic, the nonprofit health center said Thursday. The cuts represent 12 percent of the agency’s workforce.

Andrea DeMeo
Andrea DeMeo

“This is an extremely difficult day for all of us,” said Trillium President and CEO Andrea DeMeo in a statement. “The impact of the coronavirus on our business finances, coupled with a reduction in revenue from pharmacy reimbursements during this fiscal year, has put us in the unfortunate position of having to make staff reductions that are necessary to ensure the long-term sustainability of Trillium Health so we may continue to provide exceptional care to those who are proud to serve.”

Officials said the organization made every effort to avoid a reduction in its workforce, including applying for and receiving a federal Paycheck Protection Program loan to help cover payroll and rent, as well as cutting other expenses.

“This was a heavy and hard decision,” DeMeo said. “We have provided as much financial assistance as possible to our outgoing employees, who have given so much to our organization.”

Trillium Health will continue to provide medical care and support services at its Monroe Avenue clinic, Pathway Pediatrics and the Center for Gynecological Health and Wellness. The reductions are expected to impact some programs at the agency and participants in those programs will be notified and redirected to similar services in the region, officials said.

“We remain a competent, compassionate team of medical and social service professionals dedicated to serving our Greater Rochester community. In the coming weeks and months, we will continue to fulfill our organization’s mission to promote health equity by providing extraordinary care for people from all backgrounds, regardless of income, sexual orientation, gender identity, race or ethnicity,” DeMeo said.

Trillium Health is a federally qualified health center that serves the nine-county Rochester and Finger Lakes region. The agency was formed by the 2010 merger of AIDS Community Health Center and AIDS Rochester.

[email protected] / 585-653-4021
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Trillium Health receives $20 million grant to help stem chronic homelessness

A rendering of Union Square, a $19.3 million mixed-use development headed by Trillium Health.
A rendering of Union Square, a $19.3 million mixed-use development headed by Trillium Health.

Trillium Health Inc. has received the largest grant in its history, enabling the organization to construct a $19.3 million mixed-use development.

The state’s Empire State Supportive Housing Initiative (ESSHI) grant totals $20 million over 40 years, with $500,000 distributed annually in five-year increments. The funds will support a housing program at Union Square on Site 3 of the former Inner Loop that will serve individuals who are chronically homeless and 55 or older, as well as chronically homeless individuals living with HIV.

Trillium Health is partnering with Home Leasing LLC, the City of Rochester, Lifespan of Greater Rochester Inc. and the Out Alliance on the initiative. The project has been in the works since 2017 and is expected to break ground next year. Occupancy is expected to begin in early 2020, with full occupancy by June 2020.

“We are incredibly grateful to Gov. Cuomo for this investment in improving the lives of our most vulnerable community members,” Trillium Health President and CEO Andrea DeMeo said in a statement. “Together with Home Leasing, the City of Rochester, Lifespan and the Out Alliance, we will help individuals who suffer from chronic homelessness and work to make a positive and enduring impact on our community.”

The ESSHI grant funding will support rent subsidies and the delivery of supportive services to program participants who will reside in 20 apartments at the site. Trillium officials said that by providing holistic support, chronically homeless people are better able to lead healthier lives independently, increase vocational skills and get jobs, which equates to lower health care and social support costs overall, as well as a lower likelihood of repeated homelessness.

“At Trillium Health, we believe that housing is health care, and I applaud Gov. Cuomo’s office and the City of Rochester for recognizing the need for additional stable housing in our community,” DeMeo said.

Trillium plans to provide individualized services and linkages to care and community resources to the residents, and support and services also will be provided by community-based organizations including Lifespan and the Out Alliance. A Trillium Health spokeswoman said some 50 families are expected to be helped throughout the course of the grant.

“As a community champion for LGBTQ+ quality of life and access to much-needed services, we are encouraged that this resource is being made available to our community,” Out Alliance Executive Director Jeff Myers said. “It is collaborations like these that are so powerful in the fight to empower and address the needs of not only the Rochester community but the Rochester queer community.”

The ESSHI funding depends on the successful development of the mixed-use housing project by Home Leasing. Home Leasing plans to build the LGBTQ-welcoming, mixed-use development with 66 one- and two-bedroom affordable apartments, a pharmaceutical health emporium operated by Trillium Health and additional space for commercial use.

Twenty apartments will be set aside for Trillium’s supportive housing programs for chronically homeless individuals from the community. Tompkins Realty also serves as a partner in the Union Square development.

“We build communities that improve the lives of our residents,” Home Leasing’s Chairman and CEO Nelson Leenhouts said. “We’re thrilled to partner with Trillium Health in the development of apartments that will become home to individuals who have experienced homelessness and offer support to their health and wellbeing.”

Trillium Health is a Federally Qualified Health Center Look-Alike community health center, which means the agency provides primary care services in underserved areas, care on a sliding fee scale based on ability to pay and operates under a governing board that includes patients. An FQHC-Look-Alike meets all of the eligibility requirements of an organization that receives a Public Health Service Section 330 grant, but does not receive grant funding.

“Trillium Health and Home Leasing are among our community’s most treasured resources, and it’s gratifying to see them form a partnership to bring supportive housing to the Inner Loop East Revitalization Project,” Mayor Lovely Warren said. “The award of this grant is a testament to their great work and will allow them to provide much-needed care and assistance to people dealing with challenging circumstances, especially those relating to housing and health care.

“Their innovative solutions to break the cycle of chronic homelessness in our city are invaluable in our efforts to create more jobs, safer and more vibrant neighborhoods and better educational opportunities,” Warren said.

[email protected] / 585-653-4021

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