“It’s Not About a Killer App”: CIO Perspectives on Digital Transformation
Guest contributor Kate Gamble, Managing Editor & Director of Social Media at healthsystemCIO, summarizes key findings from a recent webinar featuring two healthcare leaders as well as Kyruus’ own Scott Andrews, General Manager, Health Systems.Since the onset of COVID-19, digital technology has continuously reshaped the experience for patients, providers, and other staff, and has prompted leaders to constantly ask a critical question: What value are organizations deriving from the investment — not just for clinical and operations teams, but also patients and consumers? And how will that value be measured on an ongoing basis?
“That’s become much more of the focus in how we evaluate both our incumbent technologies, as well as those solutions we’re looking at now,” said Rob Bart, MD, CMIO at UPMC, during a recent webinar.
Whereas prior to the pandemic, digital strategies concentrated largely on point-specific solutions, now it’s a whole different landscape, he noted. “There’s been a rapid maturity within the space into different platforms that people can leverage to create a much more holistic experience for the patient or consumer.”
It has forced leaders to reassess their digital transformation strategies and take steps to ensure their teams are taking the right approach to drive the best possible outcomes. According to Joel Vengco, Chief Information & Digital Officer, Hartford Healthcare, who also served on the panel — along with Scott Andrews, General Manager of Health Systems, Kyruus — it starts with changing the lens.
“Digital isn’t about the technology in and of itself,” he said. “It’s not about a killer app. It’s about capabilities that enable you to harness what you have in your organization.” At Hartford Healthcare, this means “selecting digital capabilities that enable us to not only be more efficient, but also more effective in the way that we provide services.”
At UPMC, it also means having to justify the spend, both in terms of total dollar amount and percentage of the total budget, noted Bart. “We’re always being asked to evaluate and reevaluate our impact on the overall health system budget,” and not just with shiny new toys. In fact, if leaders fail to justify the spend even years after a technology is deployed — and document those findings — it can easily be “lopped off of the budget.”
And so, demonstrating technology’s value on an ongoing basis “has become much more of the focus of how we evaluate our incumbent technologies, as well as those solutions we’re looking at right now,” he added.
Building a Platform.
Like many initiatives, digital transformation requires a solid foundation. The bottom layer is comprised of data that have been collected via EHRs, with digital capabilities making up the next layer, according to Bart. These platforms are then populated with use cases from clinical, financial, and other areas so all constituencies can find value in the tools, he noted. “It’s not a technology project as much as it is a business and a clinical transformation story,” and with involvement from teams across the enterprise, UPMC will be better equipped to replace one-off solutions with “a true digital front door.”
Product, Not Project.
Another key component in creating a successful digital strategy is to break out of the project management mindset," said Vengco. When he started with Hartford Healthcare in March of this year, his first priority was to rationalize applications through an initiative called Project One, where his team works to identify redundancies and reduce the number of apps.
The next focus was optimization, which required a dramatic shift. “We needed to start thinking about our portfolio with a product mindset rather than a project mindset,” he noted, and abandon the traditional approach of focusing on individual projects, then moving on to the next. “Now, it’s about how do we optimize the product’s capabilities so that you’re evolving it and continuously making it better for users and customers.”
Leaders are also rethinking total cost of ownership (TCO) – both what it means and how it affects decision-making, according to Bart. “In the past, we might have said, ‘This makes the doctors and nurses more efficient,’ or ‘this makes the consumer patient experience better,’ but today we don’t have the ability or the finances to make that the sole criteria for success.” Now, it’s about demonstrating results and documenting them. “The days where we could put in a shiny object that the customers loved, even though we needed 10, 20 or 50 FTEs to make it run on the back end – they don’t exist anymore. We don’t have that luxury.”
Now, leaders must be able to establish a business case, while also articulating the ultimate goals of the initiative — in other words, why it matters — and connecting it to the overall mission of the organization. “It’s always asking, what’s the north star, and then working backwards from there,” said Vengco. For example, if the objective is personalized care, leaders need to determine how digital capabilities can help meet organizational objectives such as improved access.
Simply deploying technology, however, is only one step, he noted. “We know it’s about people, process, and technology, but we like to say it’s about outcomes, experience, and operational change, with digital wrapped around it. If you want a different outcome and a different experience, there must be operational changes,” he noted.
Doing so helps create a pathway to measure success and identify areas for improvement. For example, “if a nurse has to change their workflow and their process, did they do all the right things? Was it cumbersome? If you follow those processes, the technology is almost in the background, and you’re able to pay attention to the metrics for success, and the processes that have changed, to ensure you can achieve those outcomes,” Vengco added.
Determining TCO and measuring it, however, can’t fall on IT – or any single department, for that matter. “It takes the whole organization.”
Both Sides of the Coin.
Similarly, digital initiatives need to be planned and implemented with the whole organization in mind — and not just those on the receiving end, said Bart. The initial forays into digital access focused much more heavily on patients and consumers than on clinical operations. “All that did was create a work queue on the internal side,” he noted. “But if I don’t have enough people to man a central call center, then I probably don’t have enough people to also oversee working a bunch of queues.”
Andrews agreed, adding that it’s critical to consider the operational impact of digital access strategies, and not just the patient experience. “You need to make sure you’re addressing both sides of the coin; if you don’t, you’re probably going to fail in this economic environment.”
Fortunately, the market is shifting to better position organizations for success. According to Bart, some of the more mature solutions now include tools like robotic process automation to provide a better experience for employees, which in turn can decrease redundancy and enable more effective care delivery. “That’s been a big focus for us.”
Through its consumer-facing provider search option, as well as online scheduling, Kyruus aims to ease some of the burden on the staff, while also empowering patients. The technology, however, isn’t designed to replace call centers, but rather to augment them.
Bart concurred with the sentiment, saying: “There will always be circumstances and situations that need to be facilitated by an agent with an interaction, but for those that don’t require an agent, we need to make sure we can help them find what they need. We’re able to document the impact so that when we look back five or 10 years from now, people will say, ‘The reason we’re spending this money here is because it had this type of value for the organization,’ as opposed to just looking at the contracted costs.”
Having that data, he added, can help his team more effectively understand total cost of ownership, along with the total impact that digital transformation can have on the organization.
Hear more insights from these engaging panelists by viewing the full webinar: Remapping Digital Strategies: Establishing Priorities in a Changing Economic Environment.