As Seattle became ground zero of the pandemic in the US, MultiCare developed best practices for other health systems around the country.
The largest community-based, locally governed health system in Washington state, MultiCare Health System, was one of the first on the frontlines when COVID-19 reached the United States in nearby Seattle. With a widespread lack of protocol on caring for and protecting a patient population facing a virus so highly contagious in nature, MultiCare quickly mobilized a successful strategy for informing a concerned patient population, establishing a sustainable treatment plan, and staffing and training overwhelmed providers.
Planning
MultiCare’s senior leadership team began monitoring the global pandemic a month before the country’s first case was confirmed near Seattle on January 21, 2020. Then, in late February, residents of nearby nursing home reported symptoms, becoming one of the first COVID-19 hotspots in the U.S. MultiCare’s providers and patient population were suddenly faced with the reality of human-to-human transmission in their own backyard, sparking a rapid acceleration in patient demand for and provider adoption of telemedicine amidst a scarcity in testing. As hysteria among a worried well population began to surge, MultiCare began executing plans in real-time to address upstream triage and informing their patient population with a Solv-powered, automated COVID-19 symptom assessment bot.
1. Caring for the worried well
With a concerned community searching for answers and reliable sources of truth, MultiCare launched an interactive online platform, including complementary virtual care access and FAQ documentation, to provide high-quality information in real time. MultiCare worked with Solv, their longtime technology partner, to deploy a scalable solution for triaging their patient population. For the worried well—those who are concerned but not sick and don’t require face-to-face interaction with a provider—the innovative bot provides access to general information and best practices for keeping patients and their families safe and healthy.
2. Fast-tracking patients exhibiting COVID-19 symptoms
The assessment bot also effectively triages patients who are exhibiting COVID-19 symptoms. Patients utilizing the bot select their chief complaint and are then guided through clinically-informed, adaptive logic questions to assess their need for virtual or in-person care. From there, providers and patients can virtually talk through symptoms and recommend appropriate next steps, such as visiting a testing center. For MultiCare, triaging to scheduled video visits with a primary care provider over on-demand virtual care guarantees protected time with patients where clinically appropriate, preventing overwhelmed telemedicine platforms from patient abandonment due to high wait times.
Execution
COVID-19 changed both provider and patient perceptions of telemedicine from nice-to-have to life-saving. MultiCare experienced a significant drop in overall patient volume across urgent care centers and emergency departments due to public health efforts cautioning against human-to-human interaction, creating an unprecedented drive toward virtual care.
1. Matching unanticipated demand in IT resources.
With providers’ concern for their own safety confounded by a lack of personal protective equipment (PPE), the number of MultiCare providers practicing some sort of virtual health grew from an estimated 15 physicians to nearly 100% of the provider enterprise. To fulfill the sudden demand for webcams, operations managers sought out supply from local retailers and even considered venturing across state borders, where there was no retail shutdown.
2. Providing flexible training for providers new to virtual care
Virtual visits are a new tool for many of the overwhelmed providers working around the clock. The MultiCare training team realized flexibility was essential to resourcing as many providers as possible. They began offering platform demonstrations, Q&A sessions, and daily informational seminars during lunchtime and at 7 a.m. to keep providers up-to-date on the latest advancements and to support an informed and safe staff and patient population.
3. Reassigning valuable staffing resources
To optimize valuable clinical staff whose patient panels have largely canceled, MultiCare began reassigning salaried, primary care providers for virtual visits.
4. Managing provider coverage
One lesson learned for MultiCare as they rolled out their care delivery plan was their laissez-faire approach to provider scheduling early on. To help cover volume on- and off-screen, MultiCare leadership advises setting clear expectations for hourly shift minimums when asking more providers to practice telemedicine.
| "Having partners like Solv allowed us to respond quickly for our patients and community." |
Looking Forward
MultiCare is planning for a marathon, not a sprint. The onset of COVID-19 brought unprecedented patient demand for virtual care—from 35 virtual visits per day to 900—and MultiCare leadership is exploring a scalable contingency plan in anticipation of another potential surge.
1. Facing difficult conversations on the frontlines
The prospect of another exponential increase in patient volume leads to difficult questions about providers’ roles. If brick and mortar sites are closed, do all providers become dedicated to virtual care?
2. Supporting providers for the long game
Self-care is hardly an afterthought as overwhelmed providers are working around the clock amidst panic and urgency on the frontlines. As the effects of COVID-19 continue playing out over the next few months, it’s critical to set clear priorities that best support IT resources and clinical staff long term.
3. Partnering with technology solutions to continue advancing care delivery
Automating virtual care as much as possible is critical for ongoing management of a large patient population. Working with Solv, MultiCare is exploring a new version of the assessment bot tool to expand clinical capabilities to include teeing up prescriptions and more advanced direct-to-chat functionality.
