When a state is ranked dead last in numerous health metrics, there is nowhere to go but up.
Leaders at Ochsner Health are banking on a 10-year, $100 million investment to bring Louisiana out of the basement and into the 40th spot in many of those metrics by 2030. The initiative is focused on improving health outcomes and equity, reducing barriers to care in underserved communities and advancing innovation.
The health system brought on Dr. Denise Basow as chief digital officer in January to help achieve some of these goals and change the narrative around the Pelican state. “The one thing that may be a little bit different about Ochsner than other health systems is that we care for a population that has traditionally suffered from a really high incidence of chronic diseases and socioeconomic challenges,” Basow said. “For the next eight years, we'll be working to improve access and care in this population.”
Basow spoke with Digital Health Business & Technology about using technology for Louisiana’s healthy state initiative, how she chooses digital health solutions among an excess of options and more. The interview has been edited for clarity and length.
How can digital health help improve outcomes and access in Louisiana?
We just completed a Medicaid pilot that is a pretty good proxy. We identified patients who either have high blood pressure or diabetes and we’ve sent them home with blood pressure cuffs and diabetes monitoring supplies. We built an app that runs through a smartphone and they have to do their own readings. And then instead of having to write those readings down on a piece of paper or just not doing them, the readings get sent to a care team through the app that connects with these home monitoring devices. The care team is specifically focused on these patients. It consists of providers who can manage their medications and health coaches, so patients understand what we're asking of them. The coaches are talking to them about some lifestyle changes and helping them just learn about their disease. It’s a combination of digital and people, which I think is really the winning combination here. We’ve seen pretty dramatic improvements in their blood pressure [readings] and diabetes control [metrics], decreased use of the emergency department and fewer hospitalizations. We seem to have hit on this combination of using digital tools in a way that gets people more engaged in their care.
How does Ochsner choose which digital health solutions to adopt?
I get five to 10 of these pitches per day. It’s pretty crazy. There’s no magic formula here. The first thing you have to know is which problems you really want to solve. We have an innovation team that's been very successful. We have a lot of technical resources and fantastic data to draw on. When you put all that together, we can do a lot of things on our own. It doesn't mean that we should always do things on our own but it's an option for us that many do not have. We look at things like cost, how much time will it take and how these extra solutions integrate into our electronic health record. We pull all that together to make a buy versus build decision. We have to focus resources on things that don't exist out there or that we can build better. It’s not a black and white decision, honestly. And the more capabilities you have, the harder those decisions are because we really can't build a lot on our own.
What metrics do you typically use to judge digital health projects?
One of the beauties of digital programs is they're highly measurable. We measure everything we do and if a program isn't working, we either abandon or modify it. It's critical that you set the goals because if you modify them as you go, you can sometimes fool yourself. Ask yourself, what are we trying to achieve? With our hypertension/diabetes programs, we look at blood pressure, blood sugar control and reducing utilization of high-cost health services like the emergency department or inpatient admissions. We have a connected mom program where we remotely monitor pregnant women and identify problems early. With that initiative, we're looking at reducing pregnancy complications and the number of visits that they make to an obstetrician.
Where do you hope Ochsner’s digital capabilities are at one year from now?
I want to make sure that we're fostering continued innovation and developing new programs, which has always been our DNA. I want to make sure we have the investment and support for that. One of the key roles I can play is in taking all this wonderful stuff that's already here and trying to organize it a bit, so instead of going after single problems, we really transform some of our models of care.
I'll give you an example. We have a lot of patients with migraine headaches. That's a common disorder. And we have a neurology team that's been inventive about how we take care of these patients. We've developed some questionnaires, and patients are served up these questionnaires monthly and if there’s anything concerning that comes out of that questionnaire, it makes its way back to the physician. We could really rethink how we care for patients with migraine headaches. When can we use virtual visits vs. in person? Can we provide a mechanism for patients to give us that feedback in real time, so they don't have to wait for a month to tell us that they're having an issue? How often do they need to see the neurologist vs. just be cared for by their primary care physician? We can play off of that and really build out that care model.
We’re in the process of identifying some strategic areas where we really want to rethink that care model. We’re starting to build out those pathways and incorporating digital tools where it makes sense. Again, it’s a combination of digital and people. But I'd like to see us a year from now having made a lot of progress in our highest-priority areas, the diseases that we that we want to work on first.