Last Wednesday, Salesforce and Ogilvy Consulting brought together a quartet of upper-level health-tech execs – Kristin Myers, CIO at Mount Sinai Health System; Roberta Schwartz, EVP and chief innovation officer at Houston Methodist Hospital; Dr. Kimberly Noel, director of Stony Brook Medicine Telehealth and deputy chief medical information officer; and Wendy Cofran, director of global provider strategy, health and life sciences at Salesforce – to discuss how technology can deliver on systemic healthcare needs during the COVID-19 era. Here are some of the insights that emerged from their freewheeling panel discussion. Among other topics, they weighed in on…
…how COVID-19 revealed flaws in the healthcare system and fueled large-scale responses
Cofran: The pandemic has exposed some of the deeper cracks that were in our industry, stemming from legacy thinking, legacy systems and legacy regulatory challenges. So the silver lining to this pandemic is that our health system was broken, and because we have an opportunity to begin to re-imagine health, that’s going to happen first in the digital space and with patient-centric experience.
Myers: What we’re all seeing is, “How do we really connect with our patients with text-to-chat, other chatbot technologies and remote patient monitoring. There’s so much technology that was advanced very, very quickly during the pandemic. Now we need to be able to support and advance.
…how doctors and patients adapted to technological change during the pandemic
Schwartz: What we saw during this time was acceptance and adoption. We were able to take these innovations and put them out into the mainstream and have physicians who said, “I will never touch that technology and that telemedicine,” suddenly say, “Oh, that looks pretty good from home.” What you suddenly had is everybody being willing to do things differently than they did them in the past.
Myers: We had a lot of telehealth pilots for two years prior to the pandemic. We had a whole program about how to enroll physicians, trying to get them to adopt the technology, and there was resistance. But the pandemic put such a fine point on it from the physician perspective – that this is the way they can continue to see their patients. From the patient perspective, this is the way that they felt comfortable. So the change has occurred. It’s not necessarily perfect, but I definitely think we’ve gone in the right direction.
Noel: The landscape is not as monolithic as it was. I think clinicians have differing levels of readiness. I think the younger generation, our trainees, are super-eager; they’re very interested and they’re adept at using the technologies. But I would not discount my older colleagues who’ve been doing the job for 30 years, because you see a lot of curiosity and engagement that has led the charge during this pandemic… There’s a lot to change in how you’ve been practicing medicine, especially when the training and the support hasn’t been so clearly delineated for providers. I don’t think it’s as big a barrier as people anticipated it would be.
…how innovation has manifested itself in wellness solutions and patient interactions
Schwartz: The amount of things that had to switch on both the employee side and the patient side into a wellness platform — over the Internet, over the phone, over everything — was astounding. I was kind of amazed at – though people miss their gyms very much — how many different apps are keeping in touch, remote monitoring wellness, how much could get done with really pushing people towards check-ins on their phones. And for us, one of the biggest wins has been in our care pathway tools, where we’ve done one-way and two-way communications through text, keeping in touch with people, and we have over 80% engagement and have reduced, in every case, including NOVID, our length of stay, our readmissions, have improved our patient engagement scores just by the act of keeping in touch with people.
Noel: With us, it was bringing in new technologies for remote monitoring and creating a proper data management infrastructure for it to be successful. It was thinking about disparities in a very serious way, about accessibility and those who have not been served effectively through digital care. And we’re also rethinking about patient engagement and what those really important patient experiences are digitally.
…what the next generation of digital solutions looks like
Cofran: The first thing to say is that much of the healthcare data is still inaccessible. Over 80% of it is unstructured. So if I want to create an entire digital experience, where I’m not just looking at my EMR and other traditional systems but am able to couple that with and engage with the customer, I have to answer several questions. Is the experience good as the customer moves all the way through the spectrum and doesn’t have to wait for satisfaction surveys afterward? Am I empowering the patient? Am I letting them tell me what is going to work for them?
Noel: We have to think about inclusive innovation, making sure those stakeholders are engaged in this process as we roll out large-scale services. And to that point, we must think of all the other areas of social disparity that we know in healthcare; you know, language was a big barrier for a lot of community health centers and even a lot of our institutions, so we must think how to do it optimally, how to make sure the patient instructions are accessible and available to all.
…how the concept of patient satisfaction has evolved, and the role technology has played in that evolution
Noel: Patient satisfaction has become way more than what the government is auditing you for or how you rank against other hospital systems. It has become a business. The consumerism of healthcare is real. As you have new players like Amazon coming into healthcare, there is a business-loss potential that has a big anchor in terms of patient satisfaction scores.
Cofran: The consumer is now going to be holding their health records and they’re going to expect providers and other health organizations to be able to accept data from them, like if it’s a record they took with them from hospital X and brought over to hospital Y. Just with like Amazon, where anybody who wants to sell on Amazon can get on and easily sell on their platform, that reverse thinking is what healthcare’s going to need right now, because the information is going to be on the mobile device of the consumer. So as much as we want them to pull that out of our EMRs and work within the MyCharts and other portals, the question is: Does that mobile app allow that to be hand-delivered digitally? And I think that’s the next level of where the consumers are driving change in healthcare right now.
Schwartz: All of us have stepped back and said, “What are the functionalities that patients/consumers/people that are interacting with our health systems most want and want most easily?” They’re saying, “I want to make an appointment. I want to get the information about how to get there. How much is it going to cost? Where am I going? How do I get my results? Where do I interact? How do I find a doctor?” When you step back and look at the things people want on the front end, that’s what you’re going to put on an app.
…on what comes next
Schwartz: When we hear from our customers – both on our care pathways and on the marketing front – they tell us that what’s most important is that they hear one set of information from all of those different players. So they get the same story from one doctor that they get from the next doctor and then from the next. I love the fact that with some of the innovations that we’ve implemented, whether it was with care pathways or something else, we went to seven hospitals at the same time, across every one of our doctors in a particular specialty, to arrive at one way of doing things. And quite honestly, until some of the technology came into place, I thought that was going to be a completely impossible thing.
Cofran: With all of this data that’s being generated, we want to be able to surface it and make it actionable and almost anticipate – as much as what we think the patient needs – what the clinical team needs. And that’s been where a lot of the discussion is – about that agility type of layer, to be able to pull that data and then make it easier for the clinical team to interact with.
Schwartz: I think all of the innovations we’ve seen are here to stay. Some of them will get leap-frogged and replaced by other technological changes. Some of those that we installed rapidly have required doing a backtrack and a rework, cleanly and sustainably. Whether it’s chatbots or symptom checkers or sticking things on the website, there is a little bit of a drift toward taking three steps forward and one step back. In addition, all of us on that leading edge are identifying what is that next solution and who are the leapfrogging players going to be that take us from where we are.
(Comments have been lightly edited for length and clarity)