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Michael Carrese: You're listening to inspiring health with Dr. Roxanna Gapstur, President and CEO of WellSpan Health. As she hosts candid conversations about organizational, culture, value, and other pressing issues we face in healthcare and business today, I'm Michael Carrese. And Roxanna, tell me what we're going to be talking about today?

Dr. Gapstur: Michael, today, we're going to talk about the importance of understanding what consumers want and need from healthcare. So delivering products and services and experiences to exceed expectations of our consumers, particularly in a post COVID-19 world through digital innovation.

Host: And who's your special guest?

Dr. Gapstur: Today, Kyle Letner Director of Connected. Health at WellSpan is here with us.

Host: Welcome Kyle.

Dr. Letner: Thanks Michael Roxanna. It's good to see you and I'm happy to be here.

Host: So let's start off with a definition of terms here, digital innovation. What does that mean to you with Roxanna?

Dr. Gapstur: Well, here at WellSpan, we think innovation starts with our organization's culture and that it's actually a discipline that we create to think about re-imagining healthcare and it it's a game changer for us Michael. We want to simplify healthcare to make it easier to inspire health for our patients, consumers and communities. And one of the most impactful ways we're doing that is through the use of technology. Particularly with the pandemic we found, it was not only convenient to serve patients in new ways, in their homes, by video and phone visit. It was also essential to transform our entire way of doing business, to continue providing the safest care for our patients.

Host: So Kyle, what's your take on innovation being a discipline?

Dr. Letner: Yeah, innovation is really a discipline that blends people, process, and technology in new combinations to generate the most value and that innovation culture puts us in the driver's seat of change. I mean, we recognize that we are all consumers of healthcare, and so much has changed in how people consume healthcare. So we need to constantly ask ourselves what if healthcare looked like other industries you think about retail or hospitality, banking or transportation and how those industries have just been transformed over the past couple of decades, you can do so much from your mobile phone or your computer now in each of those places. So we're asking what experiences are we having as consumers in other spaces that might lead to innovations within our own organizations? One quick example was the drive-through COVID testing sites that we created as a response to COVID when it reached South central Pennsylvania, we quickly created these drive-through services like you see in these other industries. So we could quickly and safely provide testing to anybody in our communities. Many people will gravitate towards technology based innovations, but I think digital tools are simply innovation enablers.

Host: Right. So let's talk about digital tools and how they can enable innovation. What was WellSpan's digital health landscape before COVID and then how would you describe it changing in this last couple of months?

Dr. Letner: We have a long offer digital health and telemedicine options to our patients, everything from fully checking yourself into an appointment on your phone, to an award winning app for radiation oncology patients to manage their care. But the latest news is how the in just six weeks, we were able to scale our digital offerings from about 200 patient visits per week to about 20,000 visits per week. This is accounting for about half of our outpatient visit volumes. Now we now have video and phone visits across all 400 of our WellSpan primary, specialty, and behavioral health practices. It's just remarkable because in early March, before COVID-19 reached South Central Pennsylvania, there was only six practices providing care this way. We've also ramped up our use of WellSpan online, urgent care as another way for patients to be seen by a provider without needing to leave their homes. We even distributed iPads to homeless shelters with free internet access, to reach even more members of our community who still needed care during the pandemic. Online access to care is not always about creating the next level and convenience. We are also looking for ways to remove barriers to care. We've taken care of patients from four days old to 98 years young with our digital health tools. It has spanned the population and has been really well received.

Host: That is just remarkable and a huge amount of change. So how did you manage to do it?

Dr. Letner: Yeah, it's, it's been a great story, but we deployed all of this stuff through a few people based tactics. So we empowered each of our practices to identify their most tech savvy people. So this is the staff or the physicians for whom connecting to their family or friends via video is just second nature. So we asked those people to champion video visits for their practices and with their team members and with our patients, these change champions were supported by a core team about a dozen people that created a comprehensive self service training website. They host a daily video Q and A sessions and provided on demand support, but it was the thousands of physicians, advanced practice providers and other team members that were committed to using new workflows, being patient with the technology and being willing to try new ways of connecting with our patients. Innovation can be enabled by digital tools, but transformation like this as about the people and all these people were United by a shared desire to care for our friends and neighbors in new ways.

Host: That's really just an incredible transformation in a really short amount of time, but it didn't happen overnight, right Roxanna?

Dr. Gapstur: You're right, Michael, maybe the most important point of our discussion here today is that innovation doesn't happen overnight. It's really a discipline that we've been working on for quite some time here at WellSpan. It's called out as a strategic priority in our 2025 plan and in our vision, which States that we're trying to reimagine healthcare. We know the phrase disrupt yourselves, or you'll be disrupted. We had this culture that started when COVID-19 changed the way all of us looked at everything. It disrupted us for the better, in this sense, serving as a springboard for convenience and high quality care, it's a way to provide greater value in our patients and providers have really taken to it. It's been really heartening to see how people have been willing to try new things during this time.

Host: Yeah, I'm sure. So value, I know it was one of your focus areas for listeners new to inspiring health. How do you define value?

Dr. Gapstur: Value to us at WellSpan is delivering the highest quality care with the best experience at an affordable price. We've spent a lot of time building strategies from consumer research and industry insights. And we've also had partnerships with organizations who share our vision and collaborate with us to bring those ideas to life. And some of our partners include capital blue, cross Highmark and CVS. We know consumers want better access to physicians and services help navigating the care delivery system, tech enabled solutions for care, where, and when they want it and lower out of pocket costs and more cost predictability. When we apply this innovation mindset, we can reduce the total cost of care and keep people healthier.

Host: So Kyle, what programs and services have you launched that have reduced the total cost of care and kept people healthier?

Dr. Letner: Yeah. In the last a year and a half, I'd say we launched several new digital health programs. I'll just talk about a couple. So 300 women are now using Madeline RX, which is a new online option for home delivery of birth control prescriptions. It's an ultra convenient customer experience and it's backed by our WellSpan providers and pharmacy. Our new Livongo platform is another, it allows disease management coaches to connect with patients remotely to send them personalized timely health messages, to better manage conditions like diabetes and hypertension. I've actually seen this in action and a very high or very low blood sugar reading triggers, an immediate phone call from a diabetes educator to check in on the patient. I have a parent that lives alone with type two diabetes, and I would love to have the peace of mind knowing that someone's going to know right away, if anything was going wrong. A third very recent addition was created as a response to COVID.

We added a component to my WellSpan called Care Companion that allowed patients tested for COVID to log their symptoms and connect directly to a team of nurses if they had questions or symptoms were worsening. We then extended this digital interaction with our patients to offer mental and emotional health support as well as open the door for difficult conversations like those around advanced care planning. All of these things are in addition to the online platforms for primary care and urgent care that I talked about before, where we saw the 100 X and 1000 X growth in appointments, providers, and practices providing care online over the last couple of months. But it's not just about the quantities. There's some remarkable clinical innovations happening too.

Host: And Roxanna, we've talked about some of those before. What's new, what are the latest advancements happening in the clinical space using tech?

Dr. Gapstur: Well, this is an area that I get really excited about, Michael. Our cardiologists are some of the best in the world here at WellSpan, and they're consistently presenting information nationally and internationally, and they're proctoring procedures around the country. And they've led some incredible innovation during COVID. With travel bans in place, our cardiologists remained here in central Pennsylvania, but of course others wanted their expertise. So through technology, they leveraged some innovative remote video capabilities to provide critical cardiac care during the pandemic. They were among the first to use a technology that's called avail med systems, video technology, and it allowed them to collaborate with other physicians during really complex cardiovascular procedures. They were able to offer real time support during live procedures that were taking place at another hospital in a whole different part of the country, through state of the art cameras and real time advice while the patient was on the operating table, it safely added the support of a second set of eyes from our expert physicians in the middle of these complex procedures, even from afar.

Another clinical advancement that we just were recognized for here at WellSpan is the prestigious John M Eisenberg Patient Safety and Quality Award. This is a national award and it's one of the most coveted in healthcare. This award was given to WellSpan for our sepsis central alert team who earned the award for successful interventions that are making care safer. A group of registered nurses with critical care and emergency medicine experience continuously monitor patients for signs of sepsis at all five of our well-spent acute care hospitals. The nurses are in a remote bunker and the team is notified when WellSpan's electronic health record detect symptoms of sepsis in a patient's vital signs. When they hear these alerts, or notice a marker, the central alert team can directly contact the patient's care team. So it's really a marriage of real time, electronic healthcare data, and a highly skilled clinical team, powerful combination that results in WellSpan having some of the best survival rates for sepsis in the country. We've saved an estimated 350 lives through this program because it dramatically shortens the time that it takes to respond to these sepsis cases and provide the lifesaving medications. On average early identification and screening times are shortened from 67 minutes to 12 minutes. So it's a huge difference. And as a result, the percentage of WellSpan patients who received timely, effective sepsis care is much better than State and National averages.

Host: That's just remarkable. And Roxanna, let me stick with, as you are scanning the healthcare industry, what do you see coming next?

Dr. Gapstur: I see that we're just getting started with the value we can generate through digital innovation. COVID-19 has really accelerated the pace of healthcare transformation in the last few months. I think we'll see lasting impacts to our care delivery model, which will improve experience. It will help patients stay safer and it will be more affordable. How all healthcare systems respond to this new normal of consumer expectations will certainly define organizational credibility and future success.

Host: Right. So let's wrap up here with one last question for each of you. So how can leaders drive innovation in their organizations?

Dr. Letner: Yeah, I think it's important that we acknowledge that innovation may be intimidating for some, because inherently it involves change and change can be hard, but change is inevitable. Just look at the healthcare industry, especially now all leaders can be innovators though. One really practical method for this is to take some time to dream about what if healthcare looked like, and then pick your brand Southwest or Lyft or Airbnb or Panera. What experiences have you had that you would want to model in healthcare? Many will gravitate towards tech ideas, but teams should also think about how to use people and processes in new ways to generate the most value

Host: Roxanna, how can leaders drive innovation in your mind?

Dr. Gapstur: In my mind, Michael, it's really all about culture. What we saw in the response to COVID-19 and our organization was that solution after solution by our teams that were closest to the work is really who got it done. We seize those opportunities that were made available to us. And I think that's a really valuable lesson. If you haven't done the cultural work in advance, you might not be able to take advantage of opportunities when they come along. And I think Kyle described the secret sauce earlier when he started with people. From our operational leaders to all of our care teams on the front lines, we empowered our team members with knowledge about why it was important and how they could each play a role in our transformation. And they did not disappoint, this is what innovation is all about. Really changing our people and processes to create new value.

Host: Absolutely. Well, it's really been very interesting conversation about innovation and putting people first. I want to thank both of you, Roxanna and Kyle for joining us and providing those insights.

Dr. Gapstur: Sounds great. Thank you, Michael. It was great to be here.

Dr. Letner: Thanks Michael. Thanks Roxanna for the opportunity to be here.

Host: You've been listening to Inspiring Health with Dr. Roxanna Gupstur, president and CEO of WellSpan Health. She hosts candid conversations about organizational, culture, value, and other pressing issues we face in healthcare and business today. Thanks for listening. And I hope you'll join us again.