In response to the Coronavirus pandemic, the healthcare sector has experienced remarkable and revolutionary care transformation.  Change didn’t proceed in small gradual steps – it occurred in a series of giant leaps and bounds – in hours rather than weeks, in days rather than months or years.

Hospitals expanded into tents and parking lots.  Telehealth visits became the norm.  Videoconferencing  and other digital collaboration tools allowed many non-healthcare workers to stay home with their families while fulfilling their professional responsibilities – often juggling family, school, and work demands at a literally dizzying pace.  Our definition of essential workers expanded beyond healthcare to include critical roles we should no longer take for granted.

Along the way, we proved that a virtual digitally enabled health system can work effectively, efficiently, and economically.  Providers can deliver high quality care while maintaining and improving the healthcare experience for themselves, their staffs, patients, and families.  The term “hospital at home” took on fresh meaning and describes what many organizations aspire to become.  Web-side manners are now as important to patients as bedside manners.

Where do we go from here?  It is time to embrace the virtual campus and plan for a new and better future.  Here are some suggested steps on how to proceed.

Embrace the same discipline and framework to create the virtual campus as for a traditional campus. Revisit the planning process you used for your existing facilities.  Consider branding the virtual campus as you would for any “bricks and mortar” building.  If you have a charitable foundation, consider naming some elements of the virtual campus for major donors – an opportunity to fund some of your digital initiatives.

Query a broader representative sample of stakeholders than you have in the past.  In addition to including patients and their families, engage non-traditional participants – payers, suppliers, and vendors.  Think innovatively about current approaches.  Innovate when creating new stakeholder experiences.  Don’t let geography limit your efforts.  Some of your potential partners and competitors may be in other states, even other countries.

Plan for the underserved and those who might be excluded because of the digital divide.  Meet them where they are.  Go to houses of worship, to homeless shelters, to soup kitchens, and other gathering places.

Develop operating principles for how you’ll create and deploy a virtual campus. Pick out one or two guiding principles, e.g., “Hardwire the Quadruple Aim” or “Never compromise on the delivery of care – quality, access, and cost.”

Define which products and services are provided via the virtual campus.  Set scope and limits.  Think about which clinical services can be done remotely, which must be done on site, and which can be done in a hybrid environment.  Think about product accessibility and delivery for remote care, e.g., pharmaceuticals and durable medical equipment.  Concentrate on the disease states which can be addressed more effectively on a virtual campus with occasional on-site visits.  Convenience and access are critical for providers, patients and families.  Like traditional campuses, the virtual campus will change and evolve – just faster, less expensively, and without geographic challenges.  Hybrid is likely the best approach.

Bring in security and privacy experts to participate in every phase of the project.  Regularly test for vulnerabilities and gaps.  Security and privacy literacy are critical – never stop developing education and providing training for all parties about their responsibilities.

Develop strong financial plans for the virtual campus.  Use the same diligence and array of services as  with a traditional campus.  Ensure that financial transactions are secure and easily managed by the patients.  Provide the ability for patients and families to validate insurance coverage.  Make it easy to collect insurance information and co-pays, to submit claims, or to enroll patients and families in easy payment plans.  Make bills simpler, more understandable, and accessible online.  Provide accurate estimates on how much an interaction for any product or service on the virtual campus will cost.

Use your digital front door, not limited to your portal, to get patients onto your campus.  Think about digital wayfinding and customer relationship management capabilities.  Provide patient and family services wherever possible.  Use chat-bots to facilitate access to services, to answer questions without patients and families having to walk through complex phone menus.  Broaden the options that are limited by telephone-only technologies.  Delight your visitors to the virtual campus.

Identify the key data related to social determinants of health which need to be collected.  Modify your EHR or other data collection tools and ensure that data which you gathered can be used with your new and expanded analytics function.

Personalize the experience for providers, patients, and families.  Use information you already have in computer systems to simplify the data collection process and to make the interactions more relevant.

Use augmented intelligence (AI) and machine learning (ML) during the data collection process.  Utilize dynamic clinical interviews and history taking to help providers and the patients and their families.  During the pre-admission timeframe, let patients and families provide required information when it’s convenient for them.

Automate data sharing and report production. Use data which are collected to help create patient summaries, to coordinate care, to send information to all appropriate destinations – e.g., referred providers and facilities, registries, and public health agencies.

At the foundation of your efforts, establish or use strong, responsive, participatory governance processes, clear and unambiguous goals and objectives, concise and timely communications.  Be flexible yet focused.  Pay attention simultaneously to all aspects of people, process, and technology.  Finally, remember that technology is the easiest part of the effort.  Focus on the people and processes – the humanity of healthcare.

Related Articles:

1. This blog is the 7^th in a series.  The other six are:
   1. Digital Health – Is Healthcare Ready? Are You and Your Organization Ready?
   2. Becoming a Digital Health System
   3. Digital Health – Governance in a Digital Health System
   4. Digital Health – The Role of Empathy and Understanding
   5. Digital Health – Language and Comprehension
   6. In a Digital World, The Human Elements are Essential