Health systems need an IT infrastructure that can respond to spikes in demand and deliver customized messages to distinct patient groups.
Getting an appointment for a COVID-19 shot is as difficult as buying a PS5 in mid-December. The supply is limited and unpredictable. Sources for the shot vary from hospitals to grocery stores to drive-up clinics. When word goes out that shots are available, tech-savvy people in the eligible age group use multiple laptops with multiple browser tabs open to increase their odds of reserving a coveted appointment. People who don't have that many devices at their fingertips rely on phone calls or relatives to snag a spot.
To meet these communications and logistical challenges, hospitals and pharmacies are using the same IT services that consumer products and concert promoters do—easy-to scale cloud computing and customer relationship management platforms.
Hospitals and physician practices are rethinking their IT infrastructure such as on-premise data centers as well as how they communicate with patients.
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Alicia Saddock, senior manager with the customer and marketing practice at Deloitte Consulting, said the intense demand for a particular healthcare service is driving a full-scale transformation in communications with patients, providers, and industry partners.
"Healthcare companies are adopting the established customer relationship management techniques and platforms that the consumer, financial, and tech industries have used for decades," she said. "Platforms like Salesforce, Adobe, and Oracle are emerging as customer engagement hubs."
Here's a look at how the demands of the pandemic are changing how doctors, nurses, and pharmacists communicate with patients and manage fast-changing conditions.
Using elastic computing to manage traffic spikes
Sean Michaels is vice president of IT operations and service delivery at Health First, a healthcare system in central Florida. Health First provides both insurance and care, including physician offices, hospitals, outpatient services, and fitness centers.
Health First provided COVID-19 vaccinations in early January, but Florida Gov. Ron DeSantis recently decided to shift all vaccinations to public pharmacies. Michaels said that at first his team used internal tools created for scheduling vaccine appointments. As demand increased, Health First partnered with Kyruus to manage scheduling.
The Kyruus platform combines multiple data streams, such as a doctor's location on a given day, his or her availability, the insurance accepted by the practice, and other data points relevant to a patient such as languages spoken or expertise with a particular health condition.
Chris Gervais, chief technology officer and chief security officer at Kyruus, said that the platform opens up access to patient and provider information that is still mostly in silos.
"We extract it, normalize it, and enable the last mile of scheduling," he said.
The platform integrates directly with a health system's EHR system to provide real-time data on a doctor's availability as well as the scheduling rules at each location.
"We bring all that into a massive search index so you can build a nice UI on top of it," he said.
Gervais said the company has expanded its services over the last year to support COVID-19 testing and vaccine scheduling.
"We put in a template for a COVID vaccine entry and then we link it to the different locations that a customer wants to provide the vaccine and then the provider decides how many slots to open up," he said.
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Gervais said patient portals are not able to handle the volume of traffic generated when a health system announces it has vaccine shots available.
"The first thing that happens when your website goes down, people start calling your phone system, and then it goes down," he said. "It's about business continuity as much as anything."
This challenge has been complicated by the fact that distribution of the vaccine has been chaotic and unpredictable. Healthcare systems often receive only a few days' notice about shipments.
"Kyruus can take advantage of elastic computing to meet demand," he said. "We had to get health systems to trust that they couldn't run this in their data center."
Healthcare systems also can use Kyruus to direct patients to partners such as Walgreens or Kroger and schedule appointments for flu shots or other care from the hospital's website.
Gervais said that his team is working on a new service for hospitals: A virtual waiting room individuals can use to wait to sign up for a shot. He expects this functionality would make the process less frustrating for patients and ease the strain on a provider's website.
CRM platforms and the vaccine rollout
In addition to managing the scheduling process for COVID-19 vaccines, healthcare systems have to make sure they are prioritizing patients based on the CDC guidelines. Healthcare systems have to know which patients should be vaccinated first and manage communications accordingly.
Alex Lennox-Miller, a senior analyst at Chilmark Research, said that outreach platforms are an essential part of the vaccine distribution push, particularly for creating precise patient stratification groups. Healthcare systems have to identify which patients need to be contacted first, in what way, and what needs to be offered to them. All this happens, he said, in an immensely fragmented healthcare space where vaccine distribution is being done by providers who don't always have a complete picture of a person's healthcare record, such as information from primary care physicians, urgent care clinics, retail/walk-in clinics, pharmacies, and employers.
"Identifying and tailoring communication to different patient groups is an essential part of making sure that outreach and clinical outcomes are as effective as possible," he said.
These outreach platforms should provide important information to patients even before an appointment is scheduled, such as shot distribution locations and patient education about the vaccination process and potential side effects.
"Ideally, communication will be relatively limited in scope and volume as you don't want to overwhelm people, which is one of the reasons setting these patient groupings is so important," he said. "A high-risk group needs more of this communication more quickly, while low-risk groups, which won't be expected to receive the vaccine, should receive different campaigns and updates."
Lennox-Miller said that the scheduling process also has to take into account the need for a second visit to get the second vaccine dose as well as post-appointment follow-up.
The Centers for Disease Control and Prevention Right is using the voluntary V-SAFE program for side-effect tracking. This includes daily text and email checks for a week and then weekly checks for six more weeks.
Lennox-Miller said that these communication channels are not well used by adults over 50, with 30% consistently using email to communicate with a provider and only 9% using texts.
"This is another area where careful patient segmentation becomes essential: Engagement and outreach platforms need to take into account patient communication preferences, and be able to tailor strategies to produce the best results," he said.
Saddock at Deloitte said that this need to segment people into specific groups has led healthcare companies to adopt established customer relationship management techniques and platforms.
"Healthcare providers are using customer engagement solutions to confirm pre-appointment details, remind patients of appointments, communicate care considerations related to COVID, and provide post-appointment follow-ups and care plans," she said.
Pharmaceutical companies are using customer engagement platforms to promote testing centers and access to vaccines, according to Saddock. Healthcare plan companies also are using customer engagement solutions to notify members regarding their benefits and share recommendations for wellness and prevention.
Saddock said that these steps are resulting in greater intelligence within the care process and driving a human-centric approach to healthcare that supports wellness through all stages of life.
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