In 2019, Cleveland-based University Hospitals saw an opportunity to use digital care technologies and automation to improve patient engagement, clinical care, and outcomes. .
PROBLEM
Ultimately, the health system is looking to improve patient engagement first and then wants to see how it can use automated tools to improve outcomes.
It also recognizes the fundamental changes happening in the health system – especially when it comes to consumer behavior and increased competition from non-traditional health care disturbance factors. The organization wants to give its patients the tools and options to support their personal healthcare journey in these ways.
PROPOSE
“We have already implemented Automated Care Programs,” said Dr Brian Zack, systems medical director for digital health at University Hospital and deputy medical director at Ahuja Medical Center. by Amwell to help us achieve our goals”. “First, we start with pre- and post-discharge conversations with the goal of preventing re-admissions and helping patients better manage their care after leaving the hospital.
“We currently have about 18 chats,” he continued. “Some programs focus on chronic diseases, like asthma and diabetes. We also have a program to help patients with congestive heart failure. Our goals for chronic disease programs are linked more tightly bonded about how we can prevent admissions in the first place.”
As the pandemic unfolded, University Hospitals’ use of automation to manage care for those with chronic illnesses prompted them to consider: How can it leverage automation as a symptom checker for patients for COVID-19? And how can it use technology to determine when clinicians need to pause clinical activity and go for a checkup for the safety of themselves and their patients?
“In general, patients really enjoy talking, but we see much better engagement results when doctors communicate solutions as an important part of the care management process.”
Dr. Brian Zack, University Hospital
“We also needed a way to reduce the administrative burden of caring for our team at a time when clinicians were already at risk of burnout,” explains Zack. “By 2020, half of all physicians and clinicians reported feelings of burnout – and the number was even higher for medical assistants, nursing assistants, social workers and inpatient staff.
“Automation of routine and time-consuming tasks allows frontline workers to focus on what they do best: providing medical care and emotional support,” he notes. “It also increases their own sense of connection with patients and their families, and increases job satisfaction.”
In these use cases, care managers can focus on higher-severity patients requiring intervention and enable stable patients to use interactive conversations as a means of communication. their main form of contact, he added.
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MEET CHALLENGES ONLY
During the pandemic, University Hospital has leveraged a public-facing patient symptom checker tool – available on its website and through a digital app – to help patients identify: “Do I need to get tested? Should I stay home or isolate from my family? How? Will I use this information to manage my life?”
“That last point is key,” Zack insisted. “People don’t want their lives to come to a halt every time they feel a little uncomfortable or fear they’ve been exposed to the virus. They want to know, as reliably as possible, what to do when. and for what.” how long.
He continued: “We have adopted a digital screening tool for consumers concerned that they have COVID-19. “During the first months of the pandemic, the screening tool provided a starting point for tens of thousands of University Hospital patients who were experiencing COVID symptoms during times of high transmission.”
In doing so, this automated system enhanced the organization’s ability to manage capacity in hospitals, urgent care centers, and emergency departments. In fact, it has given the organization the tools to ensure the right patient gets the right care in the right environment.
“We then leveraged this relationship to launch an employee screening tool for COVID-Zack recalls. Every day, employees enter their information into the tool to ensure that they are given the green light to get to work safely.”
RESULT
The digital screener has provided a A starting point for University Hospital’s 100,000+ patients with symptoms of COVID to get medical feedback on staying safe at home.
“It prevents patients from unnecessarily exposing others to the virus and – in the event they do not have COVID – eliminates the risk of exposure in the healthcare setting,” Zack reports. “It also frees up overwhelmed doctors and nurses by providing patients with access to on-demand COVID symptom screening.
Today, this tool continues to help preserve capacity in the health system’s emergency and urgent care centers. “Meanwhile, our ability to remotely screen 29,000 employees gives our frontline workers peace of mind during each difficult virus outbreak. Employees already use this screening tool. more than two million times.”
University Hospital also found that many patients prefer automated conversations.
“Conversations can not only monitor a patient’s progress and vital signs, but they can also alert clinicians and care managers when intervention is needed,” explains Zack. “Ultimately, this helps strengthen the relationship between the patient and the care manager.
“Care teams also benefit from the way conversations allow care managers to focus on interactions that allow them to make their own clinical judgments,” he added. “They also remove the administrative aspects of care that get in the way of relationship building and contribute to clinician burnout.”
The conversations have helped improve care for patients with chronic illnesses. Since 2019, the use of chatbots to interact with patients with chronic diseases has increased Zack says it reduces readmissions in patients with chronic illnesses, improves health outcomes, and helps build strong, trusting relationships with care managers.
“Over 2,162 patients have used the tool to date,” he reports. “It’s a solution that increases the touchpoints of care for people with asthma, diabetes, heart failure, etc., without adding additional stress on care delivery teams and care managers. .”
TIPS FOR OTHER PEOPLE
One of the biggest lessons University Hospital has learned is about communication.
“In general, patients really enjoy talking, but we see much better engagement results when physicians communicate solutions as an important part of the care management process,” advises Zack. “This type of communication from physicians and care teams is key to helping patients understand the value and use of the solution.
He continued: “When implementing digital platforms, it is important to design KPIs that are achievable and reasonable – including engagement. “For example, we found a significant difference between patients who participated once, those who participated multiple times, and those who did not participate at all.”
Through data collection and analysis, the health system is beginning to better understand these populations and how it can create opportunities to manage digital care for more people through strategy. interaction strategy tailored to each patient.
“Ultimately, my biggest piece of advice is to set up an adoption process for implementing digital health,” says Zack. “This will help you define your organization’s goals for the platform and build a program that delivers value.
“Be very clear about what you are trying to achieve and make sure you have access to the data before intervening,” he concludes. “Otherwise, you’ll have to work 10 times harder to aggregate that data later when you evaluate ROI.”
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