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Implementing Digital Health Solutions Amid an Evolving COVID-19 Pandemic

GE Healthcare and Roche recently sponsored a webinar on the topic of COVID-19 and Digital Health Care Resources. The panel included Stacey Johnson, MD, vice president and chief medical information officer at Baptist Health; John Beaman, chief business officer at Adventist Health; and Jeff Hersh, MD, PhD, chief medical officer for GE Healthcare Systems. Below are highlights of the conversation.

How has COVID-19 accelerated the implementation of virtual care and “care anywhere” models?

SJ: With tongue in cheek, I’d say we were just dipping our toe into telemedicine, and then when COVID hit, we implemented about five years of a telemedicine strategic plan in approximately five weeks. In all seriousness, the way I see “virtual care” goes beyond just telemedicine. It's truly a virtual-care platform. It's not just your telemedicine visit. It’s online check-in. It’s bill pay remotely. It’s embracing the patient portal to allow for them to have a more virtual experience.

JB: We were able to do a lot of innovation, a lot of deployment, in 30 to 60 days that in normal circumstances may have taken years and not months. One thing we took beyond that, was starting to look at some targeted populations. One in particular that resonated for us was the senior population. They were heavily impacted by COVID, but they were probably even more impacted by the stay-at-home orders. And so, with the “care anywhere” idea, the thought was how could we not just think of medical care, but also behavioral care? How could we deploy the anxiety and stress counseling that may be needed for some of these targeted populations like seniors in their homes, because they weren't interested or were actually discouraged from leaving their homes and their environments to seek in-person care? So we deployed a web-based, AI-enabled behavioral platform as well, in addition to some of the traditional care platforms.

JH: I love this concept of “care anywhere.” I would add to it, “consult anywhere,” and “information anywhere.” Imagine if you had technology so I could look at somebody's vitals in real time, while I’m in transit or at bedside. I could envision looking at their laboratory results as soon as they come back, in real time. I could jump into their medical record and get historic information. And if I could do it in an intelligent way, because these medical records today are so incredibly long and detailed, it would be nice. The way I think about this is, I'd like to know what I want to know, when I want to know it, even though I don't always know what I want to know.

How do you ensure you secure buy-in from stakeholders as you implement the “care anywhere” approach?

SJ: We can't forget that our clinicians are also consumers. They're consumers of care in addition to consumers of information. So we have to ensure that whatever technology we deploy is easy for both the patients, as well as the providers. If you go down the road of implementing strategy or technology that is difficult to use, you will not reach the adoption rates that you will need in order to be successful.

New technologies and Big Data can be overwhelming. How can technology help manage cognitive burden for providers?

JH: There are so many intricacies for each individual patient. And it becomes important when you're managing that patient to fully appreciate those nuances. Clinicians also have to make sure that you keep in the forefront of your mind just what is pertinent for the individual patient in that instance. So, let's say you're in the ICU and you're caring for six different patients. Which one had a borderline creatinine two days ago, or was way ahead in their I’s and O’s? There's so much information now, and so much data, that making sure you have all of that readily accessible becomes more and more important.

SJ: One of the things that we're implementing currently is a palliative care, artificial intelligence algorithm. It uses a cognitive computing model that takes into consideration not only the patient's medical information from their EHR, but also social determinant information, as well. This helps to inform clinicians as they make their own decisions whether this patient is actually more appropriate to receive palliative care, or whether it is more appropriate to continue pursuing the current medical care that they are receiving at that time. Those are promising technologies that can support the physician in hopes of decreasing cognitive burden.

COVID-19 helped force changes that might have otherwise taken much longer to implement. What did you have to give up in order to achieve rapid deployment?

JB: I don't think we're giving up anything. In fact, we're enhancing the care side. Probably some of the steps we may have streamlined included consensus-gathering and some formal process steps. I'd say what we've learned is that, going forward, there's a new purpose for those processes that is focused on accelerating the great ideas. Finding a way to do that - in the right manner - that keeps that sense of alacrity that we found so helpful in the last 90 days is key.

How has your experience with COVID-19 affected your financial priorities as you look to the coming months?

JB: My prediction is that we’ll now see less spent on building new wings and towers and more invested to repurpose the spaces that we already have. How do we use them effectively, maximize our capacity and schedule better? All that so we can take the learnings from the virtual or “care anywhere” environment and provide care in the right setting at the right cost. I think it’s the right thing to do from a financial standpoint and I also think our consumers are going to appreciate that. It goes to the affordability of healthcare over time.

How do you build flexibility into these new models of care, so that you will be prepared for further disruptions or major health events?

SJ: We have developed a very detailed COVID dashboard that we are monitoring closely. So not only do we see our own hospitalization rates, but also the hospitalization rates of the local community hospitals, as well as those within the state. So we are aware of what's coming down the pipeline for us. That being said, should we have another surge or micro-surge, we've actually built out multiple bay areas that could quickly be converted into hospital locations.

JH: Flexibility is incredibly important in being able to utilize physical space, as well as the other resources you have. Those other resources need to include your clinical workforce and your human resources. And one of the big things that we all need to be working on is to allow clinicians to practice to the top of their licensure, as well as the top of their expertise. In order to do that, we've got to take some of the busywork off of their plates. We've got to automate some of the day-to-day stuff that doesn't utilize their clinical skill set, and, honestly, just takes them away from patient care. So, it's flexibility, very much in the resources we have, but resources across the entire board: the physical resources as well as the human resources.

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