Updates from the field: Insights & actions from health systems


Whether it’s planning for an uncertain rolling recovery, implementing contact tracing, or coming up with innovative solutions to persistent shortages in PPE, the AVIA Network is acting and innovating at a rapid pace. Check out the list below for the top areas where health systems are acting today.

  1. Planning for rolling recovery and “new normal”: Some systems are still experiencing initial COVID-19 surges, while others have settled into a surge strategy and are starting to plan ahead — including processes to retool, scale, or integrate new digital tools implemented during the crisis period. The rolling recovery and “new normal” period will be characterized by potential re-surges, a critical need for automation, diminished cash flow, patient volume bounce-back, and new digital modes of working and caring for patients.
  2. Shift from digital screening and triage to contact tracing and rapid, large-scale testing: Systems are very committed to scaling virtual triage, with a priority on self-service solutions (i.e. chatbots). Additional priorities include rapid deployment, interoperability with existing technology and workflows (e.g. EHRs), and cost-savings. Systems are also leveraging existing relationships with solution companies to quickly add COVID-19 use cases. Challenges persist around testing availability, but multiple solution companies are quickly creating offerings and systems are starting to explore contact tracing, either using their own analytics teams or third parties.

    Example: One system accelerated contact tracing efforts and faster testing after Google and Apple announced that they’re enhancing mobile contact tracing capabilities and releasing APIs to enhance interoperability between Android and iOS devices.

  3. Rapid deployment of remote monitoring: Health systems are still looking to rapidly stand up remote monitoring devices and digital app solutions to manage surges and to use in the rolling recovery and “new normal.” Plug-and-play options that support hospital-at-home strategies, including care for non-COVID-19 patients, are of particular interest. Remote monitoring solutions are early in maturity, so health systems are collaborating with solution companies, leveraging EHRs, or considering homegrown solutions all while navigating device shortages.

    Example: One health system is filling gaps in virtual visits through an automated outreach program to ~3,500 patients that reminds them to measure and report their temperatures twice daily.

  4. Innovative approaches to supply shortages: Supply limitations persist across the nation, resulting in systems bidding against each other for finite supplies or dramatic cost increases per unit. Health systems are developing innovative methods to manage these challenges, such as stringent conservation policies, designated disinfection rooms, 3D printing supplies, and sourcing new manufacturers.

    Example(s): One system took a community approach and partnered with local universities, high schools and an engineering company to 3D print inhaler devices, ventilator parts, helmets, nasal swabs, and housing for portable respirators. Another system’s task force has created a new partnership with an engineering school to develop a line of 14 new products, and worked with a fashion school’s textile experts to create prototypes for surgical and isolation gowns. Other systems report that they are working directly with local manufacturing companies who have 3D printing capacity.

  5. Intense financial planning and modeling: Systems are facing huge financial losses and are creating plans and models for the short-term, mid-term, and long-term. They are taking action as pressures increase across the revenue cycle and workforce. Some health systems are currently furloughing staff and/or freezing wages while revenue streams are deferred (i.e. elective procedures) and demand for COVID-19 treatment persists. Health systems are modeling for cash flow, volume bounce-back for pent-up non-COVID-19 patient demand, staffing, elective surgery demand, and ongoing virtual visits demand.

    Example(s): One system is developing a model for several scenarios that links projected infection rates, timing estimates, and projected service line utilization to financial estimates. Another system is leveraging previous investments in an Enterprise Data Analytics platform to provide operational and financial leaders with real-time insights.

  6. Optimizing virtual visits beyond the surge: Virtual visits have been deployed during the surge with great success, helping physicians and nurses manage demand and also keeping them safe. Virtual visits now need to be optimized and scaled for the rolling recovery and “new normal.” This includes understanding the future of reimbursement and other policies supporting the current use of virtual visits. To capture revenue, proper documentation and coding will be critical as well as tight caregiver and revenue cycle/coder coordination.

    Example(s): One health system reported that almost a third of video visits during this period are new patients and they’re seeing a strong and steady referral stream. They expect to retool processes, infrastructure, and training if they maintain this volume. Another health system is developing pathways for patients to self-schedule for their virtual offerings.

  7. Rising behavioral health needs across all populations: More than four in ten individuals feel that coronavirus-related stress, anxiety, and social isolation have had a negative impact on their mental health.1 Women, hispanic adults, and black adults are reporting major impacts. Health systems recognize that this issue applies not only to patients and the community, but also for clinicians and staff. Health systems are starting to provide telemedicine solutions to combat social isolation, anxiety, etc.

    Example(s): One health system is providing patients with safe space to connect online. The digital solution also notifies clinical staff of patients with rising risks (i.e. self-harm thoughts or behaviors). Another system launched a peer outreach program for socially isolated seniors, extending volunteer time to assist with outreach and increasing staffing for a senior resource phone line.

  8. Creative and collaborative partnerships: Health systems are innovating to manage COVID-19 decision-making and are sharing lessons learned. Task forces, health system coalitions (e.g. to share data to manage surge), and community partnerships (e.g. with universities and engineering firms) are forming to address PPE shortages, IT support, recovery planning, financial planning, community centered initiatives, and more.

1. KFF. Health Tracking Poll – Early April 2020: Impact of Coronavirus on Life in America. Accessed April 2020.

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