While there has been a lot of talk about technology disruption in the health care industry lately, the COVID-19 crisis has created an opportunity to accelerate value by combining the unique resources and skills of health systems and technology companies. Technology organizations in recent years have looked at the $3.2 trillion dollar health care industry’s being full of friction as an opportunity for disruption. However, because they aren’t health care providers, tech companies typically don’t have deep access to the systems required to tap into a caregiver’s expertise or continuous access to the environments that allow for quickly and rapidly testing technology in the real world.
Conversely, health systems know the problems they face in care delivery, but often have limited in-house technical resources from which to draw — putting them at a disadvantage when it comes to creating and implementing next-generation technologies. Even systems like Providence, which made significant investments in digital transformation, can benefit from thoughtful collaboration with traditional technology providers.
The Providence Digital Innovation Group (DIG) is focused on creating technology solutions for health care’s most pressing challenges — both internally at Providence and externally for other health systems. The team is staffed with over 100 software engineers and product leaders, some of whom hail from large tech companies such as Amazon and Microsoft. Once DIG has identified a particular problem to address, it seeks out a digital solution in order to achieve scale. This solution could be built independently by DIG’s software engineer team, or in partnership with other companies who share the same goals and have a proven technology DIG can put to work right away. For example, DIG collaborated with several large technology companies, including Amazon, to deliver a HIPAA-compliant Alexa skill to help patients schedule appointments.
With the onset of the COVID-19 crisis, the value of collaborating with large technology companies became clearly evident.
For approximately two years, DIG has been working on a chatbot framework called “Grace” to support patients with navigation, symptom checking, and triage. In February, days after the first COVID-19 patient in the United States began receiving treatment at a Providence hospital in Everett, WA DIG deployed Grace to focus on COVID-19. The updated chatbot — utilizing Providence clinical pathways and using the Microsoft HealthBot service — asks patients questions to help them self assess their risk for the coronavirus, keeping the worried well at home and triaging them appropriately if they need additional care. If they have symptoms, patients are guided to a telehealth appointment through Providence Express Care Virtual. Depending on the outcome of the virtual visit, patients may be directed to a testing site with capacity and provided with tools to do home monitoring of their symptoms — accomplished through other technology partnerships with Providence Ventures portfolio companies Xealth and Twistle. Grace also provides patients with access to frequently asked questions about COVID-19.
Launched on March 8, the COVID-19 chatbot was the first of its kind in the country. Since then, there have been hundreds of thousands of chat sessions and millions of total messages exchanged between patients and Grace at Providence — and Microsoft has deployed the template to other health systems, as well as the CDC.
“Based on the success of our Grace chatbot framework over the last two years and our plans to expand the scope and scale for intelligent patient navigation scenarios, we were evaluating options for scalable platforms for NLP and other AI-enabled cognitive services to innovate and build upon,” says Aaron Martin, Chief Digital Officer at Providence Health. “We had started conversations with [the] Microsoft Healthbot team in September 2019. That weekend in March, our Chief Clinical Officer called and expressed the need for an immediate response to the needs of our community around COVID-19. The teams were working on it in a matter of hours. We spent many hours together working virtually, working from home, despite time zone differences, to quickly build and deploy the MVP in three days. It was an amazing partnership between our team, our clinical experts, and the Microsoft team. We all knew how important this was. Since then, the two teams engage multiple times a week to troubleshoot issues, analyze results and brainstorm new ideas that can serve our community. It’s been a phenomenal collaboration.”
The collaboration between DIG and Microsoft to create the COVID-19 chatbot in a matter of days highlights what can be achieved when health systems team up with technology companies to address common goals — and how a collaboration mindset on both sides will lead to shared solutions for some of health care’s biggest problems. The new challenge before providers today is how to build the new business models and customer experiences that will be required in a post-COVID world. Utilizing sophisticated technology is now an essential element, and technology partnerships are likely to have a lasting impact and become common practice in addressing community health care needs.
As Aaron Martin, Chief Digital Officer at Providence Health, put it;
“We thought the biggest disruptive influence in health care would be technology disruptors. Instead, it was a pandemic. The biggest disruptor we’ve had is COVID-19.” — Aaron Martin
From here, we need all hands on deck in the coming months and years — health systems, payors, employers, big tech, venture-backed tech, government, and pharmaceutical companies — to continue to move at the pace of change initiated by COVID-19. In the coming months, we’re hopeful the pace and level of collaboration continues to accelerate for both the response to COVID and the long-term betterment of health care in the United States.