Excerpts From Our Interview with Lisa Griffin of Jefferson Health

Here are some excerpts from our interview with Lisa Griffin, vice president of front-end operations Jefferson Health. They have been edited for length and clarity.

On the pivot to telehealth

We were actually able to pivot very quickly because we had been scheduling telehealth visits. Telehealth has been a part of a patient's choice. So patients had choices of in-person and telehealth our schedulers had the ability to give those patients those choices. Not to the scale that we moved to because of COVID-19, but it has always been a part of our normal scheduling.

We had physicians internally that had already been trained, and they were already seeing patients, but that was happening in another arm of our organization, Jeff Connect, that outside of our employee physicians. So we ended up just flipping that (Jeff Connect) model into the same model that we would use with our physicians. So we scaled that up by asking our retired of providers to begin to come back and work with us. Emeritus, retired physicians that were a part of our organization. We reached out to them and then we scaled up using that other Jeff Connect arm. we just had to really scale that up pretty quickly

On making in-person visits safe

We decided early that there were a specific number of patients that had to be seen face to face. And so we had to make sure that those patients felt safe enough to get us and that our operations were safe and that they could come to us. So we spent a great deal of understanding the patient's fears, and things of that nature, and making sure we address them, so we didn't lose those patients.

On not “losing” patients

We had to stop elective surgeries because of requirements. We were forced to do that. So we kept a handle on those patients and actually went through and said, which ones could wait truly wait.

\We kind of went through like a command center and going through these processes with a patient-safety mindset, keeping them safe and not losing them because of the shifts in telehealth and in- person.

So it was pretty intense in the beginning trying to make sure that we kept our pulse on those patients.

On getting reimbursed for telehealth

We had to come together as executives and say, either we're all in or not. We had to not just look at it from single view of being revenue generating. We knew that the implications were there where we potentially could not get paid. And so we had to make those types of decisions very early to say, you know, we're here for this specific reason, and take care of patients and care for people. And we had to make a decision to say that's our guiding principle, our North Star. So, or we look at the revenue, let's make sure we have that as a North Star. And I think that allowed us to guide how we do business from a humanity perspective versus us not being reimbursed. And of course, we know this is a business. So we did keep our pulse on that, keeping those patient visits within our EMR with an identifier.
But we decided that we had to operate with that North Star mentality of caring for people.

On switching patients to telehealth visits

Systematically we had to change in our EMR, so you have the ability to take a regular appointment as a scheduler (and switch it to a telehealth visit). So you could call us, and say, “Hey, I am going to be 10 minutes late for my in-person visit.” And based on what you're coming for, we could say, “Well, you can be 10 minutes late or would you like to switch to a telehealth visit,” Having the ability to be that nimble to flip that was not easy. We had to go through to change our scheduling, making it where the scheduler could do it. We really pressed the issue of saying this needs to be seamless at the scheduler level — seamless for our patients.

People already have angst. And we would be adding to the angst. So we had to really look at this from a patient-centric viewpoint.

On being called the “seamless access” department

We're called seamless access. And that just means that every connection point for our patients that they want to connect with us, it has to be barrier free. If they're calling to pay a bill, if they want to speak with our customer service and ask questions, if they want directions, if they want to schedule an appointment — all those avenues have to be seamless and barrier free to where the patients can get to us. So that is a premise around something being seamless.

On changes she made in the department

I've been here a little over a year. I ripped off the Band-Aid and changed all of my positions, the task competencies, key measures and weightings, and then put training around those job roles so that we can get the right people that understand the concept of first-call resolution from every patient that calls in, or if they decide to use our chatbot online to get to us or fill out a form on our website. All those channels are employees within seamless access. They are trained on all of those channels,

On payment and insurance

Our schedulers are trained on if you're self-pay, and you need additional services, linking you up with a payment plan. If you can't do a payment plan and you need financial assistance, we are a nonprofit hospital, so we have financial assistance programs that allow patients to seek care without the ability to pay. So there are a number of ways that we're addressing when patients may be at that stage where they can't pay but they need the services. So our schedulers are trying to do all of those things I just mentioned, talk to them find out about where they are. We also have social workers that can help a patient get Medicaid coverage or help guide them through that process.

There were people that were losing jobs very quickly. Unemployment was held up because of the vast number of claims. Some of them, not because of any fault of their own, now are faced with “I need to be seen” and making a decision if I can I be, based on payment. And so we had to let really impress on our schedulers the need to have different type of conversations today because these patients, some of them have never been in this situation. They're faced with the unknown. They've always worked, they always had insurance, and now they're faced with waiting for unemployment, and no insurance.  We really had to have some sensitivity type of training and reinforce on high alert the need to be able to meet the whole person related to their health care.

On race and inequity

I am finished my dissertation around that subject in a healthcare environment, so it is close to my heart to make sure that we're dealing with those things.

I came here because that conversation is an open conversation. We have a team that's called B.R.A.V.E. [Bold, Relevant, Authentic, Valuable and Educational]. And that B.R.A.V.E. team allows us to have those types of discussions. The one thing I can tell people is be OK with being uncomfortable — with uncomfortable conversations. And sometimes you have to look at it in that perspective and be OK with someone else's viewpoint and being challenged by that viewpoint, because we all have a viewpoint.

Early on in my life I was told by my own grandmother, you know, people hold the purse, so you do what they say, be silent, don't put a lot of attention on yourself. And so just having been in a work environment that has allowed me to say, “Here's what I think, here's what I'm feeling. Here's why I'm feeling that way,” and having the other person be okay with that, and vice versa. And being able to educate each other.

I think that is that brave mentality that Jefferson has taken on and that our employees have embraced of talking to one another.

I'll leave you with this thing. My five-year-old granddaughter watched Sesame Street on racism. And she calls me every day she says, “I'm worried about you.” And I said yes. She said, “I looked at that Sesame Street thing on race,” and I said. “Oh, you did. What do you think about that?” And she says, “The adults have the problem. My friend is white.” And I said, “You may have something there.” This is a five-year-old. So I take that every day and I keep it in my mind.”