The novel coronavirus pandemic is challenging our society and healthcare system in unprecedented ways. While the initial crisis exposed significant gaps in our preparedness, it also highlighted that the acceleration of certain technologies and frameworks will be essential to managing through what may well turn out to be waves of Covid-19 crisis interspersed with times of “relative respite” when health systems will need to rapidly re-open access to care for millions of patients with non-Covid-19 conditions.
Health systems will not only need to oscillate between their own physical and virtual environments as work-from-home orders come and go, but also dynamically route care to different settings based on their regional situation. During times of crisis, patients with certain symptoms may be referred to a nurse line or a retail clinic with a testing tent, while those with other types of conditions may be offered virtual visits. During times of relative calm, those same patients may need access to in-person visits or even elective surgery. Delivering top-quality care will be measured not just by morbidity and mortality statistics, but also by the flexibility with which systems can pivot to provide access to care to the different segments of their patient populations.
Here are some key observations on the strategies and practices that we have witnessed in working with health systems so far:
Organizations that were able to respond the quickest often had a digital front door strategy that was cohesive and integrated into their overall access strategy. They rapidly updated their websites to provide clear information and instructions to patients, with many leveraging virtual assistants to provide much-needed initial triage and avoid unnecessary phone calls. In addition, their online directories for patients to find care were up-to-date, enabling them to self-navigate when possible instead of queueing up to speak with someone.
What’s more, when they did need to call in, access center agents had access to the same information patients saw online, avoiding confusion and frustration. Even more importantly, systems were able to steer patients dynamically to different sites of care in a coordinated manner. As Covid-19 cases began to spike, we saw health systems rapidly transition condition searches like “cough” from in-person visits for primary care providers and pulmonologists to virtual and urgent care visits. These changes propagated simultaneously across all their channels of access so that they could efficiently and effectively match patients to the right resource in the moment.
It was equally important that these organizations had a digital strategy built on a robust data management foundation that allowed them to route demand across various “clinical assets.” Load balancing the surge in patients required not only an accurate provider directory, but also the inclusion of various locations, virtual care offerings, and different sites of care (e.g., urgent care clinics, retail clinics) configured correctly to appear in Covid-19-related patient and agent searches. This hinged on having an updated clinical taxonomy and rapid process for disseminating new clinical terms (e.g., Covid-19, coronavirus) to provider and location profiles. With the ability to map different conditions and search terms to different sites and types of care, as well as individual providers, leading organizations were able to triage patients in a strategic and safe way that matched their communities’ needs appropriately with the health system’s assets.
As demand surged and health systems quickly re-allocated resources, the situation also forced fast adjustments to appointment availability and scheduling, particularly in the digital channel. Inundated with demand amid changing protocols and priorities, many health systems quickly switched off online self-scheduling. As the initial surge passed, others took a more nuanced approach, such as exposing only specific types of appointments online. Those best positioned for future waves will have flexible scheduling approaches that enable them to tailor their scheduling options for different types of providers and patient needs and integrate virtual care booking into their offerings as well.
As we deal with what could be repeated waves of the Covid-19 crisis in the years to come, the ability to triage, route, and schedule different types of patients to the right care options will be essential – as will the ability to pivot quickly in the face of circumstances that can change overnight. Despite their best efforts, many organizations found their operations paralyzed by this first introduction to the infection. While so many rushed heroically into battle and sacrificed their time, relationships, and sometimes their lives to care for patients with the novel coronavirus, many other providers were completely locked out of caring for their patients. As a result, we may now see an equally overwhelming demand for non-Covid-19 care whenever we have our first “respite.” Our nationwide patient search data suggested that more than 90% of requests for care in the last month were for conditions other than Covid-19. As such, we have to be better equipped to manage any next waves of Covid-19 cases without shutting down care for the rest of our patients, particularly the most vulnerable. This will require clinically precise routing of patients to different sites and modes of care so that we can ensure we still function as a comprehensive delivery care system amid recurring sources of strain.
We anticipate that health systems will have a small window of time to learn from this first wave of this pandemic and prepare for the next one. Taking a coordinated approach will be critical to maximizing responsiveness and minimizing disruption as we move through and beyond this period in our history.
Photo: nicescene, Getty Images
