5 high-impact areas for digital innovation in response to COVID-19: Insights from Jefferson's Neil Gomes

Neil Gomes founded the Digital Innovation and Consumer Experience (DICE) Group at Jefferson five years ago to build solutions for Thomas Jefferson University and Jefferson Health that address consumer needs and the evolution of healthcare delivery. In the past month, much of their foundational work has been critical to the health system's response to COVID-19.

"Since the COVID-19 crisis hit us, digital technologies have had to play an important role in healthcare. Digital health solutions have helped manage patient volumes in hospitals, assisted with crisis and disease management, enabled patients to connect with their clinicians and loved ones, enabled patient data collection, and connected people as they work from home in self- quarantine or self-isolation, or practicing social distancing," said Mr. Gomes, who serves as the executive vice president for technology innovation and consumer experience and chief digital officer of Thomas Jefferson University and Jefferson Health. "These projects are being developed very rapidly, but our investments in digital technologies and skillsets, have enabled us to rise to the challenge."

In the past six weeks, Jefferson's DICE Group has developed and launched around 50 projects in response to COVID-19. Its systems have handled the scale well because Jefferson has invested in the cloud, making it easier to expand access rather than trying to add local resources to support the increased need.

Here are a few examples of the most pressing projects the team took on:

1. Expand virtual work capabilities. Many health systems in hard-hit areas have asked non-clinical team members to work remotely, which is no small feat for the IT team. "We recognized that we would need to be able to enable people to work from home easily," said Mr. Gomes. "We upped our Zoom Healthcare HIPAA-compliant license, and now we have over 6,500 licensed users in six weeks."

The team has supported thousands of meetings with hundreds of thousands of participants and used more than 146 million minutes of time on Zoom calls.

"To enable this accelerated usage, we had to create secure request systems for employees that want accounts," said Mr. Gomes. "We had to build very rapidly and scale into these systems as well as scale access to the systems very quickly so we could start extending it to patient care."

2. Enable virtual communication within the hospital for patients in isolation. Patients with COVID-19 stay in designated hospital rooms to prevent further spread of the virus. The care team needed a safe way to communicate with the patients remotely or from within the hospital. The DICE Group at Jefferson worked collaboratively with other teams including the JeffConnect telehealth group and IS&T to outfit those rooms with tablets and Zoom video technology so they could connect with their care teams as well as their families while at the hospital.

"The patient-to-family connection enables families to still interact with the patient and makes it a much more human experience for the patients if they have to be physically separated from their families" said Mr. Gomes. "It can be a lonely experience. We hope these technologies make it a little easier for our patients and reduce the feeling of separation."

The remote video communication also reduces clinician exposure to COVID-19 and saves on much-needed personal protective equipment (PPE) that might be required to interact with COVID-19 patients. "We anticipate all of this will continue because there is a personal touch of patients being able to connect with their families at inpatient hospitals with digital technologies," said Mr. Gomes. "I'm optimistic about that. I know we will get out of this crisis, and there will be a new realization of how digital technologies can help us all."

3. Triage patients who call in concerned about whether they have COVID-19. As more information spread in the general public about COVID-19 symptoms, Jefferson experienced a rapid increase in patients calling in with a cough or other light symptoms, worried about whether they should seek further medical care. In most cases, these individuals did not show enough signs of COVID-19 to require additional treatment, but the care team needed help triaging such individuals so they could spend time on patients who did need their services.

The DICE Group at Jefferson worked with chat-bot platform company LifeLink and Jefferson clinicians to build and launch an online appointment system with a chat bot that allows individuals to enter their symptoms, and then be directed to the next step in their care. Patients with concerning symptoms were elevated to video visits for easy access to clinicians or scheduled for testing appointments, while most other patients without severe symptoms were directed to report back if their condition worsened and provided with education about how to keep from spreading COVID-19.

"The chat bot enabled individuals to access different workflows and pathways for them to care for themselves, and it helps them set up a test or appointment or access telehealth immediately if they need it," said Mr. Gomes. "We think that this will help our patients understand their status at that point in time if they are worried; and for those that do have a concern and an issue, one of the pathways is to get really quick and easy access to a healthcare provider or get a test done."

4. Determine when employees that were exposed to the coronavirus could return to work. In addition to triaging patients with COVID-19, the team needed to monitor staff that were self-isolating after exposure to the coronavirus to help them manage symptoms and determine when it was safe for them to return to work.

"We developed a system to engage our employees that may have been exposed to the coronavirus to make sure they were okay to continue work, and if they did have symptoms and decided to self-quarantine, we wanted to monitor them to see whether they were getting better or worse and when they could return to campus," said Mr. Gomes. "The DICE Group at Jefferson built a system in collaboration with the Jefferson Occupational Health Network to input, review, and manage employee exposure. Our system makes it a lot easier for us to do this versus using a pen and paper or Excel sheets. Since our system also collects symptom information from exposed employees twice a day, we can report changes a lot faster and ensure our employee’s and patients’ safety."

5. Prepare for increased telehealth. Jefferson has had telehealth capabilities built out for several years via its JeffConnect telehealth group, including a robust program for managing stroke patient follow-up virtually. However, the JeffConnect team and The DICE Group at Jefferson needed to scale the program quickly. Most Jefferson physicians had already been through training on telehealth but many needed a refresh on how to use the technology and support with some of the new additions to the telehealth suite of products and use cases.

"It's a very concerning and worrisome time for us, but an inspiring time for the use of technology during a crisis," said Mr. Gomes. "The world is seeing the benefits of telehealth now, and hopefully, patients will continue to want to do telehealth in the future."

More articles on digital transformation:
The legacy of COVID-19: How key innovations will outlive the pandemic
How CIOs can prepare for digital transformation after pandemic
Mayo to become investor in COVID-19 remote patient management platform: 4 details



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