Renton, Washington-based Providence knew healthcare was becoming more consumer-driven and believed that meant digital needed to play a role in how care was accessed and delivered.

THE PROBLEM

Like many health systems, Providence needed to dramatically evolve its digital capabilities not just to meet, but exceed customers' expectations of accessing care where and when they needed it.

"Providence had developed Express Care, our retail medicine and on-demand virtual service, and initially we were thinking about a platform that could help with digital patient-acquisition for that same-day care business, strategically navigating patients to the most appropriate care setting within Providence," said Sara Vaezy, executive vice president and chief digital officer at Providence.

"We needed a digital platform that would fully integrate with all existing IT investments, but allow us to seamlessly shift resources between in-clinic to telehealth visits, ensuring the hundreds of thousands of patients we serve received the care when they needed it," she added.

PROPOSAL

The Digital Innovation Group at Providence was built to help the health system and the industry more confidently adopt digital solutions. It's a group that builds on the insights of our clinical and operating partners to shape, build and scale meaningful digital solutions at one of the largest health systems, then offer them to other health systems.

"With any of those ideas the first question we ask is, 'Does something exist out there that we could buy,' or, 'Is there a partner to work with?'" Vaezy explained. "Early in our consumer-driven access journey with Express Care, the available care options that used telehealth and scheduling technology were beginning to grow, but these solutions were not well integrated and did not consistently deliver better, more convenient, easily accessible care.

"We concluded the solution we had been looking for did not exist on the market, so the Digital Innovation Group began working on one from the ground up," she said. "The solution focused on our own ambulatory care network, and optimized how patients searched for and accessed a clinician at Providence who suited them and had open appointments."

The technology pulled information from Providence's electronic health records and workflow system. In turn, it identified which providers or facilities had capacity to receive new patients, and gave current and prospective patients a choice of locations and appointment times, guiding individuals to the most convenient and appropriate care setting in real time.

"Then COVID-19 hit and put the solution to the test, scaling to meet a 30-times increase in patient-visit volume, allowing Providence to seamlessly shift resources between in-clinic to telehealth visits, getting patients the care they needed at a critical time," Vaezy noted.

"After nearly five years of incubation at Providence, DexCare proved to be an engine that could help propel distributed care forward for not just us, but other health systems as well," she continued. "As a result, we spun it out into the digital health market."

DexCare's core offering is a platform-as-a-service that intelligently orchestrates health-system capacity and digital demand across all lines of care. The DexCare platform automatically allocates, flexes and optimizes health-system resources to best meet both consumer demand and business goals – expanding the reach of all service lines into a new, digital, on-demand consumer arena.

MEETING THE CHALLENGE

The platform attracts and caters to healthcare consumers by providing a fully digitized, unified experience that routes them to their best, most relevant care options while leveraging existing EHR, caregiver and brand investments by linking multiple applications to meet patient needs with real-time demand aggregation and appointment booking across services like primary care, same-day and urgent care, as well as across care modalities like in-person and virtual care.

"The DexCare operating system focuses on all the core functions needed to make digitally enabled care efficient and effective, while providing our health system with the infrastructure needed to deliver this experience," Vaezy explained. 

"More specifically, DexCare's data intelligence capabilities and unique traffic-control technology connected all existing point solutions and disparate processes to create one connected experience by offering a unique combination of access, navigation and optimization."

Vaezy said the system offers:

• Demand aggregation. It attracts health system consumers to digital offerings in two clicks, from internet search to appointment.
• Intelligent navigation. Initially focused on Providence's ambulatory care network, the solution optimizes the process for patients searching for an on-demand provider to find a clinician at Providence that suits them and has available appointments. The platform identifies which providers or facilities have capacity to receive new patients and give current patients and prospective consumers a choice of locations and appointment times, guiding individuals to the most convenient and appropriate care setting.
• Capacity optimization. It automatically allocates resources to meet patient demand where and when those resources can be most productively utilized.

RESULTS

Providence has been able to bring more new patients into the health system, retain those patients and increase downstream revenue from the influx of new patients. Optimizing digitally enabled care offerings enabled the health system to achieve operational, growth and savings goals, while providing a better experience for consumers, Vaezy reported.

More specifically, she said, Providence has achieved the following improvements and results in 2021 with DexCare:

• Improved access to care. Providence increased the percentage of patients scheduling digitally enabled visits via DexCare's ecosystem by 65% – meaning improved access to the health system enabled more patients to seek and receive the care they needed.
• Growing patient population. Newly acquired patients – 30% of the patients coming in through DexCare-enabled Express Care service are net new to the health system. New patient return rate – 30% of them are returning to the health system within a year.
• Increase in revenue and downstream revenue. Approximately 20% cost savings per low-acuity visit – these savings are attained through distributing the workload to the technology in the form of self-service tools, such as digital registration and self-pay. Downstream revenue – incremental 90-day downstream spend of approximately $840 by net new patients acquired into the health system.

ADVICE FOR OTHERS

"In recent years, the available care options that use telehealth and scheduling technology have grown in record numbers, but better, more convenient, easily accessible care has not always been the result," Vaezy observed. "Point solutions often are not integrated well with core-technology infrastructure, such as the EHR, or with each other."

For example, telehealth offerings were not well integrated with in-person scheduling solutions.

"Many other industries have moved to omni-channel models – from retail to banking – the lessons show that integration across modalities, navigation and access matter," she concluded. "As an industry, we have to continue to evolve to meet people where they are so they can access the care they need – and digital is at the center of that experience."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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