A new normal for clinical operations: UNC Health identifies long-term changes from its COVID-19 response

UNC Health is a healthcare system comprising 11 hospitals and hundreds of clinics across North Carolina. Using data reported by the New York Times in late April 2020, several national studies identified North Carolina as a growing risk area or potential “hot spot” for the COVID-19 pandemic. As a public health system, UNC Health focuses on its mission of improving the health and wellness of all North Carolinians. To that end, it developed a system-wide data and analytics strategy to better understand and respond to patients' needs. The COVID-19 pandemic led UNC Health to accelerate that strategy.

“Throughout the pandemic, health data has been a primary driver in nearly all policy decisions at every level of government,” said Jeff Fuller, Executive Director of Analytical Solutions. “Because we support our state's hospital system, our analysts and data scientists are laying the groundwork necessary for responding to the current crisis and to future unforeseen events.”

Maintaining a high level of care and trust with North Carolinians requires UNC Health to be strategic with its data analytics. When the COVID-19 pandemic started, analytics teams rapidly created new dashboards in Tableau, starting with reports for executives and leadership teams. Within just a few weeks, the teams' focus shifted from pandemic management to the rapid creation of sustainable new tools that supported data transparency and better data-driven decision making. During the first weeks after pandemic response began, UNC Health scaled up these efforts to provide updates for more than 30,000 internal users. Data helped teams and individuals align to a common mission, created an organizational shift in healthcare data modeling, and reassured stakeholders that UNC Health was prepared to meet rapidly changing needs.

The dashboards showcased data on testing, utilization, PPE inventory, available bed space, and supply chain vulnerabilities. Among other uses, clinical teams and hospital administrators used the data to rank vulnerability for patient cases and manage care delivery priorities.

With new data-driven operations underway, UNC Health saw that some of the operational changes would fundamentally change certain post-pandemic operations. The organization had developed a 2019 strategic plan that called for gradual data transformation using pre-pandemic financial and operational models. COVID-19 accelerated new technology uses and new kinds of collaboration—changes that will persist even after things return to so-called normal.

According to Jeff, these changes include how UNC Health incorporates analytics and data-driven decision making into daily operations. “We have to feel comfortable taking 'COVID-19' off the label of these new learnings, because the ways we've been forced to innovate have provided valuable new ways to look at our business, including how we deliver better health outcomes overall.” UNC Health is synthesizing its learnings from their COVID-19 experience to create new models based on these new assumptions.

Examples include the blending of forecast models to account for key pandemic management criteria, such as new capacity management, patient confidence, and key supply-side metrics. To respond to the rapidly changing pandemic landscape, care teams demanded and grew accustomed to data transparency through real-time or daily reporting. This will be a permanent improvement to the pace and prominence of making data-driven decisions.

Similarly, Health System BI Analyst Chris Paolini shared that “before COVID-19, we were looking back at financials and other KPIs on a monthly basis. But now there's a need for daily and weekly reporting. We need to look at things on a real-time basis so our leaders can make decisions faster. I don't see that going away.”

For example, analytics leaders are working with surgeons on how to predict surgical procedures going forward. “We're taking into consideration constraints and limitations around PPE, staffing, and new protocols for making sure our patients are safe,” said Jeff. “We have to be able to always be two weeks ahead of ourselves to understand what's happening.”

Tableau provides the ability to try several different variables in a 'what-if' scenario analysis. For example, Jeff explained, “if we reached 70% of normal operations, how quickly would we burn down our PPE supply? What would our reserves be for a potential future surge? We need to manipulate these factors to see different scenarios, and we're able to do that in Tableau.”

COVID-19 has also been a catalyst for UNC Health's pivot to telemedicine. The organization had plans for implementing more virtual experiences for patient care, but the pandemic accelerated their move in this direction. Between March and the end of May 2020, UNC Health provided more than 154,000 virtual appointments to its patients, and saw a significant increase in utilizing 24/7 virtual urgent care and inpatient consults.

Using telemedicine, UNC Health met patients' needs while ensuring a safe environment for both patients and staff. Expanding telehealth options has also become an opportunity to build trust with patients in new ways. Consulting remotely during times when in-person appointments were not available helped to reassure the public that UNC Health was able to deliver appropriate health solutions, as patients could consult with providers even when clinics were closed. This rapid shift to telemedicine has also helped to set expectations that such virtual forms of care could become more commonplace in the future.

The dramatic increase in telehealth since early March, according to Chris, “is a level of ramp up we've never seen before, for any service. It's been tremendous. We built a telehealth dashboard in Tableau that shows the impact of telehealth on the revenue cycle, and now we can more easily see a significant amount of telehealth billing that we didn't see before the pandemic.”

At UNC Health, pursuing modern healthcare operations as a data-driven culture has never been more important. The organization takes pride in being a regional and national authority on healthcare analytics. Over recent decades, it has built expertise to become a leader in proactive, innovative healthcare throughout the state and across the country. UNC Health is also one of many Tableau customers leading through change by using COVID-19 data to make critical decisions confidently and quickly.

For more information on how other healthcare leaders and organizations from other industries are transforming their data operations during COVID-19, visit the Tableau COVID-19 Data Hub.