Jonathan Witenko, system director of virtual health and telemedicine at Lee Health
Photo: Jonathan Witenko
Lee Health has been an essential part of healthcare delivery in Southwest Florida for more than a century, since opening its first hospital in 1916.
The not-for-profit health system, one of the largest in the Sunshine State, offers comprehensive services through four acute care hospitals, Golisano Children’s Hospital, three skilled nursing locations, outpatient facilities, urgent care centers, and a wide network of primary care and specialty practices.
With a strong commitment to community health and wellness, the health system is committed to evolving with the growing and changing needs of the region. Part of that evolution has been an ever-expanding and successful use of telehealth.
Jonathan Witenko is system director of virtual health and telemedicine at Lee Health. He brings more than 13 years of experience leading the evolution of its telehealth program from a pilot to a comprehensive and system-wide strategy spanning inpatient, outpatient, ambulatory and population health services. We spoke with him recently to learn some lessons about Lee Health's virtual care success story.
Q. What primary challenge led Lee Health to initially explore and then expand its telehealth capabilities?
A. Our telehealth journey started more than 10 years ago, initially to securely connect our pediatric services with an outside physician group for sub-specialty care. As a computer engineer by profession, I led that first project focused on application and network security – VPNs, provisioning, and so on.
Interestingly, a personal family medical emergency that occurred shortly after go-live vividly highlighted the impact remote collaboration and access could have. My young daughter suffered a serious injury that needed specialist consultation not immediately available on-site. We were preparing for an air transfer when we realized the very connection we built could enable a remote consult, allowing her to stay local.
That experience shifted the view from a one-time project to a strategic priority: How could we use technology to connect patients and providers more effectively and eliminate barriers of distance and time?
The main challenges we aimed to tackle were improving timely access to specialists across our facilities, reducing provider "windshield time" spent traveling between campuses, and enhancing convenience and continuity of care for our patients. This project evolved from basic secure access to exploring video consultations and eventually developing a comprehensive telehealth strategy.
Q. Please describe Lee Health's approach to building its telehealth infrastructure, including key technology decisions and integrations.
A. Our approach has changed a lot over time. At first, dealing with high costs for commercial telehealth carts, our engineering team decided to build our own carts in-house. This method was much cheaper, and those carts reliably served us for about 12 years.
As technology improved and our needs increased, we moved to forming strategic work with vendors. A major goal was to make systems easy to use for both patients and providers. We quickly learned – through my mother-in-law as a test case – that systems requiring app downloads or complicated logins created barriers. We needed options accessible through simple text links or web browsers.
This led us to start working with Caregility about six years ago, and we use their platform's ability to integrate smoothly, especially within our Epic EHR environment, including the MyChart patient portal. This collaboration enables straightforward scheduling and initiation of visits.
For our "Room of the Future" initiative, we work with Vibe Health by eVideon to turn the in-room television into an interactive hub for patient education, entertainment, communication and scheduling. We also integrated translation services through Martti to ensure language isn't a barrier during virtual consultations.
The goal has always been to incorporate these tools into existing workflows – like Epic – to make telehealth a natural extension of care, not a separate, cumbersome process.
Q. Implementation of telehealth involves various stakeholders. How did you approach securing buy-in and addressing the needs of patients, clinicians and the health system itself?
A. Successful implementation of telehealth required us to balance the needs of three key groups: the health system, our clinicians and staff, and our patients. For the health system, the value proposition focused on efficiency, cost-effectiveness and strategic growth.
Telehealth kept programs like oncology and genetics operational and enabled them to improve years before we could recruit enough on-site specialists. It helped us avoid unnecessary patient transfers and related logistical costs.
For clinicians and staff, the benefits included less travel time, more flexible work arrangements such as our psychiatry team working remotely, and better work-life balance – which helps with retention and recruitment. Although there was an initial adjustment period, showing how telehealth improved their ability to care for patients effectively was crucial.
For patients, the focus was on convenience, quicker access to care and involving family members. Our early palliative care program demonstrated how telehealth reduced major patient logistical burdens.
We clarified that the quality of care remains the same, just delivered differently and often more quickly – such as in stroke cases – which helped address initial preference for in-person visits. Family participation in virtual rounds also proved extremely valuable.
Q. What have been some of the most significant results Lee Health has achieved through its telehealth program?
A. Telehealth has been crucial in strengthening essential clinical programs and increasing patient access. A clear example is our tele-stroke program, which now functions entirely virtually. This change significantly cut important time-based metrics like door-to-needle and door-to-doc consult times, ensuring specialists respond faster when every second matters.
Likewise, our psychiatry program faced difficulties, but telehealth played a key role in its success. It helped us keep valuable providers who moved out of the area and also allowed us to recruit specialists at the state level. Telehealth transformed these struggling programs, ensuring their survival and supporting their growth.
Since we officially adopted telehealth initiatives around 2015, the technology has consistently helped us reach our strategic goal of expanding access. We've observed this impact across various specialties.
For example, by implementing virtual consults, we significantly reduced the door-to-consult time by about four hours in areas like cardiac thoracic surgery. This often eliminates the need for patient transfers solely for a consult and allows specialists to conduct virtual rounds more flexibly, rather than only after their clinic day.
Fundamentally, these successes highlight telehealth's key benefit: its capacity to remove traditional barriers of distance and time, effectively connecting patients and providers when and where care is most needed.
Q. What advice would you offer other healthcare provider organizations considering similar telehealth technology?
A. My most important advice is to start somewhere. Don't wait for the perfect, all-encompassing system. Perfection can hinder progress, especially when you're just beginning. Focus on one major need or pain-point within your health system – such as specialist access, patient convenience or provider efficiency – and develop a system for that. It doesn't need to be perfect right away – but it must be safe, secure and compliant.
Learn from that initial implementation, gather feedback and iterate. We made mistakes along the way, but each step informed the next. Focus on the core goal: Use technology to bridge the gap between patients and providers and eliminate barriers like time and distance.
Don't underestimate the positive effect on your workforce. We've heard directly from physicians that telehealth capabilities have enhanced their quality of life and given them back valuable time they previously spent on travel or administrative tasks. It's a journey, not a destination, so take that first step.
Follow Bill's health IT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.
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