September 14, 2020 – Like so many hospitals and health systems across the country, the emergence of the novel coronavirus forced AdventHealth to go from zero to sixty launching consumer-focused patient engagement technology.

While before March the health system, which has over 80,000 medical providers practicing in ten states, was behind the scenes building its digital front door, the COVID-19 outbreak forced AdventHealth to unlock it for patients, and fast.

“Our work plan for the whole year got stood up in probably a period of a month to six weeks,” Tricia Edris, senior vice president and chief consumer officer at AdventHealth, told PatientEngagementHIT. “And we just started adding to it as we started to understand more of the patient needs and phases that we were going to experience.”

From the get-go, AdventHealth quickly needed to prop up some sort of communication channel to help patients seeking information. In March, there was so little information about the coronavirus — even less of it accessible for the layperson — and AdventHealth knew it would need to be a contact point for worried patients.

Building on technology options that has been in the works, Edris and her team began by standing up a call center for patients. The 24/7 inbound contact center quickly iterated, and AdventHealth went on to build 807-VIRUS-HQ, a centralized number that patients can easily recognize and access for more COVID-19 information.

READ MORE: 7 Steps to Open the Healthcare Digital Front Door, Care Access

AdventHealth advertised the number on billboards in its service areas and on its digital media platforms, but the draw went beyond its usual patient panels. The health system quickly found itself as a resource for people around the globe, fielding calls from California, Canada, and even Australia.

After that, Edris and her team took that call center to its website. As AdventHealth saw increased volumes on its hotline, Edris and the health system’s IT team built Hope, an artificial intelligence bot that can help pick through general questions about COVID-19.

In addition to Hope, AdventHealth installed a live chat feature, where patients can communicate directly with a human AdventHealth employee. This is an important step, the research shows.

Although patients are able to trust a virtual chatbot, that trust only comes when patients perceive the bot is competent, and competency may be in the eye of the beholder. Offering chat capabilities with actual humans is important to catering to all patient needs.

“Once we got past that initial stage, it became clear that everybody was preparing for surge in hospital settings,” Edris recalled. “We watched New York and other cities become overwhelmed. And so we then said, are there ways that we could manage capacity in the hospital, in our ER, by providing remote patient monitoring through the team of nurse triage agents?”

READ MORE: Healthcare’s Next Steps to Opening the Digital Front Door

That was a key job for Duncan Grodack, senior vice president and chief operating officer of AdventHealth Information Technology (AIT), and his IT team, who were instrumental in standing up this entire consumer-facing technology suite.

“Like most other hospitals, we were working to keep an adequate level census to be able to accommodate COVID patients,” Grodack said in a separate interview. “It’s important that you manage the census. And one of the ways we were able to do that is through that at-home monitoring program where we were able to get patients back to their homes instead of in our hospitals.”

Keeping a lid on hospital volumes has been a very important step during the COVID-19 pandemic. Unlike primary care practices that were hurting for more patient volumes, hospitals needed to ensure they had the ICU staff and material resources available. The best way to do that, Grodack and Edris both said, was to simply keep patients at home.

“As patients would come in who were symptomatic for COVID-19, instead of admitting them into our hospitals based on their acuity, we had technology that we were actually able to prescribe them, a digital therapeutic pathway, and get them where they are safest, which is in their home,” Grodack explained. “We were able to digitally engage with them throughout that pathway.”

As of August, AdventHealth could report just below 5,000 patients were using that remote patient monitoring suite, which largely centered around a pulse oximeter to assess the severity of COVID-19 symptoms. If numbers skewed out of whack, AdventHealth would call the patient in for more intensive care.

READ MORE: How AdventHealth Saved Patient Experience During COVID-19

Meanwhile, on the provider side, telehealth became a key lifeline. As mentioned above, primary care clinics were hurting for the patient volume after guidance came out requesting clinicians delay non-emergency treatment. That financial note, alongside critical chronic disease management, would have been challenging had it not been for mandates making it easier to stand up telehealth, Grodack said.

“We had an explosion of use around our telemedicine or telehealth work,” Grodack recalled.

As of August, the health system had seen over a quarter of a million telehealth visits.

“And it was really through that process that we learned a ton from our consumers and our providers who were now using all of these telehealth capabilities,” Grodack added.

The IT team, which included consumer experts and engineering and designers, looked into how to make telehealth a better experience for both the patient and the provider. In answering that question, Grodack and his team created an EHR-based capability that let providers bounce from the scheduling system directly into a video visit, easing the process for the patient and provider.

After that, one of the biggest questions arose: how can healthcare transition to a new normal?

“May going into June, we quickly realized that to reopen, we needed to make sure that we were able to do that very safely,” Grodack said. “Again, we came to the table and looked at, okay, how do we take some cues from other industry as far as curbside check-in, and these things that maybe you have experienced prior to COVID, how do we take some of that and apply it to healthcare?”

Most of the technology AdventHealth utilized created a curbside experience, Grodack and Edris said. In addition to the safety protocols that were necessary inside a clinic — temperature checks, social distancing, access to PPE — AdventHealth was committed to keeping patients outside the waiting room and making that feel pleasant.

Through the organization’s app, Grodack and Edris built a consumer-focused curbside experience that helped patients stay connected to the clinic as they waited for their care. Automated messages let patients check in, advised patients to remain in their cars, and notified patients when it was time to go into the office.

This was the consumer-centered experience that AdventHealth had always wanted to build, and in fact was in the process of building when COVID-19 struck.

“All of these things were in our strategic roadmap related to our consumer engagement and journey,” Edris said. “So we had a lot of the tools, a lot of the tech, it was just bringing it all together and applying it to COVID.”

That lightning-speed pivot came with some unexpected but important lessons learned. Notably, Edris and her team gained a deeper understanding of what consumers want out of their healthcare experiences.

“The consumers want care that comes to them versus them having to come to us,” Edris explained. “We had been already looking for ways that we could put care in their hands, through digital and other tools. Now, when they need us, they want to come into physical spaces and be safe.”

While that lesson confirmed for Edris and the rest of the AdventHealth team that they had been on the right track moving toward consumerism, it was also a really important lesson in how facility operations have to adjust for a digital front door. That door has to open to somewhere, after all.

“We talked about this front door, and it doesn’t work with just having an app. We have a great app, and call center, and website,” Edris said. “But it had to be connected into our actual physical locations as well. And we know that a portion of COVID patients that we were monitoring will most likely end up in the hospital. How do we create a seamless path into the eCare settings, or the ER, wherever those services are?”

In other words, this digital front door can’t be the only way patients access care. It has to be exactly as it sounds: a digital front door to the care they’ll receive. While healthcare is quickly learning that some of that care can indeed be remote, all of the access processes — the app or the chatbot or the call center — need to seamlessly plug into the actual care delivery process.

“The app would be great or this call line would be great. But if we didn’t have the information from operations to be able to solve problems and get people the physical services they needed, we would have missed the mark,” Edris asserted.

Making this pivot, and doing so quickly, as solved a lot of problems, but also upped the ante moving forward, Edris concluded.

But as COVID-19 continues to rattle the healthcare industry, there may be room for continuing to advance patient care.