As the coronavirus wreaked havoc on the American way of life in general, and healthcare in particular, UNC Health leaders realized that proactive measures would be required to balance the pandemic and their core business.
With its partners at Conversa Health, UNC Health, which operates 13 hospitals in North Carolina, launched a coronavirus chatbot to let patients quickly receive their COVID-19 test results, while simultaneously converting its transitions-of-care outreach program to give patients with four chronic diseases an option of whether to engage in a phone call or a chat.
This is just one example of how today’s most innovative healthcare organizations are using automated virtual care to counteract what Dr. Peter Pronovost has called the “trillion-dollar problem.” Healthcare in the United States harms too many patients, costs way too much and makes only incremental improvements. In their 2021 study Making a Dent in the Trillion-Dollar Problem: Toward Zero Defects, Pronovost and his colleagues described a system plagued by defects in value that cause it to waste $1.4 trillion a year—a third of total healthcare spending—on suboptimal behavior.
By targeting specific defects in care, northeast Ohio-based University Hospitals, where Pronovost is chief quality clinical transformation officer, reduced its annual per-member-per-year cost by 9% over 12 months—and followed that with an additional 12% reduction.
A key ingredient in this success has been the use of automated virtual care. In a recent webinar presented by Conversa Health and the UCSF Health Hub, Pronovost and three other national leaders in healthcare and technology discussed their firsthand experiences in leveraging automated virtual care to manage capacity challenges, deliver better patient experience and improve population outcomes, all at lower cost.
Virtual Care Is Here to Stay
As innovative healthcare systems have embraced new technologies to economically scale care capacity in the face of the pandemic, virtual care has established itself as a tool that is here to stay.
With the healthcare industry’s “quadruple aim” as a north star, health systems are making significant investments in automation to reduce or remove traditional “value defects” from the equation. Leaders have leveraged these steps to address a wide variety of persistent challenges.
Among the defects addressed by the webinar panelists were:
- Failure to treat the whole patient
- Social determinants of health such as food insecurity and lack of transportation
- Neglecting to give patients sufficient guidance to help them make informed decisions about where they should go
- Unwanted outcomes, side effects, infections and other unwanted outcomes that can happen when patients are admitted to a hospital
The ability to address these and other defects is at the forefront of the move from reactive to proactive care—and leveraging patient data is key to that ongoing transition, Conversa Health CEO Murray Brozinsky said. That means collecting as much information as possible from the patient and then integrating that with information that you already have.
From What Is to What Should Be
Changing behavior is key to success in many areas of health. And the transition toward proactive care, designed to help in that regard, is a shift from what is to what should be:
- From episodic visits to longitudinal relationships
- From poor patient experience to collaborative experiences
- From limited visibility to actionable “patient signals”
- From descriptive to predictive
- From access barriers to a focus on access and equity
- From resource intensive to resource optimization
The result is an increasingly hybrid delivery model, as Brozinsky illustrated. “As you move from the current world of synchronous episodic to more asynchronous and continuous, you can collect that much more data,” he said. “It’s real-time assessment of how patients are doing. You can intervene and make sure that you’re driving the outcomes that we’re all hoping to achieve.”
Brozinsky referenced a chart showing the color-coded status of patients discharged from a hospital—green for patients who are doing fine, yellow for those who are having problems but can be nudged back on track using automated technologies, and red for those needing more extensive care.
“If you can collect patient data and analyze it, it illuminates the status,” he said. “If you can illuminate when patients are doing fine, you can eliminate the need to utilize resources in those cases.”
Reducing readmissions and length of stay is an important focus area for El Camino Health, which operates two hospitals in the heart of California’s Silicon Valley. “Tools like chatbots have really helped us drive engagement with our consumers,” said Deb Muro, El Camino’s chief information officer.
Conversa has helped the hospitals send patients home earlier while continuing to monitor them closely, constantly reaching out to them to check their status and having a human intervene if necessary. This has been especially useful for patients with respiratory problems, who “can get in trouble very quickly,” Muro said. The system is now expanding that approach to surgery patients and maternal child patients.
Chats have also been indispensable to UNC Health. “We have patients who we think are doing OK, but through the chat they let us know that they are not, that they need our nurses to reach out to them,” said Stephanie Turner, vice president, population health clinical services. UNC Health’s conversion of its transitions-of-care outreach program, for example, created a convenient way for patients with COPD, chronic heart failure, acute myocardial infarction and pneumonia to quickly let their care team know how they are doing.
“These chats gave us a lot of efficiencies,” Turner said. “Our nursing staff could be utilized to do top-of-license work, to focus on those patients who need nursing-level care and not spend as much time reaching out to those who are doing OK and staying on their care plan.”
Surveys and data analysis during the pandemic have made it clear that consumers want a broad array of available services, including virtual care. That option helps keep care local and more congruent, allowing patients to remain in their homes when possible and ensuring they have a voice in decisions about their care.
“We have a real opportunity to help patients on a daily basis,” El Camino’s Muro said.
For more real-world examples of value defects and how they can be eliminated, boosting clinical, financial and operational outcomes, check out the webinar “Automated Virtual Care Is Making an Impact on the Trillion-Dollar Problem”.
To learn more about how your organization can begin making automated virtual care an integral part of its healthcare delivery model, get in touch with Conversa Health.