By Robbie Hughes, Founder and CEO, Lumeon
The value of large-scale care coordination in times of crisis.
While well–coordinated care is without question an admirable goal (and with the latest ONC rulings now has a substantial push from the federal government), executing it at the scale required to respond to the COVID-19 crisis is all but impossible for most health systems.
At Lumeon, we have been deploying our platform to enable population-level care coordination for over 10 years and thus we are seeing our customers deploy immediate and comprehensive interventions that address the near term challenges, as well as setting themselves up well for the future. Here are some tangible examples:
At one integrated health system, a huge variety of care is delivered at ‘million-plus patient scale’. Their short–term challenge is to limit cross-contamination and ensure that healthy patients can still receive appropriate care. Moving into a medium–term scenario where they may need to free up beds for acute respiratory cases and possibly support public health initiatives – despite being a private provider. (note – this particular provider does not have an emergency department)
To deliver this capability, this customer turned to Lumeon to enable dynamic population screening. This is a new pathway that the customer developed in partnership with Lumeon’s solutions team over three phone calls in the space of under two days. The pathway identifies all patients that are scheduled for care in the coming month and then triages these by procedure type and patient problem list. This produces a series of dynamic patient cohorts that can be used as proxies for risk levels. The system then engages each of these patients individually and asks them to complete an online Health Risk Assessment (HRA) to determine if they have a temperature, recently traveled, or present with the other leading indicators of a COVID-19 infection. Based on these responses, the system then automatically guides the patient on the appropriate next steps to take, including quarantine, moving to a remote consultation or normal attendance at their visit.
Crucially, the system continues to follow–up automatically with patients as the time of their appointment gets closer and if they start to show symptoms, these patients are then redirected accordingly.
Over time, as the guidance changes and the needs of this health system changes, they can adjust the pathways instantly from the centralized platform, ensuring that the best care is delivered given the appropriate guidance.
To operate or not to operate:
With surgery forming such a substantial portion of most US health systems’ revenue, taking the step to cancel all surgeries to free up capacity is a step that may be necessary, but could be resisted until the last minute.
As a result, screening patients appropriately based on their individual risk is a step that can help prolong normal operations for as long as possible.
For one health system rolling out Lumeon to coordinate surgical processes, the original rules they designed are no longer appropriate as the COVID-19 risk increases. They now need to be assessed in the context of their surgical preparation.
By working with Lumeon, this health system has been able to update not only their patient COVID-19 guidance but crucially how these new procedures are then operationalized at enterprise scale – importantly, this has been done from one place – Lumeon’s control center.
Patients are dynamically screened for underlying conditions and exposure risk, enabled through Lumeon’s configurable pathway engine. Patient care is then dynamically adapted to either postpone the intervention if the procedure is not critical, or move them into a quarantine process that enables the team to ensure there is no possibility of cross–contamination.
Reminding patients to do the right thing:
For one of our customers, using a simple appointment reminder pathway, their needs have evolved from revenue assurance to risk mitigation. As a result, rather than reminding patients to come in for their appointments, they now need to sensitively educate their patients about their symptoms and then only remind patients when they have urgent appointments. Less urgent appointments are redirected to later dates through a ‘bump and rebook’ program, offering new slots several weeks out. This simple change in the pathway content allows their teams to coordinate the response across the whole health system and ensure that capacity is reserved for patients who need it urgently.
While all of these examples would have been possible without Lumeon, there is no doubt that this enterprise–wide change in behavior and operating processes could not possibly have been executed on a same-day basis without it. As the crisis evolves, these health systems and others with the Lumeon platform will be very well positioned to ensure that they are providing the best possible care to their patients. All of this while meeting the needs of their community at a time when every medical professional’s skills and focus are desperately needed to look after the frail and vulnerable, rather than getting caught up in administrative and burdensome procedures.
If any of this sounds familiar, and you want help implementing these solutions in your instance, or if you’re not a customer but want these capabilities in a turnkey solution that doesn’t require any software to be installed, please contact our teams who will be happy to help using the form below or find more information at www.lumeon.com/coronavirus/.