"Best of Both Worlds": How an Innovative Partnership Is Re-Imagining Care at Jefferson University Health

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"It's going to be the best of both worlds."

So says Stephen Klasko, MD, CEO of Thomas Jefferson University Health System and president of Thomas Jefferson University in Philadelphia, of his plan to combine the expertise and reputation of the 190-year-old organization with cutting-edge technology and commercial partnerships to re-imagine care delivery.

"The things we do well we will continue to do well," he says, referencing TJUH's No. 17 rank on U.S. News and World Report's list of the best systems in the country and multiple award-winning specialties.

What Jefferson and the healthcare industry could do better will be addressed through new technology, new partnerships and a new focus of innovation.HeaderImage2edit

One of the partnerships Dr. Klasko is most excited about is with Boston-based American Well, a company specializing in on-demand telemedicine services. American Well, which currently has a presence in 45 states, with physicians able to prescribe medications when appropriate in 37 states, is a platform designed to connect consumers with physicians virtually for consults or care, says Chairman and CEO Ido Schoenberg, MD. Currently, users in most areas can be connected with a company-affiliated physician in under three minutes.

"Mobile [devices] have changed our lives, it's so compelling here in our hands," says Dr. Schoenberg, and it seems like a natural evolution for consumers to access medical care on the device most have with them at all times. "People love this platform," he says.

American Well has enjoyed its fair share of success. Hawaii's Blue Cross Blue Shield was the first to partner with American Well to provide telemedicine services for its beneficiaries, followed shortly by other BCBS plans. American Well's prominence was solidified when WellPoint partnered with the company to provide telemedicine coverage for its 36 million lives in June 2010.

However, American Well continues to face challenges surrounding consumer awareness and trust. "The patient is the most important part of this," says Dr. Schoenberg. "We need to trust the people who treat us."

When Jefferson patients use the service under the new partnership, however, they will be connected with a Jefferson physician, allowing patients to access the familiar and trusted Jefferson care experience beyond the organization's physical perimeter, he says.

The American Well technology will be the basis of Jefferson's new virtual emergency room, bringing the patient-centered focus into a part of the hospital where patients routinely wait hours for medical attention that may not be necessary or appropriate.

For Judd Hollander, MD, Jefferson's associate dean for strategic health initiatives in the Department of Emergency Medicine, the emergency department was the most striking example of non-patient-centered care. "You have to think, 'What are they waiting for?'" he says, knowing the answer is high-cost, possibly unnecessary care. "That's where we could deliver care better," he says.

Using American Well's telemedicine platform, Jefferson ED physicians will soon be able to connect with patients while they're still at home, provide a preliminary analysis and determine if the patient needs to come to the ED or whether an office visit would be better suited to the level of care the patient requires.

The virtual ED will help the health system deliver care "in the right medium, in the right place, at the right time," says Dr. Klasko.

Jefferson's plans extend beyond a virtual ED to virtual rounds, an expansion of the American Well telemedicine platform throughout the health system that will let patients' families participate via videoconferencing. This level of innovation does not come easily, nor will it come easily, agree the health systems' leaders. But in order to be an innovator and leader in healthcare transformation, taking big steps and trying new models is a necessity. "People laughed at Amazon when they started," says Praveen Chopra, executive vice president and CIO at Jefferson. "Putting the customer front and center… it's a paradigm change."

However, this emphasis on the patient and helping the Jefferson care experience extend beyond the organization's physical boundaries will likely help Jefferson create the consumer "stickiness" Amazon has enjoyed with its customers.

"They'll have one interaction with this, and then say 'I want to go to Jefferson,'" says Mr. Chopra.

Jefferson's new partnership, and its new path forward, is creating a culture both of innovation and optimism at the organization. Dr. Schoenberg recalls attending an organization-wide meeting at Jefferson and noticing not just the high-level employees at the front of the room, but the employees in the middle and back were excited about the new direction.

Dr. Klasko credits the optimism to the organization's proactive approach to a rapidly changing industry. "Every industry has disruptions," he says, so successful organizations will get out ahead of the pack, lead and "create positive disruptions."

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