Shorter and less hospital stays, less severe and fewer complications and better patient results are just a few metrics used to rank Mercy as one of the top five large health systems in the United States. As in hospitals, Mercy Virtual Care Center teams work 24/7, collaborating in the direct care of people. However, there are no waiting rooms, hospital beds or patients. Under the leadership of dr. Randall Moore, the Mercy Virtual Care Center became described as the “virtual hospital”. We spoke with him about his vision about the future of healthcare, the role of technology and the transformation of Mercy Virtual.
How would you envision the future of healthcare?
Separate healthcare into health and care. Health is what we all desire. Our “highest value care” is often directed at late advanced sickness. The highest value care usually occurs as physician led teams within a hospital approach 24/7 full patient centric care. Underlying Mercy Virtual was our hypothesis that progressively extending and augmenting care within and beyond the hospital would block or slow progression of disease, improving health, and lowering the intensity and costs of care. We believe future value will be optimized by our ability to shift from a provider centric to person centric health system – minimizing people’s time as patients. Progressively filling gaps in preventive care, can enable lifetime, integrated care and health continuums.
“The healthcare system of the future will have the patient at the center of care, but integrated with the person as the center of health.”
Why is it necessary to transform to a health-oriented system?
Simply, our current system focuses most resources of late, reactive, expensive care, failing to realize the potential value in full patient centric care at all times. A system never optimized for advancing chronic disease demands ever increasing volumes of work by medical professionals with burnout negatively impacting all. We need to enhance patient experience, improve population health, reduce costs and improve the work life of healthcare professionals: the quadruple aim. Disruptive technologies enabling innovative solutions allow earlier, higher impact and lower cost care. Virtual care, e.g. can augment and extend care within and beyond the hospital, with promise of 30-50% less care for superior outcomes.
How was Mercy Health able to create the Mercy Virtual Care Center?
Mercy launched its v.ICU solution across the system in 2006. Through board, executive leadership and clinical team support, a 24/7 full team model became the basis for strategic growth. Earlier recognition and treatment of conditions decreased morbidity, mortality and costs of 30% or more. Iterative expansion of the 24/7 model within the hospital and into the home environments center on removing barriers to just-in-time (JIT) care. The core patient centric solutions are evolving and filling gaps within the ICU, hospitalists, sepsis, stroke, transitional care, and a range of ambulatory conditions. Recognizing the growing impact, Mercy Virtual Care Center was opened in 2015 to accelerate collaboration, innovation and quadruple aim impact. Although initially visualized as a new channel of care, the strategy shifted to seamlessly integrate into the fabric of all care.
Value supports growth. Virtual care transforms expert teams from facility based, primarily Monday-Friday care to 24/7/365, where and when needed. Proactive adoption of artificial intelligence adds to team capabilities and impact, diagnosing and intervening earlier. The results: simpler, timelier, health optimization at lower costs.
Which barriers did you had to overcome during the transformation?
The primary barrier was how to develop a sustainable, high value business model. JIT virtual care usually detects and treats conditions earlier, decreasing care needed but natively impacting volume driven stakeholders. Stakeholders wanted to evaluate virtual care as a standalone model, instead of integrated into system care. Further, we needed to show complementary virtual care resulted in superior outcomes. We needed to show virtual care would improve outcomes, lower costs, decrease system demand, while rewarding all participants.
Multiple concurrent operational, technical, human resource, regulatory barriers to operate within and beyond our several state systems required significant investment to maintain 24/7 operations. Further, the requested solutions required new approaches and investment, driving improved team workflows.
And how did you align all the medical professionals and patients within Mercy?
Our approach to reengineering clinical care models and teams relied on the development of a separate entity, building dedicated teams of dedicated physician led interdisciplinary teams. A patient segmentation strategy was used to guide the teams to support our traditional teams in solving problems in care around their most complex patients. Mercy Virtual teams were keenly aware that the degree of improving quadruple aim performance would be proportional to the level of trusting partnership established. Results delivered with early adopters accelerated expanded trust and demand to expand virtual care. We took the time to meet with medical professionals to show them how the added value for them and their patients. In addition, we addressed their concerns upfront to prevent possible resistance.
“Progressively more and more medical professionals would become part of our ecosystem.”
Building trust was paramount for adoption by patients. We believed that starting the patients with the highest needs would also demonstrate the highest impact on individual lives and costs. Consumer facing solutions had to be simple and deliver obvious value in their lives. Working through their current doctors and teams, with assurance that virtual care did not remove any current benefit was particularly important for people with the most disease. Patients could quickly see that our holistic approach to their care and health, with focus on early recognition of gaps in care, and activation of patients and teams alike, combined to block the progression of disease and keep people from becoming patients.
What are potential hazards of the technological developments?
The primary hazard of technology shows when focus is placed on the technology, instead of the problems to be solved and the value to be delivered. Reliable, interoperable, easy to use technology must overcome obstacles to optimizing health and lower costs. Future technology must enable a new ecosystem supporting seamless, frictionless care and health, and add value to evolving workflows.
Experience within Mercy Virtual has reinforced the need for stakeholders to combine our efforts as stewards of our collective care and health.
“The future is not to compete on common tools that should be shared by all, but to differentiate delivery of quadruple aim value.”
