An application of Harrison's system theory model to spark a rapid telehealth expansion in the time of COVID-19.

Abstract

IntroductionIn response to the COVID‐19 pandemic, health systems had to quickly adopt a process for enabling targeted and patient‐centered care delivery. This case study describes the utilization of Harrison's open‐systems model to create an approach for rapid adoption of existing telehealth technologies in a large scale academic medical center.MethodsAn internal group of organizational developers, was enlisted to enable this effort. Local networks were employed and organized into focus groups to rapidly assess and address barriers to adoption and informal interviews with executive leadership were conducted to align organizational goals. Interventions include rapid deployment of focused and data driven provider, staff and patient support bolstered by effective communication and resource management.ResultsThere was an increase in the number of patient portal activation codes by 75% during the month of March. The number of activation codes generated expectedly decreased in April as many patients now had activated patient portals. The video visit volume as a result of provider self‐scheduling increased went from a baseline of 0 to over 600 clinical visits.DiscussionExperienced organizational development programs can facilitate adoption of change. The faculty practice of CUIMC has years of experience with supporting wide scale operational change centered on technology. In this case, providing engaged networks with tailored content that is focused on the process and available technology promoted rapid adoption and optimization.ConclusionIn the setting of profound external pressure, experience with the ability to focus on tailoring training and support to the culture of the organization helped to rapidly increase the availability and success of telehealth visits for a large scale academic medical center.