The Next Digital Revolution: Transforming the Future of Health Care Delivery


By Jeremy Cauwels, MD, chief physician, Sanford Health

Sanford Health plans to use cutting-edge technologies to provide more care options for patients and families living in rural and underserved parts of the Midwest.

The time has come for the digital-access revolution – an innovation that started in banking with the first automated teller machines in 1966 and then, with the introduction of smartphones, pivoted to mobile banking in 2007 – to finally be realized in the delivery of health care and services across America. 

That is the intent of a $350 million gift that Sanford Health received from philanthropist Denny Sanford in September 2021.

Our vision is to create the world’s leading virtual care center, which will coordinate and deliver direct and immediate access to care and resources for people living in rural and underserved areas of the Midwest. We believe the full impact of this initiative will transform the future of care delivery for generations to come.

Take, for example, the need for urgent mental health support. The mental health challenges facing Americans during the pandemic have been well reported — from unprecedented levels of anxiety and depression to trauma and stressor-related factors to suicidal thoughts among children and an increase in eating disorders. This all comes at a time when rural parts of the country are facing a critical shortage of mental health providers, making it even more difficult to access mental health care when it’s needed the most. 

The Sanford Health virtual care initiative will help us deliver on our promise to patients by leveraging the best of technology to provide high-quality, safe care with an emphasis on convenience and affordability.

Recently, a mother of a suicidal young teenager living in a small town in the very remote northwest corner of Minnesota – just 70 miles south of the Canadian border – called in desperation to schedule a clinic visit for her child with a mental health provider. The earliest in-person behavioral health appointment available to her adolescent in crisis was eight weeks out at a medical facility located two hours to the south in Fargo, North Dakota, which would have required the mother to take a full day off from work just to make the round-trip drive. Fortunately, an alternate option was available to her. Sanford Health was able to help her schedule a virtual video visit for her adolescent with a licensed psychiatrist in less than 72 hours.

Sanford Health’s ultimate goal with our virtual care initiative is to improve even a few days waiting time, making virtual visits possible within 24 hours for anyone in our care footprint needing access to professionals from our mental health care team. 

Of course, our vision goes beyond just mental health. The virtual care initiative will extend the care provided by our 10,000 physicians and nurses to the more than 300 mostly small communities and farms scattered across 250,000 square miles of rural America. 

Among our virtual care innovations, Sanford Health will establish state-of-the-art tele-hospitalist services and provide virtual rounding for patients remaining overnight in rural hospitals and clinics to ensure they continue to receive constant care and electronic monitoring while also supporting the well-being of our rural clinicians, many of whom are experiencing high burnout.

We also intend to deploy advanced in-home systems to provide around-the-clock support and monitoring for patients with chronic conditions such as diabetes and hypertension – which will allow us to intervene early and prevent complications that would require hospitalization.

Sanford Health will centralize and oversee remote monitoring and care coordination from a new command-and-control virtual hospital staffed with physicians, advanced practice providers, nurses, pharmacists, respiratory therapists and behavioral health specialists. Design for the two-story, 60,000-square-foot Sanford Virtual Care Center in Sioux Falls, South Dakota, is ongoing, with a groundbreaking planned for 2022.  

Creating and deploying a patient-centric digital experience will require new website structures, more agile customer-relationship-management database functionality, connectivity with existing and new electronic health records and interoperability with emerging new software.

At the co-located Sanford Virtual Care Innovation Institute, physicians will work directly with research and regulatory teams – and medical students – to test and accelerate new advances in digital health that offer solutions for monitoring and improving health in the future.

Further afield, acting as the spokes of the virtual care system, will be five pilot satellite clinics in rural communities, which will pilot telehealth and physician-to-provider consultation to care for patients in new and unique ways.

Today’s patients are looking for a trusted one-stop-shop to meet their health care needs. As in banking, health care consumers will continue to seek simplified ways to monitor their health, understand their care options and access resources. The Sanford Health virtual care initiative will help us deliver on our promise to patients by leveraging the best of technology to provide high-quality, safe care with an emphasis on convenience and affordability.

What the adolescent patient in Minnesota needed most was a conversation with a trained and licensed mental health provider in time to make a difference – in many ways, conversation with a health care professional at the ready is perhaps the best of what virtual care has to offer.

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