Pandemic responses have varied across health care organizations. BayCare Health System, a network of 15 hospitals based in Clearwater, Fla. that participates in value-based care arrangements and a provider-sponsored plan, has recorded approximately 650 COVID-19 admissions and more than 400 discharges as of mid-May. When cases first began rising locally, BayCare launched several provisions to address new demands created by the pandemic.
The use of technology and analytics to inform care decisions was a linchpin in BayCare's response, which aided in targeted engagement for its community served. BayCare Chief Medical Officer, Nishant Anand, MD, and Director of Physician Systems and Population Health, Chris Eakes, provide insight into the organization's technology-driven COVID-19 response and recovery strategies. Many components of BayCare's pandemic response have become more than tools to combat a crisis — they've become important elements of the organization's long-term strategy.
The start: Stratifying potential COVID-19 patients
One of the first challenges organizations faced as COVID-19 took hold was triaging potential cases to the appropriate setting, whether that be a testing center, urgent care facility or other venues and virtual channels.
To meet this challenge, BayCare used technology and advanced analytics to stratify COVID-19 patients before they presented to the organization. A triage phone line was immediately set up for patients to discuss their symptoms with nurses. Staff directed patients to the BayCareAnywhere app, which enabled them to check symptoms before seeking care. Community care managers then guided patients through treatment decisions.
Part of the organization's strategy included tracking potential hotspots where people tested positive and using analytics to predict where they might seek care. The information came from a universe of sources, including surveys, claims, lab, clinical systems, public data and its EHR. The sources provided centralized insights to BayCare's populations served — including more than 260,000 value-based members — all hosted within the Cerner data and insights platform, HealtheIntent®.
"One of our biggest challenges was organizing this data across all parts of the health system," Mr. Eakes said. "We're a large, very complex organization trying to accomplish a lot of things and serve the community in different ways," he said.
BayCare addressed this challenge by utilizing the data and insights platform to aggregate and normalize its data into dashboards that could present information in ways upon which providers could act. The dashboards helped the organization identify correlations and trends and stratify COVID-19 patients into segments based on risk. BayCare also mined the data to develop its own regression model to predict COVID-19 infection rates, in addition to other models.
The next step: Meeting virtual care demand
With BayCare's COVID-19 triaging, testing and treatment strategies in place, the organization turned to another challenge: helping patients connect with their providers from the safety of their homes.
Health care organizations nationwide have seen an unprecedented increase in virtual care visits during the pandemic. BayCare already had a telemedicine infrastructure in place and acted fast to expand its virtual care offerings to its employed providers, BayCare Medical Group. In roughly a week, BayCare launched telemedicine capabilities to over 500 providers. The organization also set up specific telemedicine tools for its Medicare and Medicaid populations, and technology that empowered behavioral health providers to reach rural areas.
BayCare noted at one point during the pandemic response its providers were seeing 75% of primary care visits virtually. The organization found providers and patients who were hesitant to use the technology before the pandemic became engaged with the virtual health ecosystem.
The change is part of the reason Dr. Anand is "convinced we're going to need to develop a health care ecosystem that also includes virtual offerings going forward."
BayCare is looking into expanding virtual appointments and at-home monitoring programs where patients can bring their own device. However, to what extent these initiatives take hold post-pandemic will be influenced by appropriate reimbursement and future regulations, Mr. Eakes said.
The now: Bringing patients back
The cancelation and postponement of elective surgeries during COVID-19 created another problem for hospitals. Organizations now face the challenge of recapturing revenue.
Amid the pandemic, BayCare went live with a new customer relationship management system to dynamically engage and communicate with patients. The new system is a Salesforce and Cerner collaboration that combines the clinical insight from HealtheIntent with the Salesforce CRM technologies, Health Cloud and Marketing Cloud. The system facilitates efficient, contextual and personalized communication between providers and patients by incorporating email, text, instant message, video, portal and phone communication with care management programs.
BayCare is taking additional technology-based steps to win patient confidence back, like providing patients the ability to check in online and wait until they receive a notification to enter facilities. Mr. Eakes credited the organization's investments in population health and care management technologies with helping its COVID-19 response and recovery.
Lasting change
While some of the changes BayCare made in response to the pandemic may be temporary, many are expected to bring lasting change to the organization.
"At the end of the day, we can't be a trusted information source for patients if we don't have the analytics," Dr. Anand said. "This crisis won't be the only one. We must be in a constant state of readiness for whatever crisis may arise."
Part of that constant state of readiness will be aided by using technology and advanced analytics that equip organizations with more holistic insights into their population and regional needs. "COVID helped galvanize the role of the health system as a trusted advisor in the community – whether sick or well," stated Dr. Anand.