.svg)
.png)
December 19, 2024
The adoption of digital patient engagement solutions skyrocketed over the past few years, as market forces such as the pandemic, healthcare consumerism, value-based care, and staffing shortages set in motion the need for more virtual touch points between providers and healthcare consumers and necessitated the evolution of engagement solutions to extend beyond appointment reminders to patient driven virtual care management solutions or digital care journeys that can be accessed from anywhere on our everyday devices. So, what are Digital Care Journeys and how do they enable healthcare systems, hospitals, and providers to automate patient engagement from a clinical perspective across surgical pathways, oncology, chronic care, women’s health, behavioral care and more?
As per the recently published KLAS Research Patient Communications Landscape report, the health IT research firm states that patient driven care management solutions are often focused on the patient journey specific to conditions or procedures including pre- and post-visit education, care navigation, post visit follow-up and patient surveys. Extending beyond just appointment reminders and broadcast communication, patient driven care management solutions empower patients to self-manage their care from anywhere enabling health systems to reduce hospital length of stay, ED visits and readmissions.
Typically, using their own devices – smartphone, tablet, or computer - patients can access evidence-based procedural education, receive step-by-step care navigation including daily reminders relating to diet, exercise, procedure prep, recovery, medication management, etc., and automatically report outcomes including the completion of surveys, pain scores, incision photos, opioid consumption and more. The always-on access to evidence-based content from their trusted provider optimizes the patient experience, closes care gaps, and improves outcomes.
Studies show that nearly one in five people experience an adverse event within three weeks of hospital discharge – but almost 75% of these could be prevented or ameliorated. Clinical studies and academic research published by leading health systems have shown how providing patients with access to digital care journeys reduces ED visits, phone calls, and readmissions.
Health systems must evolve as payment is increasingly dependent on better outcomes and patient satisfaction rather than simply providing care. This shift to value-based care has nudged many health systems toward coordinated and standardized healthcare delivery on a system-wide level. By reducing variability in care, patients receive a higher level of care at a lower cost. To deliver this, providers need to engage patients outside the four walls of the hospital to meet their needs and lower costs.
During a recent fireside chat, Dr. Joshua Liu, CEO and Co-founder, SeamlessMD sat down with Janette Wide, Managing Editor, Healthcare Innovation to discuss new trends in digital patient engagement and the role of digital care journeys. With a background in the clinical world and a passion for quality, safety, and the patient experience, Dr. Liu explains how he along with his co-founders and team of healthcare specialists are on a mission to help health systems better engage and monitor patients to prevent outcomes such as readmissions.
Take a look at some of the topics that Janette and Dr. Liu unpacked during their discussion.
Q. What are the challenges you're hearing from health systems to solve when it comes to patient engagement, what are you helping them with?
What you realize as a patient going through a healthcare journey is that whether it's a surgery, a cancer journey, maternity care, chronic care journey, 95% of that patient journey really does happen when you're at home, alone in the community with very limited support day-to-day from your healthcare team. Our providers are giving patients lots of verbal and paper instructions, which patients will tell us that they lose, they forget, there's no day-to-day reinforcement.
Then providers will tell us that there's no easy way to keep patients on track, no easy way to follow patients and monitor them. If patients can't stay on track with their instructions and your caregiver can't keep an eye on you, bad things can happen maybe longer than expected, like stay in the hospital, avoidable readmissions. Ultimately, this drives up costs in the healthcare system.
Imagine we could digitally engage and monitor every patient every step of the way throughout these journeys before, during, and after their hospital stay to keep them on track with those instructions to allow their care team to monitor them and catch problems earlier, what if we could build a world like that? That's what we do at SeamlessMD.
For example, let's say you have a patient undergoing a total knee replacement, patients will access SeamlessMD on their own smartphone, tablet, or computer and are guided step-by-step with their pre- and post-surgery instructions. Patients get a just-in-time reminder, a week before surgery, test out their blood thinners on time or the night before surgery to make sure they do their antibacterial shower. Then after surgery, they get video-based education on how to do their physiotherapy. Then, at home every day, they're checking in on the app, they are tracking their symptoms, their pain scores, and photos of their incision after surgery.
Back at the hospital, we have clinical teams that can write within their EHR, access our dashboards, get alerts, monitor all that data being tracked by patients so they can catch issues much earlier, and that way they can prevent an outcome such as a readmission and improve both the patient experience, but also the value through the health system.
Q. As the adoption of solutions for remote patient monitoring and patient engagement increase, which we've been seeing a lot through our interviews and all the things we're writing at Healthcare Innovation, can you share with us how some healthcare organizations are using the technology?
When we started SeamlessMD about nine years ago, we were initially focused on just the surgical space. That's where we saw the initial adoption. But since then, the use of SeamlessMD has really expanded across all things from surgery to maternity care, to cancer care, behavioral health, and so forth. So now we're being used in dozens of specialties across a wide variety of health system settings.
UAB, in Alabama, it's the largest academic hospital in the state, they've really focused on using SeamlessMD to serve high-risk surgical population. They're supporting and monitoring patients going through major heart surgery, lung surgery, gynecologic cancer surgery, colon surgery, and so forth.
Then we have folks over in Washington state like MultiCare, a large 11 hospital system, they've fully integrated SeamlessMD with their Epic and MyChart system. Their goal was to deliver standardized, truly differentiated consumer experiences across all their high-volume patient journeys. So, they have deployed SeamlessMD for hip and knee replacement, maternity care, spine, and bariatrics.
We also serve the Canadian market. One of our customers there, Thunder Bay Regional, is this rural hospital that serves a region the size of France, and they have patients who live two or three hours away, and they're remotely monitoring patients on SeamlessMD from surgery to cancer care to maternity care, to really support patients who just can't drive in two or three hours every time.
It's been fascinating to see how Digital Care Journeys are being used across so many different settings - academic, community, rural and urban, it's been phenomenal to see how innovation can work in any setting.
Q. What's the role of digital care journeys in a health systems digital front door strategy?
A report that came out about a year ago from Deloitte and the Scottsdale Institute, they surveyed a group of health system executives on, "What are your digital transformation priorities going forward in 2021 and beyond?" The two priorities that came up most were:
- improving the consumer experience.
- improving health outcomes, all centered around what does digital front door mean for us.
When we look at the digital front door strategy as it's evolved in the market the last few years, we've seen it initially start off, I'll call it the bookends of the patient journey. A lot of folks have spent time on how do we do digital patient acquisition and digital search and schedule online. That starts the patient journey with the system and a lot of folks focused on the end of it. How do we do better payments in terms of digital payment experiences for patients?
All that's important, but I think what was missing for a long time, and that's now come front, and center is what happens in between during the actual healthcare journey when you're going through a surgery or a cancer journey? That's where the digital journey has come in, it fills that gap around, how do we not only improve the consumer experience, but actually engage patients during their actual acute health care journey clinically so we can improve their health outcomes as well? We sit right in the middle of that.
Q. How do digital care journeys help health systems differentiate from a competitive perspective, increase revenue, combat staffing challenges, and improve customer retention?
If you were to ask a patient about their experience with the healthcare system, I really don't think they're going to remember or point out to you, "Wow, what an amazing payment experience that was." Or I don't think they're going to look back and say, "Wow, the way that they acquired me as a patient, that was a phenomenal digital experience." But I think what patients do remember, and what we want them to talk about and rave about is how amazing their experience was during the actual care delivery, how engaged they were, how supported they were when they were most vulnerable going through an illness or surgery.
We've had so many patients who've been engaged and monitored on SeamlessMD, give us feedback around how they had less anxiety because they knew just in time what to expect from their care team. We've had patients tell us how their life was saved because a blood clot or an infection was caught way faster on our platform and the nurse picked it up sooner and got the patient treated remotely or brought into the hospital to be seen much sooner.
We've had patients rave about how they didn't have to travel two hours back just to see their clinician because the clinician could monitor them remotely and just do things for the patients at home.
These are the powerful stories that will spread like wildfire and truly differentiate health systems with the consumer experience, which then leads to more patient market share, more revenue, and so forth. The other thing that we think a lot about is how do we enable providers to use digital and remote monitoring solutions like SeamlessMD but in a way that doesn't add to staff burnout. A lot of the traditional monitoring solutions require a nurse being alerted all day long, monitoring all these patients, doing this actual work they never did before, that can certainly lead to burnout. We've approached it a bit differently.
We have this intelligent approach to monitoring where actually when patients record an issue, the baseline level of support from SeamlessMD is that we mostly prompt patients on what to do based on their issues. For example, If a patient records that they have some low-risk issue like constipation on SeamlessMD, we find that 80% or more of the issues patients record on SeamlessMD are actually low-risk things that don't need a provider to call in and do something, we actually tell our patient what to do, we'll tell them how to manage that constipation at home or how to take care of that low-level pain. We've found that it cuts calls back to the hospital or clinic by over 50%.
So, what we're doing is we're getting rid of a lot of the low-risk issues that a provider really shouldn't be spending time on and we're only escalating or alerting the top 10% or 20% of issues that the clinical team wants to know about and are the only people who can help the patient. That's been a game changer for staff.
Q. With the ongoing shift to value-based reimbursement, how are health systems using digital care journeys to improve quality and patient safety?
A big one lately has been reducing the length of stay. We have all this data that's come out from different specialties and providers on how they've used digital care journeys to cut length of stay.
First, we're getting more patient compliance with evidence-based care plans that lead to earlier discharge. For example, a lot of evidence-based care plans are getting patients up and moving sooner, walking sooner after, eating sooner. The data shows that when patients do those things earlier and sooner, they feel better and go home sooner. So, we're actually getting patients following those things much more easily.
Second, we've seen is that just by giving patients and providers this tool to stay connected after discharge, it gives both parties confidence to leave the hospital half a day or a day sooner, whereas, in the past, they would say, "Maybe I'll stay an extra day, I'm not totally sure I feel ready to go home." Now patients are saying, "Oh, you're saying that I'm still going to be connected to my provider through SeamlessMD even if I go home today? Okay, I'm up for it." We've had some of our partners dramatically increase the number of same day surgeries they do because they have more confidence on both sides of the table to go home earlier. We have some customers that are doing same-day procedures for things like major colon surgery that would have been unheard of even just a decade ago. So, length of stay is a big one.
Another big one is we're reducing readmissions, as we all know, there are penalties for certain readmissions and other value-based care models where we want to cut down on readmissions but in a safe manner, and certainly remote monitoring has been big for that.
Lastly, the impact of digital care journeys on tackling the opioid crisis. What we've been doing for many years, particularly with our surgical patients, is helping them track the amount of opioids they take after discharge when they go home. We have patients who are tracking daily, "How many pills or these narcotics did you take?" And on the backend of SeamlessMD, we have analytics for the providers to understand, "Well, how many pills are patients actually consuming?" What we found is that maybe we're prescribing patients at discharge, let's say, 30 pills of narcotics for their pain and the data might show, well, actually, patients are only taking 15. Now providers have the data and confidence to say, "Hey, you know what, we don't have to prescribe 30. No one's taking 30." We can drop it to 25, 20 because we have the data to show that patients don't need that many. Whereas in the past, providers would just keep prescribing 30 because they had no idea what the actual usage was.
We even have one customer that did an analysis that they presented a couple of years ago at a conference where for major pancreas and liver cancer surgery, they found through SeamlessMD that patients were self-reporting only using about 10% of the opioids therapy prescribed.
Hospital length of stay, readmissions, and opioid use are three big quality outcomes that we’re helping health systems achieve.
Q. Remote patient monitoring is not new. So, what's different about your offering?
I like to think of SeamlessMD as leading the way for what I call remote patient monitoring 2.0. When I think about what health systems were doing for the last decade, I call it remote monitoring 1.0, meaning a lot of them were doing device-based remote monitoring for the top 5% of patients at risk. So, the typical use cases, patients with heart failure, COPD, they're the top 5% of patients at risk of readmission. We're going to deliver a kit to their home with a blood pressure cuff, a Bluetooth-enabled weight scale, and I'm going to have a ton of nursing resources invested to really monitor all these patients at all times. That's worked out well for that top 5%.
I think what's changed in the last couple of years is that health systems, as part of their digital transformation strategies, don't only want to support just the top 5%, they want to have a digital experience for 100% of patients. But they also want that in a way that's scalable where they don't need hundreds and hundreds of nurses monitoring all these patients throughout their journeys. For a lot of these journeys, a knee replacement, or a colonoscopy, or a cancer journey, those don't really need heavy device-based monitoring. They don't need tons of nurses monitoring every single issue, but they would benefit from scalable, automated app-based digital care journeys. That's what I think of when I see remote monitoring 2.0, and that's what SeamlessMD does.
We're often viewed by our partners as a scalable way to reach 100% of patients, whether they have a low-risk or high-risk journey.
Q. So what factors should health systems consider when determining their readiness to incorporate digital care journeys as part of their patient engagement strategy?
There are many factors that we could dig into, but I would say there's one specific one I'll really emphasize. For us, that's been having truly engaged clinical champions. I've learned over the years is it doesn't matter if even the CEO of a health system wants to implement digital care journeys, or, the Chief Digital Officer, which is probably the new leading role for this. Despite that support, if there aren't strong clinical champions paving the way to the frontlines, you just won't be successful. Often, we'll see health systems start in a few specific high volume, high ROI clinical areas like orthopedics, cardiac, maternity, gynecology, but what's most critical is that the Chiefs of the service lines are incredibly engaged, they're bought in, they're excited, they're spreading their excitement to all the other frontline providers.
Then that excitement from everyone in that service line translates to more patient engagement, more adoption and ultimately, you need that adoption to get great results. That's why we've invested so much in building out more and more of our body of evidence with our clinical partners.
What we find is that a lot of digital and IT leaders often focus on the technical features, but that's not what clinicians care about. Clinicians care about, "Okay, well, what's the evidence behind this nice-looking solution?" They don't care about features, they care about outcomes and results on patient experience and if there isn't strong evidence behind it, it's really getting hard to get clinical champions paving the way.
So, I would say the biggest factor for readiness is to find those clinical champions, make sure they're bought in so that way, if you decide to invest in these solutions, your setup for success, otherwise, you're going to bring in something that no one uses, and no one wants that.
Q. What measurable outcomes have you seen from your clients who have leveraged digital care journeys to optimize the patient experience? I know you touched on a few before, but if you could give us a few more examples, I think it would be helpful.
We've had customers who've demonstrated cost savings between $1000 to $8,000 a patient, reductions in readmissions between 45% to 72%, length of stay reduction between one and two days, ED visit reduction, upwards of 68%, phone call reduction by 50% to 65%. We do all of this while still dramatically improving patient experience.
We've had patients tell us that, "I wish I had this for my first C-section. It would have made a huge difference." So, when they compare the same experience with digital care journeys vs. without digital care journeys, it's just that much better.
One thing we've really done well with our partners, is pointing out to them, "Hey, we've put hundreds of patients through SeamlessMD at your organization, we really want to do an outcomes analysis, we really want to show you that this has made a difference." Because if it hasn't, then we're frankly not satisfied, and I don't think enough vendors care about that. Because at the end of the day, it's a partnership, and we want to create value.
Q. What advice do you have for health systems who are embracing technologies and putting these new practices in place and gearing up to deliver digital care journeys to their patients?
The biggest piece of advice for health systems is if you're going to go down this route with a technology partner, really focus on a partner who puts the clinical aspect at the center and not just in what they say, but in what they do and the team that they assign to work with you. For example, when we implement the solution with the health system, one of the team members that is part of that implementation from our side is someone called a Patient Education Specialist. This is someone who comes from a clinical background in some way - they are nurses, pharmacists, dieticians, health communication specialists, and they're the ones who lead the frontline clinicians through all the customization and configuration of the content and protocols on SeamlessMD.
I would advise health systems, if you're implementing digital care journeys, realize it's not a tech solution. It is a clinical solution, and make sure your partners are bringing that clinical DNA to the table, otherwise, you might be left with yet another app that looks nice but doesn't make sense clinically, and your patients won't actually use.
Q. How do you see digital patient engagement evolving maybe for the rest of 2022 and beyond, let's even say 5, 10 years from now?
I think digital patient engagement is in the early innings of this evolution away from, let's call it operational digital patient engagement, to something more clinical and patient focused on the healthcare journey. Many health systems have already checked off, I've done my digital appointment booking solutions. I've done my digital payment solutions, my kiosks, etc. That's table stakes.
Now it's about leveraging digital patient engagement to truly guide patients through the actual healthcare part of their healthcare journey. How do I drive and improve health outcomes? How do I succeed in an increasingly value-based care environment? And knowing that it's no longer good enough to just say, "Hey, we're doing digital and monitoring for the top 5% of patients at risk, I need to find a way to better care for patients digitally at scale for 100% of my patients."
I think the health systems who figure this out quickly are going to be the real big winners from all of this, and it's going to be their patients who get better care because of this transformation. That's going to make winners out of everyone. I do think digital care journeys are the next big thing in digital patient engagement.
Five years from now, it's absolutely going to be the standard of care and if you're going to stay ahead of the curve, I think it's something that folks must start looking into now.
Interested in learning more about Digital Care Journeys?
Download the eBook The Role of Digital Care Journeys in a Health System’s Digital Front Door Strategy to learn how leading health systems have realized that digital care journeys are key to optimizing the patient experience and reducing high-cost services, such as length of stay, readmissions, and ED visits.
.png)
