An innovation insider talks about the collaboration and teamwork behind the scenes that accelerated the deployment of multiple solutions within weeks to millions of patients.
Many healthcare systems are deploying digital innovations to address COVID-19. CommonSpirit Health, a nonprofit, Catholic health system operating in 21 states, had to do this on an unprecedented scale, accelerating deployment of solutions already in use and developing new adaptations to address the specific needs of the pandemic.
In a matter of weeks, the health system scaled virtual visits and AI-enabled assessments and screenings to millions of patients across the enterprise. These technologies are being used to coordinate care and resources across CommonSpirit’s 137 hospitals and 1,000+ care sites. Among the solutions being offered:
- Free virtual urgent care visits
- AI-powered self-assessments via websites that "chat" with patients and direct them to appropriate resources for care
- Onboarding 3,000 physicians during a two-week period to enable them to conduct virtual primary care visits, which skyrocketed to 5,000 encounters daily
- Automated screening and triage tools that prompt patients to provide symptoms and medical histories before a visit and flag high-risk patients for clinical staff
HealthLeaders recently spoke with Marijka Grey, MD, MBA, FACP, executive leader of Transformation Implementation—Physician Enterprise at CommonSpirit Health, who was involved in rolling out these initiatives. She shares an inside look at CommonSpirit's experience to help other hospitals and health system rapidly scale their own innovations. Following are excerpts from the interview, which have been lightly edited for clarity and space.
HealthLeaders: How did the pandemic impact the digital platforms CommonSpirit uses with patients?
Marijka Grey, MD, MBA, FACP: We have always had a strong telehealth network group with the legacy CHI and legacy Dignity markets, with several centers of excellence. So whether you're talking Pacific Northwest or the Kentucky area, there've been groups who have been working on telehealth for years under the direction of Jim Reichert PhD, vice president system, CommonSpirit. So with this national crisis, we literally leaned on them to expand their efforts nationally. So between Herculean efforts by our Digital team to be able to make sure that our networks and systems could all support this, as well as enabling those content leaders in different areas who had already developed the workflows and how to use these platforms, we brought them together quickly to be able to scale this to a national size.
We always try to be on the cutting edge of innovation, and we had already been working with several artificial intelligence companies on ways that we could help with our patients and intake. When the state of emergency came about, these companies came to us and said, "here are some ideas of how we can help you." With that, we took a look at how we can work to help the clinics, in which case we are actually screening patients before visits to make sure that they are not symptomatic so when they come in, it's protecting not only themselves but the staff. [We've] also been able to put that screening tool across all our websites so that patients could get the comfort of being able to go to a trusted healthcare source, put in their symptoms, and really get good feedback as to whether they should be seeking care.
HL: What had to happen logistically to accelerate these innovations?
Grey: We basically set up several scrum teams from the IT side, as well as an agile development process to be able to pull this forward, [including] experts from all different areas of CommonSpirit. We came together in a way that was unprecedented so that we had all team members at the table. We not only had subject matter experts from a digital perspective, we had operations experts, physicians, clinical and the revenue cycle management [representatives], as well as our IT folks both from the tech side as well as the network side. We came together for daily meetings, including over the weekend, to make sure that we were progressing with the scope.
HL: How did you decide who would be on the team?
Grey: It was a very fluid process. The best part was that it was being led by Digital so they had the knowledge of the IT infrastructure, which was of course of basics that we needed to get most of this work done. But they quickly reached out to subject matter experts in different areas as we realized we needed them, for example coding and compliance for the virtual visits, Basically, as a need was identified, someone was tapped and brought forward. The person had to have not only the organizational knowledge to be able to contribute, but also the organizational leverage to be able to take it back to their teams and disseminate.
HL: What advice would you give to a health system that was trying to prepare in the same way you have?
Grey: If you haven't started yet, you're already behind the eight ball. I would also say to involve as many stakeholders as you can and have that second and third eye on the ball and the product. Really make sure that you're not missing the basics. Of course we want to roll something out fast, but we also want to make sure that what we've delivered is something that is [high] quality and really works for our patients of physicians and clinicians.
HL: You onboarded more than 3,000 physicians to your virtual platform in a two-week period. How did that happen?
Grey: First of all, we leveraged the beauty of IT and the good spreadsheet to be able to upload a large number of physicians and advance practice providers (APPs) into the computer system at one point in time. The provisioning aspect was quickly rolled out. In addition, we have been doing daily classes for the physicians and APPs for training. We've leveraged training materials from our CHI Franciscan group in the Pacific Northwest. We white label their information so it can be used in any of our departments around the country. What we basically [created] was an essential training spot where any team can get information and training materials, and adapt them quickly to their local needs, depending on their local electronic medical record, which practice management system [they use], and any state-specific rules or regulations. We also served up virtual happy hours, as well as national virtual training, giving folks the ability to connect with physicians and clinicians across the country and get quick tips and tricks on how to do these visits.
HL: What else would you like to say about this topic?
Grey: I'd like to stress that the healthcare system is here for our patients. One of the challenges with COVID-19 is that folks are appropriately performing social distancing. But there are those with medical needs who still need to be followed up on, who still need to be seen, and in some cases, who still need to have hands laid on them to ensure their general health. So we're making sure that if your visit can be done virtually, we have the right tools so that a physician or advanced practice provider can reach out and do that for you. And if you need to visit in person, that you have a safe clinic environment in order to be able to do that.
Mandy Roth is the innovations editor at HealthLeaders.
Creating teams with the right representatives was essential to the process.
The health system built on resources and infrastructure already in place, and also employed adaptations vendors created to specifically address COVID-19.