Simplifying Care Through Improved Digital Engagement

Delighting Patients Through Digital. 

Today, the world of planned, non-emergency procedures such as knee-replacements is often complex and confusing for patients. Health systems ask individuals to be the “general contractor for their own care” as Providence St. Joseph Health (PSJH) Chief Clinical Officer Amy Compton-Phillips says. Patients organize finding the right doctor for their problem (covered by their insurance), getting appointments and procedures scheduled, coordinating pre-surgical prep, post op care and rehab, and managing the bills — all while suffering from the ill health that brought them to seek care in the first place. The situation is equally complex for the caregivers (physicians, nurses, and staff) charged with taking care of the patient — each individual patient is unique, but rules vary by insurance payer, and practice routines vary by hospital and doctor.

Imagine a different world in which PSJH patients planning non-emergency surgery are prescribed a program making the entire process much simpler and more transparent. It starts with ensuring the patient has all the right information to make an informed decision about the procedure, then guiding him or her through the experience front-to-back. Patients can choose an in-person or telehealth visit with a specialist who can walk them through the tradeoffs of treatment for their condition using a shared decision-making platform. From there, they can build a treatment path forward together. Prior authorization is taken care of automatically, making it easy for patients to get referred to the right specialist quickly. If surgery is the right choice for the patient, the patient is coached through activation of a program in their PSJH mobile app that then guides them through their entire care journey step-by- step before surgery, during their stay, and all through recovery when they return home.

Patients can access the digital concierge solution via any device: mobile phone, tablet, digital voice assistant like Alexa or Siri, or their computer. The app is powered by an interactive care pathway tailored specifically to their needs providing relevant patient education content, trackers, and proactive prompts for patients to assist them across prep before, in hospital self-care and every step of self-management after a procedure. Answering “Should my incision look like this 5 days after surgery?” is made easy with a smartphone in one’s living room rather than a trip to the doctor’s office across town.

The app also involves the patient’s community of caregivers and support network with regular updates and the ability to communicate with the patient and his or her family. We know surgery is often a family affair; if the patient wants his/her caregivers to get their health info or be able to ask questions of the care team, the tool would simplify the communication. The technology provides dynamic, flexible pathway management which takes inputs from the patient and provider, and adjusts the pathway as clinically appropriate in an automated, evidence-based way while simplifying workflow for clinical care teams.

The digital concierge also offers curated, contextually relevant, and valuable non-clinical products and services that will ease the patient’s way such as Lyft rides, scheduled home meal delivery, and clinician-recommended products after surgery — no more driving from medical supply store to medical supply store to find exactly the right size post-op shoe and gauze pads. Clinicians can see the progress the patient is making through an interface within the electronic medical record (EMR), while the patient continues to receive guidance on wound care, how to manage their medications, and reminders about post-operative visits all in the same, user-friendly interface. After the surgery, patients receive a single, easy-to-understand bill that has all information in one place while taking into account insurance coverage and payment plans. The end state would change a procedure from a series of complicated pieces into a coordinated, seamless and predictable whole for patients, families and physicians alike.

Not only would this comprehensive set of services be available, but patients from all over the world could discover the program via a helpful, informative, digital platform that highlights the exceptional experience patients have had in the PSJH program, serves up personalized content, and answers questions. Patients can see online ratings and reviews, published quality statistics, patient reported outcomes, and pricing, bringing to life the always sought but invariably elusive goal of transparency in healthcare value.

We Have Work To Do. 

Now, the world today looks very different from the world described above. The experience before and after surgery is much more challenging for patients to manage. There often isn’t a comprehensive end-to-end solution, either through a set of digital tools, or offline with their care team, to guide them every step of the way throughout their journey. The consequence is that patients may miss appointments, skip their pre-surgical exercises, or show up for their surgeries still taking the medicine they needed to stop pre-op. This means they may need to reschedule, which adds to their stress and anxiety during an already-difficult time. It is also very inefficient for the health system. An even worse possible result is that patients may need to go to the emergency room or get readmitted to the hospital after their surgery because they didn’t understand everything they needed to do after their surgical experience to recover properly. In other words, a fragmented patient experience is not optimal for patients, families, nor the health system.

Progress on the Horizon. 

That said, there is hope! We are making progress toward a world where we’re able to digitally assist patients end-to-end across a planned procedure, while building a longer lasting relationship with the health system through digital capabilities and other value-added services. At PSJH, we are starting by providing tools with dynamic care pathways built specifically for our patients containing tailored educational content and self-management tools (like trackers). Over time, we envision building in the fuller suite of digital products and services that will move us closer and closer toward this vision of the future of a simpler, safer, more transparent experience. We hope to provide our customers with an exceptional experience, while also creating the opportunity to partner with technology and clinical partners to provide a set of wrap-around clinical and non-clinical services to offer a complete experience for patients and healthcare consumers.

While what we’ve described here is focused on a patient’s surgical experience, it’s broadly applicable to PSJH’s entire digital strategy: first get our healthcare consumers to transact with us online by creating a 10 times (10x) better experience, then once we’ve earned the right, engage with our patients digitally on an ongoing basis. In fact, PSJH has already applied the notion of the 10x better experience to a suite of services known as Express Care which delivers care when, where, and how patients want it for non-emergency, low-acuity care. We’ve also applied the notion of ongoing consumer engagement to two products, CircleTM and XealthTM. Circle by Providence and Circle by Swedish is PSJH’s personalized platform which delivers relevant content, products, and services for women to help them manage their health and the health of their families, starting with maternity and expectant mothers, and extending through pediatrics. Xealth is a digital prescribing platform that allows providers to ‘prescribe’ digital applications, content, services, products, and devices directly through the EMR, with a connection back into the EMR and patient portal.

Starting with Express Care, Circle, and Xealth, and now moving toward planned procedures, simple digital transactions, interactions, and continuous digital engagement will be the way by which we build enduring and efficient connections with our patients and healthcare consumers — taking a few steps closer to a modernized, 21st century healthcare world where we can delight consumers throughout their healthcare journeys.