Digital transformation leaders must balance blue sky thinking with day-to-day task management. The COVID-19 pandemic required a dynamic response on both ends, especially for OurHealth’s CIO Sherry Slick and Director of Solutions Engineering Barton Bridge. Within 10 days they implemented a solution to book virtual and telephonic health appointments through a massive IT infrastructure project — a feat that, for a company with multiple locations across the country, was not necessarily easy.
“The last thing we wanted was for patients to go to an urgent care facility, where they might contract COVID-19, only because they couldn’t reach their primary care physician virtually,” said Sherry.
I had the opportunity to interview Sherry and Barton about their experience leading OurHealth’s IT teams through this process to understand what the scope of the project looked like and what lessons can be learned for other IT and digital transformation leaders.
OurHealth pairs convenient near-site and onsite clinics with a dedicated healthcare team to manage the everyday needs of a company’s entire workforce. In addition to the savings OurHealth provides at the business-level, employees enjoy benefits such as having clinics near their workplace or community, customized wellness programs, increased access to care at a reduced or zero cost, and improved health outcomes.
Sherry and Barton focus on keeping those clinic providers up and running with the proper technology and tools they need to meet patient demands. When COVID-19 hit, they had to think about not only protecting their employees while simultaneously setting them up to work from home, but even more pressing was the need to identify a strategy for remote, virtual patient healthcare appointments. This article will focus on the process OurHealth took to create the infrastructure environment needed to successfully implement virtual and telephonic patient healthcare appointments.
The Technical Task
As COVID forced shelter-in-place orders around the country, it became apparent that they needed a virtual solution to provide patients access to the care they would need without requiring an in-person visit to the clinic. This virtual capability was also an important driver of keeping the clinic staff healthy and reducing their exposure to COVID.
In the beginning, Sherry said, “we had to ask ourselves, how do we fundamentally shift our business from in-person visits to virtual?” OurHealth had been piloting a solution for virtual visits, but not nearly at the scale that was required for their entire patient population to access it. Says Sherry, “within two weeks time, we’d change how we did business.”
There were many technical solutions needed for what a user might find to be a simple task. Patients needed the option to select telephonic or virtual for their appointments, and providers needed a tool that could see inside their calendar to automatically send the patient appointment reminders with the details on how to access the virtual session. All patients need consent forms on file, so they needed to be able to do a lookup and, if the patient doesn’t have one, send them one.
Their existing ‘boutique’ virtual vendor was unable to scale with OurHealth at a price-point that made sense for the business. Decisions had to be made about how much they wanted to code themselves and what off-the-shelf solutions they could work with. They had to juggle being as fast as possible but also provide a solution that was right for them.
Ultimately, they chose a vendor and a solution that could provide that right balance. “I signed a contract on a Friday evening and we had the system up and running by the end of the next week, everybody was live,” says Sherry. It would be only 10 business days between when they began implementation and when the technology was rolled out to providers and users.
Barton and his team worked with the new vendor, Qure4u, to configure all the OurHealth providers with accounts, the necessary Single Sign-on (SSO), schedule integrations, and assemble training materials. Over the weekend, the OurHealth Solutions Engineering team worked to build new scheduling logic and user interface (UI) elements within their proprietary Patient Portal. OurHealth went live with a new scheduling experience that limited in-person visits, but offered telephonic or virtual appointments with the same providers that patients were familiar with seeing. It was not designed as a ‘band-aid’, rather time and effort were put in place to make this as seamless as a transition as possible.
“This speaks to our philosophy of our tech stack. We build what we have to. Where we can use an off-the-shelf solution and stick it together and still have a really good patient experience, that’s been our philosophy all along. Let’s build what truly differentiates us,” says Sherry.
“We effectively took a nine-month project and slammed it into two days. We knew we wanted to design not just a workaround but something that, in theory, could be the full fabric of our go-forward plan. We’ll slam this in, but let’s do it in areas where it can be permanent. We expect telephonic and virtual appointments to be part of our fabric,” says Barton.
Some of the success of today’s implementation is due to previous decisions made based on the philosophy to build only what they truly needed to build. “When we implemented athenahealth three years ago, we created a digital ecosystem where we leverage athenahealth’s APIs to facilitate other workflows. This is one fantastic example of how that played out,” says Sherry.
Full Circle Care
In addition to the technical implementation, users needed to understand how to use these new features, so Barton and Sherry also created new workflows and training documentation to support the rollout. “There had to be things they could hold in their hands, so we generated PDFs where we did screenshots of how to login and see your workflow. We also have an internal LMS (learning management system) where our training team recorded videos that we could assign to all of the providers and track engagement,” says Barton. Five hands-on webinar sessions were held so that providers who needed to could join at any time, as many times as needed.
A “white glove” service was designed to support providers who were not as tech savvy or didn’t see as high of volume as other providers and required different workflows. “We would reach out and ask them about how the implementation was going. Anytime you do something like this you can’t expect total adoption to happen organically. You gotta work at that,” says Sherry. For the first few weeks or so, every provider was contacted directly to check in on how their first few virtual sessions went. Any issues were addressed from a training or troubleshooting standpoint.
OurHealth didn’t see their responsibility for patient care ending at the rollout of the new technology. They launched into a patient outreach campaign by leveraging their tech stack to mine data for their sickest, who was due for a prescription medication refill, chronic disease patients – people who needed additional support and were likely to need it soon. They started calling people and sending educational materials to let them know that they had these new virtual and telephonic options. 10,000 calls were made the first week after the new patient outreach process was implemented. The goal was to make sure the patients’ knew OurHealth was there and ready to answer their questions during this difficult time.
“We pivoted in a way that was meaningful to our clients and meaningful to our patients, and we leveraged technology to do that,” says Sherry.
- “Recognize when things aren’t going well and shift gears.” Sherry and Barton made lightening-fast decisions when their existing technology provider couldn’t meet their demands. They found a partner who had that same sense of urgency.
- “Go into these projects with an expectation to get everyone involved.” OurHealth’s tech teams certainly carried the weight of the implementation, but the marketing, sales and clinical teams all played a part in making the project a success. When everyone is engaged, they feel like they are part of the process.
- “Good foundational decisions enabled us to do things quickly.” The digital ecosystem OurHealth had put in place three years back allowed them to pivot with the speed that was required for the scenario.
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