Issue link: https://beckershealthcare.uberflip.com/i/1273352
32 QUALITY IMPROVEMENT & MEASUREMENT How COVID-19 is changing hospitals' population health strategies By Kelly Gooch T he COVID-19 pandemic has challenged hospitals to develop new approaches to managing patient populations. To effectively manage population health, organizations must balance keeping people in their communities healthy and caring for patients infected with the illness, all amid worsening care disparities and social determi- nants of health. Here, hospital and health system leaders shared with Becker's how they maintain that balance and how their approach has changed. Editor's note: Responses were lightly edited for length and clarity. Don Calcagno, senior vice president, population health and managed care at Advocate Aurora Health (Milwaukee and Downers Grove, Ill.) At Advocate Aurora Health, we have been able to use, or in some cases adapt, certain population health programs to serve COVID-19 patients. One example is using our population health team to monitor patients discharged from our hospitals or emergency rooms. Not only has the program shown great statistical results; more importantly, we continue to receive grateful comments from patients who had felt isolated and afraid prior to this outreach. We could not be more proud of our teams and this important work. More broadly, the pandemic has highlighted the need to accelerate some of the population health work we already had started. For exam- ple, having physicians on an integrated electronic medical record has greatly helped us collect data and create patient registries over these last few months, confirming the value in bringing even more of our clinicians onto a common platform. Like other providers during this pandemic, we have seen significant reductions in certain types of utilization, including skilled nursing facility and emergency room visits, and increases in other forms like virtual health. We must now ask ourselves: In cases where not using the emergency room was clinically the right decision, how do we hardwire that decision beyond the pandemic so we can provide safe, high-quality, efficient care in the right care setting? With more patients and physicians now more comfortable with virtual health, how do we maintain and expand the use of these services mov- ing forward? Addressing these types of questions will help inform our future population health strategy. Lastly, we have always believed bearing financial risk is the best way to advance key goals of providing the safest care and achieving the best health outcomes possible. ese models made it easier to pivot our resources to where they could serve our patients best. Rebecca Cunningham, MD, associate CMO of Brigham and Women's Physicians Organization (Boston) and Daiva Braunfelds, executive director, population health management and physician engagement, Brigham and Women's Physicians Organization At Brigham Health, we have adapted our population health strategy to focus on proactive outreach to vulnerable populations most at risk for coronavirus infection or complications. We are identifying patients with medical conditions or of older age that place them at risk, as well as pa- tients who reside in hot spot communities with high infection rates. We are leveraging our existing population health teams, including nurses, community health workers, community resource specialists and others to reach out by phone to provide education, assist with healthcare proxy identification and address social determinants of health. We are also using new modes of connecting with patients, including text-based outreach and virtual visits for patients identified at risk for care that may have been delayed, or whose primary care physician is concerned about their well-being. We have established pop-up sites for COVID-19 testing, screening for social determinants of health needs and provision of resources, including masks, hand sanitizer and home food delivery for patients. We've been better able to help patients in hard-hit communities by removing barriers to care and providing the resources that people need to stay safe. e response from patients has been very positive, as many have been reluctant to reach out or seek care, and they appreciate the care team coming to them. We are adapting our approach as we move forward and anticipate the reopening of ambulatory sites, and using our learnings from the crisis to drive positive changes in our popu- lation health approach to needs identification, outreach, access and follow-up with patients. Cynthia Litt Deculus, vice president of population health manage- ment for Cedars-Sinai Health System (Los Angeles) We are working to ensure that our patients do not delay getting neces- sary in-person care, such as cancer screenings, diabetic retinal exams and childhood vaccinations. It's very important to make patients feel safe coming into the office for necessary visits and to use effective alter- natives to close gaps wherever possible, such as at-home FIT testing for colon cancer screening. Much of primary care is handled virtually now — which has proved very popular — and we're supporting our primary care providers with tools and workflows that help them make this process run smoothly. Complex care management is going very well because the staff is 100 percent focused on their highest risk patients, and patients are more accessible and willing to engage over the telephone than ever before. Our pharmacists and dieticians are having meaningful phone consul- tations with diabetics and patients with high blood pressure, and we're calling our socially isolated seniors frequently and engaging them in a free online exercise program. We find that our high-risk patients are taking better care of themselves because of their fear of the virus. Overall, patients are finding that their physicians have greater acces- sibility through virtual options such as secure messaging, and we're getting wonderful feedback about how easy it is to stay in close touch. Carrie Harris-Muller, senior vice president of population health for OhioHealth (Columbus) Pre-COVID, our population health goals and strategies were de- signed around challenging the status quo to improve health in our communities. We were making progress, but the pace of change and acceptance has definitely accelerated with the pandemic.