A Healthcare Provider’s Insights on Surviving the Pandemic
The global COVID-19 pandemic has raged on for almost two years now. When it first started and even as it continued, many of us expected a quick end. But now it may be time to accept that this is the way that things are going to be for a while.
This past September, Dr. Robert Bart, CMIO of University of Pittsburgh Medical Center (UPMC), spoke at the Digital Healthcare Investment Symposium (DHIS), a conference that KLAS Research puts on for healthcare investors. I was very intrigued by Dr. Bart’s insights on the strategies that his organization is using to navigate the complexities of the COVID-19 pandemic.
The New Normal
Healthcare employee shortages have really taken off since the pandemic started, and according to Dr. Bart, they may be one aspect of “the new normal.”
“People thought that the pandemic was going to be a time-limited experience, and it’s not.” Dr. Bart explains that viewing the pandemic this way has allowed him to rationalize what he does every day as he and his organization face new telemedicine challenges.
While this news probably isn’t what healthcare workers have been hoping for, adopting this new perspective may help providers adjust to their day-to-day workflows.
Telemedicine and Workflow Management
During the telehealth boom that has occurred as a result of the pandemic, many telehealth companies have focused their efforts on improving their systems’ audio and visual features and tools. While those are critical aspects of telehealth, there hasn’t been nearly as much focus on improving a system’s workflow management.
Dr. Bart worried that UPMC would end up strapped due to the number of clinicians that they had, and he felt that they needed something to extend care. More specifically, they needed a solution that could scale to manage 80–100 ICU beds on call at night.
In order to address this problem, they built their own workflow solution for telemedicine in their ICU. They were able to do that during March and April of 2020, a time when many healthcare organizations were really struggling. The platform not only supported UPMC but also some New York hospitals. It was such a success that UPMC ended up expanding it to be used for their other specialties, such as telestroke and teletoxicology. The platform has both mobile and desktop utility within the ICU environment, and it allows providers to manage that environment.
Addressing Home Health
While Dr. Bart counts his organization as having been lucky enough to never get oversaturated during the pandemic, he recognizes that other organizations weren’t so lucky.
Dr. Bart states that, “the standard of care in most US hospitals is a rapid-response team . . . [We] need that equivalent [in people’s homes].” Thus, they formed their Home Assessment Response Team, or HART for short. The HART team allows providers to respond to “patients who require urgent assessment and treatment at home, but do not require 911.”
Dr. Bart detailed examples of three patients who were aided by the HART team. One had new onset congestive heart failure. Another had elevated potassium levels, and the last had vomiting and urinary difficulties. In each case, the HART team was able to respond to the patients on-site and diagnose problems or administer medication to prevent admissions or return visits to the hospital.
Dr. Bart expressed that the most important parts of home health were policy reimbursement, safety, rapid responses, redundancy in technology, and platforms that could leverage intelligence. The goals of the HART team were to decrease unplanned care and respond to acute events in peoples’ homes. They also wanted to prepare to respond properly to hospital-at-home programs in the future.
The HART team is still in its very early stages, but it has already allowed patients to avoid a significant number of meetings, visits, and admissions.
Monitoring and Wearables
Dr. Bart quotes Jon Meliones, Chief of Cardiology at The University of Texas Health Science Center, in saying that, “bad information is worse than no information . . . but clinician judgement tends to be better than bad information.” He further points out that many monitoring and wearable devices don’t have any artificial intelligence attached to them. That can cause confusion, misinformation, and even legal liabilities.
Physicians need to be notified of relevant information so that they can reach out to patients and improve the quality of their care. This is an area where the HART team can really make a difference. However, most solutions can’t provide those notifications. Thankfully, “good information results in timely decision making.” Monitoring and wearable devices can provide a lot of good and relevant information under the right circumstances.
Digital Gateways
The home health area has grown immensely during the pandemic, and with that growth, many healthcare organizations have renewed their efforts to create a digital front door. “I actually think that what we need to be looking at is creating not the digital front door, but the digital gateway to the care continuum with the next phase of patient portals,” states Dr. Bart.
Dr. Bart further expresses that patients don’t just need a digital doorway into unauthenticated experiences. They need a gateway that will give them access to authenticated experiences that will increase patient memory and participation. Dr. Bart points out that, “It turns out that if you have patients self-schedule their own appointments, their no-show rate is significantly lower.” Eventually, Dr. Bart wants patients to truly be able to own their patient portals.
Dr. Bart shared these insights and many more at DHIS. If you would like to know more about how to implement Dr. Bart’s ideas into your own organization, check out KLAS reports about the digital front door, telehealth, and home health. To attend one of KLAS’ events in the future, please reach out to KLAS for more information and to lend your own insights.