Does ‘Digital Health’ Have a Future in Patient Experience Anymore? Lurie’s Children’s VP Talks ROI

Hi, I’m Jessica DaMassa with WTF Health, what’s the future of health? I talk to the who’s who of health tech and healthcare innovation, and I’m doing a deep dive into what’s changing with the patient experience. I’m doing it here at Artera’s first ever customer event, Heartbeat. So joining me right now I have Ravi Patel. He is the Vice President of Digital Health from Lurie’s Children’s Hospital in Chicago. Ravi, it’s great to have you here.

Thanks for having me.

I really want to dive right into what’s going on at Lurie’s, so I think it’s really cool to start talking about the patient experience you know at a children’s hospital, because it’s just a different kind of patient. It’s a patient and a family and so on, so tell me what are the three big things that are top of mind in terms of redefining the patient experience at Lurie’s right now?

Sure, so I’ll start with access and that is more important than anything else especially in the pediatric space. Access is becoming more and more difficult. There’s less pediatric beds available, there’s less children’s hospitals out there, and as that’s becoming more and more tight our tertiary, quaternary care is becoming more difficult to access. So number one is access and that’s where Artera really comes in. It’s our ability to be able to actually make sure that all of our patients show up to these appointments, so that we don’t have wasted appointments, and then the next patient can actually get in.

Second is really about the patient experience. Healthcare is complex. We don’t have to pass all that complexity on to the patient and the family. There’s a lot that they’re going through with a new diagnosis or potentially a chronic diagnosis that they’re having to manage and that complexity doesn’t have to be passed on to the patient. Let’s keep it simple for the patient so we can consolidate appointments, where we can make them more structured and multidisciplinary. Care is critical without being able to actually effectively manage the whole patient and all of the variety of specialties that they need to access. You don’t actually have a simplified solution for the patient.

Third, I think probably more important than anything else is really having to make it an empathetic approach. In this complexity of healthcare we’re all trying to solve how to get the patient the right care that they need, and how do we do it in a way that actually makes it not necessarily enjoyable. I don’t think anyone ever wants to get healthcare, but making it as least painful as possible. So to do that, we have to figure out how to communicate, and that communication goes beyond just the interpersonal communication right in the middle of a physician’s visit, but rather all of the pre-visit communication, all the post-visit communication, all of that full on end-to-end patient experience. And so how do you make that whole end-to-end experience become one simplified journey for the patient, that’s the big question.

Right Ravi, that’s what we’re all working on. I think it’s interesting that the third thing you mentioned is building not only just that routing, but also making sure that it has that empathy piece to it. I love that and one of the things I wanted to ask you specifically about being at a children’s hospital, as it isn’t just the patient, but the patient and their family too. So talk to me a little bit about the caregiver and the caregiver as far as helping in terms of the thinking around the patient journey. I often feel like the caregiver is left out of that completely and it’s not just children that have caregivers. If you’re somebody who is older, if you are somebody who is suffering from a really serious disease, even if you’re just somebody who has a family wrapped around you, caregivers are there so how are you guys thinking about including the caregiver as part of the patient journey? And what can general health systems learn from your approach in terms of making sure that the caregiver is included?

I’ll start with that it is complex and it’s really painful.

Great, that makes everybody want to do it.

The pediatric space is really difficult because you have proxies, you have all of these patients, parents, guardians, DCFS and unfortunate cases and so how do you actually communicate with those proxies that are out there? Defining the proxy is critical and doing that up front is also an important factor. I think different platforms are getting better at that. They’re actually allowing self-selection of proxies and that makes this a lot easier downstream because now you can communicate everything to the patient the patient can now independently make the decision of to make this person my proxy the person who’s going to help coordinate all the health care that I need to give as my caregiver. So in the pediatric space unfortunately you can’t do that with a five-year-old, so what we end up having to do is define those proxies up front. I think in the adult space you have a lot more opportunity and there’s an opportunity to grow that experience up front. So in that first interaction can we do a better job at defining those proxies? Are there people that can help you through this new diagnosis or navigate the healthcare system to provide the complex care that you’re about to get? If you can figure out how to do that up front you can now bring them along in the journey along with the patient. So that’s really where it becomes a kind of critical unlock. Everyone is now all on the same page, everyone’s getting the same message. From there then all that communication going back and forth becomes something that is one episodic experience at the end of the day.

Ravi, “Digital Health” is in your title and so I’ve got to ask, how do you decide where to put tech? Especially in a process where we’re talking about these are sick children you know and so there’s a lot of need for empathy. Sometimes tech can be a little cold, so how do you decide where in the process you put technology?

So it really is two fold is how I think about it. One, how does it make the patient experience easier? I don’t really care about the bright shiny objects. There’s a lot of opportunity to get into the bright shiny objects. Remote patient management monitoring – we’re still trying to figure out what the return on investment is for some of those items and what that patient experience looks like. Is this just another device I have to carry around or is it something that’s actually going to make my whole care experience easier? Because that’s what technology is supposed to do. aAt the end of the day it should make it a more facile approach for our patients. So if we can really focus on what makes it easier for the patient and then that value can be generated. Sometimes it’s non-monetary value and that’s fine. As long as there’s value being generated for the patient, it’s something that is a good investment for the organization.

The second piece is it’s got to be something that is sustainable and scalable more than anything else. And so we can have all the technology in the world, but if I can only deploy it to a hundred patients because it involves all this complexity of coordinating care and I need to have six people in the background coordinating the care for the hundred patients, that’s not ever going to be sustainable. I’m never going to be able to grow that from five hundred patients to a thousand patients or even from one hundred patients to a hundred thousand patients, because that’s what we’re really targeting. We have about two hundred seventy five thousand unique patients that we’re interacting with over the course of a year and as you think about all of those patients we want to make sure that everyone, every patient, every time, has the opportunity and that’s pretty much our motto from a Digital Health perspective. So whatever we roll out, the whole goal is to make it available for every patient and they’re only going to adopt it if it’s making their life easier.

I’m curious to know, you mentioned ROI. I hear you get very passionate about the subject of ROI, especially when it comes to technology. So I want to hear from you – what are you looking at, how long of a time period are you willing to give the technology to generate ROI and when it’s ROI, is it really just a monetary return? Is there an engagement piece that we’re looking at? Tell me how you’re thinking about ROI when it comes to the patient experience and particularly with technology.

So first is the short-term return on investment and then the long-term more sustainable return on investment. So in the short-term I think most of our technology should have some immediate at least hypothesized return on investment and that return on investment as I said, could be monetary. And then in many cases it’s not. It has something to do with the value of care and that value of care can either be an improved patient experience, improved quality of care, or improved safety of care. All of those factors weigh into that return on investment. I have to be able to see the short-term return on investment. And whether that be that I’ve made it easier because I I get that return right away or I get the return on investment because I’ve made it easier for this patient to get in and thereby fill my backlog. All of that becomes something that we prioritize. That then allows me to invest on the long-term returns on investment. So there’s things that we’re going to go do that are the bright shiny objects in the remote patient management space and as we go do that I may not see that investment. I may not see that investment pay off right off the bat. So as an example, for Artera, we just deployed it from a short-term return on investment. It’s very clear we need to figure out how to get appointment reminders to the right patient, at the right time and make sure that they can show up. If I can get them to show up, I thereby have now effectively gotten my return on investment. Because if a patient doesn’t show up, that’s all wasted resources. My clinic space, my physician, all of our ancillary services and support staff, don’t have anything to do for that time period. More importantly, that patient now has to be rescheduled for a month from now, thereby displacing a future patient from getting that appointment and thereby we have these long long lag times and wait times. That short-term investment has paid off for our remote patient monitoring programs. So we have one program that has a short-term investment. Our short-term return on investment. It’s perioperative care for tonsillectomy and adenoidectomy. We’ve been able to actually guide a patient from when they see an ENT surgeon to when they actually have their surgery and postoperatively in the 30 days after their surgery, to actually guide them through the whole process. From scheduling a surgery to doing the follow-up care and making sure that they know what’s coming. We know that if patients engage in that pathway they’re fifty percent more likely to get their surgery done at our institution. That’s a pretty staggering difference at the end of the day, a great short-term return on investment. Long-term return on investment, we’ve got a similar diabetes pathway that is going to be more value based. That’s going to be more quality and safety based. How do I actually see that? It’s going to take me years to get there. That’s okay. That’s okay because I’m investing in these short-term returns on investment that’s funding my long-term. So if I’ve got a good balance in my portfolio, I can actually create more of these opportunities and as some of that long-term return on investment starts paying off, we actually then create a good strong following of adoption. So our patients are now adopting all of our digital tools. They’re actually engaging in all of the tools that we’re providing them. And then they’re utilizing it to the fullest capability.

I love that. I love that. The diverse portfolio and especially the utilization to the full capability. All right so tell me this then Ravi, what does the patient experience nirvana look like to you? What is it? I’m really curious to hear this because you seem to have a very solid perspective on the fact that it needs to be an in touch human experience, with the technology, so what does the patient experience nirvana look like?

Seamless. It’s got to be something that is simple. So back to my earlier comment, healthcare is complex. Don’t ever pass that complexity on to the patient. Let’s not make it more difficult for our patients to try and get the care that they need. Let’s try to streamline it as simply as possible. Now there’s a stepwise approach to getting there, so making sure that we’re not letting perfect get in the way of good. Because good is progress and let that progress happen. That’s totally okay especially in the digital space, but how do we make it so that it’s simple, streamlined. It’s truly frictionless for a patient to be able to get the care that they need. So they need to actually get the care and then their post visit care needs to be something that can be continuous in that experience. And that’s something that we can guide them with. Something that they’re not left on their own because we all have been there. You’ve shown up to a doctor’s office, they’ve delivered some bad news or you’ve been there with a family member as we talked about, caregivers, and no one remembers what’s going on at that moment. Great, all of this stuff was just thrown at you right at that moment. How do we make sure all of that is available post visit and not just in some after visit summary? And not in a 15-page after visit summary, but something that’s actually going to guide them through what the next steps are to actually make this a seamless experience downstream.

All right Ravi, well we look forward to that. So thank you so much for stopping by and sharing your thoughts with us. I really appreciate it. It’s a pleasure to speak with you.

That’s Ravi Patel, the Vice President for Digital Health at Lurie’s Children’s Hospital in Chicago, my hometown, gotta shout it out. For more interviews with the who’s who of health innovation, they are changing the way that we do healthcare, especially the patient experience side of it, you can check out more interviews on my YouTube channel. It’s youtube.com/wtfhealth. All the episodes that I do regularly are up there along with some of these special episodes about patient experience filmed here at Artera’s Heartbeat event. I’ll talk to you guys real soon. Thank you so much, take care