Rush Health explores video visits to meet new patient needs: 5 Qs with Abigail Boyer, director of clinical outcomes and population health

Healthcare organizations are constantly learning about their patient populations — from new services patients want their hospitals to offer to how patients interact with the digital tools hospitals provide them.

One key trend affecting hospitals nationwide is the shift from patient to consumer. Patients today want seamless, convenient interactions with their healthcare provider, just as they experience in retail, hospitality, banking and several other industries.

In advance of the Becker's Virtual Health IT Summit Nov. 6-8, 2018, sponsored by Lenovo Health and Intel, Becker's Hospital Review caught up with Abigail Boyer, the director of clinical outcomes and population health at Rush Health in Chicago, to learn how Rush is meeting its patients' changing needs.

Editor's note: Responses have been lightly edited for clarity and length.

Question: What's one thing you learned about your patient population that really surprised you?

Abigail Boyer: Rush Health currently provides care management services to 60,000 patients in our commercial and governmental value-based care contracts. What has become clear is that the care management services our governmental value-based care patients need are different than the services our commercial value-based care patients need.

Our patients covered by government-sponsored plans require more extensive services that are often shaped by their social determinants of health. These patients welcome and are accustomed to services being delivered in different settings, so they are accepting of our care management delivery model. Our patients covered by commercial plans tend to be healthier, generally do not understand our care management services and are less willing to accept relationships outside of those with their physician.

Q: In the past 12 months, how have you adapted to new patient experience expectations in the age of consumerism?

AB: We have had to refine our care management delivery model to support patient engagement. We are moving care management services to each individual practice so care managers become part of the patient's local care team. We have also learned that our patients need familiar and easy access to our services, so we are in the process of rolling out virtual and e-visit capabilities to meet specific access gaps and emergent needs. Care management is not a person but a process in which the entire care team works together.

Q: What technologies does your organization use, or is considering, to enhance the patient experience?

AB: We'd like to start leveraging video visits to stretch our limited resources for care management for certain chronic disease programs. We are working to provide a video visit service for our certified diabetes educator who is dedicated to our value-based patient population. She is centrally located but supports patients who live up to 50 miles away. These patients want to interact with her, but it is difficult when they are only able to connect via phone. We think video visits will help us engage those patients who have been reluctant to talk with an 'anonymous' voice over the phone. We want to use technology to support specific care redesign workflows, and measure success as we go.

Q: How have you used technology to engage patients at your organization?

AB: Using predictive modeling, we are looking to target patient education initiatives to the right patients at the right time. For example, we are able to predict which patients are most likely to visit the emergency room in the next three months for a nonemergent condition. We then embed that risk score in the EMR, flag the patient as at-risk and at the patient's next visit, discuss alternatives to the ED. The insights we gain from aggregated payer data, which includes all out-of-network patient care, are sent to the value-based care registries in the EHR and marked as follow-up care within the patient record. A value-based care dashboard provides care managers and providers with a snapshot of the care, quality, utilization and cost of their patient panels.

Q: What is your organization's No. 1 strategy to improving care collaboration?

AB: Our strategy encompasses sending care data back to the record for follow up and identifying intelligence across the continuum of financial and clinical data by establishing continuous plan-do-check-act cycles [a four-stage model for continuous improvement in business process management] to improve care.

Our strategy also addresses the transitions of care workflows. We've been focusing on collaboration among ambulatory and inpatient care management services — specifically, how can these teams support each other when caring for patients who need the most support? — and are looking at the best ways to connect teams when patients transition to different care settings.

In addition, we are devising a CVS Pharmacy medication multipack benefit for our Medicare Shared Savings Program population, in which the multipack medication is sent directly to the patient. Our goal is to improve medication adherence at lower cost.

To learn more about how healthcare organizations can prepare for the new patient as a consumer, register for Becker's Virtual Health IT Summit Nov. 6-8, 2018 here.

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