Engaging Patients During COVID-19: Q&A with Operose Health CEO

Business, International

10/02/2020

physicians and nurses consult in hospital

COVID-19 has infected more than 338,000 individuals and claimed more than 41,000 lives in the U.K. Local health authorities required primary care practices to quickly adapt to remote operations when the outbreak hit and reserve in-person treatment for the most vulnerable.

Operose Health is Centene's organization of general practitioner (GP) practices in the U.K. It provides services to approximately 100,000 patients, as well as behavioral health and outpatient care to the National Health Service. Operose Health CEO Samantha Jones reflects on the organization's efforts to continue engaging patients in their care, despite the pandemic.

Following is a Q&A with Samantha Jones:

Q: Can you characterize the success you've had transitioning to primary care that emphasizes telehealth?

A: The pandemic has allowed us to work smarter using telehealth. Within 24 hours of national shelter-in-place orders, we moved to making sure that all initial contacts in community care used some form of telehealth. This kept our patients safe and allowed care to continue. As we have moved through the pandemic, clinicians have moved from a roughly 90 /10 split of face-to-face appointments versus telemedicine prior to the pandemic to 80/20 in favor of telemedicine.

Q: How has that changed doctors' roles?

A: Clinicians have had to get used to new technology and rely on clinical skills that were part of their basic initial training, i.e., relying on the patient's history and using examination and diagnostics sparingly. Patients have transitioned exceptionally well and are generally content with a process that keeps them safe while not visiting primary care facilities. We have seen clinicians able to better suit the method of communication to an individual. More experienced clinicians have face-to-face patient-visit rates of less than 5%, video rates of 20% and the rest of their appointments are completed using alternate means, including email and phone calls.

Q: Have you evolved your approach to encouraging primary/preventive care over the last few months?

A: Through the whole pandemic we have successfully managed to keep primary care available to all our patients at all times, even on the rare occasion where we have had to shut an individual surgery for a few days, by using a buddying system with our practices. In the first few days, patients were reluctant to access care, but awareness of telehealth opportunities to receive care has been reassuring and an increased confidence in the service has been seen. Anecdotally, our patients are reporting greater satisfaction with care they are receiving. We have found new remote ways to close our care gaps: for example, teaching wound management to patients who can then be monitored remotely. Finally, our staff have been very proactive in terms of contacting patients who they were aware may be at risk. We have also proactively reached out by offering services such as health checks to patients who may benefit in the longer term from earlier intervention.

Q: What challenges are you seeing now that are different than what you encountered at the outset of the outbreak and its height?

A: Getting back to what will be our new normal is still an unknown. As more people restart accessing care, with increased demand, we have seen proportionately less use of video, with some providers opting for the phone instead, but confidence in video usage is increasing for patients and clinicians. In the U.K. there are concerns about unmet healthcare needs, but as access by patients is improving, we are seeing patients present with illnesses that we can address. Early on in the pandemic, we started to closely monitor the care pathways that interface with our local hospitals, made sure follow up was occurring, and put extra measures in place to create a safety net for our patients with symptoms that require exclusion of serious pathology.

Q: Have the needs of your employees and GP practices changed since the start of the outbreak?

A: In any stressful situation, people react initially with lots of energy. This can’t be kept up for a long period of time, and so we have had a big focus on employee well-being, including putting support programs in place for our teams. These include offering several services that support mental health and well-being for our staff, as well embarking on a well-being week. We have also been very keen to make sure that people are getting regular breaks, both in work and with annual leave.

As those individuals from ethnic and racial minority groups have been found to be most at risk from COVID-19, we have ensured that 100% of our staff have been offered individual risk assessments and that the most appropriate personalized support is put in place.

Q: What are you doing to try to stay ahead of the evolving situation in the U.K., where there is fear of a second wave?

A: As we head to the business of winter, we are aware that we have come through a very busy season. We have prioritized the well-being of our staff in preparation for the winter season and will have a dedicated staff program focused on flu vaccinations. We have changed our working practices in our GP practices with PPE being used by all staff in all environments, temperature checks, social distancing, and shielding so that staff can talk freely and safely to patients. We have recently completed a staff survey asking what we should continue from the last few months and will be analyzing these results. We continue with a focus on excellent, regular communication channels to all our staff. We are confident that these processes will help if we do get a second wave, as we have had much more time to prepare.

Learn more about how the leadership of Centene's international operations in the U.K. and Spain have adapted to the COVID-19 pandemic, including an interview with Operose Health's Chief Medical Officer. Centene's COVID-19 Resource Center offers additional information on our continued relief efforts. Domestically and abroad, Centene is committed to keeping our members, employees, and communities safe and healthy.