Looking back at Digital Transformation in 2021
As we near the completion of another you’re marked by the COVID-19 pandemic, we have continued to support new digital models of care, including telehealth, digital therapeutics, and longitudinal care supported by remote patient monitoring. If 2020 was about rapidly standing up these services, 2021 was about building them for long-term durability, closer integration with clinical operations, and laying the groundwork for future change.
We continue to envision a hybrid care world, where digital care and in person care each other appropriate places within a patient journey. In all likelihood, patients will weave in between these worlds, perhaps engaging in virtual triage, seeing a provider in person, and engaging in digital therapeutics and virtual care for follow up, all in a way that’s built around the needs in the context of the patient.
As 2021 comes to a close, I wanted to recap our top five areas of accomplishments in our digital care work.
- Remote patient monitoring
We continue to invite all patients who test positive for COVID-19 at Froedtert & MCW to enroll in our RPM program. We have monitored up to 500 patients per day in the service. Our initial analysis has shown that monitoring and clinical coaching is associated with a reduction in the odds of hospitalization by 30%. This is an important strategy to ‘right-size’ the number of patients being admitted and cared for. We are also now looking into ways where we can decrease the length of stay for patients with COVID-19 who require supplemental oxygen but not intensive care through the use of RPM.
- New mobile application
We rebuilt and relaunched the Froedtert & MCW Mobile application for iOS and Android this year. While it looks similar on the surface, lots of changes under the hood prepare us to offer more personalized services to our patients in the near future. Our digital engineering team also substantially expanded this year, enabling us to move faster in creating value for patients.
Along with our mobile application we launched a new patient identity service. This enables us to better manage identity in an ever-complicated digital world, and provide better services to patients such as single sign on to multiple digital services at Froedtert & MCW.
- Telemedicine Look back and Rebuild
We continued to use telemedicine and virtual visits in 2021 to care for patients in their homes, places of work, or wherever they happened to be in the state. While the regulations and reimbursement for telemedicine remain to be worked out, we are investing in making a resilient and smooth experience for our patients and staff.
As we have written previously, we expect a hybrid care model, and this will require teams and providers to swap back and forth between in-person care and virtual care. We have put workflows and the technology under a microscope, and we look forward to unveiling a new experience in the coming year.
- Digital formulary expansions
We believe that software will augment, and potentially reshape, the care experience for many health conditions. For our mental health tool, SilverCloud, we have been able to expand the number of conditions we can help with, including insomnia, chronic pain, and complex medical illness. Results show a 20% reduction in depresion and anxiety scores.
We have brought on new partners, such as MedBridge. For our patients that have physical therapy with us, we create a customized digital experience for them to use at home to continue their rehab.
We now manage 41 different conditions, supported by digital therapeutics.
- Asynchronous care
“E-Visits,” a misnomer of sorts, are questionnaire-based interactions to help people get started or to the right level of care. We have used them extensively for COVID-19 testing, freeing up staff from the telephones or from secure patient messages to more efficiently get tests ordered and scheduled. Our COVID-19 testing process is an example of an entirely digital end to end experience: patients complete questions about their symptoms and reason for testing, providing any data we need to report to the state; testing is ordered in the EHR, and patients receive a message that enables them to schedule their appointment; patients receive results through our app or portal; lastly, patients testing positive are automatically enrolled in our RPM solution (described above).
At a time when we face staffing shortages, we have also taken other common protocolized treatment conditions (e.g. if a patient sends a free-text message or calls into the clinic with a particular set of sumptoms, from back pain to UTI), we have moved those to the asynchronous care platform.
Taken together, we can clearly see that healthcare is moving away from its traditional visit-based model roots. We see more in the home care, either remote patient monitoring, telemedicine, or digital therapeutics. Will 2021 be the tipping point for moving care to be more patient-centered, wherever they are? Is an ‘always-on’ approach the future of healthcare, will it sustain, and will care models catch up? Time will tell, but we see our investments in the above areas as placing us in a good position to better serve our patients.