The healthcare landscape is full of digital technologies striving to make an impact. The consistent question is whether these technologies are transforming healthcare in a way that gets us closer to the “quadruple aim”: improving population health, providing a better patient and provider experience, and lowering costs. With this in mind, Providence was an early adopter of technology and innovation, and to address these needs, they started an in-house technology incubator, called the Digital Innovation Group (DIG). Providence’s Digital Innovation Group is primarily focused on standing up technologies that move the needle. And now, in the midst of a global health care crisis, DIG is putting these solutions to work in the fight against COVID-19.
Working shoulder-to-shoulder with care teams, DIG’s software product and engineering teams are creating technologies to support providers as they treat the problems that matter most to patients. Feedback is immediate and iterations happen quickly as solutions are tested within the Providence ecosystem, and then scaled. With access to subject matter experts and the entire provider ecosystem, DIG is able to build the right kinds of solutions targeting the highest-priority problems in healthcare. DIG’s investments — in AI chatbots, self-service tools, digital prescriptions, telehealth, remote patient monitoring, and flexible digital workflows — have allowed Providence to quickly stand up several programs to support caregivers and patients during the COVID-19 pandemic.
One such program is Grace, Providence’s patient-facing chatbot framework. The DIG team collaborated with Microsoft to deploy Microsoft’s HealthBot within the Grace framework to help patients self-assess their symptoms and answer FAQs. The close relationship between DIG, Microsoft, and Providence’s clinical teams made the collaboration and quick deployment possible.
With the first positive case of COVID-19 in the United States being treated at Providence Regional Medical Center in Everett, Providence went into high gear to reconfigure the chatbot as a COVID-19 self-assessment tool. Since early March, there have already been more than a million messages exchanged between Grace and patients. This iteration of the Grace chatbot guides patients to determine whether they are at risk of COVID-19 and then directs them to Providence Express Care Virtual if their symptoms suggest they should speak with a doctor.
Express Care Virtual is powered by DexCare — a technology DIG pioneered and scaled across Providence. The volume of video visits increased 20 times overnight with the platform scaling to meet demand — serving more patients in one month via video visits than were seen in all of 2019. In the growing needs for virtual healthcare visits, DexCare has been deployed by DIG at a second health system seeing a similar COVID-19 surge in their markets in the Midwest. DexCare is now working to deliver the platform to several other health systems to help them respond to the COVID-19 crisis.
After patients identified as needing a higher level of care by Grace are triaged to Virtual Express Care, the provider can then determine whether they need to be tested or enrolled in home monitoring. Xealth, a digital health platform incubated at DIG and spun out as a standalone company in 2017, allows doctors to prescribe digital apps, content, and services and automatically integrates care information into electronic health records (EHRs). Providence is pairing the Xealth platform with a solution from another Providence Ventures portfolio company, Twistle, which enables remote monitoring via text for COVID-19 patients who need monitoring but are well enough to stay at home rather than be admitted to the hospital. Twistle requests patients input their temperature, pulse oximeter data, and other more subjective data points three times a day for a 14-day period. The data is sent back to Providence providers who can review the data and proactively reach out to patients whose symptoms may be worsening and require direct intervention.
With the Xealth-Twistle solution, over 1,000 at-risk or positive COVID-19 patients have been monitored at home to date. As more patients stay away from hospitals, the burden on overworked healthcare providers is reduced while patients still get the support they need. Both the DexCare video visit platform and Xealth/Twistle solutions provide the ability to deliver care at a distance, which keeps patients and providers safe.
For health systems in the United States and around the world, DIG’s experience with quickly standing up assessment, triage, and home monitoring illustrates the benefit of having an incubator within a health system, which enables caregivers and product developers, side by side, to collaborate quickly to create their best solutions together, and deploy them in the real-world setting of a health system.
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