Preparation for Virtual Care Rollout Improved COVID-19 Response

June 08, 2020 - Before the COVID-19 outbreak, Novant Health had plans to build out its virtual health efforts. When the public health emergency struck, its preparation laid the groundwork for an effective response to the coronavirus.

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Digital health is not a new concept that emerged in light of the COVID-19 pandemic. Many health systems have been leveraging telehealth visits, remote patient monitoring, and digital health tools since its inception. But many also kept pushing for innovation, seeking for its digital health solutions to lead to better patient outcomes, lower costs, and improve value-based care.

“We’ve been working on building out our future-forward approach to digital health,” R. Hank Capps, Jr, MD, FAAFP, senior vice president and chief digital health and engagement officer at Novant Health told mHealthIntelligence. “We’ve had a long history of being innovative and utilizing digital health tools and virtual visit options.”

Novant Health’s goal was to stand up virtual care as an independent avenue of care similarly to ambulatory care.  

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“In that process, we had all kinds of different ideas about what this might look like. One of the things that continued to surface was that traditional telehealth options had never included a physical exam,” Capps explained. “The physical exam is a differentiating factor to the level of the visit, the types of things you could do, and the quality that you’d be able to provide to the patient. So we sought to find a way to create a new venue of care: virtual physical exams.”

The organization first needed to answer some key questions.

“What are the technologies that would be needed to extend care in these new and innovative ways and in ways that consumers are wanting care delivered?” Capps asked. “How do you do that with the same quality that you would when you were face to face with someone in a brick and mortar location?”

Novant’s original plan was to build out the answers to these questions specialty to specialty. These building blocks would empower providers with a new vision of care.

But on March 12, 2020, the coronavirus pandemic became inevitable and the organization’s plans changed. Digital solutions were no longer a part of its future strategy but an inescapable foundation needed to respond to the coronavirus.  

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“The world advanced five years in 48 hours,” Capps emphasized. “When we saw the wave of COVID-19 in the US, we made a pretty monumental shift in a very short period of time to stand up decided on-demand resources and increase our volume significantly from one day to the next.”

This transition included training the entire medical group of over 1,500 physicians to conduct video visits in just four days. Novant Health went from completing about 1,000  virtual visits a year to over 1,000 virtual visits a day.

“It’s been an incredible sprint and beginning of a marathon that we’re all facing in the midst of these extraordinary times,” Capps emphasized.

A large part of the success in this implementation was also linked to Novant’s strong patient engagement. Before the pandemic, over a million people used the organization’s online platform, according to Capps.

Amidst the pandemic, on-demand services for these patients needed to grow to fit the need. Patients wanted real-time care while staying safe at home.

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“We had built all the pipes for this,” Capps continued. “We developed resources for patients to help them understand what options they had to still access care and we had to streamline that process for those who were ill and protect those who were not sick.”

Virtual care is here to stay, Capps said.

“If you consider the intersection of technology, the consumer expectations, and the payer environment that has shifted remarkably in the midst of this crisis, we can anticipate this is a long-haul moment,” he emphasized. “The landscapes have been altered permanently. There will be pieces of what we do that can go back to how it was. But for the most part, we’re at a moment where we’re having this generational shift in how we deliver care.”

In hindsight, the virtual technology plan Novant was anticipating rolling out slowly over time put in place the necessary resources for an effective COVID-19 response. Now that virtual health has exploded, there is no going back.  

“We were moving to more of a digital-first approach to help patients get their first line of care in the way that would be the absolute safest for them,” Capps concluded. “Digital care is going to connect into a broader care delivery in a way that had not been conceived to be anything beyond futuristic a couple of weeks ago.”