– AVIA, a healthcare innovation network comprised of 50+
health systems and other healthcare stakeholder groups, today announced that
Geisinger, Presbyterian Healthcare Services, and OSF HealthCare have renewed or
expanded their partnerships with the organization to accelerate digital
transformation within their individual systems.
– While hospital spending has steeply declined due to the
COVID-19 pandemic, today’s announcement indicates that AVIA Members value the
Network’s shared learnings and rely on AVIA’s unique service model to better
understand new markets and select/scale digital solutions.
While hospitals and health systems across the country face
tremendous financial pressures and declining consumer confidence, AVIA Network
Members continue to lead healthcare toward practical, impactful, and
transformation. AVIA is the nation’s leading digital
transformation partner for healthcare organizations. Through renewed and
expanded partnerships with Members and new initiatives underway with consulting
clients, AVIA sees strong momentum across the country in the
strategic moves powered by digital.
This momentum is accelerated by AVIA’s differentiated
service model. Unlike other services firms, AVIA enables sustained
results through its membership insights and customized support. Insights are
distilled and delivered to Members from AVIA’s deep expertise coupled with
long-term relationships and understanding of where health systems are acting.
a nationally-renowned leading health system in innovation, renewed their
membership in the AVIA Network. “At Geisinger, we’re constantly
seeking new ways to improve care for our patients, our members, and our
communities,” said Dr. Karen Murphy, Executive Vice President, Chief Innovation
Officer, and Founding Director of the Steele Institute for Healthcare
Innovation. “In AVIA, we’ve found a partner to help us operationalize and
accelerate our innovation efforts.”
In the next chapter of Geisinger’s AVIA membership, the two organizations will work closely together in support of the Steele Institute’s Digital Transformation Office (DTO). With a charge that includes purview over advanced and predictive analytics, informatics, software development, experience strategy, product design, and product management, Geisinger will prioritize their key capabilities with AVIA’s support. AVIA will help the DTO team assess the market for digital solutions that enable these capabilities, and accelerate technology selection and deployment.
Expanded partnership and tailored support
Presbyterian Healthcare Services was
looking to innovatively improve how they digitally serve their patients, to
extend support both locally and to remote communities through telehealth and
innovative models of care. In a time of great uncertainty, Presbyterian wanted
to partner with an organization they trusted to catalyze the work, and chose to
partner with AVIA.
“AVIA knows us, and they’re already an extension of my team. The support they provide goes beyond what a traditional consulting firm would provide, because they have an active membership of like-minded health systems, and are gaining real-time insight into what other organizations are doing successfully, and where there are roadblocks. This sets us up to innovate effectively and with speed, especially during unprecedented times,” said Ries Robinson, Chief Innovation Officer at Presbyterian.
HealthCare engaged AVIA to assess the opportunity for
digital technology across the system to inform their operational and transformational
activities in support of current year financial targets. Specifically, AVIA mobilized
and assessed OSF stakeholders to identify where AI and robotic process
automation could enable Mission Partners to more meaningfully contribute to the
Ministry as well as support a sustainable cost structure for the system. In the
next phase of work, AVIA will develop a prioritization framework and
make final recommendations to the OSF executive team.
AVIA furthers its Members’ insights through tailored support that provides strategic advice for action, grounded in what is possible, not theoretical. “It has been exciting to see health systems both embrace digital and AVIA’s service model. Through membership, we’ve been able to offer a combination of market research, advisory support, and peer collaboration,” said AVIA’s Chief Product Officer, Eric Jensen. “This unique mix is helping our members to move faster.”
Living through a pandemic is stressful and anxiety-inducing. Stay-at-home measures are compounding this stress, resulting in social isolation and unprecedented economic hardship, including mass layoffs and loss of health coverage. Fully understanding the impact of these pernicious trends on overall mental health will take time. However, precedents like the Great Recession suggest that these trends are likely to worsen the conditions driving suicide and substance-related deaths, the “deaths of despair” that claimed 158,000 lives in 2017 and contributed to a three-year decline in US life expectancy among adults of all racial groups.
Even before the emergence and spread of COVID-19, the US was experiencing a behavioral health treatment crisis: 2018 data showed that only 43% of adults with mental health needs, 10% of individuals with SUD, and 7% of individuals with co-occurring conditions were able to receive services for all necessary conditions.
The treatment gap is staggering, and COVID-19 is exacerbating it: an estimated 45% of adults report the pandemic has negatively impacted their mental health, to say nothing of the disruption of essential in-person care and services. In a similar vein, a recent CDC report has highlighted the staggering and “disproportionately worse mental health outcomes, [including] increased substance use, and elevated suicidal ideation” experienced by “younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers.”
Consistent with the CDC report’s findings, the crisis can be felt most acutely by the very workforce that must deal with COVID-19 itself. Hospitals, health systems, and clinical practices – together with other first responders – comprise the essential front line. They bear the burden of their employees’ stress and illness, and must also cope with the many patients who present with a range of mental illnesses and substance use disorder (SUD).
But providers don’t have to face this burden alone: numerous behavioral health-focused digital solutions can support providers in meeting their most urgent needs in the era of COVID-19. Many of these solutions have made select services available for free or at a discount to healthcare providers in recognition of the immense need and challenging financial circumstances. Some solutions also help systems take advantage of favorable, albeit time-sensitive, conditions, enabling them to lay the foundation for broader behavioral health initiatives in the long term. Several of these solutions are described below, in the context of three key focus areas for health systems.
Focus Area 1: Supporting the Frontline Workforce
Health system leaders need to keep their workforces healthy, focused, and productive during this period of extreme stress, anxiety, and trauma. Providing easily accessible behavioral health resources for the healthcare workforce is therefore of paramount importance.
Health systems should consider providing immediate, free access to behavioral health services to employees and their families and consider further extending that access to first responders, other healthcare workers, and other essential services workers in the community.
Many digital product companies are granting temporary access to their services and are expanding their offerings to include new, COVID-19-specific modules, resources, and/or guidance at no cost.
Fortunately, the market is rife with solutions that have demonstrated effectiveness and an ability to scale. However, many of these rapidly-scalable solutions are oriented toward low-acuity behavioral health conditions, so it is important that health systems consider the unique needs of their populations in determining which solution(s) to adopt.
The following are several solutions to consider:
Online CBT solutions. These tools are being used to expand access to lower-acuity behavioral health services, targeting both frontline workers and the general population. MyStrength, SilverCloud and others have deployed COVID-19-specific programming.
Text-based peer support groups. Organizations are using Marigold Health to address loneliness and social isolation in group-based chat settings, one-on-one interactions between individuals and peer staff, and broader community applications.
Focus Area 2: Maintaining Continuity of Care
As the pandemic continues to ripple across the country, parts of the delivery system remain overwhelmingly focused on containing and treating COVID-19. This can and has led to the disruption of care and services, of particular significance to individuals with chronic conditions (e.g., serious mental illness (SMI) and SUD), who require longitudinal care and support. Standing up interventions — digital and otherwise — to ensure continuity of care will be critical to preventing exacerbations in patients’ conditions that could drive increased rates of ED visits and admissions at a time when hospital capacity can be in short supply.
In the absence of in-person care, many digital solutions are hosting virtual recovery meetings and providing access to virtual peer support groups. Additionally, shifts in federal and state policies are easing restrictions around critical services, including medication-assisted treatment (e.g., buprenorphine can now be prescribed via telephone), that can mitigate risky behavior and ensure ongoing access to treatment.
The use of paraprofessionals has also emerged as a promising extension of the historically undersupplied behavioral health treatment infrastructure. Capitalizing on the rapid expansion of virtual care, providers should consider leveraging digital solutions to scale programs that use peers, community health workers (CHWs), care managers, health coaches, and other paraprofessionals, to reduce inappropriate hospital utilization and ensure patients are navigated to the appropriate services.
The following are several solutions to consider:
Medication-assisted therapy (MAT) via telemedicine. These solutions provide access to professionals who can prescribe and administer MAT medications, provide addiction counseling, and conduct behavioral therapy (e.g., CBT, motivational interviewing) digitally. Solution companies providing these critical services include Eleanor Health, PursueCare, and Workit Health.
Behavioral health integration. Providing screening, therapy, and psychiatric consultations in a variety of care settings — especially primary care — will help address the increased demand. Historically, providers have had difficulty scaling such solutions due to challenging reimbursement, administrative burden, and stigma, among other concerns. Solutions like Valera Health and Concert Health were created to address these challenges and have seen success in scaling collaborative care programs.
Recovery management tools for individuals with SUD. WEConnect Health and DynamiCare Health are both offering free daily online recovery support groups.
Focus Area 3: Leveraging New Opportunities to Close the Treatment Gap
As has been widely documented, the pandemic has spurred unprecedented adoption of telehealth services, aided by new funding opportunities (offered through the CARES Act and similar channels) and the widespread easing of telehealth requirements, including the allowance of reimbursement for audio-only services and temporarily eased provider licensure requirements.
Tele-behavioral health services are no exception; the aforesaid trends ensure that what was one of the few high-growth areas in digital behavioral health before the pandemic will remain so for the foreseeable future. This is unquestionably a positive development, but there is still much work to be done to close the treatment gap. Critically, a meaningful portion of this work is beyond the reach of the virtual infrastructure that has been established to date. For example, there remains a dearth of solutions that have successfully scaled treatment models for individuals with acute illnesses, like SMI or dual BH-SUD diagnoses.
Health system leaders should continue to keep their ears to the ground for new opportunities to expand their virtual treatment infrastructure, paying particular attention to synergistic opportunities to build on investments in newly-developed assets (like workforce-focused solutions) to round out the continuum of behavioral health services.
COVID-19 has all but guaranteed that behavioral health will remain a major focus of efforts to improve healthcare delivery. Therefore, health systems that approach today’s necessary investments in behavioral health with a long-term focus will emerge from the pandemic response well ahead of their peers, having built healthier communities along the way.
About Victor Siclovan
Victor Siclovan is a Director on the Medicaid Transformation Project at AVIA where he leads work in behavioral health, chronic care, substance use disorder, and Medicaid population health strategy. Prior to AVIA, Victor spent nearly 10 years at Oliver Wyman helping large healthcare organizations navigate the transition to value-based care. He holds a BA in Economics from Northwestern.