How redesigning the patient journey will save lives during COVID-19 and beyond
The COVID-19 pandemic has pushed America’s healthcare system and society to adapt at remarkable speed. Change that usually would take years has occurred seemingly overnight.
Medical staff have developed creative care approaches in the moment, local governments have helped create entirely new treatment spaces in days, and patients have instantly rethought how they engage their providers.
Just as the pandemic has illuminated the courage and ingenuity of healthcare staff, it’s also revealed a need to rethink the patient journey. As we’ve fought COVID-19 with social distancing, we’ve seen that navigating healthcare spaces and understanding the appropriate venues for care isn’t always intuitive to patients. As just one example, consider how patients often rush straight to Emergency Rooms (ERs) when they have any alarming symptoms. This reality leads to overcrowded ERs like those we saw across America in March and accelerates spread of any virus.
As our healthcare system emerges from this crisis and moves from reactive efforts to proactive measures, redesigning the patient journey should be a key focus. It can help limit the spread of COVID-19 should additional spikes occur later this year, and will also help us limit the spread of both common and new viruses into the future.
Here are three strategies healthcare can advance to reshape the patient journey and inseparably fight future outbreaks:
Sustain telehealth’s momentum
Even as Telehealth’s popularity grew with providers in recent years, it still lacked mainstream patient acceptance before the COVID-19 outbreak. While certain population groups (the elderly, those in rural areas) found it extremely beneficial, most patients still preferred to leave their homes and venture to a doctor’s office, clinic or urgent care center.
With the spread of COVID-19, telehealth became a necessary lifeline for all patients essentially overnight. Whether stricken with mild COVID symptoms, sore throats or mental health needs, the best way to receive care during the pandemic has been virtually. Serving as the first line of care for patients, telehealth has been a massive tool for fighting further virus spread.
“It’s really remarkable,” said Juliet Rogers, president of Blue Cottage of CannonDesign. “Providers have been promoting Telehealth for years and just like that, it’s widely accepted. It shows these massive behavior changes are possible. Now we’ll have to see if they’re sustainable.”
Health systems should embrace this patient behavior change and encourage it to certain extents even after the COVID-19 pandemic has resolved. If Telehealth becomes more normalized for American patients, we’ll be able to reduce cost of care, ease health staff burnout, limit the spread of more common viruses like seasonal flu, and keep EDs less crowded if new COVID strains emerge in the future.
Revamp how patients wait for care
Rewind two months back, step into most any care setting in the country, and you’d be sure to find waiting rooms full of people sitting less than six feet apart as they wait for their appointments. This seemed natural in February 2020, but today we’d be alarmed at the lack of social distancing.
Given the technology available and all we know about how disease can spread, there’s no reason not to rethink these spaces moving forward. Here are different possibilities:
No-wait zones: Health systems like Minnesota Health (M Health) have significantly reduced the number of waiting areas in their buildings. In M Health’s Clinics & Surgery Center, public areas are designed more like retail settings, and everyone who enters the building is equipped with Radio-Frequency Identification (RFI) badges. This empowers patients to move throughout the building as they wait, finding areas they can have personal space, privacy and comfort.
“The Clinics & Surgery Center was an opportunity to create a new vision for how we want to provide healthcare in the future,” Mary Johnson, COO of the University of Minnesota Physicians said. “We didn’t want to be limited by past precedent or current technologies, workflows or payer models.”
Socially distant waiting areas: Even more traditional waiting areas can be rethought to allow for distance between patients. Queen of the Valley Health in California is currently creating an emergency department with lounge space immediately outside exam rooms for only up to four patients at a time. This helps break patients into clusters and could limit the spread of germs and infection.
Segment patient flow: Systems like Northwell Health have relied on “super-track” patient flow models in their EDs to gain operational efficiencies in recent years. These models rapidly split patients with low-acuity needs from high-acuity patients. A “super-track” ED features a mix of open treatment bays and flexible treatment rooms, sub-waiting areas, and vertical waiting patient positions along with interview and consultation rooms. While these models have gained popularity for their operational benefits, they will also naturally reduce the spread of viruses by keeping patients separate. Northwell’s “Super-Track” has reduced “door to doc” time for patients between 30-40%.
Don’t shy away from mobile or modular experiences
As numerous health systems and states have opened drive-through COVID-19 testing centers over the past month, there’s been this sense that these are temporary solutions. But, maybe they should have more permanence.
The benefits of drive through testing – keep possible sick patients in their cars, better protect healthcare staff and other patients, general convenience – are just as relevant during a normal flu season. What downfalls would there be to offering drive-through flu shots?
Even after COVID-19, it will be hard for health systems to stockpile all the possible resources they may need during future pandemics or other emergencies. Knowing this, they’ll seek out highly adaptable real estate that can serve multiple purposes. Any space that can deliver ongoing value and equip providers to best respond during a crisis will be especially valuable.
Health systems will also probably look beyond drive-through settings to other modular environments that can help control COVID-19, and other infectious diseases going forward. Portable modular testing units may be an answer, particularly in dense urban areas that have seen high infection rates. A walk-up testing booth could both protect healthcare workers and test a large number of people safely, a concept we’re fleshed out in concept drawings.
Every virus the world faces is its own unique challenge, but they all spread through some form of human contact and interaction. This reality should motivate health providers to embrace how design can help them inherently redesign patient journeys for increased social distancing. Measures like those listed above won’t stop a pandemic dead in its tracks, but they are essentially pre-engineered ways to reduce spread and save lives this November, next flu season, and during any future epidemics.