Why Providence's caregiver burnout initiative is giving Tesla a run for its money

About two years ago, health plan leaders at Renton, Wash.-based Providence came to Todd Czartoski, MD, the system's chief executive of telehealth and chief medical technology officer, with a question: Can you build a solution to better tackle caregiver burnout?

Dr. Czartoski and his team got to work developing a telehealth-based service that would give clinicians a safe, secure and quick way to address burnout, among other mental health needs.

Providence launched its Telebehavioral Health Concierge service in June 2019, offering about 40,000 employees and their dependents same-day or next-day virtual access to licensed mental health professionals. The service provides caregivers with long-term, personalized care plans — not just one-off conversations — and users can access up to 10 free visits per health issue.

"It ties people into our ecosystem so they can be seen multiple times and then handed off to a higher level of care, if necessary," Dr. Czartoski told Becker's.

The health system first piloted the concierge program in Seattle with strong results and overwhelmingly positive feedback from employees. The program's initial Net Promoter Score was 87, which Dr. Czartoski said is relatively unheard of — especially for healthcare organizations, which typically have very low scores.

The index is used to measure overall satisfaction and loyalty based on how likely consumers are to recommend the organization to friends or family. The only company they could find with a higher Net Promoter Score was Tesla, which historically sits in the mid-90s.

During the pilot period, Providence recorded more than 1,100 virtual visits, about 21 percent of which involved physicians.

"Even though burnout is so high in physicians, it's often difficult for them to seek help, so this figure really surpassed our expectations," Dr. Czartoski said.

The Telebehavioral Health Concierge has also reduced the time for caregivers to be seen. Sixty-four percent of people who request a visit are seen the same day, and nearly 100 percent are seen within 48 hours.

"If someone is in crisis or having a bad day, waiting over a week to be seen is not a huge satisfier," Dr. Czartoski said. "Moving that from eight days to zero is really substantial."

Providence has since rolled out the concierge program at its healthcare sites in Washington and Montana, with California, Oregon and Texas next. The program has been growing by about 20 percent per month with the goal of hitting 5,000 virtual visits by the end of 2020.

All 119,000 of Providence's employees and their 80,000-90,000 dependents across seven states will be able to access the health concierge by the end of the year, as well.

For Dr. Czartoski, the Telebehavioral Health Concierge is about so much more than just the technology. He said the initiative proves that this type of care delivery model — in which nurse practitioners, physician assistants and other allied health professionals are patients' first point of contact — is an effective, scalable and sustainable way to relieve some of the strain from physicians.

"One of the reasons physicians are so burned out is because there are not enough of them," he said. "This program has been a great example that we can use licensed social workers to be that tip of the spear to touch people's lives in a positive way. We're looking at possibilities in a lot of different disciplines to build that same type of model that isn't so physician-centric."

 

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