How Digital Health Lays the Groundwork for Future Healthcare Strategy

Baptist Health in Arkansas is adapting digital health tools and platforms to improve inpatient care, a pathway that may change how hospitals of the future do their business.

Virtual care technology is giving health system administrators new ideas on how to deliver care inside the hospital.

Baptist Health is one of many health systems using digital health to improve its ICU services and connect care providers throughout the Arkansas-based 11-hospital network, improving care at the bedside and enabling small, rural hospitals to reduce transfers and care for more patients. Executives say the platform, which has been in use for roughly 14 years, allows them to coordinate care from the main hospitals in Little Rock and give outlying hospitals with fewer resources the support they need.

"We're improving care at the bedside," says Kourtney Matlock, corporate vice president of population health. "We can expand our specialists' reach beyond our Little Rock locations and help [rural sites] keep more of their patients."

That's especially important as the health system deals with the pandemic, which has filled up hospital beds and strained workloads. And it will be important beyond COVID-19, as hospitals look to move services onto virtual platforms and reconfigure inpatient care so that those occupying hospital beds are the ones who really need hospital-based care.

"This isn't just about how we use technology," says Danny Kennedy, the health system's IS field services manager. "It's about how we use our hospitals."

Kourtney Matlock, corporate vice president of population health, Baptist Health. Photo courtesy Baptist Health.

As the healthcare industry moves toward the concept of hospitalizing the sickest patients, it's turning the concept of remote patient monitoring around. Telemedicine platforms and digital health tools are being deployed within the hospital setting to capture more patient data and send it directly to who most needs it, no matter where that care team member is located. That may be the nurse down the hall at a central station who's keeping track of all the patients in a specific area, the hospitalist in Little Rock assigned to watch patients in a small hospital a few hundred miles away, or the specialist who's keeping an eye on a patient with complex care needs at another hospital.

Matlock says Baptist Health had been using a physician group in Israel to remotely monitor its ICU patients up until 2019, when it shifted to a model that kept its care providers within the health system. That's been part of a long-term strategy, she says, to develop inpatient virtual care that makes the best use of staff and allows clinicians to practice at the top of our license.

"We've had a lot of these conversations for years," she says. "We want to be able to utilize our staff differently" and create workflows that benefit them.

Both Matlock and Kennedy say Baptist Health has had many physician champions for virtual care, but there were also a lot of clinicians who didn't want to move in that direction.

Danny Kennedy, IS field services manager, Baptist Health. Photo courtesy Baptist Health.

"A lot of physicians were skeptical at first," Kennedy says. "We could just never get them on board prior to COVID. Now they're coming to us."

The pandemic changed that, bringing not only clinicians but entire health systems into the digital health ecosystem and cramming five to 10 years of innovation into two years. And while technology was trained on caring for infected patients and reducing the chances of exposure for care teams, forward-thinking health systems were eyeing strategies that took them beyond the pandemic, where digital health would be used inside the hospital to refine and direct care to where it would be most needed.

That requires a different way of thinking, and one that is challenging health system leaders to recognize that tomorrow's hospital will be considerably different. It will involve more integration, as services are coordinated through digital health channels, and an understanding of how nurses and doctors can be redeployed to improve care management.

Remote patient monitoring will play a significant part in the reimagined hospital of the future, where patients receive more care at home. But that's still a ways off. Matlock notes that Baptist Health had been using an RPM program since 2003, but dropped it roughly two years ago because reimbursement wasn't there to support the service.

"It'll be back," she says. "I see it as one big offering."

It may also include the hospital-at-home concept being shepherded by the Centers for Medicare & Medicaid Services, which combines RPM, telehealth, and in-person services to care for patients at home who might otherwise be in the ICU. That could help hospitals relieve stress on inpatient services and give more patients an opportunity to recover at home, where studies have shown they tend to have more positive clinical outcomes.

Matlock expects that Baptist Health will use some of the technology and strategies they're now using in their ICUs to transition into a hospital-at-home program.

For now, the health system is focusing on the inpatient network. This includes coordinating care with the smaller, more remote hospitals in their network, where ICUs are either small or nonexistent and a patient transfer to a larger hospital might take dozens of phone calls. Linking to the larger hospitals in and around Little Rock enables those small hospitals to expand their ICU capabilities, even create ICU beds where they didn't have any, and care for more patients, keeping them closer to home and their families instead of shipping them off somewhere distant.

In some cases, Baptist Health is using telemedicine carts to manage care, and many rooms are being equipped with tablets that synch with a virtual care platform developed by New Jersey-based Caregility and the health system's Epic EHR, allowing not only providers to connect with the patient record but giving patients a means of connecting with friends and family, or for those who need interpreters.

"That was a big satisfier for us," says Kennedy.

He also notes that some clinicians were hesitant to embrace monitoring and caring for patients in other hospitals, fearing it would add to their workloads and be unreliable. But many were convinced as they used the technology, he says, and worked with clinicians in those other hospitals to coordinate care.

"Everyone is a lot more receptive to the concept now that they've used it," he says.

The platform has also allowed Baptist Health to expand the reach of its specialists, giving those smaller hospitals access to pulmonologists, infectious disease and wound care experts, and lactation consultants—neurology consults are being handled through a third party—with more services on the way. This once again allows those smaller hospitals to provide more and better care for the people in their surrounding communities, an important factor at a time when many small hospitals are struggling to stay afloat.

Matlock says Baptist Health has been contacted by other healthcare systems about those services, but currently doesn't have the staff or the bandwidth to expand. She says the health system might someday fine-tune its platform to a point where it can market those services through a new business line.

All that is in the future, of course. But it's tucked into a long-term strategy that mirrors the direction of the healthcare industry. Health systems need to reimagine how care is delivered, expanding the platform to cover patients no matter where they need that care, and offering services that interact with the communities they serve. The hospital may sit at the geographical center of that platform, but it will no longer be where everyone goes to get care.