Innovations should improve patient experience, reduce burden on workforce, CEOs say

Calls for healthcare to do more to embrace technology as a means to improve care delivery must first address whether such changes add to or ease the burden of a workforce that's been beleaguered by the pandemic.

Advancements made in the use of digital tools like telehealth, remote patient monitoring and predictive analytics have been touted throughout the pandemic for helping healthcare organizations address the access challenges caused by months of limited in-person patient contact at many facilities.

But it's critical that stakeholders ensure these innovations make life for easier, not harder, for clinical and administrative workers. That was an overarching message from leaders during Modern Healthcare's 2021 Transformation Summit held virtually May 18-19.

"We all recognize that electronic health records are critical, but I think the complaint that we have had is this 'innovation' has put more work on the back of nurses and doctors and pharmacists and technicians. We've got to solve that," said Dr. Rod Hochman, CEO of Providence and current chair of the American Hospital Association, during the summit's opening keynote address.

The pandemic helped to accelerate the conditions that have led to a growing problem of burnout among healthcare professionals.

A survey of more than 1,100 healthcare workers conducted from June through September 2020 by Mental Health America found 76% reported experiencing burnout and exhaustion while 75% reported feeling overwhelmed.

Ketul Patel, CEO of Seattle-based Virginia Mason Franciscan Health system, part of CommonSpirit Health, said it became apparent early in the pandemic that home-life pressures were as much of a source of stress among clinicians as treating COVID-19 patients. Virginia Mason created a care-at-work benefits fund that employees can use to pay for day care or pet care services. Patel said a second fund was created during the pandemic to provide workers with support for needs like rent assistance or paying for utilities and buying groceries.

"We looked for areas that would make our team and our staff's lives easier outside of work," Patel said.

Dr. Janice Nevin, CEO for Wilmington, Del.-based, ChristianaCare, said while much of the focus on technology has been to provide clinical care, she saw "enormous opportunities" in healthcare to apply it toward reducing waste and easing some of the workload.

ChristianaCare started to automate some of its administrative functions and is looking at efficient ways to allow for more of their nonclinical staff to work from home.

"Our mantra here is that everything that can be digital will be and everything that can be done in the home will be," Nevin said.

A growing number of "digital front door" tools for hospitals and health systems has created new opportunities to connect with patients, but may also result in a fragmented experience.

A hospital's digital front door can include patient portals, online self-scheduling, chatbots and other digital technologies used to engage patients outside of the facility's walls. But while helpful, those one-off solutions can be confusing for patients if they're frequently sent to new websites or asked to download new apps from various companies to access healthcare, experts said during the Transformation Summit.

"I don't want (patients) to come in and there's one experience for check-in, one experience for scheduling, one experience while they're at the virtual visit," said Suja Chandrasekaran, senior executive vice president and chief information and digital officer at Chicago-based CommonSpirit, during a panel discussion on digital engagement.

Patients should have one consistent experience they can access from a single platform, she said, with data that flows from each point to the next, so they're not constantly filling out the same forms.

Developing that cohesive view for patients requires coordinating across the health system.

That can be particularly challenging for large organizations with multiple service lines, across multiple hospitals, across multiple regions.

"If each one of these (groups) goes out and says, 'Here's our digital strategy for the consumer,' the consumer ultimately doesn't win—they end up with a bunch of different experiences," said Jeff Johnson, vice president of innovation and digital business at Phoenix-based Banner Health. "How do we bring every single one of these possible touch points together?"

Johnson said he hopes the new data-sharing regulations from HHS, which aim to spur adoption of standard application programming interfaces in healthcare, will encourage digital health startups to make it easier to link up to one another and "really integrate into our overall Banner customer experience."

A push toward wanting a single experience that encompasses multiple capabilities is likely one of the factors underpinning continued mergers in digital health, as startups that were founded to solve single problems consolidate to create broader platforms.

Fifty-seven mergers or acquisitions of digital health companies were announced in 2021's first quarter, according to data compiled by Rock Health, an early-stage digital health venture fund that also compiles research on the sector.

One of the mergers involves Doctor On Demand, a telehealth company, merging with Grand Rounds, a company focused on navigation for specialty healthcare.

"The industry has been very saturated with point solutions, but we're starting to see a lot of companies merge," said Missy Krasner, venture chair at healthcare innovation firm Redesign Health, during a panel discussion on digital health startups.

There were 142 digital health M&A transactions in total last year, notably including a merger between Teladoc Health and Livongo, which focuses on chronic condition management.

Already in 2021's second quarter, employee benefits company Accolade shared plans to buy virtual primary-care startup PlushCare.

In fact, while special purpose acquisition companies—or SPACs—have garnered attention in the past year thanks to companies like 23andMe and SOC Telemed going public through them, mergers and acquisitions remain the most common exit strategy for digital health startups, according to Bill Evans, CEO and managing director at Rock Health.

Merging with another digital health startup has proven an especially popular way to exit.

"For the last several years running, including so far this year, mergers between digital health companies remains the largest form of M&A," Evans said. "We're seeing consolidation."

Some innovations have less to do with the use of a new digital tool and are more about workflow and collaboration.

Tommye Austin, senior vice president and chief nurse executive at University Health System in San Antonio, said the organization's chief behavioral health officer during the pandemic established an office where employees having issues could visit and get mental healthcare support.

The pandemic also gave the health system better insights into patient flow, she said, including scheduling elective surgeries.

"We have the opportunity to triage better now, but if we had it to do over again, we would make sure the physicians had the opportunity to choose who needed surgery and who didn't need surgery," Austin said. "Giving the physicians more autonomy would be a lesson we have learned."

Healthcare will likely have to contend with the health effects of COVID-19 in patients for years after the pandemic ends. Hochman compared the new landscape to the way the healthcare around patients with HIV has evolved over the past three decades from a deadly infectious disease to a more chronic health condition in need of management.

That likelihood is why organizations moving forward should look to create more compassionate work environments that encourage greater transparency and honesty and fosters a willingness among employees to talk about their stress-related issues, said Dr. Melinda Estes, CEO of St. Luke's Health System in Kansas City, Mo.

"The impact of this pandemic is going to have long tentacles," Estes said.