How a New Clinical Innovation Fellowship Will Support RPM, Referrals Management

September 16, 2022 - The digital transformation of healthcare is underway, with the COVID-19 pandemic driving the use of health IT to new heights. But, as healthcare organizations determine how best to incorporate digitally enabled care into their standard processes, some have found that they may benefit from in-depth technical expertise and resources.

To support its digital care goals, Providence, a 52-hospital nonprofit system spanning seven states, teamed up with Microsoft to establish a clinical innovation fellowship.

The projects that will benefit from the knowledge and skills gleaned through the fellowship involve remote patient monitoring (RPM) of chronic disease conditions and developing a digital tool to enhance the referral process.

A FELLOWSHIP THAT AIMS TO SHAPE HEALTHCARE INNOVATORS

The fellowship will combine Microsoft's technology solutions and IT experience with Providence staff members' clinical and operational expertise to advance healthcare innovation. 

"The Providence Clinical Innovation Fellowship with Microsoft is an opportunity to connect healthcare delivery teams with technology innovators," Providence Chief Clinical Officer Amy Compton-Phillips, MD, said in a press release. "We are only beginning to learn each other's language and culture."

The first two staff members selected for the fellowship are Travis Sewalls, MD, chief medical officer at St. Joseph Eureka and Redwood Memorial Hospital in California, and Arpine Nicholson, director of programs, orthopedics and sports medicine, at Providence.

The nine-month fellowship, which began in May, will involve 156 hours of training with Microsoft, Sewalls told mHealthIntelligence in a phone interview.

"[The training will help us] to build skills, and develop change management skills, and be able to really apply what we learned both in our day jobs and in our fellowships," he said.

Further, the fellows will receive mentorship from Providence's corporate development and clinical innovation teams and Microsoft's Customer Success Unit.

Each fellow has a project they are currently working on and one they will select as a capstone project.

"We're just still in the ideation phase of understanding what's available from a tech perspective that could help solve issues," said Nicholson in a phone interview. "And then really trying to understand… what are some things that we can really think about — outside of the box, innovatively — solving, considering time constraints, and what we also have going on in our day jobs?"

SUPPORTING REAL-WORLD PROJECTS THROUGH TECH TRAINING

Sewalls and Nicholson are currently working separately on projects aimed at solving different but pressing healthcare problems.

Sewalls' project aims to evaluate RPM's efficacy in caring for patients with chronic obstructive pulmonary disease, chronic heart failure, hypertension, and diabetes.

Using RPM tools, clinicians can monitor patients in their homes and intervene if they have any medical issues. If the patient's care must be escalated for any reason, the care team makes the necessary adjustments and follow-ups.

"What I like to describe it as is really high-touch, high-impact medicine," he said. "I think that normally we're seeing people for those chronic diseases [with] much larger intervals. Like maybe it's every couple of months, three months, or maybe every six months. But the ability to connect with patients on a daily basis really makes the care that they receive — it's very personalized, it's very intense, and it actually creates better patient outcomes... the care teams really appreciate what [RPM] allows them to see and do — [to] manage their patients in a timeframe that's just shorter."

The patient outcome goals differ by condition. For example, lowering blood pressure is the goal with hypertension patients, while with diabetics, it is reducing A1c figures.

"You're trying to keep people out of the hospital and really optimize how their disease is managed," Sewalls said.

Nicholson's project centers on developing and testing a tool that can help streamline referrals from primary care providers to improve provider satisfaction and avoid patient leakage.

The tool, which is currently being piloted at Providence hospitals, includes a clinical library of over 300 referral guidance resources that primary care providers can utilize to ensure patients receive the appropriate referral.

"The premise of [the] project is improving access and making sure that patients receive the right care, at the right place, at the right time," Nicholson said.

Referrals are one of the most common pain points for the orthopedics and sports medicine service line at Providence, which Nicholson leads. Often, the patient surgery referrals that come to her team aren't necessarily appropriate candidates for surgery, "creating a lot of work for the specialists, as well as for primary care; because those referrals end up going back to primary care," she said.

According to Sewalls and Nicholson, the fellowship provides an opportunity to enhance their skills for the projects they are currently attached to, as well as for their future capstone projects.

Sewalls, for instance, has undergone change management training with Microsoft through the fellowship, which he has been able to apply to the change management socialization process of introducing the RPM project to different divisions of the organization – from the leadership to the clinics that deliver care.

Further, Sewalls and Nicholson said their training on various Microsoft tools, like Word and Excel, has been helpful.

"The tools actually integrate and really communicate better than maybe the average user realizes," Sewalls said. "There's a couple [of tools] that I just don't use really at all but could solve a lot of problems in how we collaborate and communicate in the hospital."

According to Nicholson, the fellowship has also provided an opportunity to network and collaborate with leaders within the organization, providing personal and professional development.

"I think in the longer term, as we go through this partnership with Microsoft's generous offering of so much training, I think we will be able to gain so much learning and be able to take them back and apply them to our areas of expertise," she said. "And I really hope to see this fellowship really evolve so that others within the organization have the opportunity to participate, and learn, and grow as well."