Key Takeaways

Travel Industry Lessons After 9/11

• Security changes were made behind the scenes and gradually travel resumed.
• It wasn’t until after the financial crisis of 2008 that the airline industry started to recover.
• A couple of lessons we learned from this:
  • We’re going to see substantial financial impacts across the healthcare industry.
  • We could see the healthcare industry restructuring as small health systems start to merge with large systems.
  • We have to challenge our pre-COVID-19 thinking and be nimble moving forward.
• We’re working with United on a program called Clean+ to help build traveler’s confidence in flying again.

COVID-19 Response 

• We first saw patients with COVID-19 in Abu Dhabi, so we initiated our incident command structure that includes all of our locations around the world.
  • We started planning in early January by looking at clinical processes and surge capacities as well as gathering stockpiles of PPE.
  • Then, the focus was setting up drive-through testing, building surge capacity, and finally, recovery and reopening.
• Now we’re looking at trying to get back to our pre-COVID-19 numbers while being prepared for flare-ups.
• Our digital platforms have had a significant impact on reaching patients and communities all over the world.
  • Since March 13, we’ve done 8,000 social media posts.
  • Our website has had 120 million sessions so far this year.
  • We’re sending a million emails a week.

Recovery Mode 

• In response to the resistance for people to return for routine care:
  • We've downsized our outpatient spaces to allow for social distancing.
  • We're running at 75% capacity but making it up through virtual visits.
  • We're doing thermal screenings and continuing to enforce mask-wearing.
  • We're encouraging our clinical departments to extend hours and provide virtual options to ensure maximum flexibility.
• We have also created predictive models, which are looking good 30 days from now.

Virtual Care 

• The physician community and health systems around the country and world have undoubtedly adjusted to virtual visits.
  • It’s only going to get better and smoother as technology advances.
• We’re looking forward to remote monitoring tools that can send reliable data to physicians and integrate with health records.
• If we do it right, we should be the big winners in virtual health.
  • Consumers will want to come to Cleveland Clinic for virtual health and not a third party, one-off visit.

What No One is Talking About (But Should)

• Elevating your internal communications.
  • We’ve learned that through COVID-19, our internal communications were a guide throughout this process.
  • Our caregivers have opened 3.3 million of our internal emails since March.
    • We have an 83% open rate with emails from our CEO.
  • We've created 25 videos with messages from our CEO.
• Regulatory areas that need to be addressed.
  • Our supply chains are predominantly outside the United States.
    • The swabs we needed for COVID-19 testing were made in Italy at the height of the COVID-19.
    • Our masks and gowns come primarily from China.

Acute Home Healthcare

• One of our goals as a health system is to reduce the length of the patient’s stay.
  • Infection rates are lower when we can get people home, so we are very focused on that.
• We have a home health division at Cleveland Clinic, and it's an integrated part of the care that our institutes provide.
  • We do it for chronic diseases, especially working with EMS teams that go to people’s homes to try and keep chronic disease patients out of the hospital.

Reimbursements for Virtual Visits 

• From a regulatory perspective, it needs to be one of our highest priorities.
  • We're going to continue to see virtual visits move forward now that we have had such a huge trial period for them.
• Those discussions take place on a state-by-state and insurer-by-insurer basis except for Medicare, but I think you have to give CMS and the government credit that they opened that up very quickly.