Experts share use cases for adapting to pandemic trends
Health systems re-examine previous approaches in making decisions and the need for agility in adapting.
The COVID-19 pandemic has pushed many healthcare providers to their limits. However, the changes necessitated by the disease and resulting lockdowns have also led to a burst of activity in technology development and deployment.
Executives at Florida’s BayCare Health System have learned to identify healthcare trends and patient needs, collaborate with vendor and retail partners, and work quickly to provide innovative solutions that will serve consumers far into the future.
“I think the pandemic caused most health systems around the country to rethink how we make decisions," said Ed Rafalski, BayCare’s chief strategy and marketing officer. "And I think the lesson we’ve learned has been to be more agile in our thinking and to be sensitive to consumer needs.”
Digital symptom checking
A recent KLAS report on patient engagement tools compared vendor-reported capabilities in 2021 to those from 2019. The capabilities that grew the most in those two years were telemedicine, self-registration/check-in, and self-scheduling/rescheduling. As shown in the chart below, the report also noted high rates of growth in the patient-centric capabilities of triage/symptom checking, self-assessments and online coaching.
In addition, Data from two Deloitte surveys showed, “Adoption of apps and at-home self-diagnostic and genetic tests is accelerating,” with about a third to half of consumers [now] comfortable using at-home diagnostics for various reasons.”
BayCare Health System saw the value of symptom-checker functionality as soon as the pandemic began. The health system’s phone lines were jammed with patients who had questions about COVID-19, and they needed a digital solution to help. So Craig Anderson, director of innovation for the organization, called BayCare’s chatbot vendor, Clearstep.
“We knew what Clearstep’s technology could do, but no one had anything out there for COVID. So I quickly called the CEO and said, ‘We need to see if we can build an asynchronous, AI-infused chatbot so that our customers can visit baycare.org at any time and learn about their symptoms that could be from COVID.’ We worked with Clearstep and brought our team together.” Nine days later, the solution was up and ready.
Anderson expects the tool to remain useful to BayCare long after the pandemic has eased. “We've adapted the symptom checker to handle not only COVID, but any other type of condition, from a rash to a cold to anything else. It’s very nice because the patient can work with the tool in an asynchronous manner at any time of the day or night that they want and still get pointed to the exact right place of care.”
The tool’s speed to deployment and subsequent success, according to Anderson, was made possible through intense collaboration. “It really just indicates the type of teamwork we used—our vendor partners, our clinical partners, our technical partners and all of BayCare leadership. We all looked in the same direction leaned into it.”
Care at home
After a 2020 survey of provider organizations, KLAS reported, “Interviewed organizations unanimously proclaim that telehealth is here to stay. While changes to reimbursement policies may dampen some adoption, organizations report an appetite from both providers and patients to continue virtual care for many scenarios. … Remote patient monitoring also comes up often as a future expansion of today’s telehealth offerings.” The chart below shows which aspects of telehealth the providers believe will continue to be used for the long term.
Before the pandemic, BayCare Health System had toyed with the idea of applying some form of what Johns Hopkins coined Hospital at Home®. When BayCare facilities began to run out of beds because of COVID-19 surges, the health system got to work on a virtual hospital solution and the technology stack to back it.
“This application, @Home, was specifically designed to address the recovering COVID patient so they didn't need to stay in a medical or surgical bed but still needed some level of monitoring and care,” Rafalski said. “We’ve also able to apply this to other concepts and low-level disease states, like respiratory disease, pneumonia, recovery from pulmonary infections, some cardiovascular applications, infectious diseases like cellulitis, some gastroenteritis disease states, and also some endocrine and renal cases.”
“With the concept of innovation, my group doesn’t focus all the time on the technology," Anderson added. "It’s about doing things differently to please the patient and give them a better experience. The expectations are being set all over the market outside of healthcare that consumers will get what they want when they need it, and have it brought to the home.”
Prescription access
CoverMyMeds patient surveys revealed that while 88 percent of patients in 2019 received their prescriptions from a retail pharmacy, half of patients had received prescriptions at home from April to September 2020. But home delivery is not the only creative way to get medications to patients. Both before and after the COVID-19 pandemic, BayCare Health has been using their partnership with the grocery company Publix to offer prescriptions in convenient places.
First, Publix is offering virtual, walk-in kiosks located next to the pharmacies in many of their Tampa Bay locations. A patient can complete a virtual visit with a provider, get a prescription and then fill their prescription, all while on their weekly grocery run. “The idea is to offer a lower-cost option for the consumer to engage with a provider if they have a low-level clinical condition,” Rafalski said. “If there’s a need for a prescription, the doctor can write one, it gets filled by the pharmacist, and you’re out of there in 10 minutes.”
BayCare also sold their on-site hospital-based pharmacies to Publix. Each of the health system’s flagship facilities now has a Publix pharmacy inside. Patients can have a retail-like experience at the pharmacy or benefit from BayCare’s meds-to-beds program.
“After your procedure and once you’re ready for discharge, the Publix pharmacist or runner will come up to your patient room and give you your medications," ” Rafalski said. "The concept is that if you do that, the probability is that you’ll refill the prescription at Publix, which is a win for them. It’s a win for us because you fill your prescription. We know that that leads to medication compliance, which then reduces readmissions, which is good for us.”
The tipping point
Rafalski and Anderson understand how challenging it can be for health systems to shift the focus of their technology from the provider to the consumer, but they’re both encouraged by how COVID-19 is pushing the industry in the right direction.
“We've talked about consumer-centric design and retail-oriented design in healthcare for years now. But I think the moment has come when technology is enabling that adoption and redesign much more quickly,” Rafalski said. “I think the pandemic has made us realize that, hey, we can actually do this.”
“And we can do it at pace,” Anderson added. “As quick as any other industry. We just need the right idea, the right partners, and the right mission. We are innovating, and it is great to see.”