Providence Health, the Renton, Washington-based health system that admitted the first COVID-19 patient, is now leading the way in using digital and telehealth strategies to assess and triage cases. Advisory Board's Virginia Reid and Taylor Hurst recently spoke with Sara Vaezy, Providence's Chief Digital Strategy Officer, to learn how the system adapted its chatbot to assess and triage patients—and how the system wants to help peer organizations do the same.
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Question: Hi Sara, thank you for taking time to speak with us. Providence's Coronavirus Assessment Tool really stood out to us as an efficient and safe way to assess a patient's risk of COVID-19. Can you walk us through how you created the tool?
Sara Vaezy: As cases of COVID-19 began to spread, we realized we would need a way to remotely assess and triage patients. We had previously deployed a chatbot we call Grace, so we partnered with Microsoft and decided to leverage Grace to adapt that chatbot with a COVID-19 specific clinical pathway and workflow as well as answers to COVID-19 specific FAQs.
Q: It's great that you were able to take existing technology and scale it to fit the current epidemic and serve patients. Could you walk us through what happens when a patient uses the Coronavirus Assessment Tool?
Vaezy: The assessment determines whether a patient needs to stay home to provide self-care or if he or she needs to be seen via virtual visit by asking about the person's travel and exposure history and health symptoms. If a patient is deemed needing greater care, Providence's chatbot seamlessly connects them to a virtual visit to assess his or her need for a higher level of care.
If patients need a virtual visit, they would speak over live video with a provider who assesses their condition more deeply and—if they need in-person care—directs them to the right location. As you can imagine, our virtual visits have scaled more than 10-15x since we started this and we're also considering other modalities and forms of communication to scale it for more patients, like asynchronous capabilities and human powered chat.
Q: Let's say a patient is triaged to a virtual visit and requires in-person testing. How do you make sure a patient seeks care at the right location?
Vaezy: We're making a lot of investments so folks can go to a location where testing is available. We're standing up different testing sites such as EDs, outpatient clinics, and pop-up locations like tents and trailers—but we need to be sure we have the testing capabilities available before we send patients there. So right now we're working on standing up live location updates.
Q: How are you promoting the assessment tool to patients?
Vaezy: We're proactively working on getting the assessment tool in front of patients. We stood up a COVID-19 assessment page on our system website and made the bot available to anyone who visits that page. We also ran an email campaign to alert patients of the new tool. Anyone can use the bot and people in the regions we cover can access a virtual visit through that site—even if they're not a Providence patient. Now we're working on how to make it available to other health systems.
Q: Realizing that Providence had robust chatbot and telehealth capabilities that allowed you to stand this tool up quickly—if an organization doesn't use telehealth visits at all, would it be worth it for them to use a tool like this?
Vaezy: The assessment tool can point to any number of resources a health system has to redirect patients. If organizations don't have virtual visit capabilities, the chatbot tool could point patients to a variety of options, like a nurse advice line or an asynchronous offering. It's agnostic to where it points patients—it primarily flags when a patient needs a higher level of care. In our case it's a virtual visit, but for others it might be a triage phone line. In fact, we're actively looking at what this would like if we had to scale up our program and provide other, more flexible modalities of patient engagement as well.
The telehealth piece is challenging to build up quickly, but an assessment tool like this is really helpful with the worried well. It enables them to get answers and provides them guidance to stay at home. Whether it's to virtual visits or they only interact with the bot, this is key to leaving the health care delivery setting for folks who need clinical care and to reduce the burden on clinicians. That's where organizations should start, and that's something they can work with Providence on.
Q: Any other lessons learned so far that you think other health systems should know about using assessments like this in their COVID-19 strategy?
Vaezy: The only other thing I would add is that assessment is a necessary but not sufficient component of how to address this challenge. The path we've taken is to stand up all the services—the assessment, home monitoring, and other individual offerings—then tie them all together. Even if you have to start by standing pieces up individually, think about how you'll want to connect them and the progression of those visits from the patient's perspective.
One final tip I'd offer is to ask for help. Health systems interested in the assessment tool can contact Providence, and we can conduct a discovery call to understand their current capabilities. From there, we'll determine next steps to give them access to the technology.
To contact Sara Vaezy, Chief Digital Strategy Officer at Providence Health, email Sara.Vaezy@Providence.org
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