Just like many healthcare provider organizations across the country, Virginia Hospital Center in Arlington, Virginia, offers patients a multitude of services spanning several floors in multiple buildings that were constructed at different times on varying terrain.

THE PROBLEM

Because of the geography, floors across buildings do not even match up. For example, at Virginia Hospital Center, what is the second floor on one building connects to the third floor on another. Compounding the issue at the organization are three onsite parking structures on different ends of the campus.

Despite best efforts to document directions, patients may end up in the wrong parking garage, then need to make their way across the campus to get to their destination. It's also not uncommon for patients to have two or three appointments on the same day in different departments on different floors of different buildings.

Concierge and staff members always are willing to help patients and guests find their way, but this turns out to be a major patient satisfaction issue. Lessons learned from the organization's COVID-19 experience showed patients are more than willing to adopt technology to make their lives easier.

"The wayfinding portion really has become the hook to get more adoption of our mobile app. The app is a market differentiator for us."

Mike Mistretta, Virginia Hospital Center

As such, Virginia Hospital Center felt that, given the right technology, a mobile app could provide patients directions to the best parking garage for their appointments and guide patients who may need to traverse different floors and buildings across the campus.

PROPOSAL

"We already had a 60-70% patient adoption rate for the Epic MyChart app," said Mike Mistretta, vice president and CIO at Virginia Hospital Center. "Phunware's mobile app leveraged this adoption by including existing MyChart functionality, and provided for wayfinding navigation coupled with Kontakt beacons.

"Leveraging the existing patients with a downloaded app was a great way to assure the functionality would be seen by patients during a rollout, and we saw this as an ideal solution to our wayfinding challenge," he continued. "Phunware also allowed for other integrations and the ability to build out other operational functionality for a more robust solution."

MEETING THE CHALLENGE

Phunware and the Virginia Hospital Center project team created an offering for patients in a single official mobile app.

"It was important that if Virginia Hospital Center were to take up real estate on a patient's mobile device, we wanted functionality to address our immediate need for wayfinding, continue to provide patient portal functionality that was already available to our patients in a mobile app format, integrate with other systems for an enhanced solution, and still allow for growth in the mobile app," Mistretta explained.

Phunware digitized Virginia Hospital Center's campus map and Kontakt beacons enhanced the organization's wireless infrastructure, providing for turn-by-turn directions across floors and buildings.

"The vendor provides home-to-hospital driving directions making use of the native mapping capability on the mobile device – Apple or Google Maps," Mistretta said. "Using Epic's MyChart SDKs, the mobile app provides access to the MyVHC patient portal [and] MyChart branded for Virginia Hospital Center, and incorporates quick access buttons to schedule appointments, request medication refills, send messages to their providers, pay bills and generate cost estimates.

"With extracts from our Cactus system, patients can find provider information when using Find a Doctor," he continued. "Our Geonetric web vendor integrates with the app via an API to display upcoming events and classes so patients and the community at large can register."

Phunware helped staff highlight hospital services for patients. In the coming months, staff will begin using advanced features such as mobile engagement for announcements and dwell-time monitoring.

RESULTS

The mobile app was available at the end of April 2021 on both the Apple and Google Play stores. Adoption of the app has been what Mistretta describes as "amazing." The number of downloads is a metric staff members are tracking closely, since the app works for both existing patients and those in the community who may have never been patients in the health system.

To date, Virginia Hospital Center has seen nearly 1,000 downloads a week. This app serves as both the digital front door and access to care.

"We also are tracking metrics on the number of times the quick access buttons are used," Mistretta noted. "Each time a patient uses a quick access button, this is one less phone call to a call center, department or physician's office. This allows our staff to spend more time on the phone with those who may require specialized attention to get their needs met.

"Another important metric revolves around Find a Provider and Find a Service," he continued. "This lets us know which providers and what types of service are in demand, and hopefully anticipate growth areas."

Ultimately, Virginia Hospital Center views the app and wayfinding as a critical piece of its patient engagement strategy that helps drive satisfaction and ultimately HCAHPS scores.

"We also have had tremendous feedback from vendors and new employees who are pointed to the wayfinding portion of the app to find their way on campus," he added. "The wayfinding portion really has become the hook to get more adoption of our mobile app. Performing the initial download allows patients to ultimately use other functions like schedule appointments, receive results, find providers and much more. The app is a market differentiator for us."

ADVICE FOR OTHERS

No matter how great an app is, healthcare organizations cannot assume, "If you build it, they will come."

"Our success would not have been possible without promotion," Mistretta advised. "Our marketing team has done a tremendous job in creatively highlighting the app to our patients and the public. Strategies need to be developed to drive adoption well in advance of the rollout.

"What is your campaign going to look like? How are you going to promote the app?" he continued. "We had emails, mailings, and cards with bar codes sent to affiliated and employed physicians. We even targeted people standing inside and outside of the cafeteria. We talk about it at every new hire orientation. 3-D bar code cards are in every discharge packet promoting the app as the way to get their clinical information."

Do not assume that only Millennials use mobile apps, he added.

"We recently heard from a 77-year old patient who shared with our VHC Foundation president that she uses the app all the time to find her way around the hospital," Mistretta noted. "This is a patient who has always been apprehensive about coming in for services because she would get lost. She now says she doesn't know how she lived without the app when she came onto the campus – and provided a financial donation to our foundation."

Another piece of advice from Mistretta: Engage the entire executive team.

"A mobile app such as the one we have developed has great potential to connect to and engage with patients in so many ways," he said. "Our CEO and my fellow vice presidents have had regularly scheduled meetings since project inception. We cover the specific metrics, including download numbers, in our weekly CEO meetings.

"Our executive team has played an active role in the app's feature/function development, rollout and future planning," he concluded. "It takes sponsorship from the top to ensure this initiative garners the attention required to make this successful."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.