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One health system on the challenge of re-activating patients

Gabriel Perna | March 9, 2021

In 2019, the Philadelphia-area health system Virtua Health merged with Lourdes Health System for $60 million, giving it the ability to offer tertiary services such as cardiovascular care and neurosurgery. It was a move that helped Virtua gain traction in a competitive market. The $2-billion health system also has cancer care, urgent care and ambulatory surgical centers on top of the services it added from Lourdes.  

But it wasn’t enough to just add those services and keep going, says Ryan Younger, Virtua’s vice president of marketing. The health system wanted to understand its patients better, particularly how they prefer to receive care.  

“You’ve got to connect with patients in new ways by creating better access and convenience. Whoever does that best in this new model of care will be successful,” says Younger. “We didn’t have the sophisticated analytics to understand who we’re reaching, who we’re not reaching or what they’re looking for and what their preferences are.” 

One of the biggest improvements Virtua aimed to make when it added Lourdes Health System was to invest in the EHR and technology infrastructure. On top of the $40 million investment into improving Lourdes’ EHR, Virtua got aanalytics-driven customer relationship management (CRM) solution from SymphonyRM that integrated with its EHR to segment and reach populations based on risk of disease, particularly those in cardiac care.  

The system uses that information to educate patients on potential programs. But Younger says the CRM is more than just marketing—it helps them understand people’s risk stratification and understand where they are in the journey of care.  

“When we know where they might be on a life journey or a different access point that they may need, we can communicate more effectively. We’re not waiting for someone to come in and have that episodic care. We’re reaching out and connecting them to information they may need about living a healthy life and staying out of the hospital,” says Younger. 

Effective tools for engagement 

For cardiac patients, engagement tools have been proven to be effective. One study from the American Heart Association via researchers at the University of Colorado School of Medicine found that nearly half of patients who received support through a patient engagement tool prior to a cardiology clinic visit had a positive change in their medication therapy compared to less than a third among patients who did not receive the engagement tool.  

The engagement tool in the study wasn’t as complicated as one that uses AI. The patients simply received access to a three-minute video and a one-page checklist, delivered electronically by text or email, at one week, three days and 24 hours prior to a cardiology clinic visit. But that was enough for 49 percent to warrant a change in their medications to improve therapy compared to 29.7 percent in the control group. 

“We are pleasantly surprised that this fairly simple tool lead so many patients to better care. It’s promising that patients were able get better treatment,” stated lead study author Larry Allen, MD, associate division head for Clinical Affairs in Cardiology and co-director of the Colorado Program for Patient-Centered Decision at the University of Colorado School of Medicine in Aurora, Colorado. “This approach validates and promotes a culture of collaboration between patients and their doctors and leads to more productive clinic visits with optimized medication prescribing, which can ultimately improve patient outcomes.” 

Younger says that the AI technology is successful, in part, because it helps understand what types of communication and information patients prefer. He says being able to give people information in this kind of manner was something not previously possible 

Critical in a post-pandemic world 

The idea of activating patients to engage in their care, regardless of the technology used, was taking shape before the pandemic. However, it has become even more critical in the year since the virus first emerged with many people having skipped critical care services out of fear of contracting COVID-19 in the past yearYounger says Virtua needs to bring them back into the fold and ensure they view the health care system as a trusted place to receive care.  

“For months everyone was being told to stay away from the hospital and stay socially distant and then we found people were actually avoiding care. They were only going to the hospital if it was a dire emergency,” he says.  

He says people who have been coming to the hospital lately for critical services like cardiac care are much sicker. This is supported by a recent survey from Cleveland Clinic, which found one-in-three people with heart disease have stopped taking heart-related medicationsand 65 percent have put off check-ups or screenings due to fears of COVID-19.  

“People are not seeking medical advice and they are staying at home despite the fact they have significant symptoms, either heart-related symptoms or not heart-related symptoms,” stated Samir Kapadia, MD, Chair of Cardiovascular Medicine at Cleveland Clinic. 

Read more about similar trends happening in kidney care management  

Re-activating patients requires organizations to have a patient-first strategy and alignment between various clinical and administrative leaders, says Younger. In other words, a set-it-and-forget-it mentality isn’t going to work in this case.  

“These tools don’t just automatically spit out the right answers. We worked hard at aligning strategy and operations,” he says. “These tools are powerful at helping you reach people, but they don’t substitute for alignment and strategy. The language you’ll need to connect with people. It’s a process. It’s a journey. But once you start humming along with it, you see a bigger impact on who you’re reaching and how you’re able to activate people.”  

(Homepage image credit: Virtua Health)

About the Author

Gabriel Perna, Senior Manager, Digital Content

Gabriel Perna is the Senior Manager of Digital Content at Health Evolution. He brings 10+ years of experience in covering the intersection of health care and business. Previously, he was at Chief Executive, Physicians Practice and Healthcare Informatics. You can reach him via email or on Twitter at @GabrielSPerna