No one can deny that COVID-19 was a shock to the healthcare system and, as any shock, it can be a tremendous catalyst for change, accelerating the development of technology and spurring innovation in care delivery. As part of Healthcare’s Next Act, athenahealth’s recent two-day virtual event on the impact of COVID on the future of healthcare, we discussed some of the ways that the pandemic has changed the pace and focus of healthcare innovation.

Holistic Patient Care

Because the pandemic disrupted in-person visits, it became essential that practices rethink care delivery, and no longer think only in terms of discrete encounters that begins when the patient shows up at the office and ends when the visit is over. It is time to take a more holistic approach to patient care.

At athenahealth, we are seeing many of our customers customize outreach programs by condition, offer patients tools to track health data between visits, and, especially during COVID, focus on risk-stratifying patients to make sure the most critical visits were happening even when offices were largely closed. Others are working to address social determinants of health by putting simulated markets and kitchens in healthcare centers to encourage healthy eating or coaching patients on how to seek companionship to stave off loneliness. Some are creating chat bots to help patients adhere to care plans or screen for depression. A next step might be incorporating biometric data from personal devices to further enhance and customize patient care.

With the right set of digital tools, taking care of patients when they aren’t in the office becomes more efficient and effective. Ironically, it even becomes much more personal

We see this as a way for our customers to differentiate themselves by creating a world class consumer experience for their patients.

Innovations in care delivery

At athenahealth, we rolled out an integrated telehealth product within a matter of weeks, knowing that practices needed a new way to engage with patients. This accelerated development process, which was very different than our normal approach, taught us techniques to innovate more rapidly than we had in the past — and that is proving to be true throughout the industry.

Although telehealth adoption spiked during the pandemic to more than 34 percent of all visits on the athena network, we have seen that number go back down and remain steady at around 10 percent – far higher than the less than 1% of visits pre pandemic.  Telehealth is not going to completely replace in-person visits, nor would that be appropriate. But it's a new vehicle, and it’s going to create new business models, maybe new entrants into the healthcare space, and new ways of making healthcare more convenient for patients while providing more holistic care.

As part of this approach, many large practices are taking on more risk, even fully capitated risk, working with patients between visits to keep them healthy. And many retail establishments are taking a whole patient approach that focuses on convenience, betting that it will lead patients to come in more frequently and get the healthcare they need more effectively.

If you can really drive down costs and improve outcomes, supporting the whole patient by taking on risk can really be a lucrative strategy. COVID showed that value-based care can also be a valuable business diversification strategy. In a fee-for-service world, when patients don’t come in, the practice doesn’t get paid. But that is not the case under value-based care.  So our customers that had value-based contracts actually saw some nice diversification in terms of revenue streams, which was an unexpected dimension to value-based care. 

Reducing work for clinicians and practices

At athenahealth we are working to create technology that is a plus for physicians, to make technology something that physicians cannot do without, rather than something that gets in the way. The goal is to get to the place where the EHR is so tailored, so intuitive, it doesn’t require any physician training. Reducing clicks, tailoring templates for each provider’s specialty and the way they practice,  designing an EHR that understands the way providers think about patients.

We are just beginning to see the impact artificial intelligence and machine learning can have on enabling the EHR — this is a huge investment that is going to pay off for a long time. Right now, EHRs are built to serve up text on the screen and let the user interpret it. But imagine if the computer could understand what those things mean, avoid asking redundant questions, and suggest shortcuts.

We aren’t there yet, but we are making inroads. For example, we are working to enhance our system so that a front desk staff scan an insurance card and our system automatically matches it to the right insurance package in athena. It’s not going to transform medicine, but it will make registering your patients a little easier.

Robotic process automation (RPA) is improving the quality and repeatability of back office services, matching faxes to patients, interpreting explanations of benefits — these are all services athenahealth is offering to our customers to streamline administrative tasks.

We are continuing to invest in our mobile product to continually improve it, such as adding voice enablement.  Following that we plan to move from simple dictation to ambient and virtual assistance capabilities, which will continue to improve provider efficiency.

Most importantly, athenahealth recognizes that improving healthcare is a problem that is bigger than any one company, we know we aren’t going to solve these problems all by ourselves. That’s why we have a truly open platform, with APIs that allow third parties to write software on top of our system.We learn from our partners, continually improving our own offerings. It provides our customers with different capabilities and approaches, and our ecosystem makes the experience completely seamless.

All of these forces of innovation, focused on both the patient and the practice, are moving healthcare in a very exciting direction, and COVID has accelerated that process in a variety of ways. There is no denying this pandemic has been a tragedy, but it may also be an opportunity to build the healthcare ecosystem we need.

Paul Brient is senior vice president and chief product officer at athenahealth. Click here to listen to the entire conversation from Healthcare’s Next Act.