Fighting COVID-19
Strategies for Mitigating the Impact of Coronavirus on Your Health System
As the COVID-19 pandemic continues to spread throughout the United States, healthcare organizations are being forced to respond to unparalleled demand for their services. This crisis is forcing healthcare leaders to rethink processes and protocols to ensure critical services can continue to be provided while prioritizing the safety of patients and employees. Healthcare executives are responding to the crisis by increasing communication with their workforce, shifting their marketing strategies and forming new partnerships to bolster their response.
Modern Healthcare Custom Media questioned three industry experts about how their organizations are responding to the COVID-19 pandemic and inquired about the best practices and knowledge needed to effectively address this crisis.
Dr. Peter Antall is the Chief Medical Officer at Amwell, where he is responsible for clinical direction of the platform as well as client guidance and training. He is also the founder and president of the Amwell Medical Group.
Bharat Sundaram leads operations at Vizient with oversight for development and delivery of products/services. His areas of responsibility include strategic sourcing, pharmacy, analytics, advisory, and market intelligence capabilities.
Lisbeth Votruba led the first hospital implementation of remote patient safety monitoring over 10 years ago. She later joined AvaSure as the senior executive responsible for clinical operations and the innovation roadmap.
How is your organization supporting your customers in preparing for and mitigating COVID-19?
PA: Amwell has been proactive from the outset to ensure our care conforms to national and international standards. We’ve trained our workforce and are working alongside our clients and government to ensure our care is coordinated. We’ve established an infection control officer, workflows to guide operations and quality, and put in place a COVID-19 Readiness Team. We are continually monitoring and optimizing the health of our platform, rapidly deploying new servers, routers and other systems to manage volume, and investing in automated provider on-boarding systems to quickly onboard additional providers.
BS: Our war room triages 1,000+ requests per week to help members access product. We’ve put our own capital at risk to support North American manufacturers in investing to begin new lines of personal protective equipment (PPE) production. We vet new product sources for our members based on compliance standards. We hold weekly webinars to share learnings with 1,500+ attendees. We’ve captured emerging practices and built a demand calculator to help providers forecast utilization. We’ve helped members procure staff to deal with surge and we’ve helped cities and providers set up field hospitals.
LV: We have offered our customers free 6-month software licenses, enabling them to set up video monitoring stations anywhere they deem it helpful to view and communicate with COVID-19 patients from a remote location. Hundreds of new monitoring stations have popped up in hospitals across the country, mostly at nurses’ stations, allowing caregivers to visualize and interact with patients via digital audio, dramatically decreasing how often staff need to enter isolation rooms, decreasing exposure for staff while conserving PPE.
The situation is changing rapidly, sometimes on a daily basis. What channels are you using to communicate with your customers, and how has your messaging changed as this epidemic has progressed?
PA: Our COVID-19 Readiness Team coordinates regular – multiple times per week – communications with our client base to provide assuredness and transparency around technical, clinical, customer service, regulatory and other developing issues. We’re leveraging email, phone calls with clients and account managers and hosting regular webinars with executive leadership. We are working around the clock with clients as needed and providing educational content to smooth telehealth workflows and experiences.
BS: We send a weekly update to our members, our field team connects daily with members, we conduct regular member update calls and we connect directly with members’ C-suites. We want to keep members informed, but also ensure we communicate material changes and facts versus rumor. We post as much content as we can to our public website to benefit the entire healthcare industry during this unprecedented time.
LV: We are very aware of how overwhelmed everyone is, so we are only sending necessary information and resources. We have a team of nurses assigned to specific customers, so much of the communication that is happening is nurse to nurse. One unique communication we provided was a special edition of our Online Reporting of Nursing Analytics report with data we had on isolation protocol violations, and suggestions on how to best document COVID-19 in the software.
As providers and consumers alike rush to stock up on supplies and demand surges for related services, how are you advising customers about how this may impact operations and financials?
PA: We’re all learning to adapt to this new normal; healthcare is going to be different from here on in; we must evolve accordingly. Operations across nearly all corners of healthcare are feeling tremendous strain, and in many instances, are overwhelmed. We’re advising customers to focus on both the short-term – keep providers on the front lines safe and accommodate patients in need now – as well as the long-term – take smart actions now to ensure scalability of their infrastructure and leverage technology to expand provider capacity. This is where telehealth provides great value.
BS: This crisis will change how future care is delivered. We advise members to consider supply chain resiliency – to understand where products are sourced and gain early insight into shortages and disruptions. We offer a resiliency
“We need to reflect on the early warning signs of an epidemic like this to be better prepared for next time.” Peter Antall, MD
platform connecting suppliers and members to do that. We’re also working with drug suppliers to identify sites of API manufacture for the most essential drugs and are sharing results with the FDA and members.
LV: We are trying to be the conduit for sharing best practices and new ideas. We have some customers in hotspots and others in the lull before the storm. We are able to convey what’s worked in hotspots. For example, when a customer moved our mobile monitoring devices into an OR that they were using as a makeshift ICU to cope with the surge in demand, we passed that practice to others in areas that are earlier in the curve.
What best practices can you share for providers as it relates to employee communication, training and engagement? What resources should they be sharing, and how can they ensure employees are calm but prepared?
PA: Communication and collaboration are key during this time. Organizations should ensure protocols are updated regularly in correlation with CDC and WHO guidelines and communicated across teams. For providers practicing via telehealth for the first time, they need to be trained on platform use, best practices for virtual interaction, assessment and diagnoses. Clear and direct communication will help keep employees informed, calm and safe.
BS: Employees of providers are experiencing unprecedented stress and uncertainty. We recommend a regular communication cadence and visibility from leadership. Also, support staff’s personal needs —e.g. shower & change facilities, interim housing, child care, sick pay, etc.,—and provide opportunities to address the heavy emotional burden this event may cause.
LV: When there is such a desperate need, the learners are eager to learn, so the teaching method becomes less important. Our focus has been the most convenient and efficient ways to train. We’ve seen a surge in the use of our eLearning modules. It’s also more important than ever to have a 24/7 support line to address questions and issues as they arise.
As the impact of the virus widens, it’s expected that more and more care will be conducted virtually. How should healthcare organizations prepare for this shift?
PA: Organizations that don’t already provide a virtual care option should get in touch with a telehealth partner to get a solution up and running as quickly as possible. At Amwell, we’ve created COVID-19 modules and programs for health systems and health plans enabling organizations to launch a telehealth program in as little as three days. Across the board, leadership should counsel providers on the capabilities and constraints of telehealth for optimum patient care. It’s a strong extender to care teams’ reach and ability amidst COVID-19.
BS: We have reached an inflection point in virtual health. Many of our members have responded to the current crisis by rapidly adopting and deploying virtual health capabilities. To harness the full potential of virtual health, policymakers and health plans should consider permanently adopting some of the new telemedicine flexibilities so providers and patients can continue to keep pace with accelerated technological advancements.
“This crisis has highlighted the need for increased transparency and supply chain resilience.” Bharat Sundaram
LV: First, they need a plan that encompasses what comes next. This coronavirus will profoundly change healthcare in terms of where care is delivered and how, especially telehealth. Be wary of investing in virtual technology for the crisis that will be collecting dust later. How and where will it be useful beyond just isolation patients?
COVID-19 could have a significant impact on provider staffing levels. How should health systems prepare?
PA: The surge in demand is creating a need for more provider support. Amwell has put out a national request for doctors and NPs to join our network and are onboarding providers at unprecedented speeds. Implementing telehealth is important as it enables load balancing of clinical resources so providers in lesser hit states can support those in harder hit areas. As state laws continue to allow for cross border treatment, health systems will be able to leverage greater pools of available doctors to “see” their patients.
BS: Providers must think creatively to increase trained staff for an influx of COVID-19 patients. For example, shift various nursing staff, such as pre-operative nurses, to other parts of the organization. Identify abbreviated clearance processes for onboarding of new staff. And find new sources for certified nursing assistant staff, such as utilizing nursing students or establishing a training program in collaboration with vocational schools.
LV: We’re collaborating with some our customers to set up remote patient monitoring from the provider’s home directly to the patient’s hospital room. Another staffing efficiency model is to centralize providers such as intensivists, allowing them to remotely interact with patient rooms across multiple care units without having to dash from floor to floor or building to building.
How can healthcare organizations ensure they’re prepared for public health emergencies on an ongoing basis?
PA: We need to reflect on the early warning signs of an epidemic like this to be better prepared for next time. No one could have predicted how this pandemic would unfold, but at the first sign of crisis in China and Italy, for example, we should have taken a more aggressive approach to preparedness. We must also maintain the fact that collaboration across the healthcare community and our country overall is key.
BS: There are a number of implications and learnings from a public health and disease management perspective but from a supply perspective, this crisis has highlighted the need for increased transparency and supply chain resilience. Having said that, it has also highlighted the tremendous capability, dedication and talent that our nation’s health systems have in their supply chain organizations – we have been privileged to serve these groups.
LV: I’ve been heartened by the outpouring of support for frontline caregivers from all Americans. It’s time to start using 21st century technology to protect our frontline caregivers, whether it’s from a virus or from workplace violence.
“It’s time to start using 21st century technology to protect our frontline caregivers.” Lisbeth Votruba