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How Privia Health is deploying lessons from Hurricane Harvey to tackle Covid-19

April 3, 2020

    In just a matter of weeks, Privia Health—a 2,500 provider multi-specialty medical group with locations in Texas, Georgia, Florida, Maryland, Virginia, and the District of Columbia—flexed its telehealth capabilities to nearly 100% of its practices to continue to serve patients amid the new coronavirus outbreak.

    Cheat sheet: 3 imperatives to leverage telehealth against COVID-19

    While Privia has been investing in telehealth for the past two years, the medical group had yet to make the jump to mandatory universal telehealth. In February, more than 500 providers were actively using the platform. Now, only a month after Covid-19 rapidly changed the health care environment, Privia has expanded adoption of the platform to nearly every Privia practice, including specialists and primary care providers. The group has already seen 30,000 virtual visits in the last two weeks—an impressive increase over the 20,000 virtual visits across 2019.

    How did Privia pivot so quickly? Two words: preparation and experience. When Hurricane Harvey devastated Texas and Louisiana in 2017, Privia's Gulf Coast and a dedicated national disaster team swiftly assembled new work streams and utilized existing communication channels to deal with the effects of the storm. When COVID-19 hit, Privia took those lessons learned and adapted them for the benefit of patients and providers.

    "We have experience," Privia Chief Clinical Officer Keith Fernandez said. "We had Hurricane Harvey in Houston, so when this happened, we just went back into hurricane mode. Very rapidly assembled work teams."

    Read on to learn how Privia rapidly increased telehealth adoption—and the advice the group offers others pursuing telehealth in the post-COVID world.

    3 tactics to rapidly ramp up telehealth adoption

    When the COVID-19 outbreak began, Privia went from 20% telehealth adoption to nearly 100% adoption in just a matter of weeks using these three tactics:

    1. Increase methods and frequency of communication (and no, we don't mean email)

      Privia used multiple communication methods to help physicians understand that Covid-19 adjusted their workflow during the outbreak, and that the world will be drastically different in the future. They assembled a work team devoted to communicating with physicians and helping them realize that something like rapid telehealth adoption was a real possibility. The team immediately transitioned its established physician leadership structure to virtually communicate across town halls and physician group meetings (POD meetings) to engage providers and staff on what was working and, perhaps more importantly, what wasn't working. In just one week, Privia held 15 communication meetings with 100% attendance.

    2. Create an infrastructure for rapid remote training.

      Under normal circumstances, Privia deploys an entire field of performance consultants who work with providers and practices to drive change and improve performance. But with social distancing measures in place, Privia focused on using virtual methods to train providers on using the telehealth platforms.

      Privia realized that everyone learns differently and sometimes it takes repetition for change to take place. As such, the medical group gave providers the option to participate in 1:1 virtual trainings, daily group webinar-based trainings, and/or self-training through online tutorials, videos, and collateral. All virtual trainings are available after hours and on weekends.

    3. Use every tool available to get the word out to patients.

      Privia promotes telehealth so patients know it is an option before they call to cancel or reschedule in-person appointments. First, Privia deployed nurses to proactively call patients and help them switch their scheduled visits to virtual visits. Now, Privia's website and mobile app have banners that link to Covid-19 resources and telehealth services with an online-scheduling platform for patients to schedule their virtual visit. Privia also utilizes its proprietary Customer Relationship Management (CRM) system to send mass communications that educate patients about virtual visits.

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    Results in the first few weeks of COVID-19 response

    Today, 45 Privia practices are doing 100% of their business virtually and the remaining practices are using a mix of virtual and in-person visits. As of March 27, 50% of Privia's total visits were virtual. The Gulf Coast practices alone have seen an increase from 25 virtual visits a day to 800 virtual visits a day.

    Leaders at Privia said the transition to virtual visits has been a lifeline for many practices. About 10% of Privia practices are no longer seeing patients in person, meaning without telehealth they would have had to close. Some practices are even seeing a net increase in patient visits due to their use of virtual visits.

    How to overcome the 2 most common barriers to telehealth—and why it's worth the effort 

    Historically, financial incentives and disruption to routines have been cited as key barriers to telehealth adoption. But leaders now are predicting that COVID-19 will be the catalyst that normalizes the use of telehealth, making it essential for providers to overcome these key barriers for successful telehealth implementation.

    As Graham Galka, Privia's SVP of Strategy & Innovation put it, "With Covid-19, I believe that the genie is out of the bottle. Now that patients have more experience with virtual care, no patient will want to take off work or drive for a visit in person if it's appropriate for a virtual visit."

    Pushback #1: "Virtual visits don't make financial sense." Misaligned incentives is often the number one barrier to telehealth adoption among providers. And patients have financial concerns too.

    How providers can overcome the barrier: To ensure providers won't be financially penalized for using telehealth, groups pursuing telehealth should advocate to get parity for providers in commercial telehealth contracts. In response to Covid-19, Medicare's emergency waivers removed some of the barriers to reimbursement, which should make it easier for physicians to transition to virtual visits.

    Of course, it is unclear if Medicare's changes will remain in place in a post-Covid world. Privia strongly believes that patients will expect this type of service as part of their "normal" patient experience.

    For patients, Privia recommends working with commercial payers to charge the same copay as an office visit so patients are incentivized to use virtual visits.

    Pushback #2: "Virtual visits mess up routines." The second most common concern is that virtual platforms aren't easy to use. Medical group leaders know all too well that if a technology isn't seamlessly integrated into the workflow—providers won't use it.

    How providers can overcome the barrier: The best telehealth platforms mimic workflows for the provider as well as the patients. At Privia, that means ensuring the workflow for an in-person visit and a virtual visit is exactly the same. The only difference is a single button that providers have to click to open the video screen.

    Use every opportunity to communicate to patients that virtual visits are a convenient option for addressing a variety of chronic and acute care needs with their usual provider. For patients it is a simple, seamless care experience. Privia offers easy online scheduling in which patients can self-book an appointment with their provider. Twenty-four hours prior to the visit, the patient is sent a link to complete a digital check-in, complete important forms, and pay his or her copay. Patients at Privia love the virtual options because it is easy, convenient, and with their own personal provider. On average, Privia patients are more satisfied with a virtual visit than they are with an in-person visit (90% great vs. 85% great in patient survey responses).

    Your top resources for Covid-19 readiness

    You're no doubt being inundated with a ton of information on how to prepare for possible patients with the 2019 coronavirus (Covid-19). To help you ensure the safety of your staff and patients, we pulled together the available resources on how to safely manage and prevent the spread of Covid-19.

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