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A master-class in rapid innovation

When COVID-19 struck, OrthoNebraska suddenly faced an urgent need for telehealth services. To deploy remote delivery, however, the leadership team had to make difficult decisions about usability, experience design, and patient recruitment—all in a matter of weeks.

With the help of NRC Health’s patient experience and marketing solutions, however, OrthoNebraska’s leaders were able to confidently develop, deploy, and test their telehealth approach. This included:

  • Designing a front-end web presence to effectively guide patients to telehealth services
  • Dramatically reducing wait-times with a digital onboarding process
  • Effectively triaging patient populations to select the best candidates for telehealth
  • Assembling a customized implementation of telehealth delivery, which met the organization’s needs better than any out-of-the-box solution



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Almost overnight, for health systems around the country, COVID-19 transformed telehealth from a back-burner issue into an urgent need. Without a solution for remote care delivery, organizations faced the prospect of missed appointments, severed relationships with patients, and, most seriously, potential adverse outcomes arising from care delays.

These would be untenable problems for any healthcare provider, and OrthoNebraska, an orthopedic specialty hospital in Omaha, was no exception. However, OrthoNebraska was especially vulnerable to patient attrition. The standard practices of orthopedic care—surgeries, imaging, physical therapy, etc.—make it unusually dependent on in-person appointments. In the era of social distancing, it would be extraordinarily difficult for an orthopedic specialty hospital to thrive.

It was this issue that drove OrthoNebraska’s leaders to develop a first-in-class telehealth experience. They knew that their organization needed an easy, intuitive, user-friendly approach to remote care—one that would drive patient engagement and leave OrthoNebraska’s customers feeling well cared-for.

But how would OrthoNebraska’s leaders know if they hit the mark? How could they proceed with confidence on their telehealth experiential design?

For this, they turned to NRC Health.

“The whole loop of communication and improvement, was essential in making the telehealth rollout come together.”

Beth Gard, Director of Clinical Operations, OrthoNebraska


NRC Health’s Human UnderstandingTM Program proved pivotal for OrthoNebraska’s telehealth rollout.

First, OrthoNebraska implemented the automated survey function reaches 100% of patients within 48 hours of their care episodes. Delivered via SMS, email, or interactive voice recording (IVR), these surveys drive high response rates and rapid turnaround times—giving leaders immediate insights into their customers’ perceptions.

Second, they implemented a reputation function which takes the survey data and publishes it on provider websites in the form of star ratings and reviews. This captures a verified portrait of the consumer experience, earning trust with potential customers and driving a deeper engagement with organizational digital properties.


OrthoNebraska’s telehealth development was an extraordinary exercise in creativity under pressure. With supporting data from NRC Health, OrthoNebraska’s leaders were able to design a comprehensive telehealth practice in just a few weeks.

Here are some of the hallmarks of their efforts.


OrthoNebraska’s leaders knew they would have to win buy-in from clinical staff in order for the telehealth rollout to be successful. The biggest obstacle was not willingness, but a knowledge gap. While most team members were eager to embrace telehealth delivery, many were uncertain about the form it would it take.

In the early phases, then, organizational leaders focused on education. At the same time, they solicited feedback from clinical teams to advise on optimal workflows. This not only helped clinicians better grasp how telehealth would work, but also created an effective triage practice—ensuring that only appropriate patients would be able to make telehealth appointments.


While winning staff buy-in was crucial for telehealth’s success, there was a more important stakeholder to convince: the patients.

OrthoNebraska’s leaders were uncertain about how their customers would receive the prospect of virtual care. Orthopedic care is a uniquely physical, tactile process. Would customers see the value in receiving such care through a screen?

NRC Health’s solution, in the end, proved essential to winning over possible skeptics. By publishing ratings and reviews from patients who’d had positive telehealth experiences, cautious customers became telehealth converts.

“They’re maybe not so certain about virtual care, but with those star ratings and reviews, they have that validation. They see that other people have tried it, so it will probably work for them.”

Bill Citro, MBA, Digital Marketing Strategist, OrthoNebraska


Of course, while drawing in customers was an important consideration, that left the major problem of designing the telehealth experience itself. It’s not enough to simply direct customers to videoconferencing software. There are a host of decisions surrounding the actual encounter—about usability, appointment setting, onboarding, and tech support—that OrthoNebraska needed to address.

They took a data-driven approach, using what they learned from patient feedback data, along with other metrics of customer interaction. By carefully tracking the results of their implementation, OrthoNebraska was able to assemble a smooth, comprehensive package of telehealth delivery.

“When we rolled out the telehealth feature, that immediate feedback was very helpful. There weren’t too many negative reactions from patients, but anything that was negative, we could address very quickly.”

Eric Smoyer, Clinical Informaticist, OrthoNebraska


Following telehealth’s rapid and expansive development at OrthoNebraska, the organization’s leaders had a reaction shared by many patients. Having experienced the benefits of telehealth firsthand, they can now scarcely imagine going without it.

Indeed, the initiative’s success has proven to be inspirational at OrthoNebraska, seeding a host of ideas for expansion of digital delivery—many of which will draw on NRC Health’s data and solutions.

“The success of our telehealth program really opened the door for us. It’s motivating us to keep the ball rolling on our bigger vision for digital strategy—we just keep wanting to go for more, and it’s exciting to be a part of it.”

Nikki Green, Manager of Patient Access, OrthoNebraska


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