Nurse triage services company Conduit Health Partners has recently started providing services to four Federally Qualified Health Centers. In a recent interview, Cheryl Dalton-Norman, M.B.A., B.S.N., R.N, president and co-founder of Conduit, described the impact of the pandemic on the company’s business model and the value it can provide to FQHCs and other health systems.
Cincinnati-based Conduit recently began working with Unity Care NW in northwest Washington; Tuolumne Me-Wuk Indian Health Center in Sonora, Calif.; Kenosha Community Health Center in Wisconsin; and Clackamas Health Centers in Oregon. The company said it has become a partner in providing care that is easily accessible to people of all ages, regardless of their health insurance status and their ability to pay.
HCI: Could you talk about your background and the business model for Conduit?
Dalton-Norman: I've been a nurse for 40 years and founded Conduit not with the intention of creating a company that would be selling to other organizations. It started to solve the issues of a large multi-state health system [Bon Secours Mercy Health], particularly around access and the need to make sure that people have access to the care they needed really quickly, and not have to jump through multiple hoops or talk to multiple people before they actually got to someone who can help them. We started out in the transfer center business, which is making sure that people who, for example, could have had a stroke or been in an accident in a rural area get that next level of care. We manage all that.
Triage and virtual care really followed on from that because what we saw in the market was people were going to the ED in the middle of the day during the week because they could not get access to advice and care. We started Conduit with a nurse-first model because with a lot of organizations you call and you might talk with someone who is a non-clinician, who takes your information and says we will have somebody call you back. Consumers today want immediate help. We employ a nurse-first model and have found that other organizations were seeking that. They want the people they are caring for to have immediate access to a registered nurse, licensed in their state, who could give them advice and help them navigate the system.
HCI: Why did you start working with the FQHCs?
Dalton-Norman: FQHCs are often serving areas, either urban or rural, that don't have the best access to care. They have folks who are needing better access to care, and what we do for FQHCs is make sure that 24/7/365 they have a nurse who is immediately going to help patients understand how to take care of themselves at home or decide if they need to go to the ER. And if they do need to go, we can help them with figuring out transportation. The FQHCs have access to even better support than some organizations might in that they have behavioral health services and dental services.
We also serve several homeless shelters with a one-touch kiosk that allows people to talk with us so that we can help them navigate.
HCI: How was your business impacted by the pandemic? People must have been calling concerned about COVID symptoms or advice. Was making that decision about whether to go to the ED or not even more fraught with issues?
Dalton-Norman: Yes, when COVID hit, our call volume probably multiplied by 10 times. It was dramatic. We went from hundreds of calls per day to thousands. We had to work with our partner organizations in the early days of COVID, asking them ‘what do you want us to do and where do you want people to go for testing?’ It was a dramatic change for us. We navigated from our teams working in a central location to a virtual organization. Our nurses work and live in multiple states. That has been great for us, but COVID changed everything.
HCI: Do your nurses have to get licensed in the states where they're giving advice to people?
Dalton-Norman: Yes, we are licensed in 47 states plus the District of Columbia. It's a lot of work and expense. I think it's something that nationally needs to be paid attention to. Of course, we love compact licensure in over 30 states, but we recognize that not every state is part of the nursing licensure compact.
HCI: Are there other potential areas of growth or other types of organizations that you might partner with?
Dalton-Norman: One area for expansion for us involves remote patient monitoring and hospital at home. I would say it's still in its infancy, but we have the ability for nurses to deliver that nursing care 24/7 by popping up on the screen and talking with you about your meds or if you have a need that is showing up. It's very exciting, and I really think we're just at the beginning of this.
HCI: Is staffing up for growth a challenge? Is it hard to find nurses who want to do this triage work? I imagine the flexibility of working remotely is attractive to people. But everyone talks about workforce being a big challenge now.
Dalton-Norman: For health systems, it is a drastic challenge. I would say right now, for Conduit, we are very fortunate because we hire nationally. In a bricks-and-mortar setting, we have to rely on the community around us, but because we want to hire nurses that live in a variety of states, we have an extremely strong pipeline.
