Delivering Care in a Hybrid World
Virtual or technology-enabled care, health promotion and disease prevention that advances the Quintuple Aim remains critical as we look in the rear-view mirror at the COVID pandemic and strive to move care forward in a sustainable and affordable manner. The ongoing paradigm shift of “care anywhere” helps meet the growing patient/consumer demands for omni-channel care. I recently discussed this concept with Jane Sarasohn-Kahn (THINK-Health and the Health Populi blog). Jane commented:
“The pandemic accelerated consumers’ physical need, then experience, for ‘omni-channel everything.” These experiences then built-up peoples’ expectations for omni-channel health care, giving health consumers choices of how and when they could access health care services – from the hospital to a clinician’s office, and the home and closer-to-home in the community through trusted touchpoints for care.”
In addition to consumer demands, we must consider what omni-channel means for our clinicians. To say that clinicians are over-worked is an understatement. A recent Forbes article by Dr. Robert Pearl highlighted a perfect storm for the “mega forces” impacting our healthcare delivery today, including inflation, the nursing shortage/workforce crisis and clinician burnout.
How can tech-enabled care alleviate these pressures on our system? More importantly, how can we enable a clinician to work at the top of his/her license with a focus on quality care at the bedside and bring joy back to his/her practice? I am proud to work side-by-side with an incredible team of clinicians and technologists who focus exactly on this. My team member and CNIO, Dr. Kathleen McGrow, worked with numerous health professionals to create our Microsoft viewpoint on changing the workplace and establishing six areas that need attention in our hybrid world today:
- Address work overload
- Establish and adjust to new models of care
- Improve rewards and recognition
- Enhance and expand community
- Improve equity and fairness
- Build a culture of Well-Being
While these are all important pillars to create transformation, “establishing and adjusting to new models of care” is bubbling to the top of many systems’ priority lists to lessen clinical, financial and operational burdens on clinicians and systems. One example of new models of care is the concept of a virtual or remote clinician to assist nurses at the bedside. I’ve seen this model attempted pre-pandemic with little success, however, in the past year this idea is gaining support and momentum across the US. A published use case from Saint Luke’s in Kansas City, MO, noted that “a 34 percent increase in the number of virtual nursing (programs) in the past year, with no signs of slowing down.” The benefit of such programs as the one at Saint Luke’s is multi-pronged, including positive impacts on the clinician and patient. For clinicians, I observed the support newer nurses have at the bedside with a virtual or remote care nurse who is more experienced. Mentorship and support is critical to ensure longevity and retainment for new nurses. For our patients, satisfaction and experience improves with direct access to a virtual nurse if their bedside nurse is busy with other patients. The discharge education and process is an area that significantly improved at one facility with the use of the remote nurse due to few interruptions, if any. While we need to study this particular workflow more, the desired outcome of this use case is to return our patients to home in better health and with fewer readmissions.
We are living in a hybrid world and I am excited to partner with our clinicians to make this transformation together.
About the Author
Molly K. McCarthy MBA, RN-BC is the National Director, US Health Provider and Plans for Microsoft. Her career journey spans almost 30 years in the health and technology industries. She is passionate about uniting technology, clinicians, and patients to improve care delivery, safety, and outcomes. Molly joined Microsoft in 2013 and served as the US Chief Nursing Officer until August 2020. She currently now leads a team of industry clinical and technical subject matter experts that drive digital technology innovation and transformation for health provider and payor organizations.
Molly graduated with a B.S. in Nursing from Georgetown University and worked clinically in Neonatal Intensive Care and Pediatric Units, and as the Pediatric Kidney Transplant Team Coordinator at Stanford Children’s. After finishing her MBA, she integrated her clinical background into a career in medical device design and health technology. Molly started in a product development role at Natus Medical Inc. in Silicon Valley. She furthered her career in product concept to launch with AWHONN where she was responsible for piloting a benchmark database that extracted data from hospital labor and delivery EMRs to provide business analytics and intelligence to hospital leadership. Immediately prior to joining Microsoft, she worked for Philips Healthcare’s Patient Care and Clinical Informatics Division, where she orchestrated large health system integrations of physiologic patient monitoring networks into hospital EMRs and networks.
Itchhaporia, D. “The Evolution of the Quintuple Aim: Health Equity, Health Outcomes, and the Economy” Journal of the American College of Cardiology Volume 78, Issue 22, 30 November 2021, Pages 2262-2264