How OSF's 6 Digital Approaches Handle More than 50,000 COVID Encounters

The Peoria, Illinois, healthcare system turns to digital innovations to better serve patients and protect its employees.

This article appears in the May/June 2020 edition of HealthLeaders magazine. 

As the countdown to COVID-19 began in the state of Illinois, OSF HealthCare rallied its digital assets and prepared them for the surge.

The 14-hospital integrated health system based in Peoria, Illinois, and operated by The Sisters of the Third Order of St. Francis, has a strong commitment to innovation, says Michelle Conger, chief strategy officer for OSF HealthCare and chief executive officer for OSF Saint Gabriel Digital Health. The system had recently rolled out an artificial intelligence (AI) chatbot and piloted a behavioral health app. In short order, these innovations were adapted, and other solutions were devised, to address the challenges of the pandemic.

In the first 31 days of OSF's COVID-19 experience, OSF's digital solutions handled more than 50,000 encounters.

A look at OSF's digital strategy provides a glimpse "into the way healthcare will be delivered in the future," says Conger. "Unfortunately, it came through a pandemic, but it's opening everyone in the system up to what's really possible to meet people where they are at home, and how we can help people stay healthy and navigate the healthcare system in a seamless fashion."

Here are six ways digital solutions are helping OSF address COVID-19.

1. On the Front Lines: The AI Chatbot

In December, more than two months before the first coronavirus case was identified in Illinois, OSF launched Clare, an AI virtual assistance chatbot from San Francisco–based Gyant, designed to triage and help individuals navigate through the OSF HealthCare system. Patients access the chatbot from the home page of the organization's website.

On March 13, as part of the system's digital preparations for the pandemic, the solution was updated to listen to and screen for symptoms of COVID-19, as well as provide basic prevention information. Based on the responses an individual provides, says Conger, Clare asks follow-up questions, such as whether a person has been exposed to others with a positive diagnosis. The resource is continuously updated based on guidelines from the Centers for Disease Control and Prevention (CDC) and the World Health Organization.

At the end of the chat, Clare suggests recommended next steps, explains Conger. This guides patients to the best resource for care and ensures COVID-19 patients are appropriately escalated, if warranted.

Among the primary advantages the AI chatbot provides during the pandemic, says Conger, is the ability to handle a great volume of encounters, enable healthcare professionals to focus on patients who need them most, and protect patients and clinicians from in-person exposure. In the first 31 days after the COVID update was made, Clare engaged in 43,410 chats, according to OSF HealthCare.

2. The Human Encounter: Digital Access to Live Personnel

While the chatbot has become a valuable asset in OSF's COVID response, leaders knew from the outset that connecting to a live person would be an essential component of the plan. Within 48 hours of making that decision, the organization launched a nurse triage hotline, dubbed OSF Knows, says Conger.

The nurses "provide some level of calm and reassurance to community," she says, and help patients determine whether their symptoms require greater scrutiny. If so, these individuals are connected to advanced practitioners—who are located in the same facility with the nurses—for a virtual visit.

During a 31-day period from March 13 through April 21, nurses handled 18,627 calls.

3. No Internet? Sometimes Text Is Best

Another essential component of OSF's digital approach to the pandemic is a free text messaging tool known as COVID Companion. Designed as another approach to educate and triage people who are concerned about the virus, Conger says the messaging solution asks basic questions, then provides tailored information in accordance with recommendations from the CDC and the Departments of Public Health in Illinois and Michigan.

Subscribers receive daily texts with educational tips for preventing or addressing COVID-19, as well as ways to connect with public health resources in their local area.

"The public deserves quick access to the most up-to-date, relevant information for their personal health situations," says Jennifer Junis, senior vice president, OSF Saint Gabriel Digital Health. "The OSF COVID Companion is a simple way to get daily updates delivered straight to your phone."

It is particularly helpful for patients who don't have access to the Internet, says Conger. As of April 21, 2,155 individuals had signed up for the service.

4. Launching a Home Monitoring Partnership With the State of Illinois

Illinois symptomatic residents may never have to leave their home for care thanks to a partnership between the state, OSF HealthCare, and other healthcare organizations. The Pandemic Health Worker Program delivers toolkits to patients' homes, which include a computer tablet preloaded with COVID-related data and an app that connects patients to their health worker, a thermometer, hand sanitizer, and a COVID booklet, says Conger. Twice daily for 16 days, workers conduct digital check-ins via video, chat, or phone to monitor each patient's progress.

Having symptoms is the only criteria for enrollment; a positive COVID test is not required, Conger explains. The program was announced by Illinois Governor J.B. Pritzker on April 11; by April 16, OSF, which serves patients in Central Illinois, was monitoring 405 home-bound enrollees. The health system expects that number to rise to as much as 8,400 individuals each month. Participants can enroll through the state, says Conger, or through the OSF Knows nurse triage hotline.

During an April 11 press conference, the Governor said that the statewide program includes partnerships with other organizations to address residents in northern and southern areas of the state. Pandemic health workers in the central portion of the state work for OSF, but the organization is compensated by the government for its participation, says Conger. Workers were reassigned from areas of the hospital that are experiencing slowdowns due to the pandemic. All workers are supervised by RNs and advanced practice providers.

5. An Elevated Level of Home Care

Certain patients enrolled in the Pandemic Health Worker Program may qualify for the Acute COVID@Home program, which provides an additional level of monitoring, says Conger. This includes those with comorbidities, immunocompromised patients, and those with higher risk profiles, as well as those whose symptoms worsen while still at home. These patients may receive blood pressure cuffs, heart rate/oxygen saturation monitors, and other tools that provide a closer look at the patient's vital signs and status. Registered nurses and licensed providers oversee care of these patients, according to OSF. If a patient continues to decline, they will be referred to a facility for care, she says.

6. A Digital Approach to Behavioral Health

Mental healthcare has also become an essential component of OSF's COVID-19 response, says Conger. Before the pandemic, the organization had piloted a digital behavioral health solution from Boston-based SilverCloud Health, maker of an app that offers users integrated support from a real person, according to OSF HealthCare Behavioral Health Manager Luke Raymond. "The platform has been clinically validated as a viable resource to deliver cognitive behavioral therapy content," he said in a news release, "and we also have a background person who will provide periodic check-ins and reviews and help you if you need connection with a live resource."

To support its own workforce during the pandemic, OSF worked with the company to "help our front-line health care workers dealing with the stressors of the COVID-19 pandemic," said Raymond. SilverCloud "added a specific program for them, which was an important resource to support our employees." On April 20, OSF Ventures, the health system's innovation investment arm, became an investor in SilverCloud Health.