The next chapter in care delivery: How to fill care gaps and realize the promise of telehealth and automation

The pandemic has made it clear: the delivery of healthcare is changing, and technology is playing a key role.

Among the most important technologies being adopted by health systems today are virtual care modalities and automation, but the true opportunity lies in our ability to integrate these technologies into a seamless care experience that blends in person care with virtual and automated interactions.

During a roundtable sponsored by Amwell at Becker’s Hospital Review’s 12th Annual Meeting, three experts on virtual and hybrid care discussed how new technology can better support patients and providers. Panelists were:

  • Tricia Baird, MD, vice president of care management at Spectrum Health in Grand Rapids, Mich.
  • Murray Brozinsky, chief executive officer at Conversa Health, now part of Amwell
  • Ken Cahill, chief executive officer at SilverCloud Health, now part of Amwell

Three key takeaways were:

1. Digital platforms address obstacles to behavioral healthcare access. According to the CDC, in a given year, one in five Americans will experience a mental illness. Yet, 60 percent of U.S. counties do not have a single psychiatrist.

Digital behavioral health platforms such as Amwell’s SilverCloud are proving effective tools for addressing conditions including anxiety and depression. According to Mr. Cahill, “Digital interventions aren’t just about serving mild populations. We see evidence of people across populations moving into the recovery zone. In addition, SilverCloud isn’t just for the episodic or the ‘now.’ Our toolkits can deliver long-lasting change. Individuals reuse them in their daily lives to address challenges like insomnia, depression and anxiety.”

2. Automation can bridge the gap between patients and care teams. Amwell’s Conversa Health automates patient and care team interactions for use cases such as chronic care management, pre- and post-procedure care, perioperative care, post-acute rehab and more. Conversa reaches out to patients and asks about their care journey. If the individual’s status has changed, the system will respond. “By constantly surveilling patients, we can get them to a higher level of care when needed,” Mr. Brozinsky said. “In many cases, the next best action can be fully automated. As systems get smarter, predictive and causal analytics can determine what might happen next. If the probability of hospital readmission increases, for example, then the patient will be escalated in a synchronous connection earlier.”

3. After deploying Conversa chats for emergency department (ED) visit follow-ups, Spectrum Health experienced lower ED utilization. About a year ago, Spectrum Health started offering Conversa digital chats for emergency department visit follow-ups among certain patient populations. “Across the board, we are seeing a 5 percent reduction in ED and acute hospital utilization among individuals who accept chat capabilities. For patients covered by our risk contracts, that represents $998,000 of reductions in the total cost of care annually,” Dr. Baird said.

Patients had been asking Spectrum Health to support text communications for some time, Dr. Baird said. Patients appreciate the help they can get with escalations as well as the self-service nature of the Conversa system. Rather than sending escalations back to the ED, a transition team handles these cases. This has also resulted in increased provider satisfaction. “The transition team loves that their entire day is devoted to deep problem solving. From a talent acquisition perspective, highlighting how we use automation is also a nice recruitment tool,” Dr. Baird noted.

Although tools such as Conversa and SilverCloud can deliver significant value, they are not islands of care delivery. Integration with physical care is essential. “For any automation system, you must think of the broader ecosystem. At Amwell, we think of automation and virtual care modalities as critical components of hybrid care delivery that maximize patient experience, minimize the burden on care teams and reduce costs," Mr. Brozinsky said.

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