If Catholic health care providers want to treat the whole person, then spiritual care is a vital piece of that puzzle. So in an age when virtual health care is becoming more and more prevalent, how do we also expand the reach of virtual spiritual care? Justin Martin, Director of Spiritual Care Innovation and Transformation at Mercy in St. Louis, Mo., returns to Health Calls to talk about his teams' latest efforts in the virtual spiritual care space. He discusses Mercy's transition from the COVID Care @ Home program, how the system pivoted to in-house technological solutions, and how to maintain trust with patients who may mistrust technological advances. Resources Learn about Mercy's COVID Care @ Home program, which won CHA's 2023 Achievement Citation award
If Catholic health care providers want to treat the whole person, then spiritual care is a vital piece of that puzzle. So in an age when virtual health care is becoming more and more prevalent, how do we also expand the reach of virtual spiritual care?
Justin Martin, Director of Spiritual Care Innovation and Transformation at Mercy in St. Louis, Mo., returns to Health Calls to talk about his teams' latest efforts in the virtual spiritual care space. He discusses Mercy's transition from the COVID Care @ Home program, how the system pivoted to in-house technological solutions, and how to maintain trust with patients who may mistrust technological advances.
Resources
Learn about Mercy's COVID Care @ Home program, which won CHA's 2023 Achievement Citation award
Brian Reardon (00:08):
Welcome to Health Calls, the podcast of the Catholic Health Association of the United States. I'm your host, Brian Reardon, and joining me is Josh Matejka. Hey, Josh.
Josh Matejka (00:16):
Hey Brian.
Brian Reardon (00:17):
Good to see you. So we are continuing our theme of technology and humanity, and this episode we're going to be talking about expanding virtual spiritual care. And in just a minute we're going to bring in Justin Martin, who is director of Spiritual Care Innovation and Transformation for Mercy. Before we bring in Justin to the conversation, again welcoming back to the show, we want to remind our listeners that Mercy actually won CH a's Achievement Citation Award during our virtual assembly in 2023 for their technological innovation around spiritual care. And so I think it's worth revisiting. And how does this program that they're doing in the initiatives they're taking it on spiritual care fit into our theme this season?
Josh Matejka (01:00):
Yeah, that's a great question. So I think one of the things that we're always kind of alluding to in all of these episodes is how quickly things are moving and how fast things are changing and new technologies are coming in and old technologies are going out. And I think the work that Mercy is doing, especially with Justin and his team is a really great example of that. So you mentioned the Achievement Citation Award back in 2023 for the COVID Care at Home program. Well, in various conversations I've had with Justin over the years after that, what we've learned is that that program has kind of folded into other programs and has informed learnings about future work that they're doing and work that they're doing now. So as we talk about how quickly things are changing, Justin has always been a really great resource for us at CHA to turn to as an example of that, and how Mercy our members are working quickly and working efficiently on those timelines and being able to see future trends and being able to care for their patients in ways that they don't experience disruptions for changing technologies and everything like that.
(02:02):
So I'm really excited to welcome Justin back in because I think people are going to really see the trajectory of how quickly things change and how our members can be proactive and provide the best care in those times.
Brian Reardon (02:15):
Great. Well, let's get to it then. Justin, we see you across the glass from me here at Clayton Studios. Good to see you again. Justin serves as Director of Spiritual Care Innovation and Transformation at Mercy. Welcome. Glad to have you back. And since you joined us last time and talked about the Achievement Citation Award, as Josh said, how has the landscape of virtual spiritual care changed, particularly as we think about it, it's a post pandemic world. So maybe there were some learnings from COVID that have now you've taken and expanded on. So maybe you could start off with just how has the world changed in this particular space for you and your team over the last couple of years?
Justin Martin (02:52):
Thank you so much for having me join you all. So what we've seen change most over the last few years is it's really required us to expand our skillsets of our chaplains in the midst of the pandemic. We were very reactionary needing to quickly change what we were doing, and now we were able to be more intentional and building out our skillset of our chaplains that how do they integrate technology into all the parts of their care and not just as a necessity when they're not able to do inpatient care.
Brian Reardon (03:18):
And Mercy had a little bit of a headstart because you obviously had a very robust virtual care program or programs, and you've got a whole virtual care center that I've toured many years ago that was, I think that was back in like 2018, was just blown away. So you started in a good place, I think with this work.
Justin Martin (03:35):
Absolutely. Mercy invested heavily in our virtual care center in 2015 and quickly started having virtual spiritual care be a service that we provide in 2017. So we did have a little bit of headstart, and we've sort of noticed during the pandemic and certainly since the pandemic, we have become sort of a subject matter expert for other health care systems that we've had. Several Catholic health care systems or hospitals throughout the country reach out to us of how do they begin to move into this space and grow their own skillset and what they're able to offer their patients and families.
Brian Reardon (04:08):
And let's take a step back to COVID Care at home. Just to remind our listeners that maybe didn't hear the episode from a couple of years ago or didn't see the video for the achievement citation, describe that program a little bit and how has it evolved?
Justin Martin (04:21):
So at the peak of the pandemic, mercy invested in a platform that allowed for us to send questions to patients that would look for spiritual distress once someone was diagnosed with COVID. And we built that around four questions, the questions being around meaning purpose and joy, isolation and then grief, and then sort of allowing people to then say, based on those questions, I would like to speak to a mercy chaplain. And we did that quite well via text message. But as we sort of evolved in the post pandemic world, we recognized that we needed to have it better integrated into our other platform step for sustainability. So we've actually pivoted to using a platform called My Mercy, which is our version of Epic's MyChart, where we have those same functionalities, but now we can allow patients to directly message a chaplain just like they would message their primary care provider. They're able to go on there and send a message to a chaplain and a chaplain's able to message back, possibly schedule a phone conversation or a video visit based on what the person may want. And we've rolled that out this past summer and we have over 1.1 million users of my Mercy platform. So it really quickly allowed us to scale it up to all of our patients.
Brian Reardon (05:34):
Nice. And so all the chaplains in Mercy accessing through that platform, is it just a select few?
Justin Martin (05:41):
So we have some dedicated chaplains in our virtual spiritual care that that's their full-time job, but we are continuing to build the skillset of all of our 150 plus chaplains across the ministry that they could do this work if called upon, because we definitely want to invest in growing our field beyond just myself or maybe one other person doing this work, but really how do we empower many chaplains to be able to do this work in a variety of different ways.
Brian Reardon (06:05):
And so the chaplains that are monitoring and responding through my Mercy MyChart tool, are they then following up the patients via text messaging or messaging in the platform, or are there cases where they may decide to call or set up a Zoom call? How does the process work once they get maybe a question from a patient?
Justin Martin (06:25):
Yeah, so part of the Myer platform allows the patient to choose how they would like to correspond. So they're asked would they like a phone call or would they like to continue to message on the Myer platform? So some of our patients may say, I would love a phone call. And some of them like the approach of doing the messaging. So it allows them to choose, and it also just allows for more patients to reach out to us no matter where they're located. So many of these patients may be not necessarily in our hospital or even in our clinics, but may just be a person living their day-to-day lives and having moments of distress and needing a resource. And they're thinking to themselves, Hey, I know that Mercy has this great way for me to connect with the chaplain, let me do that. And it doesn't require them to drive to a Mercy facility to get the care that they want and deserve.
Brian Reardon (07:12):
And so what has the reaction been among, I'll start with the patients that are using this. Have you had any feedback?
Justin Martin (07:18):
Yeah, so we've had some great feedback from patients about the accessibility of, once again, not needing to come to us, but for them to be able to call us or reach out to us and say that there is a need present. We've had everything from people dealing with ongoing chronic grief to people that are needing help, navigating difficult family dynamics to people who are just needing connection to support in their local community, whether it be getting connected with a local Catholic parish or different grief support groups or different affinity groups in our community. We've been a great resource of allowing patients to reach out to us and then we can go from there of how to best support them.
Brian Reardon (07:57):
And for the chaplains using it, I would imagine initially they might've said, huh, I'm a chaplain and I'm used to sitting with folks that face-to-face connection, that in-person relationship that they have. How have they responded and what are some of the feedback from the chaplains that are on the other end?
Justin Martin (08:13):
Yeah, I think I have to shout out, I'm a member of my team, Cody Alley. So it was Cody and myself that started the original COVID at Home program. So he's been on this journey with me for the last two and a half years, and we've been able to move him into this full-time role doing virtual spiritual care. And he has really honed his skill and be able to, how does he take those same interventions that he would provide? And really how does he do that via messaging or how does he facilitate a video or phone call.
Brian Reardon (08:42):
And the infrastructure... you mentioned the Epic tool, and I think a lot of folks are familiar with that. I use it to see my lab reports communicate with my primary care physician, but I would imagine there some more infrastructure around building this virtual chaplaincy. And we talked to Joe Kelly in the last couple of episodes, and he had described some of the relationships Mercy has with third party vendors, other organizations. Did that factor in at all? Did you have a lot of conversations with Epic or talk us through a little bit about how the infrastructure, without getting too technical please, how the infrastructure for this virtual chaplaincy was put together.
Justin Martin (09:22):
Absolutely. So we definitely have built upon those relationships with those third parties. Relationships. Obviously my Mercy is built on the Epic platform, so we've used many of those resources available for us being an Epic system, but we've really empowered our internal relationships. The team that particularly helped build us this platform, were able to really connect it to the formation they received at Mercy. They were very quickly able to recognize that this is just not a technical build, but how are they furthering the mission of Mercy and how providing more patients with spiritual care connects to the larger mission and our larger strategic
Brian Reardon (10:01):
Goals. And had you mentioned this earlier that some other health systems, maybe Catholic health systems have looked to you. What advice would you give to somebody listening as like, oh, this sounds like a good idea, we should try this at our organization?
Justin Martin (10:13):
Yeah, I would definitely say the beginning places, start with relationships. Look within your internal system. Who can you collaborate with? Sometimes we may think our epic teams are quite big, or sometimes from a chaplain perspective scary, but maybe reaching out and building those relationships, seeing who do you have internally that could be a support and advocate for you. And maybe starting with a whole platform may be quite daunting, but maybe starting small, looking at some of the things that Mercy's done previously and maybe start there or even reach out to us at Mercy and see how we can support you.
Brian Reardon (10:46):
And I think, Justin, I remember mentioning that your staff also has the ability to tap into this resource as well. Is that correct?
Justin Martin (10:55):
Yeah, so anyone that has my Mercy account can use it. So we've had some of our own caregivers use this platform to reach out. We've had family members of patients reach out, so it's anyone that has access to the platform can send a message.
Brian Reardon (11:08):
I want to switch gears now a little bit and talk about another program you have in rural areas. Mercy obviously has a very strong commitment and a large footprint in providing care to patients, living in communities that are more rural. Can you talk a little bit about how you've extended that commitment to spiritual care for those patients?
Justin Martin (11:28):
Absolutely. This conversation has been happening for several years internally in Mercy about how do we get professional spiritual care into these smaller facilities that may not be able to meet the traditional model of having a full-time person on site. And it really caused us to set back and think, how are we going to be able to further that spiritual care presence in these communities? So we've really leveraged some our other platforms of video visits and how can we do a video visit with a patient in a small critical care access hospital that may have only five or six beds and would never necessarily be able to afford a full-time chaplain on site, but how could we do a video visit? That same chaplain that does the contact spiritual care also provides care at our critical care access hospitals. We have one chaplain supporting 15 of our critical care access hospitals right now, and we have found that our patients and our caregivers find that to be very fruitful, and it allows them to have the same great level of care that they would receive if they were at our larger hospitals.
Brian Reardon (12:30):
And a question again that would I think be of interest to listeners that are thinking, oh, we should try this, and maybe some of our rural hospitals. How does reimbursement work for that? Is Mercy reimbursed through Medicare for those chaplaincy visits or is that something you just do is a benefit to the patients in those facilities?
Justin Martin (12:48):
So spiritual care in itself is not Medicare reimbursable, but it is something that we at Mercy see very much tied to our identity of the care that we want to provide. We are living into this reality with our strategy 2030 of we want more people to be inspired to choose Mercy for more of their care. And part of that more of the care is more of their spiritual care. How can we have more people look to Mercy to meet their spiritual care needs?
Brian Reardon (13:12):
And the technology, again, it sounds like telehealth essentially. So we have all maybe not experienced that, but we're very familiar with different physicians coming in via screen. And I've seen demonstrations of virtual nursing even within a facility where a patient can talk to a nurse down in the basement in the same building, but it's a way to, again, free up the bedside nurse. Is the infrastructure pretty much the same? So a virtual chaplain would basically use the same monitors and technology that's available for other clinical providers,
Justin Martin (13:46):
And that's what's made it quite sustainable. So it's been much easier just to use what's already in place. So in a lot of these smaller facilities, we already provide virtual care, whether it be virtual ICU or virtual stroke or different specialty services. So we're using the same platforms and same hardware, which it makes it much easier to say, can we just tap into what's already there? Versus saying, we need you to invest in putting cameras and TV screens in every room, but it's already there and we're just tapping into that resource.
Brian Reardon (14:14):
Yeah, it makes sense. Well, before I bring Josh back into the conversation, any challenges in your experiences? You've rolled this out and the program has evolved, both the virtual chaplaincy through MyChart and the telehealth component of that. Any advice or maybe barriers that you encounter that you could kind of talk through how those were overcome?
Justin Martin (14:37):
So a challenge that we continually deal with is variation. As we try to roll into all of our critical care access hospitals, we are really pushing towards standardization. How do we provide the same great one model of care to every facility versus facility A may have a part-time chaplain on site versus hospital B may have a virtual chaplain and hospital C may have volunteers. And the variation sort of allows there to be gaps in coverage. And if we truly live into our values that all of our patients are created an image of God, they all deserve the same level of care. So we're constantly working towards how do we move away from variation and move to a standardized approach that can allow all people to flourish. Yeah. Josh?
Josh Matejka (15:21):
Yeah, Justin, thanks so much for all the updates on the work that's happening at Mercy. I have a question for you more On the humanity side of our technology and humanity seasoned theme, it strikes me that spiritual care can be a really vulnerable process for the patient, especially maybe people are hesitant to talk about how they're feeling about their care or their condition. And so it requires a lot of trust between the chaplain, the spiritual care provider, and the patient. And I think there's a tension there because a lot of technology with it updating so quickly can cause some hesitation on the technology side, people don't necessarily trust new machines and computers and technology, and even if you're not using those things to provide the care, it can kind of create this barrier of trust. So as you lean into this idea of needing to create this trust with patients and also doing it in a way that might seem scary or new to some people, how do you develop that trust with patients in these new forms of caregiving?
Justin Martin (16:22):
Yeah, I think we lean heavily into person-centered care and recognizing that there are limitations to virtual spiritual care. There's some particular things that we are not skilled to do, and we're very honest about that. We recognize if there is a trauma situation or a crisis or death, having a tablet or someone on a screen may feel very impersonable and may not be the best care model. And we recognize that limitation and we create other solutions, provide needs that do feel more living into our mission. But as I've also found that patients build trust by having a person they're able to see on video, video is a great way of removing that barrier of this sort of disenfranchised voice talking to you that sometimes we have patients that can fill on telephone, and we found that many people are quite receptive, especially if the model before was them receiving no care. I always use the phrase, some care is better than no care, even if it is far from perfect.
Brian Reardon (17:27):
Yeah, and I think this again speaks to how essential spiritual care is in the delivery overall of care. It's again, addressing the whole person. And I think that definitely distinguishes Catholic hospitals maybe from other hospitals in the emphasis on making sure those spiritual needs are met. And I think this is just another approach to ensure there's no gaps in that care.
Justin Martin (17:48):
Absolutely. And I would just add, we are very clear that virtual spiritual care will never replace in-person spiritual care. Oftentimes, I encounter that as a fear of chaplains or even patients that by having virtual spiritual care, we're somehow removing that human connection or devaluing the traditional models, but we're actually adding to an augmentation of what was lacking previously. And another thing that I would sort of note from the previous answer, we recognize that sacraments are something that we will never be able to provide virtually.
Brian Reardon (18:20):
Oh, good point, yeah.
Justin Martin (18:21):
So we're always, in virtual care, very cognizant of our limitations, and if we have a patient that is needing the sacraments, we're very mindful of our limitations and we'll help connect them to an onsite appropriate resource.
Brian Reardon (18:33):
Justin Martin, Director of Spiritual Care, innovation and Transformation, it was great to have you back again with Mercy to give us an update. Really appreciate your time and the good work you're doing. Thank you so much. This has been another episode of Health Calls, the podcast of the Catholic Health Association. I'm your host, Brian Reardon. Health Calls Executive Producer is Josh Matejka, and we have additional production support from Yvonne Stroder. This episode was engineered by Brian Hartmann at Clayton Studios here in St. Louis, Missouri. You can find Health Calls on all of your favorite podcast apps and services, as well as on our website, which is chausa.org/podcast. You'll also see links to the achievement citation video that we mentioned. If you enjoy the show, please give us a five star rating, share your feedback. We'd love to hear from you. And as always, thanks for listening.