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How can Digital Health Reach Beyond Hospital Systems out into the Community?
Episode 339th June 2022 • This Week Health: Community • This Week Health
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June 9: Today on TownHall, Jennifer Junis, Senior Vice President at OSF Healthcare - OnCall Digital Health talks with Bill about digital health and its impact on health in the community. How does she deal with the challenge of ill-equipped homes for digital health? What potential does she see with asynchronous telehealth visits? What does OSF Healthcare do to impact health in the communities?


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Today on This Week Health.

We do an SMS outreach and ask them to join our health loop and for 30 days they have the ability to be nudged, to ask how by automation, how they're doing and how they're feeling.

And we're starting to see some really great results of that we recently had an 80 year old retired nurse that didn't want to leave after 30 days. She was like, "I want to keep talking to you."

Welcome to This Week Health Community. This is TownHall a show hosted by leaders on the front lines with interviews of people making things happen in healthcare with technology. My name is Bill Russell, the creator of This Week Health, a set of channels designed to amplify great thinking to propel healthcare forward. We want to thank our show sponsors Olive, Rubrik, Trellix, Medigate and F5 in partnership with Sirius Healthcare for investing in our mission to develop the next generation of health leaders. Now 📍 onto our show.

Alright, here we are from the desert again. And I am here with Jen Junis, who is with OSF health. And, you're working on all things virtual for OSF. Tell us a little bit about what you're working on.

Yeah, so I am charged with really standing up our digital health entity within our Catholic healthcare system.

So really looking at waking up every single day of how we are providing digital care across our health system. And.

So why'd you break that out out of curiosity.

Yeah. So our chief strategy officer Michelle, Congar had the vision of really care where I am and took that to our board of sisters to say, unless we put structure and rigor around this, it'll continue to incrementally.

And evolve across our system in project format, as someone's other duties as assigned. My background is as a chief nursing exact, a hospital president. So coming in and really treating digital as its own entity across our system, building the structure vice presidents in charge of each division, a chief medical officer, chief nursing officer building the quality, the final.

The business development was really in that vision.

It's interesting. You brought up business development. It's one of those things. When we start something internally and we say, we're going to, we're going to reach out to employers. We're going to do those kinds of things. We're not wired for that.

It's not like what we normally do. And so standing this up as its own entity gives you potentially. I mean, obviously you have the culture of the sisters. Those are the things, but potentially a different type of culture to, innovate on.

Yeah, that's really why we branded it OSF on-call we were pretty adamant about that consumer facing brand and then also that that could be a brand direct to providers, health systems payers and insurers and employers.

So really thinking about not only building it for our own patients that we serve, but how do we help others that haven't built the infrastructure that we've built.

So when people hear this, they're gonna hear digital health. Virtual. They're going to think immediately tele-health but it's, but it's more than tele-health.

Yeah, I really telehealth is really a small piece is what I would say. I would say a lot of asynchronous, a lot of remote patient monitoring even our acute hospital at home taking care of acutely ill patients in their home, direct from the emergency room. All of those things fall under the umbrella of digital care

while we talk. John Hopkins, but Mayo about their care at home and higher acuity care at home. That's. Because not all homes are set up for it, not all environments. How did you get past that? The challenge.

Yeah, so we really COVID accelerated that. We had capacity challenges in our acute care facilities.

So we started our program by bringing patients out of the hospital. That's right. And we brought, we brought presents patients out so we can get. And, and we learned a lot through that. And then we took a step back when the CMS waiver came out and said, we're actually going to pay you to do this. And we really redesigned it acute care focus to really admit those patients directly from the emergency department.

And so that's really a core list of DRGs, their core conditions social screening of home screaming to get the right patients.

What kind of just out of curiosity, what kind of technology are you putting in.

Yeah, that's a great question. So, we work with a a partner in this space and I think the key piece of it is the redundancy in the home.

So there is certainly ability iPad type device that is able to connect back there's peripherals. So think a scale and, and pulse oximetry, blood pressure cuffs. Those types of equipment, as well as I think a key piece is just that central monitoring of in the command center that we've been able to build in our on-call digital health.

That, so that command center becomes central for a lot of these pieces, I would assume.

Yeah. So the command center really is the 24 7 monitoring that occurs. And then you have to provide that in-home service as well. So we have our providers going into the home, our nurses going into the. Other modalities going into the home, but the core really is around that command center.

So the just, so if people aren't familiar with OSF, your upper Midwest, so give us your geography.

Yep. So, we, our Peoria Illinois base is where our ministry headquarters is. We're 15 hospital system across to Illinois and upper peninsula of Michigan. So in Illinois, we range from, we have.

Uh, Hospital in Chicago all the way down to Alton at the St. Louis border.

So, I mean, I've driven that a fair number of times I used to live in St. Louis went to Chicago for a lot of business. There's a lot of rural in between there obviously St. Louis is a city, even east St. Louis, the city all the way up to Chicago being a city.

But you do have a lot of geography in there. Are these services addressing that outreach to those patients?

Yeah. So we've really been fortunate during the pandemic to learn a lot about our rural communities and how they would interact with us digitally. So we use a hub and spoke type model.

We created community health workers that are digitally enabled and local communities, neighborhoods, our rural geography. And then we've built that clinical expertise in the command center that supports that. So we just partnered with the state of Illinois for Medicaid, transforming. We were awarded $64 million over the next five years to transform Medicaid, to really look at how we digitally can care for our Medicaid population and doing that in our rural and our rural geography.

We're going to learn a lot. So we're just getting started with that.

It's interesting. We heard from one of the panels, we just heard a lot about asynchronous and a lot of times overlooked when we talk. It's so funny when we talk about. It's still the number one modality for tele-health is this phone?

Yes. And asynchronous has a lot of potential that sometimes gets overlooked as we try to, go to the Jetsons. But in reality, a lot of people still text A lot of people still email and those kind of things. So there's asynchronous. Talk about a little bit of what you're doing,

Yeah. Give you an example.

So, we know that hospital readmissions. is A big focus for a lot of health systems. So we deployed to all of our high risk, medium, high risk, medium risk patients that get discharged out at any of our 15 hospitals. We do an SMS outreach and ask them to join our health loop. And for 30 days they have the ability to be nudged, to ask how by automation, how they're doing and how they're feeling, but then also the secret sauce is really that centralized clinical.

team That can then personally outreach as well. If they want to text back and forth, so two way chat. So, and we're starting to see some really great results of that we recently had an 80 year old retired nurse that didn't want to leave after 30 days. She was like, I want to keep talking to you

well, and you can do that with those things like health loop.

I mean, the, technology helps you to continue that outreach. You know, it's interesting. I, I, I used to, when I first came into health, No, it's great that we're making all this healthcare within the buildings really nice, but somebody is got to stop me from eating. McDonald's no offense to the McDonald's.

Shareholders will not, but eating McDonald's is not good for you long term. And it's that, reminder. It's that, Hey, how you doing? And those things it's, it's getting more involved. And so I've talked to a lot of people about how do we increase the number of touchpoints and this virtual model gives us the opportunity to increase those touches.

Not only to extend care, but to, impact health, I guess, are you guys looking at that of how we impact the health of the communities?

Yeah. So we really think about remote patient monitoring on a continuum. And when I think about the lowest touch of remote patient monitoring, it's the work that our community health workers are doing that are screening for social determinants of health.

They're doing that digitally out in the communities that we serve and able to connect. Then those patients to community-based resources, we may not be able as a healthcare system to provide all of those things, but we certainly can build the network and the connection and the trust with those patients so that they do have that connection.

So how, so those partnerships does that fall under your org? You're part of the organization

It does. It does. It's kind of naturally gravitated towards that from the standpoint of, with the pandemic. Really working with the state of Illinois on how we digitally can enable community health workers locally to get patients to the right resources, whether at the, in the beginning, that was really just the worried well and digitally texting with them and an asynchronous visiting with them to.

Calm their fears so that they didn't present to some of our locations. When there, they didn't have a need to, and then really monitoring once disease was more prevalent in our communities with COVID monitoring through pulse oximetry, so they could stay in their homes and not have to be in a facility.

And then what I would say, then just learning all of the social determinants of health, because with all of those, we embedded that. screening So then that forced us to really make those partnerships in the community to say, we've got to do something with this information. We can't just know that you have food insecurities.

We have to figure out where the food pantries are, where, what churches are open on Saturday to get a family that really needs food this weekend when the food pantry is not open.

Yeah. That's fantastic. Well, Jen, I want to thank you for taking the time to share with me great work. I really appreciate it.

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