compounding issues for post-acute clinicians

Compounding Issues for Post-Acute Clinicians

compounding issues for post-acute clinicians


Originally, to highlight the compounding issues for post-acute clinicians, this article was meant to have a funny tag line like, “Doctors are People, too,” an attempt to tease out the fact that physicians have regular lives like the rest of us.  An allusion to the idea that in order to be better physicians, they should have the time to tend to those lives – just like when we mortals clock out from work each day.

However, when researching the current literature behind subjects like burnout and the national physician and nursing shortage we are currently experiencing, the topic suddenly became less humorous. Not only is this subject not funny, neither has been our cultural reaction to it – nurses are simply encouraged to work more and physicians operate by day and take call at night.

Booming Issues

Let’s start with the source of our collective challenge: World War II. In our country’s understandable exuberance in the climactic suppression of global fascism, we procreated at an exponential rate, producing that aptly named Baby Boomer generation. That generation now makes up our venerated grandparents and parents who are aging into the post-acute portion of the medical complex in the United States. According to the Association of American Medical Colleges, “The population of individuals 65 years and older is projected to increase by 42.4 percent between 2019 and 2034, outpacing general population growth at 10.6 percent during that period.” Among those 65 year-olds are going to be an accelerating group of retiring physicians, exacerbating the challenge of how we plan to care for this aging population. It is also from this age range of patients we see an ever increasing rate of the diseases which are the leading causes of death in the United States: heart disease, stroke, cancer, diabetes, COPD, and dementia.

This convergence of increasing and decreasing populations (patients vs. clinicians) does rationalize many of our current conversations with Skilled Nursing Facility (SNF) leaders who explain shortages in personnel to cover their daytime clinical needs. With these compounding issues, it is routine for SNF buildings to have a clinician physically present only 3-4 days a week. None have physicians present at night, when many change of condition events occur.

The humor vanishes because the patients involved are our grandparents. They will soon be our parents. Eventually, we all are destined to become patients of an environment in which we are estimated to have a lack of up to 124,000 physicians by 2034. Juxtaposed against this are the recommendations made by Lockley, et al in 2007, in which they published their recommendation in the Joint Commission Journal of Quality and Patient Safety for the United States to strongly consider the establishment and enforcement of safe work-hour limits for clinicians due to the preponderance of evidence linking performance decline to fatigue.

Fighting Fatigue

Our doctors and nurses are tired.

Turns out, Europe agrees, and their agreement predates the Lockley conclusions by 9 years in a law passed in 1998, becoming 100% enforced by 2009. Their policy even has a snappy, yet benevolent title: The European Work-Time Directive. Here is how its policy is applied to physicians. In it are what would be groundbreaking concepts within the United States healthcare apparatus – 11 hours of rest per day, a day off each week, and a requirement on the employer to keep records of hours worked.

And then there is the pandemic. In all the chatter about how businesses are disrupted, schools turned upside down, and so much more white-collar work now getting done in pajamas, did we forget about the most vulnerable among us – the elderly and infirmed? ,It was the nursing homes in this country which bore the brunt of COVID-19, compounding even more issues for post-acute clinicians. They were the most vulnerable prior to the pandemic and they will remain so in the its waning days and beyond if we don’t move to address some of the glaring gaps in care. What should we do for this population at the beginning of what is predicted to be hockey-stick growth? Also, do we have anything to offer the post-acute clinicians who have chosen to dedicate their professional lives, caring for our vulnerable?

Let’s hope so.

Doing Better for Our Clinicians

If not groundbreaking for the post-acute space, perhaps measures such as those from Europe mentioned above would simply be … a relief?  Warranted? Deserved? To the Director of Nursing doing night shift due to lack of staff.  To the contracted nurse practitioner working all day and then manning the pager at night.  To the primary care physician doing the yeoman’s work of driving from building to building in effort to reach all the patients under your care while knowing with the certainty of arithmetic that you can’t reach them all. We have something for you – a pillow.

At Third Eye Health we are a physician practice, focusing exclusively on the post-acute space during periods of time where providers typically take call but should really be sleeping. Our typical coverage hours are 7pm – 7am weekdays and 24/7 on the weekend. What did that EU law say clinicians should have?

11 hours of rest – we provide 12

1 day off per week – we provide 2

Documentation of hours worked – no problem. We provide custom integration with post-acute EHRs, including leaders in this space, PointClickCare and MatrixCare. Everything is documented in your system of record.

As the saying goes, necessity is the mother of all invention…

Relief for Post-Acute Clinicians

When we made the determination to become an exclusively after-hours practice (in so doing becoming Third Eye Health), it was with expressed purpose to create an environment in which post-acute clinicians can sleep through night and have their weekends back – just like every other person in a “typical” job. Afterall, doctors are people, too, right? We leverage our proprietary telemedicine technology to receive calls from SNF nurses, treating patients in place +90% of the time. Our team of board certified physicians do this with an average response time of less than 2 minutes per call. To date, Third Eye Health provides this service to +800 clients, and has fielded +500,000 encounters.

Those who continue in their pursuit of clinical improvement on behalf of the vulnerable are to be praised. However, in the pursuit of the level of care wished for ones own family members, the privilege of sleeping through the night simply should not be on anyone’s list of concerns. There are much larger fish to fry as we all work to bridge the ever-growing gap between the number of patients needing our attention and the clinicians who strive to meet that need.


written by:

Joshua Streit

Director of Growth

Third Eye Health


Nurse Telepresenting to Man

Case Study: Integrated Telehealth with MatrixCare & CarDon

CarDon MatrixCare Third Eye Health Case Study Image

This case study demonstrates how the existing partnership between Third Eye Health and MatrixCare paves the way for integrated care.  CarDon, a Midwest-based post-acute operator, recently sought out Third Eye Health to provide physician consultations to residents in their senior living communities over nights, weekends and holidays.  In addition to providing immediate physician access, improving quality measures, and reducing medical costs, a large factor that led CarDon to choose Third Eye Health was its existing partnership with MatrixCare and its ability to provide secure, integrated telehealth in real time. 


CarDon needed a solution that could positively impact return to hospital (RTH) rates by treating patients in place.  Once learning that the their EHR provider, MatrixCare, had an existing partnership with Third Eye Health, the decision in choosing a telehealth provider was easy.  Through secure integration, both the providers and nurses at CarDon and the Third Eye Health physicians have real-time access to patient records.  This is especially important as the quality of resident care relies deeply on accurate data.

“It really takes the work off of our staff, especially having the documents import directly into the resident documents section with the physician signature. We don’t have to wait days for these notes; they’re already in there.”

Brandy Armstrong, Director of Clinical Information at CarDon & Associates


The first six months of service by Third Eye Health resulted in an 88% average treat-in-place rate across over a dozen skilled nursing facilities, an improvement from the previous quarters, leading to fewer RTH and avoidable readmissions. Physician satisfaction has also improved, as primary providers are able to get some much needed rest by trusting the Third Eye Health physicians in the care of their patients, mirroring their own protocols.  Quality measures are improving, as well, including RTH reductions and clinical outcome improvements, all stemming from immediate physician access.  Warm hand-offs from Third Eye Health physicians to CarDon’s primary providers and nurse leaders through Third Eye Health’s Care Coordination daily summary reports ensure that patients continue receiving high quality care around the clock.


View Case Study

Complete form below to read the case study for CarDon, MatrixCare and Third Eye Health



long-term care nurse and patient

Pursuing Value in Long-Term Care

Pursuing value in long-term care starts today.  Prioritizing the improvement of care quality for its more than 6,000 beneficiaries, LTC ACO has joined forces with Third Eye Health, the leading virtual provider for post-acute and long-term care.

This newly formed partnership makes 24/7 physician access for LTC ACO beneficiaries a reality.

As the nation’s first long-term care Medicare Shared Savings Program, LTC ACO’s success requires an all-hands approach aligning providers, long-term care facilities and health systems to increase value by improving quality and reducing costs.  Partnering with Third Eye Health will have a profound impact on the value created by LTC ACO. With over half a million encounters, Third Eye Health successfully maintains a 90% treat in place rate by providing immediate virtual physician access during nights, after-hours, weekends, and holidays.

EHR integrations and the ability to communicate via video, text, and shared photos, makes thorough physician evaluations possible to when in-person physician visits are not available.  With Third Eye Health, LTC ACO beneficiaries can now be treated in place as soon as a change in condition is noticed, reducing their risk of complications or hospital acquired infections, and ultimately saving the cost of unnecessary readmissions.

An added benefit of this new union lies with skilled nursing facilities qualifying for LTC ACO partnership.  Once implemented with Third Eye Health, the facility’s virtual physician accessibility will be available to all residents, not just the long-term care beneficiaries, and at no additional expense of adopting a telehealth program.

Both LTC ACO and Third Eye Health have admirable track records. In 2019, LTC ACO experienced a 19.6% cost savings rate with a 94.5% quality score resulting in Medicare fee-for-service savings and earning the ACO $18.8 million in shared savings distribution.  The expectation from the inclusion of Third Eye Health’s physician services and telehealth technology is to drive the quality and healthcare efficiencies by keeping beneficiaries in place to receive care.


Ready to bring LTC ACO and Third Eye Health to your long-term care patients? Complete the form below, and a member of our team will be in touch.

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LTC ACO Partnership with Third Eye Health is More than Telehealth

Third Eye Health is more than just telehealth, it is a comprehensive virtual care solution to improve the overall quality of care in post-acute and long-term settings.  LTC ACO acknowledged this when the two organizations announced their partnership earlier this year.  Comprised of secure, EHR-integrated mobile telehealth technology, Third Eye Health also boasts a large practice of over 75 experienced physicians nationwide.  These two elements, telehealth technology and physicians, are vital to successfully treating beneficiaries in place, but Third Eye Health provides one more essential component – care coordination.

Every site with access to Third Eye Health telehealth technology and physician services receives a dedicated Care Coordination Manager, who is fundamental in providing warm hand-offs back to the primary care team following all Third Eye Health encounters.  Every day, Care Coordination Managers, who are nurses by trade, review the details of each consult for quality assurance, looking at notes and orders.  As the primary care team and providers are just beginning their days, they receive a secure, custom care summary from the Care Coordination Manager.

The Care Coordination team reviews all Third Eye Health physician encounters, serving as a second set of eyes and ensuring the proper treatment and care of each beneficiary.  They also recognize areas where protocols and procedures may need to be tightened up and work with post-acute and long-term care leadership to improve those procedures and enhance quality initiatives affecting care 24/7, not just when Third Eye Health is on call.

Much like physician access and telehealth technology, long-term care facilities qualifying for LTC ACO sponsorship will have the added benefit of Third Eye Health’s care coordination services available to all residents, not just LTC ACO beneficiaries.  With these extensions of Third Eye Health in place, it is certain that outcomes will improve for all involved, while returns to the hospital and unnecessary readmissions will diminish.



Provider Groups and Third Eye Health Align with LTC ACO

LTC ACO brought on the leading telehealth provider for post-acute and long-term care, Third Eye Health, earlier this year to enhance its quality improvement efforts. Their partnership marks the first of its kind where providers, health systems and now telehealth are aligned in rolling out quality initiatives to reduce the cost of long-term care.  Together, they work toward a common goal of positively moving the needle for outcomes and quality measures that impact the value of care they are providing.

By adding Third Eye Health to the mix, beneficiaries now can be consulted by a physician at their bedside 24/7.  When an in-person visit is not possible on nights, after-hours, weekends, or holidays, Third Eye physicians can be reached within minutes and consult a beneficiary right in place, positively influencing the caliber of care beneficiaries receive.  They no longer risk being transferred to the ER for conditions or issues that could be treated in place.

Provider groups are especially supportive of this new partnership between LTC ACO and Third Eye Health.  Being relieved of call, they can rest easy knowing beneficiaries will continue to receive high quality care. In turn, providers get their weekends and evening back, restoring a proper balance between work and personal life and improving their overall professional satisfaction.

The clinical expertise from the Third Eye Health physicians complements the care from the primary providers.  Protocols and processes established by the Medical Director are carried through by Third Eye Health physicians and medical alerts are provided following all Third Eye Health consultations.  Additionally, with secure EHR integrations, Third Eye Health physicians can review medical records, protocols, as well as write notes and orders that are sent directly into the medical record. This transparency enables warm hand-offs from the primary provider to the Third Eye Health physician and then back to the primary provider, again.

Around the clock care has several advantages appealing to those provider groups affiliated with LTC ACO.  Primarily, the ability to treat in place when a change of condition is first noticed prevents the condition from worsening.  This also prevents the heightened risk associated with transfers to the ER, including added stressors during transportation and exposure to new illnesses, which can be taxing on the beneficiary’s clinical outcomes. The likelihood of readmission once in the ER is also high and comes with a large price tag attached. Additionally, there is no guarantee that the beneficiary will be discharged back to the same facility following readmission.

With Third Eye Health now available to reduce the returns to the hospital during nights, after-hours, weekends, and holidays, LTC ACO and its affiliates see this partnership as vital to driving further value.  Beneficiaries are treated in place.  Clinical outcomes improve.  Returns to acute care and hospital readmissions decrease.  And beneficiaries remain within the clinically integrated network for care.  Care quality rises while associated costs are minimized.

OHCA 2021 Booth 729

Third Eye Health at Ohio Health Care Association’s Annual Conference

Third Eye Health will be at the Ohio Health Care Association’s (OHCA) Annual Conference in August!

August 23 -26, 2021
Greater Columbus Convention Center
Columbus, OH
Booth #729


We are excited to see everyone in-person this year at the OHCA Annual Conference. While much has changed in the past year, our technology and services are still the most utilized telehealth solution in the nation for post-acute care. Our board certified physicians were able to support our SNF partners in treating over 100,000 patients throughout the pandemic, 90% of which were treated in place.

If you’re attending the conference, please stop by and see us at booth #729. You can also set up a meeting in advance by emailing

Third Eye Health at Florida Health Care Association’s Annual Conference

Third Eye Health will be at the Florida Health Care Association’s (FHCA) Annual Conference in July!

July 25 – 29, 2021

Rosen Shingle Creek

Orlando, FL

Booth #132


We are excited to see everyone in-person this year at the FHCA Annual Conference. While much has changed in the past year, our technology and services are still the most utilized telehealth solution in the nation for post-acute care.  Our board-certified physicians were able to support our SNF partners in treating over 100,000 patients throughout the pandemic, 90% of which were treated in place.

If you’re attending the conference, please stop by and see us at booth #132.  You can also set up a meeting in advance by emailing


Leveraging Telehealth to Improve the Future of Facility-Based Care

There were many lessons learned throughout the pandemic with respect to telehealth, specifically in the post-acute world. Dan Herbstman, Third Eye Health’s Co-founder and Chief Strategy and Product Officer, provides a glimpse of the shifts in virtual care and the exciting future that lies ahead for Third Eye Health in an exclusive interview with Healthbox.

Topics discussed include the fast-paced adoption and implementation of telehealth in the immediate onset of the pandemic, the technology involved, the impact of the pandemic and telehealth on post-acute care.  Also, looking forward Dan discusses advances or changes to telehealth came from the pandemic and where is telehealth headed, including what new markets are next for telehealth.

Addressing Physician Burnout Head-on

Physician burnout is at its peak following a year of limited resources and uncertainty. More and more providers are leaning on Third Eye Health for post-acute call coverage on nights, weekends and holidays, allowing time to focus on their own health and well-being. For the first time in years, providers can rest easy knowing Third Eye Health physicians have eyes on their patients and are treating in place with detailed notes and orders available directly in the EHR.

In this article, Megan Lenthe, Third Eye Health’s Director of Product, explores physician burnout, addressing its root cause and how provider groups and health care organizations can proactively reduce overextending our population of providers across the nation.


Introducing the Virtual Care Network: Accessible Telehealth to ACO Beneficiaries

We are excited to announce Third Eye Health and LTC ACO have teamed up to create a first-of-its-kind virtual care network. The announcement of the partnership is the first step in providing 24/7 care to LTC ACO’s 6,000 existing beneficiaries, and future beneficiaries, as well. Under the partnership, provider groups and long-term care facilities, affiliated with LTC ACO, will have access to Third Eye Health Physicians providing night and weekend coverage at no additional charge. Under the umbrella of the ACO, provider groups and long-term care facilities will align with Third Eye Health, working together to improve quality metrics and outcomes. Beneficiaries will experience immediate bedside care, reducing unnecessary readmissions to the hospital.

Through their affiliation with LTC ACO, providers and long-term care facilities outside of Genesis Healthcare now have the ability to integrate Third Eye Health’s platform into their care processes. Beneficiaries will experience improved care. Physicians will experience improved work-life balance. Long-term care facilities will report fewer returns to hospitals. Collectively under the ACO, providers, long-term care facilities, and Third Eye Health – all held accountable for improving outcomes and quality metrics—will share in the savings once these goals are attained.

In 2020, Third Eye Health conducted over 100,000 moments of care in skilled nursing facilities nationwide, 90% of which we were able to treat-in-place. We are here to help.

Read More about this exciting partnership.