Credit Suisse https://www.credit-suisse.com hosted Aaron Martin, Executive VP and Chief Digital and Innovation Officer, and Sara Vaezy, Chief Digital Strategy and Business Development Officer at Providence St. Joseph Health http://www.providence.org, for a virtual meeting with a small group of investors.
Providence St Joseph Health with 51 hospitals, more than 1,000 clinics, and many other health and education services, employs more than 120,000 caregivers, and serves patients in communities in seven states in the U.S. In 2019, the health system had more than 5 million inpatient admissions, >2 million ER visits, around 700K surgeries/procedures, and around $25 billion in revenue.
Providence had the first confirmed case of COVID-19 in the U.S. In March, the health system, had to begin dealing with the surge of new patients as Washington State became the first American epicenter of COVID-19. The speakers noted that Providence’s focus on digital investments pre-COVID turned out to be incredibly useful in addressing the surge.
To begin to deal with COVID-19, Providence repurposed Grace, the health system’s chatbot which navigates patients to the appropriate care venue and conducts differential diagnoses as a triage and assessment tool. The health system further used Grace to redirect patients to their virtual visit capability, a technology built internally called DexCare, which is able to rapidly pivot and load balance the availability of clinicians with patient volumes.
This resulted in Providence going from performing around 70K telehealth visits in a year to 70K in just one week. Today telehealth visits are averaging between ~9K per day with over 80% of these visits conducted via video and the remainder by audio only. It is also noted that around 80-90% of the telehealth visits are currently scheduled visits, with the rest are on-demand virtual visits.
As for telehealth moving forward, both speakers believe that over time, health systems and enterprises will migrate from bespoke telehealth platforms to more integrations with video platforms like Zoom, Microsoft Teams, or Cisco.
The speakers think that it doesn’t make sense for health systems to have clinicians discuss business and have internal meetings on a Microsoft Teams/Zoom platform and then switch over to an entirely separate screen and technology stack to engage with a patient on a different video platform.
The health system is beginning to think about their operating model in terms of allowing clinicians to work from home 2-3 days per week where they can conduct video visits and then come into the clinic on other days to perform in-person visits.
However, the speakers see three components that could cause the telehealth industry to backslide such as issues related to reimbursement, credentialing (i.e. interstate licensing, and the operational piece of telehealth visits.
As for remote monitoring, Providence’s digital team has worked with a couple of Providence Venture’s portfolio companies, Xealth and Twistle, to stand up their Remote Patient Monitoring (RPM) capabilities. This enables the health system to operate at a 1/100 nurse/patient ratio and monitor patients using a simple, text message and web-based response approach to gather data from patients (e.g. temperature, pulse oximeter readings, etc.).
Providence is able to track/measure data and then proactively reach out to patients if their health metrics deem it necessary. Providence has gone from a full stand-still in terms of RPM capabilities to standing up a solution specifically related to COVID in a span of four days.
Summing up with thoughts on other technologies, Mr. Martin sees clinical documentation integrating with telemedicine and sees using front-end speech recognition as a huge opportunity for telehealth.
He sees the video component being controlled by the large-scale tech companies over the long term. He notes that what happens before, during, and after the visit from a technological value-added standpoint are areas that can become big opportunities.
Mr. Martin reports that his team is particularly interested in the use of AI. With the number of physicians and nurse practitioners coming into the labor force relative to the huge amount of patients expected to come through the healthcare system in the future, there needs to be algorithmically driven diagnoses and treatments that can take over what physicians are doing today. As a result, Providence is interested in taking low-acuity/low-risk diagnose and treatment scenarios and finding ways to make them fully automated, but this can be years away.
For more information and to provide feedback, email Jailendra Singh at jailendra.singh@credit-suisse.com or call 212-325-8121.