For Entrepreneurs5/21/20

COVID-19 constraints push healthcare organizations to innovate around the consumer

Healthcare innovation leaders face a daunting challenge. They must prepare their organizations to manage their population’s changing needs throughout the COVID-19 pandemic while pivoting to a new normal—all without a playbook. A couple of weeks ago, we spent an hour with healthcare leaders from across the industry to understand how the pandemic is transforming their work and the healthcare delivery system at large. Representatives from three Rock Health corporate partnersBlue Shield of California Chief Innovation Officer Jeff Semenchuk, Banner Health Innovation Group Executive Director Christy Anderson, and Strategic Benefit Advisors (SBA) National Clinical Leader Louise Short—shared how their organizations are navigating the crisis response. As these leaders adopt a consumer-focused and innovation mindset, they explain how actions taken now will impact the future of the healthcare industry. We outline key themes below, and the full conversation is available on the Rock Health podcast.

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New innovation momentum is driven by constraints

Leaders should take advantage of the mandate COVID has created for change
Working in healthcare innovation can sometimes feel like Sisyphus pushing the boulder of change up the hill every day. But our partner panelists are optimistic the COVID-19 pandemic has flattened that hill. There’s a renewed appetite for change within their organizations, which creates opportunities to move faster than they ever have before. As today’s constraints force a reimagination of a future care delivery system, Banner, Blue Shield, and SBA are leading with a holistic approach to innovation rather than bolt-on changes to an already fragmented system.

The heart of innovation is not in having all of the answers, it’s in adopting a ‘progress over perfection’ mentality. I’m seeing healthcare organizations with a new appetite for that, which will drive innovation going forward in a way we have not seen in the past.

Christy Anderson, Banner Health Innovation Group Executive Director

Expanded telemedicine opportunities and reimbursement
Our panelists noted that the hockey-stick increases in telemedicine utilization since March show that consumers are, perhaps for the first time, seeing the value and convenience of virtual visits. But this wasn’t just another conversation about virtual visit growth. Our panelists discussed virtual visits going far beyond the basic general medical visits that were the mainstay of telemedicine in the pre-COVID world. Telemedicine visits are expanding into specialty care, and the breadth of these visits will persist long after the crisis has subsided. A clinician by training, Louise expects the increased quantity and type of telemedicine visits will spur even more innovation around remote monitoring and at-home diagnostics to guide clinical decision-making.

One thing that is going to be a lasting change is the virtualization of healthcare, which really puts the consumer at the middle—we were moving there, but this has rapidly accelerated the pace by removing some of the barriers to adoption.

Louise Short, SBA National Clinical Leader

Louise also noted that, because the emerging “behavioral health epidemic is going to last longer than COVID-19, employers are going to be open to a lot of new solutions and innovation—because they’re going to need it.” With this in mind, Blue Shield is now reimbursing for tele-behavioral health visits, which they started doing at the onset of California’s stay-at-home orders.

Greater collaboration for data fluidity
The COVID crisis has brought longstanding issues with siloed health data to the forefront.
To ameliorate those issues, Blue Shield of California is working to integrate with providers across the state to improve outcomes for its members. Blue Shield has continued to invest in its partner, Manifest MedEx, to expand their health information exchange and allow providers in California to share key patient information between hospitals to improve patient care. This increased data sharing will be critical for tracking positive COVID-19 tests across California, and will continue to provide actionable data for clinicians after the crisis.

Tackling age-old efficiency blockers
Blue Shield of California is working toward making its claims processing more efficient by reaching into provider medical records to generate claims automatically. This would eliminate the claims submission burden that providers currently face, lead to faster adjudication, and could ultimately eliminate the need for prior authorization for some claims. Blue Shield is also working with OODA Health to develop an automated monthly statement for members where they can review their healthcare utilization and payment plan options for out-of-pocket costs.

Consumer obsession is no longer optional in healthcare

Christy has been putting her years of experience in retail and ecommerce to develop a more seamless patient journey across the Banner Health system. This means integrating data across Banner so that every one of their physical and digital touchpoints is powered by critical information on each patient, from their patient-facing mobile app to care pathways in the EHR.

To connect with patients where they are, Banner Health is partnering with Buoy Health to deploy a symptom checker to automatically triage patients. This provides patients with a simple, streamlined way to access the right level of care at the right time. The online symptom checker is integrated with Banner’s online scheduling tool to help patients seamlessly book a visit when necessary.

One of the biggest aspects coming out of this is how we put the consumer at the center of our decisions—[…] this is going to force companies to make changes.

Christy Anderson, Banner Health Innovation Group Executive Director

Christy is also studying how the pandemic is altering consumer’s mindsets and what will persist beyond the pandemic. Her early hypothesis: human nature is to revert back to old ways, but people will continue to see healthcare in a new light and newfound table stakes will stick. Consumers will expect healthcare organizations to meet them where they are with convenient options like telemedicine.

Human behavior change is one of the hardest things to achieve. COVID-19 has given us a long period of time to think differently and develop different behaviors.

Jeff Semenchuk, Blue Shield of California Chief Innovation Officer

The bottom line

There’s no shortage of challenges ahead, but we’re encouraged by the leadership of our partner organizations, who are utilizing their expertise to respond, adapt, and build a better healthcare system on the other side. With providers and consumers seeing the value of modern technology in the healthcare delivery system, many will not be looking to fully revert back to the pre-COVID world.

While some traditional barriers to progress are withdrawing, leading in a time of crisis remains an enduring challenge. Christy shared some great parting wisdom: “Be calm and assume positive intent—we’re all trying to respond and react as fast as possible.”

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