How Collaboration Accelerates Innovation During the Pandemic

A Banner Health and Kyruus collaboration on a COVID-19 vaccine scheduling solution illustrates the complementary roles health systems and vendors play, and it highlights the advantages of working together to meet changing healthcare demands.

The healthcare industry is experiencing an era of accelerated innovation driven by the novel coronavirus pandemic. For some, the symbiotic relationship between health systems and the vendors that serve them has intensified, resulting in close collaborations to adapt existing products to meet emerging needs.

The development of technology solutions to schedule health system COVID-19 testing and vaccine appointments offers a glimpse into the advantages of these cooperative arrangements.

Phoenix-based Banner Health, which operates 29 hospitals in six states, had been using the Kyruus ProviderMatch for Consumers platform since 2019, enabling patients to make appointments online with Banner's primary care physicians. When the need to schedule COVID-19 tests arose last year, followed by the need to schedule flu and COVID-19 vaccinations at the end of 2020, representatives from Banner and Boston-based Kyruus worked together to adapt the product.

The benefits have extended far beyond Banner's service area. The vaccine scheduling enhancement is now being used by 14 other health systems. Along with Banner, these organizations have booked a combined total of nearly 300,000 vaccine appointments using the new capabilities, according to Kyruus.  

Here's a look behind the scenes at how the relationship evolved to meet the innovation needs demanded by the pandemic.

Evolution of a Collaborative Relationship

In June 2019, Banner Health debuted a digital front door to direct patients to appropriate resources for care and enable them to book their own appointments online without placing a phone call. Behind the scenes, the Kyruus platform enabled patients to schedule visits online with primary care physicians (PCPs).

With the arrival of the COVID-19 pandemic in March 2020, Banner suddenly had a need to arrange appointments for COVID testing. To better manage thousands of inquiries, says Christen Castellano, MBA, vice president of customer experience channels at Banner Health, it made sense to enable patients to automatically book their own appointments. The platform, however, was set up to schedule visits with providers—not to book time slots at testing site locations. The health system and vendor worked together to adapt the technology.

"This was the turning point," Castellano says. The team took the platform's original "capability and transformed it in a way that improves our business and improves customers' access to care. We started using the tool by location instead of by specific provider."

Chris Gervais, chief technology officer and chief security officer at Kyruus, says Banner's testing sites were added as standalone locations that have their own associated visits and schedules. Kyruus also added the ability to ask patients questions during the scheduling process.

As with earlier versions of the product, appointments go directly into Banner's electronic health record (EHR), although the company also offers a standalone solution for customers who may not desire this type of integration.

At the same time these new capabilities were being added to Banner's platform, the health system also expanded access to additional providers, says Heather Francis, RN, MBA, clinical director of digital integration for Banner Health. This provided consumers the ability to directly book video or office appointments with hundreds of specialists and advance practice providers (APPs) in addition to the PCPs already active in the system. "When we pivoted to the COVID work," Francis says, "we were able to grow our physician population at the same time."

Vaccination Drives Deeper Cooperative Efforts

Another transformation occurred in the fall of 2020, when Francis inquired whether the platform also could be adapted to book flu and COVID-19 vaccine appointments. This led to a second collaboration with Kyruus.

COVID-19 vaccine appointments involve more complexities, Francis explains. Banner Health has 52,000 employees, and the health system is providing multiple COVID vaccine destinations in 15 different counties in six different states.

The Kyruus platform was expanded to handle new workflows that would accommodate vaccine appointments for employees and patients. Employees receive a link to directly schedule appointments; the general population has different entry points, through their local county health departments.

To communicate relevant information, the Banner Health website features a page devoted to COVID-19 vaccinations. It offers a screening tool to help community members determine whether they are eligible for the vaccine, scheduling guidance, and links to county websites where patients can schedule vaccine appointments at multiple locations in their county, including Banner facilities.

"One of the many things that's important to us, is the concept of scale," Castellano says. It was essential to "be able to do this with great accuracy and the ability to replicate it at scale as we launched it out to our community."

In November, consumers and employees began scheduling flu vaccine appointments through the platform, followed by COVID-19 vaccinations in December. With about 150,000 vaccine appointments booked through February, the online capabilities helped Banner in another significant way. "That could easily have been [150,000] phone calls," Castellano says, "which would've completely overwhelmed our system."

Providing digital scheduling access enables Banner to address the "sheer volume of appointments booked," Francis says. In addition, research shows that some consumers desire digital tools, while others prefer speaking to a representative at the health system's call center, Castellano says. Online booking offers the option to meet the needs of those who prefer the convenience of digital connections.

"The platform is accessible 24/7," Francis says, "and we did see in our data that people are booking their appointments at 10 o'clock at night, and sometimes at three o'clock in the morning. It opens up access for their preferred channel and helps offload calls to the call center, which provides concierge [level] service to folks who prefer that channel."

Teamwork: A Look Inside the Provider-Vendor Relationship

While collaborations between health systems and vendors are not unusual, the pandemic accelerated the need and pace for innovation.

"We've had the benefit of working with the Kyruus team for two years, so I felt like we were really well positioned to pivot during COVID," Francis says. "In particular, as we learned of design requirements, we were able to work directly with the Kyruus team to say, 'This is what we need in order to be accurate. This is what we need in order to meet the demand of vaccines that are going to be allocated.' "

"Understanding our organization and our customer needs helped us bring to the collaboration a level of creativity and adaptability that's needed to continually react" to developments, Castellano says. "You need those ingredients of a deep understanding of your business in relationship to your customers, a collaborative effort with your vendor partners, and, quite frankly, other partners who are helping you do this across functional areas."

Francis says it was essential to have a team that was willing to be creative in "solutioning" those issues. "It was the first time we did scheduling for locations and the first time we utilized asking specific screening questions within the tool itself."

The collaborative process expanded over time, Francis says. The team built upon lessons learned during development of COVID-19 testing appointments and further iterated to develop processes to schedule COVID-19 vaccination appointments.

"It's about looking at your design requirements and the needs from the customer perspective, and having a team that's willing to push boundaries, do things a little bit differently, and see how you can be creative," Francis says. "It's been an extremely positive process, and we've been able to do things very quickly."

Gervais says that the collaborative process enabled Kyruus to accelerate product enhancements that were already in development and use Banner's insights to refine the model.

"The Banner team approached this from not just a methodical and thoughtful perspective, but they also were willing to think through some of the different issues and not just sweep stuff under the rug," Gervais says. "Sometimes, in times of stress, when you're trying to go fast, you're just focused on that golden task to get you through."

The insights the Banner team shared helped Kyruus fast-track development. Gervais says.

"It was the best of both teams putting not only their creativity together, but also having folks who understand their domain really well. Christen's organization is very adept at working at scale and [they] also have laid a tremendous framework with their digital front door initiative and getting online scheduling embedded. That allowed us to move fast because the team was so well prepared. It let us make decisions quickly because we had such a strong foundation to build from. That made a big difference."

Accelerating Innovation to Serve Broader Industry Needs

The collaborative process between providers and vendors during the pandemic is producing tremendous benefits for the healthcare industry, Castellano says. "From a strategic perspective, you have a capability. In a pandemic, you repurpose it. In repurposing it, beyond the pandemic, we actually will have stronger capabilities. It's a virtuous cycle of continuous improvement and continually using creativity to take existing technologies, repurpose them, and use them in more meaningful ways that truly transform your business."

Not only did Banner's input influence the design of the Kyruus product, but it also provided information that helped the company prepare other health systems to launch their own online vaccine scheduling systems, Gervais says. For example, Kyruus advised other organizations to prepare for an initial crush of traffic that could force a website to shut down if it surpassed capacity, then might lead to a flood of calls. The company also stood up an alternate mechanism to help its customers handle potential traffic overflow.

Understanding the scale at which Banner is servicing the community provided huge inputs that enabled  Kyruus to "better understand some of the inherent complexities in this model and better prepare some customers who are smaller, who came after Banner," Gervais says. "Banner indirectly was helping to shape future efforts in other locations. A lot of what we learned in the early days with Banner really helped shape that playbook."