Digital health leaders are applying lessons learned about what has worked during successive phases of the pandemic to their strategies for patient engagement going forward. Leaders from SCL Health, Boston Children’s Hospital and UPMC Enterprises shared their thoughts during a recent webinar.
Mona Baset is vice president of digital services at Colorado-based SCL Health, which has eight hospitals and 150 physician clinics mainly in Colorado and Montana. She said that to meet the information-sharing needs of both patients and employees during the pandemic, the nonprofit SCL Health relied on the digital health foundation it had already established.
“What really guided us throughout this is a set of digital guiding principles that we used with our work, even before the pandemic,” Baset said. “We were able to test these principles out and found that they were very sound. It involves making experiences easy and low effort — don't put friction into your processes, make it as easy as possible. And then really focus on the user and their needs, not our own processes. We all have very complex processes in the background. Let's keep those behind the scenes and give users what information they need to do their tasks effectively and quickly.”
Baset was speaking during a May 11 webinar, sponsored by patient engagement solutions vendor Kyruus, and hosted by Healthcare Innovation.
She added that SCL Health also tries to leverage the smallest number of connected platforms. “This helps as we resource our teams and as we partner with vendors to come up with innovative solutions, and it makes the whole ecosystem much simpler,” she said. SCL Health personalizes the experience based on the knowledge that it has of its users and patients. Another key, she said, is providing options for engagement. “We always want to make sure that we provide different options for people to address their comfort level and to adjust to their current needs. We often use the phrase ‘digital front door.’ It could be our website; it could be our mobile app; it could be a chatbot .We’re giving people enough different options so that they're comfortable to engage with us the way they want to and need to.”
Looking ahead, SCL Health is prioritizing its highest-risk patients to come in for care — those who are most likely to have delayed care and who had chronic conditions. “We're using many different techniques, including targeted e-mails, community campaigns and messaging focused on safety. We also have vaccination-related campaigns to encourage people to get back to their lives by getting a vaccine.”
SCL Health is continuing to follow its digital roadmap. “We had a couple of things delayed a little bit, but primarily we continued to implement the items on our digital roadmap because they were all related to the consumer and the patient,” Baset said. “We are continuing all those work streams now at the speed that we know we can manage it. We've got to focus on the consumer and think more like some other organizations out there like retail and travel. We have to keep that consumer mindset because people are going to be making decisions based on experiences and convenience.”
She said health systems should take advantage of the new pace. “We all were able to deliver so many solutions at speed that we've never thought was possible. So let's accelerate in a few areas. We will be looking at taking a 360-degree consumer view and leveraging the information we have to provide an experience to consumers that is similar to what they experienced in other industries, and accelerate automation — things we can do behind the scenes that will help us become more efficient, that will allow self-service.”
Boston Children’s Hospital
Bill Gagnon, senior director of digital engagement at 450-bed Boston Children’s Hospital, noted that what happened in pediatrics mirrored what happened in the adult care sphere in terms of virtual visits during the pandemic. “We went from a low usage of virtual visits and skyrocketed overnight to give access to care,” he said. “We were at 1 percent before COVID, and it rose up to 80 percent during that time.” They also sent 12,000 workers home to work remotely. The main thing, he stressed, is that patients, families and employees needed information 24x7. “It was a scary time, but they needed to have answers. Rare and complex patients still need to be seen as in-patients, and families, referring physicians, and even our own employees needed to have answers,” Gagnon said. “So we set up a couple of different digital access solutions. First and foremost, we set up a COVID website. We knew that we needed to direct people to a centralized location with data that was available 24x7 to support all audiences. The next thing that we did is that we partnered up with Microsoft to bring a COVID symptom checker to life. Different symptoms were coming up on a regular basis, so we had to be nimble and change that out.”
Boston Children’s also put together a COVID testing locator tool. That tool now has transitioned from a testing locator to a vaccine information update.
The organization put a lot of work into its AI chatbot. Before the pandemic, they had about 40,000 answers in a tool that was able to basically talk back and forth with the patients, families, and referring clinicians. “The nice thing about this tool is it's available 24x7, and it gives the ability to answer all sorts of different types of questions, and almost simulate the experience of dealing with a person all that time,” Gagnon said.
Boston Children’s also focused on e-mail automation. It sent out over 125 COVID e-mails last year, and the open rates were double what we usually saw on regular e-mail messages.
He said patient and family expectations have changed during the pandemic and many of these things aren't going to go away. “People expect certain things to be accessible to them — things like self-scheduling. We're going to be working with Kyruus to set that up,” he added. “People want to be able to log on and set up their appointments and get that going. So we're excited about doing that.”
Boston Children’s set up a lot of tools to make sure that it was giving the right advice and the right information to different users. “Now’s the time to integrate our AI chatbot with live chat, text to speech, and other functionalities that we can use to make the experience even more robust,” Gagnon said. “We are launching a new content management system for a new website. We're going to have needs-based navigation. We are going to be able to have the ability to serve up content based on the user's needs or expectations.”
UPMC
Katie Scott, vice president of digital strategy and innovation for UPMC Enterprises in Pittsburgh, stressed the importance of seeing the challenges of the past year as an opportunity to study where digital tools can provide value. She posed a series of questions for health systems to think about as they come out of the pandemic. “It accelerates a lot of trends that were already under way,” she said. “What does it teach us about what consumers truly want? And how do we leverage that going forward?”
One of the places UPMC saw interest on its platform was patients messaging with their providers. Rather than calling, they would send a message to their doctor. “One of the things that we did early on was stand up, in partnership with Kyruus, virtual primary care, and then allowing for self-scheduling of that virtual primary care,” Scott said. Previously they had allowed self-scheduling and they had virtual visits, “but this involved marrying the two together to make sure that our patients had access to their provider at this critical time. They could book their own virtual visit and they could get seen by someone they knew.”
UPMC had done work in 2019 and early 2020 around standing up infrastructure for telemedicine, but Scott said the usage zoomed during the pandemic. “We had done some pre-visit calls and post-visit surveys to make sure that we understood in some of the early telemedicine use cases that the satisfaction was where it needed to be, then taking that and scaling it up,” Scott explained. “We started we see a lot of patient satisfaction in this pivot to digital access, and I think over the course of the year, we converted patients and providers who were skeptical that this was going to work into believers. What can we do with that interest and that drive for telemedicine more broadly?”
Thinking ahead, Scott said, they have to look at balancing digital and in-person long-term. “We all have the question about what the new normal looks like and what's the right mix of virtual and in person, and it varies significantly by use case, by patient preference, by need.”
Another issue to address, she added, is how does the rest of the care environment adapt to the move towards digital, with telemedicine, remote patient monitoring, appointment reminders, visit summaries, and referrals. “All of that needs to be different when the patient's not in the office,” Scott said. “How do we take all of those pieces and make them work just as well and just as effectively for the patient either virtually or in person?”
She said digital convenience may help with branding as well. “How do we take advantage of this new level of digital engagement of our consumers? Can convenience drive loyalty? Can we make it easy enough to work with us, easy enough to access care that we stay top of mind? Can those convenience levers and the ease-of-use levers engender loyalty?” she asked. “If you think about curbside pickup and some of the new things that have happened in the last year that has made us more loyal to different brands or changed our purchasing preferences when we think about retail or other industries — how does that apply to healthcare? How do we take the new patterns that are emerging and use them to drive loyalty? I think there are certainly some opportunities presented in the new space that we're all tackling, but I think there's a million things to figure out as we go forward.”
