Large health systems across the United States are zeroing in on "systemness" as they attempt to compete with digital care providers that brand themselves as one-stop-shops. Integrating care services across the organization can make it easier for patients to navigate offerings, clinics and medical portals -- and many leaders suspect it will lessen referrals to competitors, improving patient retention and driving higher revenue.
But by going all-in on "systemness," health care organizations may be missing out on valuable community partnerships, health system and tech leaders agreed at a recent Newsweek event.
The webinar, "Preventing Chronic Disease Patients From Falling Through the Cracks," took place on February 3. An expert panel -- including Dr. Kevin Pantalone, Cleveland Clinic's Director of Diabetes Initiatives; Dr. Lakshmi Halasyamani, Endeavor Health's Chief Clinical Officer; Dr. Richard Milani, Sutter Health's Chief Clinical Innovation Officer; and Dr. Ricky Bloomfield, OURA's Chief Medical Officer -- spoke to and answered questions from an audience of health care leaders.
Much of the conversation focused on how new technologies can help clinicians maintain more frequent touchpoints with chronic disease patients, allowing them to catch and address warning signs before they escalate into an emergency department visit. However, the discussion took an interesting detour when Halasyamani was asked to expand on Endeavor Health's community partnerships.
Endeavor Health -- the third-largest health system in Illinois, based in Evanston -- has noticed "significant health literacy gaps" within its patient population, Halasyamani said. When the organization started including community health workers as part of patients' health care teams, they found that it was easier to connect with, build trust with and educate certain populations.
The health system has especially seen success with, "patients who are Spanish-speaking or come from a specific background where perhaps they're more comfortable asking those questions to someone who speaks their language or looks like them," Halasyamani added.
And rather than attempting to meet every patient need internally, the system developed a Community Investment Fund to aid organizations that support positive health outcomes. For example, Endeavor works with a number of food banks in the Chicagoland area to ensure that they stock low-sodium foods for people with high blood pressure and healthy options for diabetics.
Halasyamani encouraged other health systems to meet patients in the places they already frequent, rather than attempting to reinvent the wheel.
"What's our opportunity to engage in those environments rather than only waiting for people to come to us?" Halasyamani asked the audience. "Because oftentimes, those community partners are viewed as more trusted by some members of our community."
"We've got large health systems represented on this call, and I think all of us are working towards 'systemness,'" she continued. "But the person in the community doesn't care about the system. They care about their local experience."
Milani, chief clinical innovation officer at Sacramento, California-based Sutter Health, said that Halasyamani was "100 percent spot-on."
Thirty-six percent of Sutter Health’s adult patients have the lowest measurable level of health literacy, according to Milani.
"That's one in three people that walk in our door and [are] getting handouts that they can't possibly comprehend without the help of others," he said. "This is where the community health resources come in to a great advantage, but we need to do a better job of not only assessing [partnership opportunities], but then modifying the information they get [from us] so that it is something they can understand with or without additional help from others."
Bloomfield, chief medical officer at the wearable technology company Oura, noted a growing opportunity for health literacy interventions as "the pendulum shifts [toward] more opportunities for individuals to take a greater role in their own care."
The complexities of a traditional health system -- deciding when to see a specialist versus a primary care doctor, figuring out how to make an appointment, finding a place to park -- can "actually make it hard for a lot of people to be part of the health system at all," Bloomfield noted.
He added that mobile technologies and AI supports can also help patients navigate the health care system.
"We need to do our part to make sure these tools are effective as possible so that someone who might be afraid of or let down by the system has a voice and has an opportunity to get back into the system when they do need care," Bloomfield said,"because we don't want individuals to avoid the system completely if they end up needing surgery or therapy that you just can't get at home."
That point resonated with Pantalone, who leads diabetes initiatives at Cleveland Clinic, and still sees patients himself. Virtual visits have "been a huge help" in meeting patients on their own terms, he said, and AI-powered medical scribes have allowed doctors to better engage with patients who visit their brick-and-mortar clinics.
"The AI scribe has really revolutionized the way that we see patients here at Cleveland Clinic because we can actually start to make those relationships and those interpersonal interactions much more impactful and meaningful," Pantalone said. "We can have that eye contact with the patient and have more of a discussion, and not be so worried about documenting every single thing that the patient is saying."
While technology may make health systems easier to navigate, it's worth considering which parts of the care continuum would actually benefit from digital augmentation -- and which have already been mastered by other trusted institutions, according to Halasyamani.
"Rather than continuing to try to sing the same song," she said,"we should probably just bring that song to that environment with the singer that they actually like or that they trust."