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Road to Recovery: Risk-Scoring Algorithms Help Health Systems Get Back on Course After COVID-19 Shutdowns

Reopening for elective and routine care is critical to keep people healthy and help healthcare organizations recover financially

The COVID-19 pandemic caused healthcare organizations to cancel most routine and elective services. The results were devastating. By early April, screenings for breast, colon, and cervical cancer were at historic lows, people with symptoms of heart attack and stroke avoided emergency rooms, and healthcare organizations’ budgets were in tatters. Groups using Epic reported an 86-94% reduction in cancer screenings, 45% fewer emergency room visits for heart attack and 38% fewer for stroke, and nearly $170 billion in losses due to reduced and cancelled services.

Reduced schedules, essential for social distancing, have put available appointments at a premium and generated a large backlog of patients waiting to be seen. To help organizations determine which appointments to reschedule first, Epic provides risk-scoring algorithms that look at factors such as age, chronic conditions, obesity, and previous hospitalizations. This information helps them prioritize appointments.

“Using Epic’s risk-scoring algorithms to re-start services, we can make sure we’re getting the patients who need care most urgently in to see their doctor first,” said Deborah Gash of Saint Luke’s Health System in Kansas City, Missouri. “As we prepared for COVID-19, routine visits and elective surgeries virtually disappeared, and many of our waiting rooms and doctors’ offices remained empty. In addition to the impact this had on our patients’ health, this had a financial impact on the organization – which has required us to rethink how we provide care, embrace technology to streamline operations, eliminate certain services, and close some operations. We are on the road to recovery but are committed to continually leveraging Epic and its capabilities to strengthen our organization.”

Hundreds of other healthcare organizations have used risk scoring to restart services. Starting in late March, groups using Epic decreased their routine and elective care by as much as 55%. Today, most are back to within 10%-20% of their pre-pandemic visit volumes.

“We’re helping hospitals and clinics understand how to prioritize appointments as they reopen, allowing patients to get the care they need while restoring the financial health of our customers,” said Dr. Chris Mast, Epic’s Vice President of Clinical Informatics.