Insights from the front lines of H1N1

Hi everyone. My name is Brian Michels. I'm a partner on the Optum Market Advantage team, and I'm here today to talk to you a little bit about my experience leading outreach teams for a system in the Chicago market back in 2009 during the swine flu, H1N1 epidemic - and hopefully what my experience will do is provide a little bit of guidance, and give you some parallels on how we successfully navigated through that situation, and give you some insights in how you are leading your outreach teams and your outreach efforts through this COVID experience that we're having today.

So first, just kind of describing the situation that we were in back then, the H1N1 hit us like a ton of bricks and it turned our ED and it turned our physician offices into flu clinics. And so what we were trying to do in that situation is just survive. We were taking conference space, we, were taking auditoriums meeting rooms, and we were creating de facto flu clinics because there was just such an influx of patients that were coming in. And so we, in essence, had to spend all of our growth related activities for about a six to eight week period.

Now the one thing I want to get across right now is in no way is the H1N1 epidemic that we experienced back then reflective of the magnitude of what we're experiencing today. So I don't want anyone to mistake my intentions here in saying that what we experienced, or what we lived through, or what we did back then is going absolutely work today. But I do think there are some similarities and some parallels that we can take and draw from that experience that may help us today.

The first thing that happened in my organization and in many organizations, is anyone who had clinical experience, whether they were liaisons, whether they were helping with outreach efforts or not - a lot of those people got repurposed. And if that's something that you're seeing or something that's happening or being suggested in your organization, I think you have to dedicate and allocate resources where the greatest need is. And so for those teams that are being reallocated to help or support clinical efforts or help in other areas that are strongly needed, that's the best thing you can do. And so what we tried to do back then was we wanted to be a valuable resource for the organization at that time. So I think with that, that makes total sense.

I think the other thing that we have to keep in mind that we have to just say to ourselves, which is hard as growth people, is that growth is not the priority right now. And it wasn't back then. And so we had to be okay with that. We had to be okay with, with saying, look, we're, we're going to take our eye off of what we typically always focus on, and we're going to help the effort where is needed. So, I think that that's important and we need to be resources wherever those resources are needed.

The other thing that became very clear for us, and something that helped us quite a bit, was because of the nature of what we did and how we kind of interconnected between different departments and different types of specialties, the knowledge and the relationships that we had in the physician community, we were really in a unique place to be resources - both for the organization and for the physician clinics, both for the physicians and their staff. So it was important more then than ever for us to make sure that we were reaching out and that we were communicating with physician offices. And so I think for you all, the reassurance that doing outreach and reaching out to physicians is the right thing to do. You should be doing that, because we need to understand what the need is. And back then it was critical for us. It was a little bit different back then because our primary care physicians were being flooded with patients. And so their need was more along the lines of what the hospitals were doing to help support them. Were there resources they needed? Was there equipment that we could get them? Was there testing that we could provide? Was there support we could help with? That was kind of the need back then. That's not necessarily what we're seeing today, but I think the point of it all is that reaching out and understanding what the need is in these clinics was critical so that we could make the right decisions, we could be informed and we could make sure that we were doing what was needed and what was best for them.

The other thing that was critical for us was to understand the pain points that they were going through. Understanding those pain points allowed our leadership to really pivot when needed and help when needed and offer up resources when needed. And so none of that's possible without us reaching out with us asking the questions.

And you know, the fact that we were uniquely positioned to be the link between our executive teams and the physicians in their offices was another critical point. And so our physicians, our executives need information in order to make decisions that will help both the community, the organization and these clinics. And so we were uniquely positioned to be able to do that and we were a resource that was relied on to do that. So it was important.

Now, one of the most critical things that we kind of saw during that H1N1 situation was it was a make or break both opportunity and situation as far as relationship building goes. So, you know, it's a time period during a crisis where you can absolutely damage a relationship by reaching out and doing the wrong thing and sending the wrong message out. But man, you can strengthen your relationship with physicians and clinics by sending out the right message, being a resource, being someone that they can trust and rely on. And so for us, reaching out was critically important, and it was helping us understand, you know, do they simply need us to back off and give them the space they need to treat their patients? Do they need resources? Do they need education? Do they need to be able to funnel patients to the hospital and understand our processes that we were putting in place? Things like that. And so that all came through liaison outreach, and us being able to reach out to those clinics and knowing who the right people were to connect within those clinics to be efficient for everyone was important. The feedback loop was critical as well, so I don't want to underscore that.

One of the other big takeaways we found during that experience that helped us was we knew that the swine flu wasn't going to last forever. And we also knew that we were taking critical hits in areas like surgery, other revenue producing areas that were critical to our survival and to our success. And so we knew that when we came out of that situation, it was going to be really important for us to jump on those areas and make sure that we hit the ground running when the opportunity was there. And so we developed growth councils. People who weren't necessarily on the front lines treating patients who were more strategy planning, liaisons, marketing,, growth business people within the organization. And we started meeting regularly to develop a plan. Typically we met about two times a week during the pandemic that was going on then, and it was really just to develop a plan with the most up-to-date information that we had, to really make sure that when this was all over, that we started to execute on that plan day one. We brought in physician leaders, a lot of our specialists who were not heavily into the treating of patients during that time period. And so it was a critical time for us and it was a really good experience because it allowed the people who need to focus on patient care to do that, and it allowed the people who necessarily weren't crazy busy with our regular growth activities to be productive and useful. And so this growth council that we developed was great because it did allow us to be both valuable and productive yet, give us something to do that was of critical importance to the organization. And as we came out of the swine flu epidemic, we were able to execute on that plan because we had the right inputs. We had surveyed the physicians in the market to understand what was happening. We understood some of the backlog issues in surgery that were occurring and we were able to start to prioritize how we were going to open the ORs again in a way that both helped us from an organizational standpoint with revenue, but more importantly helped from a patient care standpoint. So I felt like those learnings and that growth council specifically really set us up for success.

Again, the swine flu epidemic of 2009 is not to the magnitude that we're facing today, but hopefully some of those lessons, some of those learnings may help you all in what you're going through, and if there are tricks or ideas that we can provide, you know, we would love to.

From all of us at Optum and on the Market Advantage team here, we want to support you and we want to help you in any way that we can. And so we're going to continue to aggregate information. We're going to try to understand if there are best practices out in the market that we can help provide - we're going to try and get that information to you all as fast as we possibly can. And by no means do we think that we have all the answers, that we know exactly what to do. We're living in really unprecedented times and we're kind of wading through uncharted waters, but hopefully the guidance that we can provide based on the knowledge we're getting from the clients that we work with, the industry experts that we have on staff here, hopefully all of that can provide you all with a roadmap to help you get through this.

So thanks for listening to me today. Again, thank you for all of the work you're doing in your communities, in your organizations. We are so thankful and grateful for all of you, and we really are hoping and wishing everyone the best. So please stay healthy and hopefully we'll hear from you all soon. Thank you.