Digital Care Technology Enables COVID-19 Care at Scale

KEEPING PATIENTS AND EMPLOYEES SAFE

When the first COVID-19 case was confirmed at a large healthcare system, leaders quickly identified the need for a robust telehealth-based response and defined six key imperatives:

• Screen, test, and treat a new disease during a global pandemic.
• Monitor and manage those with mild symptoms at home and reduce the potential spread.
• Keep the workforce safe and active.
• Expand availability of ‘routine’ care and preventative wellness.
• Be a trusted source of information for the community.
• Recruit recovered patients to donate convalescent plasma.

They also observed key clinical needs driven by COVID-19, including remote monitoring and care for patients with COVID-19, providing virtual care, communicating changing guidance from the Centers for Disease Control and Prevention and the state, and supporting a new convalescent plasma donation program.

BROADENING USE OF PATIENT ENGAGEMENT PLATFORM

The rapid expansion of Twistle by Health Catalyst, a patient engagement platform already deployed at the organization for other use cases, facilitated the scale and standardization of COVID-19 messaging and care across the health system’s entire network. The secure, text-based messaging outreach allows patients to participate even if they don’t have access to the internet, a computer, or WiFi, helping the organization overcome health equity challenges and provide care in new ways. The health system uses a variety of communication protocols to facilitate the provision of care for patients and staff, including:

• Screening after potential COVID-19 exposure.
• Communicating return-to-work clearance.
• Symptomatic self-monitoring at home.
• Monitoring and bidirectional messaging of patients with COVID-19.

For patients with COVID-19 recovering at home, a Twistle pathway is initiated as part of the EHR order set. The organization first used twice-daily assessment forms to gather and report patients’ symptoms and remote physiologic monitoring to collect temperature and oxygen saturation. This information is integrated back into the EHR for a comprehensive record. As more was understood about the COVID illness, the assessments were decreased to once daily. The care team is alerted when data indicates patient deterioration, focusing attention on patients requiring intervention while safely supporting the care coordinator’s ability to manage a larger caseload.

RESULTS

Using the Twistle patient engagement platform, the health system expanded care capacity to meet increasing demand, continue providing necessary primary and preventative care, and keep its workforce safe. Results include:

• More than 38,000 patients were supported through COVID-19 screening, testing, treatment, and monitoring.
• 64.1 percent of patients said Twistle reduced the need to contact a provider by phone.
• 95.7 percent of patients adopted the technology, and patients read or responded to 76.5 percent of all messages.

"With Twistle, we could quickly centralize support for COVID-19 screening, testing, and monitoring for a huge population, including our care teams and patients. That was essential for us to manage a new and rapidly changing situation effectively."
Chief Medical Information Officer

ADDITIONAL READING

• Drive Better Outcomes with Four Data-Informed Patient Engagement Tactics
• Unleashing Patient’s Power in Improving Health and Care
• How Telehealth Improves Revenue, Cost, and Quality
• How to Scale Telehealth Solutions to Increase Patient Access During COVID-19
• Virtual Visits and Analytics Enable Continued Delivery of Ambulatory Services During COVID-19 Pandemic