Accessible & Integrated Care

Overview

Cleveland Clinic is caring for more patients by building a sustainable model for growth that embraces digital care, expands our service and location offerings and reduces healthcare costs. Our multidisciplinary caregiver teams provide a continuum of compassionate care and support to patients throughout their health journeys.

Access Transformation

In 2021, we committed to an enterprise-wide access transformation to dramatically improve the way we connect people with care—knowing that to be the best place to receive care, we have to be the best place to access care.

The first question we asked ourselves was, “what do people want when they access care?”—and second, “do we really know?” We have since reviewed the literature, including internal and external research in healthcare and other industries, thanks to the support of our strategy, marketing and patient experience teams. We found that across industries, people want immediacy, convenience and autonomy.  When individuals have control, their experience improves. In healthcare, that means we need to be available in ways that are consistent and transparent across modalities, and at the same time, make people feel reassured and known as an individual.

Our opportunity to differentiate as a healthcare provider is to be more available, remove pain points, know our patients and give them control.

We laid out an operational and strategic plan with key building blocks that connected and unified work across our IT, Clinical, Marketing and other teams. Since then, we have operationalized patient outreach, scheduling over 334,000 appointments for needed care as of May 2023. Our patients and caregivers have expressed appreciation for this work, which will be integrated as a standard process in our future operating system.

We also launched a massive digital marketing effort to establish Cleveland Clinic as the industry leader in health information. This is important because our website is a key entry point and often represents the earliest experience for people seeking access to our care. We are currently ahead of schedule for content development and organic website traffic, with 486 million visits to clevelandclinic.org as of May 2023, up 78% from May 2022. Additionally, traffic to our health library (293 million visits) was up 66% year over year for this same period.

We have also made technology improvements to expand online scheduling capabilities. From March 2022 to June 2023, 103,150 patients scheduled screening mammograms via MyChart, and our patient self-scheduling interactions have continued to increase year over year at a rate of 63%.

Throughout this work, we have remained deeply committed to our guiding principles: empowering our caregivers to treat our patients like family, deliberately leveraging technology and employing a true continuous improvement mindset throughout, with ongoing learning and iteration. We have seen great results in our areas of targeted improvement, but many of our patients still do not have access to care in a way that meets their (or our) expectations. Our focus in 2023 and 2024 will be on building the needed teams and capabilities to change the experience of all patients across our entire enterprise. This work requires significant organizational investment of time and resources, and we are committed to executing it the right way—remaining focused on patients and outcomes.

Community Health

Cleveland Clinic offers the highest quality of personalized primary care for patients, from newborns to older adults. We are committed to delivering exceptional care that is comprehensive, coordinated and accessible for patients and communities. Our physicians are part of teams that include advanced practice providers, nurses, medical assistants, behavioral health social workers, pharmacists, care coordinators and navigators.

Using data to target improvement and patient engagement, these care teams focus on optimizing patient outcomes, quality and cost through proactive management of a patient's health, wellness and chronic diseases. Services include departments that provide coordinated care across the practices of adult and pediatric primary care, consultative internal medicine, geriatrics, hospital medicine, medical care at home, clinical genomics, functional medicine, and wellness and preventative medicine.

We use internal capabilities and collaborate with community partners to bridge clinical efforts with community needs, removing barriers to care. These barriers often include social needs, or nonmedical aspects of individual and family lives that can affect health and well-being, such as housing, food security, employment and other social determinants of health.

• Learn more about our Community Health Strategy

Research & Innovation

Researching for health is an essential part of our mission. Cleveland Clinic’s clinicians work with researchers to address patients’ unmet needs and invent tomorrow’s care. In 2022, Cleveland Clinic received $402 million in research funding and supported 3,627 active research projects.

Cleveland Innovation District

Launched in 2021, the Cleveland Innovation District is a collaboration involving government, medical, academic and business institutions to position Ohio as a leader in the healthcare and IT sectors. Cleveland Clinic is the anchor institution of this public-private collaboration, which aims to advance healthcare and digital technology, attract and create new businesses and develop talent.

The Innovation District will serve as a catalyst for economic development in Northeast Ohio, generating an anticipated 20,000 new jobs in the next decade. To support the growth of research operations, training and innovations, Cleveland Clinic added new labs to existing research buildings and began design work on new research towers in 2022.

Discovery Accelerator

Announced in 2021, the Discovery Accelerator is a 10-year partnership between Cleveland Clinic and IBM to advance the pace of discovery in healthcare and life sciences through high-performance computing. The Discovery Accelerator will enhance research in the new Sheikha Fatima bint Mubarak Global Center for Pathogen & Human Health Research in the fields of genomics, population health, clinical applications and drug discovery through the hybrid cloud, artificial intelligence and quantum computing technologies.

In 2022, IBM began installing the IBM Quantum System One—the first private sector, on-site quantum computer devoted to healthcare research—at Cleveland Clinic’s main campus. Cleveland Clinic and IBM unveiled the system in March of 2023 and are collaborating on multiple projects to help expedite discoveries in biomedical research.

Cleveland Clinic Brain Study

While one in every six people around the globe has a neurological disease, medical intervention often happens late in the process, making it challenging to cure or stop the progression of disease. In 2022, our Neurological Institute launched a 20-year landmark study to improve the identification, prevention and treatment of neurological disease. Through the Cleveland Clinic Brain Study—the largest clinical study ever for brain disease—we will collect data from up to 200,000 neurologically healthy, at-risk participants with the goal of identifying biomarkers of early-stage neurological diseases before symptoms begin to occur. That data may reveal new targets for preventing or curing diseases—such as Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, stroke and epilepsy—in their earliest phases.

Virtual Health

The mission of Cleveland Clinic’s Virtual Health Program is to connect anyone to care, from anywhere. We seek to harness technology to reimagine and transform care, expand access and deliver the best patient-centered experience.

Cleveland Clinic’s program offers a range of synchronous virtual offerings, including on-demand urgent care, telestroke, primary care, behavioral health, medical and surgical subspecialty visits, eCoaching, shared medical appointments, remote patient monitoring and paramedicine. Asynchronous options include eDermatology, ePharmacy and written second opinions.

Digital access plays a crucial role in the overall health and well-being of a community’s residents. It affects an individual’s access to education, health information and care, and employment and economic opportunities. Because it touches so many other areas of social well-being and physical health, digital access is often referred to as a “super social determinant of health”. Digital access refers to:

• Access to low-cost, high speed internet service.
• Access to effective, reliable devices.
• Digital literacy skills and knowledge.

Although digital technology is increasingly available to many, some families may face situations that limit or prevent their access to this important resource. In an ongoing effort to positively impact the overall health of our communities, Cleveland Clinic Community Health & Partnerships is partnering with community and social organizations to address this need through the Digital Equity Program.

The Digital Equity Program is designed to meet the diverse and differentiated digital access and literacy needs of our patients through referrals to trusted community partners, who provide a wealth of services including low-cost/no-cost devices, affordable high-speed broadband services and digital literacy training.

The Digital Equity Program has developed and implemented a patient screening strategy, which deploys community health workers as digital navigators dedicated to providing this screening. Patients from Langston Hughes Community Health & Education Center and the Stephanie Tubbs Jones Family Health Center who are being seen for primary care from zip codes with the highest need are screened as part of a pre-visit consultation and social needs assessment.

Since the launch of the Digital Equity Program in 2021, the Community Health and Partnerships team has screened a total of 3,000 patients, with 40% of those screening positive for a digital access need having it fully addressed by a local community organization.

Inpatient connections to help close equity gaps

The inpatient telehealth program that began in September of 2021 uses the time that patients are already spending in the hospital to introduce virtual-visit technology and set up out-patient appointments. Patients may connect with a social worker to educate them about using virtual visits and obtain a free government-issued smart phone if they need it for appointments, managing diabetes or other health issues they may have. 

Additionally, virtual inpatient consultations provide subspeciality access for patients while remaining in their regional hospital, closer to their home and support system.  Cleveland Clinic Mentor Hospital, which opened in July 2023, was optimized for inpatient telehealth. Equipment attached to the patient’s television allows for access to sub-specialists at the main campus or other regional hospitals within the system.

Inpatient telehealth education can prove especially important for patients who are inexperienced with digital technology. Using inpatient time and resources to set up follow up care improves continuity after discharge. This is especially helpful in the management of chronic health conditions, such as diabetes, and its complications, which disproportionately affect low-income populations, older adults and communities of color.

After hospital discharge, virtual medical visits can be transformative — especially for patients who cannot easily miss work or who experience barriers to transportation. Inpatient Endocrinology Consultation has enabled care for hundreds of new patients. Patients seen in the hospital have a higher rate of outpatient follow up after discharge, increasing opportunity for proactive disease management.

MyClevelandClinic and MyChart

Cleveland Clinic’s Virtual Team and Information Technology Department worked to redefine our digital front door to provide ease of access to care through the MyClevelandClinic patient mobile application.

MyClevelandClinic improves the patient experience by consolidating our mobile apps into a single app where patients can access MyChart (our online portal that connects Cleveland Clinic patients to portions of their electronic medical record), virtual visits, visitor information and more.

The platform is available 24/7, secure and free to download. Some key features in the app allow users to: 

• See a healthcare provider live 24/7 for non-emergency concerns. 
• See Cleveland Clinic providers for scheduled appointments. 
• View health records. 
• View test results. 
• Schedule appointments. 
• Message a doctor’s office. 
• Pay bills. 

In 2022, we made the following enhancements to create a more seamless experience for patients on MyChart:

• Opted all patients into paperless billing—this environmentally conscious decision also resulted in savings due to significant reductions in mailed paper statements.
• Opted all patients into a two-factor authentication for MyChart login to provide a much more secure experience for the patient, and to enable them to set up trusted devices tied to their accounts.
• Expanded ticket scheduling opportunities in MyChart, making it much more convenient for patients to self-schedule important visits, such screening mammograms and colonoscopies.

Plan-of-Care Visits

A plan-of-care visit brings together the provider, nurse and patient at the bedside to communicate the patient's daily plan of care. This discussion standardizes how patients and caregivers collaboratively develop treatment plans that provide the highest quality of care.

Plan-of-care visits benefit both patients and caregivers by:

• Including patients as part of the team creating a collaborative treatment plan.
• Involving patients in making decisions and inviting them to ask questions about their daily plan of care.
• Increasing caregiver engagement and communication using our team of teams approach.
• Improving patient safety, satisfaction and health outcomes.

In 2022, our patients self-reported having plan-of-care visits 68% of the time, a 5% year-over-year increase. In 2023, we will also begin measuring the quality of these visits by asking patients and their families how helpful the visits are. By creating a collaborative treatment plan with patients as part of the team, we also reduce patients’ length of stay and readmissions.