By Sara Heath

October 20, 2020 – At CommonSpirit Health, a nursing phase doesn’t just begin and end with the administration of a treatment or intervention. The organization, which was founded in 2019 as a result of the coordination between Catholic health initiatives and Dignity Health, instead strives for holistic patient care.

That’s because patient health and well-being rarely exist in a vacuum. Health is not just the sum of the interventions performed during an individual care, it also encompasses the overall experience of the care and the factors that patients see outside the hospital.

To this end, the Catholic healthcare giant is expanding its strategy of using patient retention technologies to ensure this holistic care. Building on a four year old relationship, CommonSpirit Health recently announced that it would use Docent Health for text-based patient communication and care coordination.

“It started off as a pilot in one of our markets, where significant numbers of patients were treated with Medicaid and Medicare, and it was really about how we help patients navigate different clinical episodes of care,” said Dr. Alisahah Cole, the systems vice president for population health and innovation policies at CommonSpirit, told PatientEngagementHIT.

“When someone came in for a right knee replacement, or someone was pregnant and had a baby, these are considered episodes of care. How can we help patients navigate not only through our own healthcare system, but all the resources they may need to achieve a successful clinical outcome? “

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The tool uses patient data and artificial intelligence (AI) to predict patient care needs, refer patients to services within care pathways, and then coordinate that care. Patient Navigators also help direct patients to various community resources and prepare patients for different elements of their care.

During the pilot phase of the program, Cole said the technology had a significant impact on care outcomes for both maternity and orthopedic surgery patients.

With new mothers, the average length of stay fell from 2.46 to 2.29 days, which corresponds to a decrease of 10 percent. For newborns in the Medicaid population, the length of stay also decreased from 6.13 days to 4.3. The program also resulted in a 37 percent decrease in premature births in the Medicaid population.

Patients undergoing orthopedic surgery also saw improvements in results. The average length of stay decreased from 3.5 days to 1.93, a decrease of 45 percent, while the 30-day readmission rate decreased by 71 percent from 3.5 percent to 1 percent.

“We have seen these data and these clinical results, and we have received good patient reviews of the program. We received good employee satisfaction and reviews about the program, ”recalls Cole.

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“The question arose as to why we shouldn’t offer this service to all of our patients who would like to have a baby or a knee replacement. And that’s exactly how the decision was made to expand this partnership and this relationship in our company. “

This type of platform really made sense given the type of holistic care CommonSpirit wanted to offer and the target audience of traditionally underserved patients. For example, the foundation of the platform in text messaging is important to ensure that the program is accessible to low-income or underfunded patients.

“The majority of people now have some kind of phone, whether it’s a smartphone or some other device, and the majority have at least SMS functionality,” Cole said. “However, not everyone has the ability to download apps and access apps, etc.”

Cole is right. In February 2019, the Pew Research Center reported that 96 percent of Americans had a cell phone and 81 percent had a smartphone. While some reports show that there are few, if any, people who don’t have data on their smartphones, there is still a 15 percentage point gap of people who have a mobile phone – not a smartphone – and may not have a data plan.

And without this data plan or a smartphone, app-based patient engagement interventions just don’t work. In order for CommonSpirit’s program to run smoothly and to work for the traditionally underserved populations, it was important that there was no need to download an app or connect to internet data.

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Using the AI ​​and text-based tool, CommonSpirit can also do some work on the social determinants of health, a long-standing priority for the health system, but especially now during the COVID-19 pandemic.

“One of the things that we added is screening for social determinants,” noted Cole. “That was one of the things that kept coming up in the pilot, that people said they needed help with transportation or they needed help with eating or they needed help with housing.”

As other providers have noted, the novel coronavirus outbreak has made the health needs of the population a little more urgent. The economic impact, the layout of housing, and the general fear of going into public spaces have made these social needs more pronounced.

“Again, it’s really about standing up for the patient and being able to connect them to any resources they may need, be it a healthcare resource or a study group report,” said Cole.

This expansion will primarily aim to roll out AI and text-based intervention to the entire CommonSpirit patient population in maternity and orthopedic surgery, which includes 11 states and more than 60 care facilities in the system.

It also aims to look at the bigger picture of health inequalities nationwide, said Cole. The nation’s other epidemic, black maternal mortality, is a crisis that Cole hopes will help with this platform.

“With this wave, we’re really, really deliberate, focusing on how we make sure we are engaging our African American mothers, that they are aware of the program and that they are connected, that we are committed to it, and that they are resourceed when needed and additional levels of care, ”she said.

“Ultimately, our goal at CommonSpirit would be to eradicate this inequality,” continued Cole. “I tell people, ‘Yeah, that’s a bold statement. ‘But we have everything we need to eliminate this inequality. We just need to be really deliberate, strategic, and make sure we collect the data. “

This program is just the first step in CommonSpirit’s journey to addressing patient care needs and ensuring holistic health, Cole acknowledged. Maternity and orthopedic patients represent only two types of care episodes, and ultimately CommonSpirit wants to introduce this type of programming among numerous other types of care.

The focus of this goal is to provide the right data to strategically implement the programming and address patients. As Cole said, it’s a bold goal, but increasingly, healthcare is creating the right tools to make it happen.

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