In driving back from a meeting with a regional hospital based in the rural Midwest, it occurred to me how these remote healthcare systems have become real forces for innovation, especially relative to the extreme community health challenges they face. Specifically, they recognize that true healthcare innovation is focused, first and foremost, on delivering better care to the people who need it. In this sense, innovation is patient-centric and technology-enabled.
This hospital was seeking to develop a new and more effective approach to effectively treating pain patients by better considering the behavioral health aspects of chronic patients and the addicted. Given the high rates of opioid addiction in its community and its central role in serving this population, the hospital’s management felt a real responsibility to upgrade its ability to handle the full range of pain patients. Their thinking was broad and holistic, and they were looking for technology to support an end-to-end approach, starting with screening of patients and then coordination and support through starkly different care paths – some inside the health system and some primarily community-based.
The main objective was to shorten the path for patients to get the right treatment from the right provider at the right time. Following a model they use for musculoskeletal care, they sought to use intake screening and triage to identify a “high risk” group made up primarily of chronic pain patients and addicts. From there, depending on patient assessments, clinical staff could route patients to a primary care physician (with recommendations for an adjustment of prescriptions or treatment approach), a recently opened pain center, specific behavioral health specialists or other community-based resources (such as a recently dedicated addiction center). A cross-functional clinical team, including psychiatrists, PCPs, orthopedists, behavioral health specialists and others, developed the protocols.
Cordata was in the room because the hospital needed to enable the clinical team to quickly review and provide recommended treatment protocols, and to provide their care coordination staff with powerful, easy-to-use tools to track patients on an ongoing basis, with appropriate follow-up communication, appointment reminders and check-ins regarding pain levels. This hospital was using Cordata to do just that in their musculoskeletal practice and wanted to know if Cordata’s system could be modified to support additional specialties and use cases, including those that cut across organizational and clinical lines. Further, the hospital needed a system that could integrate data from various systems, which the Cordata platform is already doing.
I was impressed by the leadership’s passion for solving the community health crisis, the alignment of various stakeholder groups around serving a variety of clinical roles, and the commitment to finding the right technology to solve a very specific problem. Unlike many larger hospital systems, there was a sense of finding the right tool for the job and embracing the post-acute services, rather than trying to make the EHR or other core system do anything and everything. The passion is fueled, in part, by their engagement with the small city and surrounding towns they serve. These people are their patients and their community. In some ways, the lack of competition in these regional areas fosters a connection that just doesn’t exist in larger, highly competitive markets.
The conventional wisdom holds that large academic and research hospitals based mostly in large cities are where the healthcare innovation action takes place – and of course many advanced treatments are developed in such settings. They are also natural environments for the piloting and adoption of the latest technologies.
But in my experience, much bottom-up and patient-centric innovation is happening away from the big cities. Why? I see a few reasons. One is that regional systems can more easily overcome bureaucratic barriers to foster collaboration across multi-specialty care teams and different facilities, including both inpatient and outpatient sites. They tend to be driven by key clinicians who are seeking solutions for patients rather than constrained by IT organization protecting the EMR-centric approach. Clearly, these hospitals have IT leaders who get that the role of technology is to support care delivery and the treating of patients. As a result, they have the tools and data to coordinate and synchronize care via ongoing, long-term clinical pathways and drive higher-quality and more cost-effective clinical outcomes.
Another is the dispersed nature of their patient base, which is spread across large geographical areas. To serve these people efficiently and effectively (especially those in need of care for complex or chronic conditions), hospitals must get creative. Care coordination is often essential to such solutions. In this case, the hospital is exploring telehealth and remote patient monitoring via locked-down tablet devices through which patients could report their current status, blood pressure or other vital information. Again, they have a “whatever it takes” attitude to meeting the needs of their patients and willingness to try new technologies in a targeted fashion.It was one of those meetings that got me excited about healthcare innovation and its potential to generate breakthrough improvements in both patient outcomes and the business of healthcare. Cordata is proud to work with both large urban hospitals and regional systems like this one. And certainly our industry needs innovation now, anywhere and everywhere we can find it.