As Health Catalyst continues to engage its health system partners in their COVID-19 journeys through virtual client huddles, topics are delving further into restarting ambulatory care and elective procedures. The May 21, 2020, forum explored how organizations are responding to the pandemic and planning for the next phases. Participants explored two vital topics in the COVID-19 era: How virtual care analytics supports rapid change in ambulatory care delivery. How analytic insights help drive a COVID-19 financial recovery plan.

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Restarting Ambulatory Care and Elective Procedures:
Analytics Guide Safe, Pragmatic Decisions

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Restarting Ambulatory Care and Elective Procedures
Health Catalyst hosted its second in
a series of COVID-focused virtual
client huddles on May 21, 2020.
These discussions aim to help
Health Catalyst and its partners
identify the data and analytics
needs for understanding the
pandemic, particularly as the
focus shifts from initial response
to recovery and rescheduling
elective surgery.

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Restarting Ambulatory Care and Elective Procedures
The second forum covered two topics:
How virtual care
analytics supports
rapid change in
ambulatory care
delivery.
How analytic
insights help drive a
COVID-19 financial
recovery plan.

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Restarting Ambulatory Care
The forum used a five-hospital, 1,200
employee-provider health system’s
pandemic response as an example.
In the wake of COVID-19, the health
system shifted 80 percent of its
ambulatory visits to virtual care—a
significant change, as less than 1
percent of these visits were virtual
before the pandemic.

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Restarting Ambulatory Care
The organization had partnered with Health
Catalyst before COVID-19 to build a robust
ambulatory management platform, which
allowed them to build and scale their virtual
care dashboard (Figure 1).

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Restarting Ambulatory Care
(Figure 1: Leading Wisely dashboard)

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Restarting Ambulatory Care
Using the Health Catalyst® Data Operating
System (DOS™) platform to perform scenario
analysis, the health system can evaluate the
impact of virtual care and reimbursement rate
changes on financial performance.

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Restarting Ambulatory Care
To support the transition to a virtual ambulatory model, the health system
needed the following insights to optimize its virtual program:
Which providers were doing
well, and which were struggling.
Provider Productivity
With many visits postponed, the
organization needed to evaluate
the backlog to prioritize which
patients to connect with.
Backlog Analysis
How can the system restart
ambulatory care and elective
procedures as safely as possible?
Safe Restart

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Restarting Ambulatory Care
Among audience questions about the
organization’s telehealth experience
was the breakdown of virtual visits by
video versus the phone.
Of the organization’s 86 to 88
percent of primary care visits
delivered via telehealth, about
50 percent were phone and 50
percent video.
Appointments were initially mostly
telephone based, but video was
increasing.

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Restarting Elective Procedures as a Step to Recovery
The organization had put 90 percent of its
elective (non-urgent or emergent) procedures
on hold for about six weeks, then restarted
elective procedures around May 2020.
It first had to identify which deferred cases
to prioritize.
As well, the health system’s financial
leadership wanted to understand the financial
impact of restarting elective surgery and
create a safe restart plan, which they
collaborated on with Health Catalyst.

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Restarting Elective Procedures as a Step to Recovery
To understand the financial, provider, and
overall impact of COVID-19-related declines
in elective surgeries, the health system
leveraged DOS and the Health Catalyst®
Financial Impact Recovery: Elective Surgery
application to understand procedure trends
and plan how to best meet patients’ needs
and effectively recover from COVID-19
revenue loss.

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Restarting Elective Procedures as a Step to Recovery
Health Catalyst CEO Dan Burton asked
about balancing restarting and recovery
with social distancing policy—namely,
with COVID-19 impacts in mind, what’s
a safe, reasonable volume to aim for?
The organization’s representative
responded that it’s taking a conservative
approach planning a return to elective
surgeries according to this timeline:
April
2020
10%
May
2020
25%
June
2020
50%
End of
2020
80%

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Restarting Elective Procedures as a Step to Recovery
Much will depend on factors including the
type of procedure, room turnover, and more.
Endoscopy, for example, could get back to
100 percent, joint replacements may be
back to 85 percent, while heart surgery
might only return to 65 percent.

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Projections for 2021
With a COVID-19 vaccine a potential
for 2021, though not confirmed,
healthcare organizations will have
more uncertainty to navigate.
To that end, Burton asked how the
health system’s leadership was
thinking about 2021 budgeting.

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Projections for 2021
Typically, the representative explained,
budgeting would start in late spring/early
summer and be done the following
October.
However, with the fluidity of the
pandemic (e.g., a possible COVID-19
resurgence), the organization is looking
at a 90- to 120- day budgeting process.

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Projections for 2021
Health systems will need to determine new
baselines for ambulatory and specialty care.
For example, primary care visits will likely
continue virtually.
Still, organizations can’t yet project what
specialty care referrals will look like, as
they’re down while patients fear re-entering
facilities due to COVID.
For both medical and data needs,
organizations will have to bucket procedure
types by specialty, then by ambulatory
setting, surgery setting, or inpatient setting

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For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

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More about this topic
Link to original article for a more in-depth discussion.
Restarting Ambulatory Care and Elective Procedures: Analytics Guide Safe, Pragmatic Decisions
Health Systems Share COVID-19 Financial Recovery Strategies in First Client Huddle
Health Catalyst Success Stories
Virtual Care Analytics Supports Rapid Change in Ambulatory Care Delivery
Health Catalyst Success Stories
Analytic Insights Help Drive COVID-19 Financial Recovery Plan
Health Catalyst Success Stories
Responding and Recovering in Clinic Operations with Advanced Analytics
Health Catalyst Success Stories
Analytics Accelerates COVID-19 Elective Surgery Restart
Health Catalyst Success Stories

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