This article, originally published by the Harvard Business Review on Dec. 4, features insights from Don Trigg, president, Cerner; John Glaser, retired Cerner executive; J. Marc Overhage, M.D., chief medical information officer, Anthem and former Cerner executive; Janet Guptill, CEO, Scottsdale Institute; and Chuck Appleby, director of publications & communications, Scottsdale Institute. This group of industry leaders explains how information technology can address the health care challenges and opportunities amid the COVID-19 pandemic and beyond.
As health care organizations grapple with responding to the ongoing Covid-19 pandemic and adapting their operations to continue to fulfill other aspects of their care mission, they must also begin to define and prepare for the future of care amid economic, regulatory, and social uncertainties. What might the post-Covid-19 landscape look like? How can health systems address a range of possible challenges? What are the opportunities to revolutionize care?
Care providers must understand the ramifications for their digital health function and agenda — and how information technology can address the challenges and opportunities of their “new normal.” To develop this understanding, we conducted a roundtable discussion with chief information officers from leading health systems at the Scottsdale Institute, a not-for-profit organization that supports its member health systems in achieving clinical integration and transformation through information technology.
The participants agreed that the new normal digital health agenda will need to focus on three overarching areas: developing virtual care, coping with the financial impact of the pandemic, and embracing the lessons learned from managing the crisis.
The volume of telehealth visits increased dramatically as patients sought to safely obtain outpatient care. Many physicians saw their telehealth visit volume increase by a factor of 50 to 175. This increase occurred over a very short period — often in days or at the most, weeks. Providers hastily constructed a temporary “bridge,” built with digital tools and operational workarounds that are not robust enough to sustain this level of use permanently. At the same time, patients have come to expect telehealth and many providers have become comfortable delivering care via the technology.
Because virtual care is now part of the new normal, health systems must construct a sturdy, permanent bridge that includes organizational, financial, and clinical structures and processes. The health system will need to integrate telehealth technology with the electronic health record, define clinical protocols for appropriate telehealth visits, obtain reimbursement for telehealth visits, and revamp hospital and physician practice processes to support telehealth (e.g., how should virtual waiting rooms work for telehealth visits?).
As health systems implement a permanent approach to telehealth, they should recognize that telehealth is a component of two broader digital health strategies: ensuring that care is delivered in the right setting and creating a great patient experience through a “digital front door.”
Delivering care in the right setting. Driven by the movement to value-based care (paying on the basis of outcomes as opposed to the volume of services), health systems must ensure that patients are cared for in the most appropriate setting. For example, how do we redirect care from emergency room that rightfully belongs in a doctor’s office? Can we provide chronic care management through home health services, reducing visits to the physician’s office?
Virtual care can help advance efforts to manage patient care across a continuum of settings. Remote monitoring can move much of chronic disease management to the home. Telehealth can enable access to specialist consultation for a patient at a nursing home without having to transport the patient to the academic health center.
Creating a great patient experience. The pandemic has increased consumer reliance on digital technologies for many of their daily activities. People work from home glued to Zoom. Groceries arrive from Instacart and Amazon delivers household supplies. Consumers will expect that their digital health experiences will be equally effective and easy to use.
To meet these expectations, health systems will need to double down on their “digital front door” efforts, enabling patients to handle routine interactions such as scheduling an appointment, paying a bill, finding a doctor, renewing a medication, finding answers to health questions, and navigating the health system itself.
Many health systems nominally offer these capabilities now, through patient portals with often opaque user interfaces and erratic performance. They must improve.