How Providence’s Digital Innovation Team Tweaked Existing Technology to Combat COVID-19

// By Althea Fung //

COVID-19 has disrupted American healthcare — killing more than half a million people, including more than 2,900 healthcare workers; challenging bed and equipment capacity; and canceling elective health services. But it also has sped up digital transformation of healthcare and brought to the forefront innovative approaches to how patients receive care.

Providence, a Seattle-based 51-hospital system with services across Alaska, California, Montana, New Mexico, Oregon, Texas, and Washington state, is on the frontlines of digital transformation. With a dedicated software development team, innovative digital strategies, and more than $300 million to invest in the future of health tech, Providence is battling COVID through technology.

Disrupting from Within

Long before the pandemic, Providence leadership decided it was time to take a swim into the tech pool. In 2014, Providence hired Aaron Martin — a veteran in the tech industry who led the digital revolution in the publishing world when his team at Amazon introduced the Kindle e-reader — to serve as senior vice president of strategy and innovation.

Aaron Martin, executive vice president and chief digital and innovation officer, Providence

“Rod Hochman, MD, our CEO, and Mike Butler, our former president and COO who is now retired, saw two horizons ahead of where they were,” says Martin, now executive vice president and chief digital and innovation officer in charge of digital, marketing, and ventures for Providence. “They saw if we as a health system didn’t disrupt ourselves using digital technology, sooner or later big tech would figure out that healthcare is a massive industry and come in and do so themselves.”

Martin quickly assembled a team of more than 100 software developers from Amazon, Microsoft, and other Seattle-based tech companies. He didn’t stop there.

Martin poached talent from the major tech and strategy companies to build his digital and marketing teams. Later in 2014, he also recruited a group of venture capitalists to invest in innovative companies to improve patient care through technology.

Determined to break the silos that often plague the healthcare industry, Martin ensures his teams work together with clinicians and staff throughout the health system to identify gaps.

“Our digital strategy team works with our clinicians and leadership, as well as talking to leaders across the industry,” he says. “They identify the key needle-movers in digital — big problem areas or big opportunity areas in healthcare. We go through a process to determine if we already have a solution. If not, we go to our Providence Ventures team, and they look for smaller companies that are solving that problem, and we sometimes make investments in those companies.”

Martin adds, “If we don’t have it and we can’t find it, then we’ll actually build the company.” Providence has built two companies:

• Xealth — a service that allows clinicians to prescribe digital tools and services (diet management through the Weight Watchers app or tools to monitor adherence to sleep devices) within the electronic medical record as you would a medication.
• DexCare — a service that helps patients book urgent-care appointments in retail clinics. Providence also incubated a product called Circle, a women’s health platfom, and sold it to Wildflower Health, and is now a customer and investor via Providence Ventures.

Using Digital Technology to Fight COVID

In January 2020, Providence Regional Medical Center Everett treated the first patient in the U.S. infected with COVID-19. Soon after, the health system pivoted care to digital and pointed existing platforms toward patients’ new needs.

Providence also launched a site for developing COVID information that spanned the seven states it serves. Additionally, the software development team launched new capabilities via a chatbot named Grace, which had been live for two years. “We worked with Microsoft. So, in a matter of a weekend, we stood up a new capability that allowed patients to self-assess whether or not they might have COVID,” Martin says. In addition to the chatbot, Providence took its DexCare platform and transformed it to work for its telehealth service.

“Our clinicians were super-busy with patients who legitimately were sick, at risk, and those who were just worried. So after you found out information about COVID and self-assessed using Grace and the bot says you might be at risk, we’d need to see you visually. At that point, we shut down a lot of the clinic access and switched it over to virtual visits because of the lack of PPE,” says Martin. Providence used DexCare to facilitate virtual visits for more than 65 clinics across the state. “Using the DexCare platform, we were able to scale our video visits by 30X overnight.”

For patients experiencing mild symptoms of COVID-19 that didn’t warrant a hospital visit, Providence tapped into Xealth and Twistle, one of its portfolio companies, to prescribe and monitor patients from home. With Twistle, patients would receive a thermometer and a pulse oximeter in the mail. Patients would be prompted via text message to track their temperature and blood oxygen levels three times a day. The platform also allows clinicians to initiate a real-time video call with a patient if necessary.

“This allowed our critical-care nurses to monitor hundreds of patients per nurse, remotely and safely. They had a dashboard so they could see who is in the green, who may be having a problem, and needs a video visit or needs to be admitted to the hospital,” Martin says.

“We stood up all this technology because it had been in place for other use cases. All we had to do is tweak it for COVID,” he adds.

Martin acknowledges that a massive part of why Providence could pull together a strong digital response was because the groundwork was already laid.

“Our response was a combination of the technology we’ve invested in over the past seven years and our close working relationship with our clinical and operations teams. But if this pandemic hit three or four years ago, it would have been much harder,” he says.

Jumping On the Digital Transformation Wave

Martin advises that health systems interested in moving into the tech space need digitally minded leaders. “I was in a panel discussion with Rod Hochman, MD, our CEO. The moderator asked, ‘Rod, who is in charge of innovation at the health system?’ and without skipping a beat, he said, ‘I am.'”

Martin explains that projects can get stalled and inadequately funded if digital innovation isn’t at the top of the CEO’s mind. He also suggests that companies recruit a C-suite-level digital officer, who reports directly to the CEO.

The role of the chief digital officer (CDO) is relatively new but fast-growing. It’s estimated that in 2008, across all industries, there were no more than a dozen CDOs worldwide. A 2017 study by PricewaterhouseCoopers found that approximately 19 percent of top global companies now have a CDO, 60 percent were hired since 2015.

Martin also recommends that health systems talk to one another to exchange ideas and experiences in developing technology. “In the past 24 months, we’ve had close to 150 health systems visit us in Seattle. We trade notes on how to innovate digitally. I always tell my team, ‘You don’t get any extra points for originality or doing it yourself.’ If someone out there has solved a problem and they’re willing to share it, there is no shame in getting help,” he says.

To that end, Providence also makes its digital strategy and digital resources accessible online for other health systems to understand its process and experience.

Althea A. Fung is a digital content strategist and healthcare journalist. She is a senior editor at NewYork-Presbyterian.