Peter Wehrwein, senior editor at Managed Healthcare Executive, spoke with Lisa Griffin, senior vice president of front-end operations at Jefferson Health in Philadelphia, about the pivot to telehealth, "seamless access" and racism.
Here are some excerpts from our interview with Lisa Griffin, vice president of front-end operations Jefferson Health. They have been edited for length and clarity.
On the pivot to telehealth
We were actually able to pivot very quickly because we had been scheduling telehealth visits. Telehealth has been a part of a patient's choice. So patients had choices of in-person and telehealth our schedulers had the ability to give those patients those choices. Not to the scale that we moved to because of COVID-19, but it has always been a part of our normal scheduling.
We had physicians internally that had already been trained, and they were already seeing patients, but that was happening in another arm of our organization, Jeff Connect, that outside of our employee physicians. So we ended up just flipping that (Jeff Connect) model into the same model that we would use with our physicians. So we scaled that up by asking our retired of providers to begin to come back and work with us. Emeritus, retired physicians that were a part of our organization. We reached out to them and then we scaled up using that other Jeff Connect arm. we just had to really scale that up pretty quickly
On making in-person visits safe
We decided early that there were a specific number of patients that had to be seen face to face. And so we had to make sure that those patients felt safe enough to get us and that our operations were safe and that they could come to us. So we spent a great deal of understanding the patient's fears, and things of that nature, and making sure we address them, so we didn't lose those patients.
On not “losing” patients
We had to stop elective surgeries because of requirements. We were forced to do that. So we kept a handle on those patients and actually went through and said, which ones could wait truly wait.
\We kind of went through like a command center and going through these processes with a patient-safety mindset, keeping them safe and not losing them because of the shifts in telehealth and in- person.
So it was pretty intense in the beginning trying to make sure that we kept our pulse on those patients.
On getting reimbursed for telehealth
We had to come together as executives and say, either we're all in or not. We had to not just look at it from single view of being revenue generating. We knew that the implications were there where we potentially could not get paid. And so we had to make those types of decisions very early to say, you know, we're here for this specific reason, and take care of patients and care for people. And we had to make a decision to say that's our guiding principle, our North Star. So, or we look at the revenue, let's make sure we have that as a North Star. And I think that allowed us to guide how we do business from a humanity perspective versus us not being reimbursed. And of course, we know this is a business. So we did keep our pulse on that, keeping those patient visits within our EMR with an identifier.
But we decided that we had to operate with that North Star mentality of caring for people.
On switching patients to telehealth visits
Systematically we had to change in our EMR, so you have the ability to take a regular appointment as a scheduler (and switch it to a telehealth visit). So you could call us, and say, “Hey, I am going to be 10 minutes late for my in-person visit.” And based on what you're coming for, we could say, “Well, you can be 10 minutes late or would you like to switch to a telehealth visit,” Having the ability to be that nimble to flip that was not easy. We had to go through to change our scheduling, making it where the scheduler could do it. We really pressed the issue of saying this needs to be seamless at the scheduler level — seamless for our patients.
People already have angst. And we would be adding to the angst. So we had to really look at this from a patient-centric viewpoint.