During COVID-19 and beyond, digital care tools like telehealth, home exercise programs, and patient education can help healthcare organizations expand access to care, improve patient engagement and satisfaction, and drive superior outcomes while keeping costs low.
We recently sat down with leaders from Kaiser Permanente, AdventHealth, and Spectrum Health to talk about their experience incorporating digital care tools into care pathways, including why they decided to do so, the best practices they recommend, and the results they’ve seen.
The article below provides some of the key insights from this discussion (featuring Christopher R. Jones and Dr. Emmanuel Fajardo of Kaiser Permanente, Jennifer “Leigh” Harris of Advent Health Sports Med & Rehab, and Marcie Hurlbutt of Spectrum Health), but you can view the full presentation here.
Q: Why did your organization decide to adopt digital care?
We began looking to digital care years ago to help serve our mission of providing care that is convenient, high quality, affordable, and connects with patients personally. Digital care has helped us drive convenient access, remove barriers to care, close care gaps, and improve operational efficiency and effectiveness overall.
This year COVID-19 has been a catalyst for digital care, but digital care is also where our world is and what our patients are demanding. So many people are seeking out digital care options. We want to meet our patients where they are and increase access and engagement.
In terms of our goals for digital health, we want to create a safe environment to make rehab more accessible, meet customer expectations for convenient care and a high level of service,
extend our reach to help more of those who need our services, and stay viable.
Ideally we want to encourage our patients to think of us as their PT provider for life, and help them feel like they always have a tie to our system. We’re finding that we’re able to do all that with these digital tools, including MedBridge’s Home Exercise Program and Patient Education.
We started our digital care journey in 2018 with three main goals: drive value, create a personalized digital experience, and grow market share.
We wanted to lower the cost of care, maintain viable operations, and achieve superior quality outcomes as a way to respond to the threats that we’re all facing, including higher payer scrutiny around therapy utilization, lower reimbursement rates, and changing payment models. It was evident that we’d have to redesign our clinical practice model in order to effectively drive value.
Q: What training strategies have you implemented to help your clinicians succeed in a digital care environment?
With MedBridge content, creating our own Knowledge Tracks, and our outcomes management system, we’re able to see our data in real time—including which centers might be struggling—and target areas of needed focus. From there, we do targeted educational breakouts.
We have leveraged our EMR system and embedded items such as algorithms into the workflow for cervical, lumbar, and hip pain criteria, and we train our staff on that. We also perform chart reviews to create a consistent feedback loop. We’ve found that a combination of digital and in-person training is most effective for us.
What this means for you: By identifying performance gaps through outcomes data, closing the gaps with targeted clinical training, and refining your training programs with real-time reporting, you can create a consistent feedback loop that allows you to improve patient and clinical outcomes.
For us, the training process is very much about the collaboration between clinician peers to advance and refine clinical practice.
In 2018, we started regional rehab practice groups in Northern California, and in March, we initiated a practice group focused on tools and resources to advance telehealth practice. We developed a playbook that uses MedBridge Knowledge Tracks, coursework for HEP adherence, dosing exercises for maximum compliance, and motivational interviewing.
Because we initiated MedBridge during a pandemic, our initial adoption rate was not ideal. As a leadership team, we made the decision to pause and focus on adoption. We improved our clinician adoption by leveraging the excellent foundational tools that MedBridge offers, as well as partnering with MedBridge to customize these tools to Spectrum Health. The collaborative relationship between Spectrum Health and MedBridge has transformed our training so that it’s delivered in a way that optimizes resources and adult learning.
Together, our teams created diagnosis-specific competency templates, allowing clinicians to spend more time with patients while still achieving competency requirements. We have also implemented virtual guided learning for clinicians who may need additional training. This streamlined approach has ensured just enough training, but not too much.
Q: What elements do you think are key to making digital care successful for patients?
It’s a work in progress, but for us the patient experience is central. We’re always monitoring it with measurement strategies like member surveys and patient interviews. We’re able to take the pulse of the patient experience both in person and also virtually with MedBridge.
In terms of the patient experience, one of the most important aspects is that initial conversation between the provider and the patient to be sure a new care program is meaningful and valuable to the patient. The content needs to be directly targeted and appropriate for that patient and condition as well as dosed in a way that is realistic, helping the patient navigate increased function, decreased pain, and increased capability.
Also, patients want and need feedback about what they’re doing, how they’re doing, and how it relates to overall goals. We continue to refine these three areas through process improvement.
Q: What outcomes have you seen as the result of implementing digital care at your organization?
At Spectrum Health, hybrid care—a combination of virtual and in-person care—has proven to be 24 percent more effective in improving patients’ function and ambulation than in-person care alone. Therefore, leveraging digital care has positioned Spectrum Health to achieve better patient outcomes at a lower cost and utilization.
Throughout the pandemic, we’ve been able to sustain our market growth, maintain employee engagement, and improve patient experience through our digital strategy.
Forty-five percent of our patients who begin care virtually stay in virtual care pathways to address their care needs, and more than 80 percent of our survey respondents have rated their care experience excellent for virtual care.
We’re able to provide access to virtual care within 24 to 72 hours and often on the same day. We average over 50,000 unique patient online PT home program prescriptions monthly, with over 250,000 logins for ongoing care delivery.
We’re definitely still learning as we go because we really jumped right in earlier this year, but it’s an exciting time for all of us. At this point, we’ve all been pushed into the future quickly, and the organizations who can adjust and learn the fastest and the best are going to be the providers of the future.
At the end of the day, digital care is here to stay. We all need to continue to improve on the clinical experience, the patient experience, and outcomes, but digital care is already here.
For additional details and insights on the topics above and to find out how participants are measuring outcomes and negotiating reimbursements for digital care, watch the full presentation here.