COVID-19 spurs innovation at health systems

While health systems across the nation struggle to meet patient surges in the wake of the novel coronavirus, many CEOs agree it’s had an unexpected outcome: bringing a wave of innovation.

“It’s caused all of us to think about everything differently—and it’s allowed all of our systems to realize just how adaptable we are,” said Dr. R. Lawrence Moss, CEO of Nemours Children’s Health System, based in Jacksonville, Fla.

He’s not alone in feeling that way. Nearly 43% of health system leaders said the COVID-19 outbreak accelerated innovation projects at their respective organizations, according to Modern Healthcare’s most recent Power Panel survey of top healthcare CEOs. And 42.9% said the pandemic both accelerated and delayed innovation.

That’s a trend seen across the industry. “We have definitely seen an increase in innovation, simply by necessity,” said Adam Seyb, a director in West Monroe Partners’ healthcare practice, noting telehealth has proved one of the most popular innovations to be adopted in the wake of COVID-19.

“Before this, if you would have said, ‘You need to stand up roughly 8,000 providers doing telemedicine in a matter of weeks,’ the answer would be, ‘Yeah, right, we can’t do that’—but they did,” he said of one health system he’s worked with during the outbreak.

Almost all CEOs in Modern Healthcare’s survey—92.9%—cited telehealth as a technology with the most potential to support response to the pandemic. But many also pointed to the promise of things like data analytics (57.1%), and 50% cited mobile devices and wearables, and 3D printing.

“I’ve seen more adoption of innovative ideas and technology in the last two months than I have probably in the last 10 years,” said Chris Van Gorder, CEO of Scripps Health in San Diego.

Carilion Clinic in Roanoke, Va., had been planning to expand its telehealth services over the next 12 to 24 months, building on efforts the system had already put in place to connect residents in rural areas to specialists. But that time frame—and plans to gradually ramp up—changed as COVID-19 cases started to climb across the U.S. early this year.

“We thought we would be rolling that out—we weren’t certain whether providers would feel comfortable using it and whether patients would want to use it,” said Nancy Agee, Carilion Clinic’s CEO. “Well, enter COVID-19.”

Now, 75% of the system’s outpatient visits are via telehealth, either through video or phone calls.

Carilion is in good company. Last year, Ochsner Health in New Orleans completed 4,000 telehealth visits; so far in 2020, it’s done 74,000. Nemours has gone from providing about 50 telehealth visits a day to upward of 1,300 a day.

Dartmouth-Hitchcock Health in Lebanon, N.H., used to average three telehealth visits per week, now it’s up to 2,000 a day. CEO

Dr. Joanne Conroy said her system is working to “reimagine” its ambulatory strategy after the pandemic, including a broader use of telehealth.

That said, there are still barriers: although CMS has expanded reimbursement for telehealth during the outbreak, those changes are designed to lapse when the public health emergency ends.

That’s one of the reasons CEOs in Modern Healthcare’s survey ranked payment models as a top area in need of continued innovation this year.

Dartmouth-Hitchcock also has facilities in two states, New Hampshire and Vermont, which creates challenges with state licensing restrictions.

“We’ve determined that patients like—and we can deliver—care through a telehealth product,” Conroy said. But the industry still needs to “figure out how to support it and pay for it.”

Telehealth is just one innovation the COVID-19 pandemic has spurred. At Scripps Health, the crisis not only encouraged more use of technology, but also reimagining how to use existing supplies and equipment in new ways.

That’s involved a variety of adjustments, including putting baby monitors at some patients’ bedsides so hospital staffers can communicate with them without having to enter their rooms—thereby reducing possible COVID-19 exposure—to repurposing the system’s cafeterias into makeshift stores so employees can avoid crowded markets after work.

“Crisis creates—sometimes—innovation and flexibility,” Van Gorder said.

One of the projects Scripps ramped up in response to the pandemic was a nurse call line to help guide patients to the appropriate care site. At one point during the outbreak that line was receiving several thousand calls a day, Van Gorder said.

Getting patients to the right care site is particularly important in the midst of COVID-19, when hospitals are dealing with patient surges and trying to keep low-acuity patients home.

To help steer patients who are concerned about COVID-19 risk to the proper care site, Sentara Healthcare in Norfolk, Va., launched a chatbot—essentially a personified computer program that instant-messages human users in plain English.

Hospitals across the U.S. have been deploying chatbots to provide users who visit their websites with information about COVID-19 or to triage patients to the right care site.

Chatbots are a promising use case for artificial intelligence, a technology that 57.1% of CEOs said has potential to drive innovation over the next year. Most said they’re seeing AI innovation in clinical practice and consumerism, two areas that overlap with efficiencies health systems hope to gain from chatbots.

Chatbots can help assess patient symptoms “in real time, so that (patients) get to the right place as quickly as they can,” said Howard Kern, Sentara’s CEO.

While COVID-19 has undoubtedly spurred much innovation at health systems, it’s also diverted time, energy and resources away from innovations unrelated to the pandemic.

Dartmouth-Hitchcock has had to slow down some of its work integrating AI into its teleICU—an effort to make it easier to monitor patients and identify changes in their condition—after redirecting its IT focus toward standing up telehealth and supporting remote work, Conroy said.

Similarly, after shifting its focus toward building up telehealth services, Froedtert Health in Milwaukee had to pause a database it was creating to analyze trends in consumer insights. It expects to return to the project soon, CEO Cathy Jacobson said.

“We’ve more than made up for that by the acceleration of the initiatives that we were able to do,” Jacobson said. “I’m not worried. We’ll be able to bring those back up in a couple of months.”

Health systems will differ in when they’re able to bring back projects put on hold during the COVID-19 crisis.

While most innovation projects have been postponed, not altogether canceled, those delays could stretch beyond the immediate pandemic as hospitals focus their attention toward replenishing some of their lost revenue, particularly as many organizations have had to put off elective procedures because of COVID-19.

Innovation can be pricey: Most CEOs participating in Modern Healthcare’s survey reported investing $5 million to $19.9 million in digital innovation projects.

“Certainly, a number of health systems were really hurt financially” by COVID-19, said Seyb from West Monroe. In the wake of the outbreak, that means many will need to start “shifting from some strategic projects before COVID-19 to things that are going to be more focused on keeping them alive.”