COVID-19 has upended essentially every sector of the economy, and none more so than healthcare. Healthcare leaders from across the United States share their experiences with disruption and innovation in responding to the COVID-19 crisis in the Fall 2020 issue of Frontiers of Health Services Management, a publication of the American College of Healthcare Executives (ACHE).
This journal is published in the Lippincott portfolio byWolters Kluwer .
Leaders at Montefiore Health System in the Bronx, New York, describe a process of "creative destruction" leading to accelerated innovation - especially in terms of rapidly ramping up digital health capabilities.
"In this new reality, digital innovation is fundamental for healthcare organizations as they make their transition into recovery," according to the article by Montefiore vice president and chief of staff Jeffrey B. Short and associate vice president and patient access transformation officer Adrin Mammen, FACHE. The theme for the new issue of Frontiers is "Response and Recovery: Healthcare Navigates the COVID-19 Pandemic."
COVID-19 'can serve as the catalyst for digital innovation' in healthcare
As New York saw its first cases of COVID-19, Montefiore leadership realized they would soon face an exponential growth rate, leading to shortages of hospital and ICU beds.
Citing the classic theory of market disruption and resulting innovations, Mr. Short and Ms. Mammen write, "In this state of uncertainty, the invisible hands of the changing market economy drove Montefiore to pursue creative destruction and accelerate innovation."
"Driven by the virus, we quickly put new ideas into practice," the authors write. Leadership established an incident command structure, providing agility to make decisions and react to challenges.
Resources were placed under central command; spaces throughout the Montefiore system were swiftly converted for inpatient use, doubling physical capacity.
Faced with disruption of normal care, leaders rapidly implemented a digital innovation program. An artificial intelligence (AI)-based, coronavirus-specific chatbot was introduced, leading to more than 18,000 engagements within 30 days.
Within weeks, the chatbot was extended to inquiries other than COVID-19.
Amid this new sense of urgency, innovations that would typically have taken many years to operationalize at Montefiore have been completed in a matter of days."
Jeffrey B. Short, Montefiore Vice President and Chief Person, and Adrin Mammen, Associate Vice President and Patient Access Transformation Officer, FACHE
Responding to plummeting in-person visits, leaders designed and implemented a new telehealth solution. This became especially valuable as it was apparent that patients remained hesitant to make appointments, even after in-person visits resumed.
Before the pandemic, Montefiore had no telehealth program; by April, more than 80 percent of visits had shifted to telehealth.
These lessons in accelerated innovation have important implications for the "new normal" in a post-pandemic world. Montefiore leaders have established a new tele-ICU command center, inpatient consultations via telehealth, real-time performance management, and extension of AI as an essential decision-making tool.
"As the barriers of the past come down, Montefiore is embracing creative destruction," Mr. Short and Ms. Mammen conclude. "As a result, the excitement of digital innovation permeates the entire organization."
The COVID-19 pandemic "continues to demonstrate healthcare's vulnerabilities and is a force with such strength that it affects all aspects of care," according to an introduction by Frontiers editor Trudy Land, FACHE. She adds: "It is imperative for organizations to move forward from a precarious state and develop stronger systems for their communities."
The COVID-19-themed issue presents reports from leaders at nine healthcare organizations across the United States - from large healthcare systems like Montefiore serving a population of millions in New York City, to a regional healthcare corporation serving three Native American tribes across 6,000 square miles in Arizona.
Ms. Land writes, "[The authors] share how they are responding to the coronavirus and navigating toward recovery, implementing changes and discovering innovations along the way."
Short, J B & Mammen, A (2020) A Pandemic Application of Creative Destruction in Healthcare. Frontiers of Health Services Management. doi.org/10.1097/HAP.0000000000000093