The New Ideas from Kaufman Hall podcast series investigates emerging and unexpected trends in healthcare and beyond, featuring Kaufman Hall experts and guests from health systems, academia and related disciplines.

“To simply be able to pull out your laptop…and get treatment for your issue in 15 to 60 minutes, the convenience speaks for itself.”

Season 1, Episode 2 - Care in 60 Minutes or Less: Virtual Visits Take Off

For busy patients, the prospect of scheduling an appointment and visiting a physician can be time-consuming and inconvenient. Amazon, Walmart, and an increasing number of hospitals are beginning to embrace the “virtual visit” approach to healthcare.

Erin Powell, system director of retail health at SSM Health, recently joined New Ideas to discuss their virtual visit program. Residents of Illinois, Missouri, Oklahoma and Wisconsin can book $25 visits with one of SSM Health’s nurse practitioners for non-urgent conditions. Depending on the diagnosis, clinicians follow up with each patient via email, telephone, or video visit in 15-60 minutes.

The conversation also touched on other aspects of virtual visits, including:

  • How to determine which conditions to include in the program—and which to leave out
  • The importance of crafting defined diagnoses that do not require additional referrals
  • How to create a seamless, user-friendly digital registration process
  • Why health systems may have a leg up on new entrants for virtual visits
  • How tech-savvy nurse practitioners are embracing the program
 
HOST
Haydn Bush

Haydn Bush

Haydn Bush has two decades of experience as a journalist and communications professional in healthcare and related fields. He currently serves as vice president in Kaufman Hall’s thought leadership department.

Prior to Kaufman Hall, Haydn worked in various communications roles at the American Hospital Association and McCabe Message Partners, an award-winning public relations firm focused exclusively on health and healthcare.

During his tenure as a writer and editor for Hospitals & Health Networks magazine, Haydn’s reporting on improving care and reducing costs for the patients with the highest healthcare costs received honors from the National Institute for Health Care Management Foundation and American Business Media.
 

GUEST
Erin Powell

Erin Powell

As System Director – Retail Health for SSM Health, Erin Powell is responsible for development of strategies for expansion of retail health and the “virtual visit” platform across the system’s four-state footprint, including Illinois, Missouri, Oklahoma and Wisconsin. Erin has 20 years of health care experience, including 18 years at SSM Health. She started her career as a bedside nurse, quickly moved into nursing leadership roles, and was integral in the development of the Neuroscience Service Line and Stroke Initiatives for SSM Health St. Louis. In 2015, she became Administrator of Retail Health for SSM Health St. Louis, where she led the region’s efforts to expand Urgent Care capabilities and its collaboration with Walgreens to develop the system’s Retail health platform, which includes 26 retail health clinics in the St. Louis region.

 

Transcription

 

Haydn Bush: Welcome to New Ideas from Kaufman Hall. I'm Haydn Bush. On today's edition of New Ideas, we'll be talking to Erin Powell, system director of Retail Health at SSM Health, to discuss their new telehealth program. Residents of Illinois, Missouri, Oklahoma, and Wisconsin can now book a $25 virtual visit with one of SSM Health's nurse practitioners for non-urgent conditions. Erin, welcome to the program. I'd like to start by having you tell our audience a little bit about how SSM Health hit on the idea of virtual visits.

Erin Powell: We are very aware of what our patients and the community are telling us as far as what they want and how they want to receive healthcare. Our public has become very educated, and they are a consumer of healthcare. They're very wise and knowledgeable. They know how they want to receive healthcare. They know that they want it to be affordable. They know they want it to be convenient. And that really challenges all healthcare systems to take a look at, how are we going to provide care and how are we going to differentiate in the market to make it convenient and have our consumers choose us? So, in that journey, we knew that we really needed to look closely at a virtual visit platform that would allow patients to receive the care very conveniently where they're at, from their own homes, from their cars, from their offices, and also in a very affordable manner. So, it really became a very strong strategy for us to be able to provide that to the community.

Bush: Erin, you mentioned the fact that a lot of consumers are sort of getting increasingly accustomed to this level of service, not just in healthcare, but in other aspects of their lives. I'm curious if you're sort of surveying the new entrants, if you will, to healthcare, whether it's Amazon or Google – if that's some of the impetus or expansion of retail health from the CVS’s of the world, and if that's some of your thinking in terms of why this made sense for SSM to give it a try?

Powell: I can't say that that is really what drove us. I think it's been something that the healthcare industry has been looking at for a long time. Some of the others that you mentioned, they may have moved a little bit more quickly and more aggressively. I think we have a lot of things to consider, and we look really closely at quality of care. We are also very focused on population health and the overall cost of care to the consumer. So, figuring out exactly how we were going to provide this and continue to provide the same quality level of care as you would get when you're seeing one of our providers within their offices or within one of our ministries, that was really an important part of how we developed our platform. We may not have moved at the same pace as maybe an Amazon or others have, but we've actually been in the retail health market for several years now. SSM Health has a close relationship with Walgreens. And we actually have SSM Health Express Clinics that are seated within about 23 Walgreens stores within St. Louis and outlying areas. So that was kind of the first step into retail health, and then expanding into this virtual health world of what's the next step of convenience for the consumer? And this really was that logical next step.

Bush: Let's say I'm a patient. I'd love it if you could kind of walk us through my process from the appointment to the visit and afterward and just give our audience a sense of what this feels like for a patient who uses the virtual visits.

Powell: It's actually a very, very simple process and that was an important part of developing this was how are we going to make this very easy for our consumer? Simply by Googling “SSM Health virtual visit,” you can get online. You simply click start a new visit. There is a really brief questionnaire that asks you about what is your chief complaint? What are the symptoms that you are having? It's a very brief registration process and then that information is all sent to one of our trusted SSM Health providers. They evaluate that information that has been provided to them and they are able to develop a care plan based on that information. There are a couple of things that can happen. They can either have enough information to say, "This is great." They simply respond via email with a care plan and possibly a prescription for you. They may choose to give you a phone call, or we can also connect via video visit where you're able to be face-to-face with your provider and they're able to ask additional questions. Regardless of that, all of this really happens in the virtual world. And the convenience factor is huge because once that provider develops that care plan, it's then emailed to you along with a prescription if a prescription is necessary. So, all of that comes to you very, very conveniently and happens in a matter of minutes. Most of our consumers will receive a response and have their visit within 15 minutes. The maximum length of time is 60 minutes. So, you can see the convenience factor. You are sitting at home and you've got the kids and how are you possibly going to have the time to go into the doctor, get all the kids packed up to go? You've got to figure out if your physician has an appointment available. And you simply have a very itchy, watery eye. You're concerned, "Do I have pink eye or some sort of infection?" To simply be able to pull out your laptop, get online, answer those brief questions, and get treatment for your issue in less than 60 minutes, the convenience speaks for itself.

I think having a large health system name like SSM behind it, you can feel confident that you are getting trusted, quality care. The experience for the patient or the consumer is really quite simple. The other advantage to our program, and I think [that of] other large healthcare systems is that there's a link back to the electronic health record. So, your physician of record is able to see that you've had a visit and it becomes part of your permanent medical record.

Bush: And Erin, let's say that I'm a new patient coming in. I'm interested in learning about how you're able to connect those patients with continuing care.

Powell: We do this within our retail health world in a really robust manner. And that is evaluating patients that currently do not have a primary care physician. And we make a very concerted effort to get them linked up with a primary care physician, sometimes even scheduling that appointment before they even leave the retail health world. We are now looking to duplicate that within the virtual health world and get them linked up with a primary care physician, as well.

Bush: I'd like to shift gears just a bit. I'm curious if you've received any feedback from patients, whether they're existing SSM Health patients or new people coming in.

Powell: The feedback that we have received has been overwhelmingly good. You always are a bit nervous when you roll out a new program. Is this going to meet the needs of the consumers? Are we going to get positive feedback? Are people going to be as excited about this as we are? And overwhelmingly, they have been. People continue to compliment the convenience and the ease [of use]. And one of the other things is that our cost is extremely affordable for all. And being able to provide this at the low cost of $25 to everyone, regardless of insurance, really is a differentiator in the market, as well.

Bush: That's great. What sort of feedback are you getting from your clinical staff? I'm interested about the nurse practitioners who are conducting these visits and just their sense of how everything's going so far.

Powell: Our providers have just really enjoyed being able to offer care in this way. You always have that subset of providers that are very tech-savvy. They really enjoy the technological world. Engaging that kind of provider into this program I think is key. And overwhelmingly, I think that our SSM providers understand that healthcare is evolving. What our consumer is asking of us continues to evolve and they have to evolve as providers to meet the needs of those patients and consumers.

Bush: Has it opened up any flexibility in terms of staffing, that it sort of gives these nurse practitioners a different option?

Powell: Absolutely. Many of these providers work within our current retail health clinics. We kind of rotate through - are they going to be seeing patients live or are they going to be seeing patients via video visit? They may do a combination of both. It just depends on what the demand is at that time. So, having that flexibility within that retail health platform has been very helpful, as well.

Bush: Thinking about this from the perspective of a hospital or a health system that's considering an initiative of this nature, what challenges, would you say, or barriers along the way would you flag for other health systems that are thinking about this? And what are some of the strategies maybe for overcoming potential challenges?

Powell: I think that one of the most important things that you have to look at as a healthcare system are what are the diagnoses or what are the different illnesses you're going to treat on a virtual visit platform? I think being very decisive and not trying to treat everything that's out there, but really having a succinct list of protocols is very important if it's a very clearly-defined diagnosis. So, a diagnosis that doesn't become incredibly complicated where ultimately, we end up having to refer them elsewhere. I think that's been a very important piece from a patient experience perspective because if you have a large number of patients that are logging on, attempting to do a video visit, and we're repeatedly having to send them out or send them to other venues of care, I think that becomes a dissatisfier for your patients very quickly. If they have the perception that, "They really can't see anything. They can't help me with anything," I think that deters patients from continuing to utilize the program. So, having a very defined list of illnesses or ailments that you're caring for, advertising appropriately is really important so consumers know what to expect. The other piece is to ensure that your computer-based program by which the consumer links to a virtual visit needs to be very easy. It needs to be quick and it needs to be very simple for the consumer to navigate through.

Bush: Well, Erin, thanks for your time today.

Powell: You bet. Thank you.

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