Troy Di Lello – Forefront TeleCare Inc.

Build it and they will come

For an 80-year-old living in a nursing home in rural Oklahoma, connecting to a psychiatric specialist might be a challenge. For starters, your doctor might work in a far-away city and travel is difficult for you.

But with the Centers for Medicare & Medicaid Services (CMS) mandating care for residents of these far-flung homes, and the advent of HIPPA-compliant telehealth platforms delivering telepsychiatry services, times are changing for the better. Your doctor can be rolled up to your hospital bed via a live feed on a big screen, or a quick wheelchair ride down the hall to a “secure room.”

Troy Di Lello – Forefront TeleCare Inc. Toggle Magazine

That’s according to Troy James Di Lello, the vice president technology at California-based Forefront TeleCare Inc. whose technologies are enabling 100 practitioners in 26 states to make “virtual rounds” to patients in remote senior living facilities and hospitals.

“The old saying of ‘build it and they will come,’ is certainly not true,” Di Lello says. “We are not building technology just for technology’s sake; we are building technology around what people need, plain and simple.”

Di Lello continues, “If our seniors don’t need bells and whistles, we aren’t creating them. What we are building is scalable and reliable technology that provides seamless secure connectivity to our patients in a highly-reliable and high-quality network. What it means to the patient is they just go see their provider.”

Why now? And how?

A burgeoning demographic of elderly patients needs behavioral health services across the United States. Despite this, Di Lello explains what has been available in rural care centers often has not involved much technology; and in more cases than not, nobody with a technological background has been on the premises to implement a solution.Troy Di Lello – Forefront TeleCare Inc. Toggle Magazine

“This is a very vulnerable population that needs help and their care is mandated by the government. Our aim was figuring out a way to serve the population in a meaningful way,” he says.

To that end, Forefront developed wall-mounted systems with large video screens accessed by a single button, as well as a rolling cart with a monitor to wheel from room to room. With a few quick clicks a doctor’s voice and image can travel across multiple platforms to appear before the patient. Together, doctor and patient can have the give-and-take they would normally have in a live visit.

“We don’t want the patient to feel as if they are having a video call; it’s just a doctor’s appointment. That is our goal,” Di Lello says.

How it works

Di Lello says setting up the system is a no-brainer.

Already HIPPA compliant, when the product arrives at the facility, it simply has to be plugged in. There is nothing to buy, rent or upgrade. It’s Forefront’s equipment offered up in a contract.

“It is great for the facility because they do not have to invest thousands of dollars to manage the system,” he says.

Product-wise, Forefront operates on the Google Cloud Platform over a highly-secured network that is complemented by scheduling software. A patient in Pennsylvania, for example, can, at the touch of a button, be easily connected with a provider of their choice several states away. If either the patient or the provider doesn’t log in to the appointment, employees with Forefront will know who is connected (or not) and can follow up via their helpdesk. Each visit is billed and processed like a regular office visit.

While the programs were initially introduced in nursing homes, services have branched out into hospitals in the past year. Rural areas have an acute need, Di Lello says, and Forefront is expanding in just about any rural area that has an internet connection. Currently the hospital program is being rolled out in Texas, Arizona, Louisiana, Kansas and Oklahoma.

“At one point we had more business than we could handle, but we simply have absorbed the requests and are planning for massive growth,” Di Lello says, estimating that the company’s size and its staffing will double in the next year. Currently there are 43 employees, including a product helpdesk, a development team and an internal support department. Di Lello oversees all of the technology and tech employees.


In terms of technological challenges, Di Lello says the same issue crops up every day: internet connections in rural areas.

“It’s a constant battle for us,” Di Lello says. “We test new locations every day and if the connection isn’t good enough, we pass on the opportunity since we don’t want to provide bad service to our clients.”

Troy Di Lello – Forefront TeleCare Inc. Toggle Magazine

However, Forefront’s helpdesk team continues to work with the clients to find better access to internet services when possible.

“We do everything possible to help our clients. Where there’s a will there’s a way,” he says.

For every inquiry Forefront gets from a facility, Di Lello explained, the helpdesk will reach out to the location and remotely test and troubleshoot and give each location a teleconnection report with suggestions to improve service.

“If there is anything I have learned, patience is a virtue and it’s important to be very patient in this world,” Di Lello says. “I learn from every small mistake and put all the energy I can into focusing on solutions. I have more than just a career with Forefront, I have an opportunity and duty to serve our patients. That is my drive and that is what gets me excited to get to the office every morning.”

Published on: October 7, 2019



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