Jeffrey Cohen, MD, has spent four decades in healthcare. For much of that time, describing patients as consumers was heresy. Not anymore.
“If somebody had talked about consumerism in healthcare when I was starting out and when I was training, that was a dirty word,” said Dr. Cohen, executive vice president and chief clinical operating officer at Hartford HealthCare. “You could never say that. People would bristle at it. If you talked about patients as consumers, they would say no, we have a higher, loftier goal than that.”
But the tide has changed and patients have more control than ever over their healthcare journey, and where they want to receive services. Patients are also less tolerant of friction and wasted time; they want healthcare to be as easy as ordering food or buying a plane ticket. That’s why consumerism is the organizing principle behind Hartford HealthCare’s 10-year strategic plan. As the largest health system in Connecticut with roughly $8 billion in revenue, nine hospitals and more than 500 sites of service, HHC has staked its future on a deceptively simple promise: meet people where they are, when they need care, on their terms.
“I don’t think there’s any loftier goal than to be consumer centric,” Dr. Cohen said. “In every other walk of life, in everything else we do, we are consumers and we have an expectation of getting basically what we want, where we want it, when we need it.”
That conviction did not arrive overnight. Dr. Cohen traces the roots of the system’s current trajectory back roughly 15 years, when Hartford HealthCare dismantled its legacy governance structure to build a clinically integrated system. Hospital boards were dissolved in favor of regions with national leaders providing strategic oversight. The health system implemented an institute model, similar to Cleveland Clinic’s, to standardize care across geographies.
“If you enter Hartford HealthCare in Norwich, which is in Eastern Connecticut, more rural, or you enter Norwalk, which is maybe the sixth borough of New York City, you’re going to feel the same about Hartford HealthCare, and you’re gonna get an integrated experience,” Dr. Cohen said. “To do that, we had to build the infrastructure first and the foundation.”
The system then spent the better part of a decade expanding its ambulatory footprint — urgent care centers, ambulatory surgery centers, imaging hubs — with a goal of being within 10 miles of every Connecticut resident. It hit that target ahead of schedule. The next frontier was getting inside their homes.
On-demand care, 42,000 interactions and counting
The centerpiece of that shift is HHC 24/7, an on-demand virtual care platform the system launched roughly a year ago. Patients download an app, register, and are connected through their Epic chart to an AI-powered chatbot — built in partnership with the company kHealth — that triages their concerns and routes them to a Hartford HealthCare clinician within minutes, at any hour of the day.
“You no longer need to leave your home to get care by an HHC clinician,” Dr. Cohen said. “Even though we built out this extensive network, over 500 sites of service over the entire state and a little bit into the adjacent states, what you now have in the palm of your hand is the ability to get healthcare when you want it at the time you want it, and you can do it from your own home.”
Virtual and on-demand care is more convenient for patients in a variety of situations: those with work constraints, lack of transportation, or parents. The mother of multiple kids who is woken up by one sick child in the middle of the night doesn’t have to rush all to the ER. Instead, she can use HHC 24/7 for an on-demand visit and assurance on next steps.
“Here, I can go on a virtual visit, AI platform based with my medical record, with a provider, a clinician, who is part of Hartford HealthCare. They can see me. They can evaluate me, and decide that maybe it is indigestion,” he said. “And I don’t have to leave my own home.”
In 11 months, HHC 24/7 has logged 42,000 patient interactions and is now handling roughly 250 patients a day. Dr. Cohen frames the math in workforce terms: if the average primary care physician sees 20 to 25 patients daily, HHC 24/7 is doing the work of 10 primary care providers virtually rather than through brick-and-mortar settings.
The platform is also expanding. This spring, Hartford HealthCare is beginning a partnership with Cadence, a remote patient monitoring company, to layer home monitoring into the HHC 24/7 experience. Patients with chronic conditions like diabetes, hypertension and congestive heart failure will have home monitors feeding data — including EKG tracings — to the clinicians staffing the virtual platform.
“Imagine the power now that we’re going to have home monitors in place in people’s homes to manage their chronic disease states, keep these people out of the hospital, but link it to HHC 24/7,” Dr. Cohen said. “Now the clinician who’s interacting with you in the middle of the night will have EKG tracings; they’ll have all types of different data to manage your care.”
Building the workforce from high school up
Consumer-centric care requires clinicians to deliver it, but like many states, Connecticut does not produce enough nurses to meet demand and some leave the state after training. Hartford HealthCare’s response has been to build its own pipeline, starting earlier in the educational lifecycle than most systems.
It began with HHC CampusCare, a business line that initially placed athletic trainers and rehabilitation staff on college campuses. That footprint quickly expanded into student health, behavioral health and pipeline development. The system now partners with seven or eight universities and has moved into prep schools and high schools through programs like REACH and CT Ready, training students for in-demand roles such as radiation technologists and echosonographers. The results have been tangible. Hartford HealthCare has reduced its travel nurse costs and headcount by more than 90% in the past two years.
“We have virtually no contract labor in nursing on any campus, and this gets to our culture,” Dr. Cohen said. “Once you don’t have to do that, now we grow our own, we build our own, we invest in our own.”
He credited Rose Sheehan, Hartford HealthCare’s chief people officer, for the success. She joined the system two years ago and led its People Promise initiative, which is organized around career development, culture, well-being and total rewards.
“It has taken us to places I am sure we would not have gone on our own,” said Dr. Cohen.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
