Expert forum: Healthcare tech boosts strategy game
By Lia Novotny | March 18, 2019
Recently, athenaInsight spoke with four technology executives about the ways their roles are changing and how that benefits patients and healthcare organizations alike. Here are edited excerpts from these conversations; tweet your responses @athena_Insight.
On the pace of change
Robert VanTuyl, chief innovation officer at Easterseals Bay Area: Technology will disrupt any industry that is slow to adopt technology as a strategic tool. The pace of innovation, the pace of change, driven by cheaper, more agile and available technology, is just speeding up. It is something I see across many, many industries. Healthcare is one of the last big industries that has not yet caught up to the pace of innovation and change that other industries are experiencing.
Paul Shenenberger, chief information security officer at Privia Health: Healthcare seems to lag behind other industries in understanding how technology is going to transform not just the experience within the business, but also the delivery of care. But I think those seismic changes in the industry have started to happen as we all begin to realize how to utilize this massive investment being made in electronic health records, in data warehouses, and applications. We're starting to realize that [new technologies] have the power to truly change physicians' lives and the lives of patients.
On including technology leaders at the table when strategic decisions are made
Shenenberger: Bringing technology experts to the table can really foster innovation within the organization. Technology is no longer an option; it is the driver of every business in the world. And when you look at the top market-cap companies, every single one of them is a technology company. Technology is not an afterthought; it is the business. It's critical that we make sure CTOs and CIOs are part of designing workflows with an understanding of the capabilities of technology – and equally, an understanding of its limitations.
David Chou, vice president and principal analyst at Constellation Research: I've been involved in a lot of turnarounds, often of financially distressed organizations, and it was critical for me to understand the business impact, the workflows, the P&L [profit and loss]. You've never seen a CIO work so hard with a CFO to maximize collections and redesign back-office processes. But that's what a CIO needs to do to be successful as a business leader rather than just a technology leader.
Otherwise, they could just hire an IT manager. You don't need a pure technologist – technology is becoming a commodity. What you do need is someone who can be the glue for the organization, put the pieces together and figure out how to use technology to be a competitive driver.
VanTuyl: Why would you not take a CIO-CTO level of expertise into your strategic planning? We have seen the benefits of this approach. Just five or six years ago, Easterseals Bay Area was a small nonprofit with about $12 million in revenue from donations. Now, we're about $300 million in revenue, serving thousands and thousands more clients – that's year-over-year growth you don't typically see in the nonprofit world.
Without the technology capabilities we built, without the cloud-based infrastructure and agile framework, that would have been impossible. Having a CEO, leadership, and board who see technology as a key driver and input into decisions has allowed us to grow and flourish the way we have. And it's positioned us to consider new business models that weren't possible before.
Chou: If you have a CEO or leader that really gets it, you can pull off some great success. Because at the end of the day, every company is a data company, every company is a technology company – no matter what industry you're in. So if you operate with that mindset, it's really helpful in terms of driving efficiency and being able to maximize the investment you make.
Shenenberger: It's all about the work. And it's important to understand that the workflow is now heavily influenced by the utilization of technology. It drives the organization in so many ways.
On where IT should sit in the organization
Chou: The question to ask is, How many CIOs report to the CEO? Because those are the ones who are always at the table. I don't think that's always the case. A lot of folks still view the CIO and technology as a back-office function rather than a competitive advantage.
Shenenberger: Where the chief of IT role sits in the organization is critically important. You don't want to bury IT too far down into the organization and prevent it from being successful. It should be at the executive level of the organization if it is going to be responsible for driving strategy. And you need to make sure your IT governance structure is set up with both technical and non-technical individuals – business leaders, clinical leaders, IT leaders — constantly bridging that gap until everyone's bought in.
On partnering with other teams and stakeholders
VanTuyl: Using frameworks, such as Scaled Agile Framework, encourages a culture of innovation and agile collaboration that can contribute to better outcomes for strategic initiatives involving technology. If you want a new initiative, if you want to build a new product, you have to start with a lightweight business case and a situation analysis. Part of that analysis is what IT involvement is required. It helps us keep that alignment – top, down, left, right, horizontal alignment as well – constantly evaluating which are the most important initiatives strategically, and which are the most critical risks to mitigate.
Shenenberger: I think the alignment between the chief medical officer and the IT organization is crucial to any healthcare organization at this stage of the game. By and large, nobody wants the IT person making clinical decisions, and there's a good reason for that. Partnering an IT person that understands the technology with that clinician, where they both understand the pros and the cons and the weaknesses of what technology can and can't do, will really help bring it back to the workflow. Because ultimately, it all comes down to that workflow within the exam room, within the patient examination, and how the doctor consumes the information that leads to different clinical outcomes.
Chou: We need the medical community's expertise. We shouldn't be gatekeepers or decision-makers, but we can be good facilitators. And we can and should simplify for clinicians how the technologies that are being deployed connect to the clinical needs.
Shenenberger: I think a good example of that is realizing when IT should lead a project and when they shouldn't. So just because technology is involved doesn't mean that it should be a technology-led project. For example, telemedicine is a technology project where the technology, in all honesty, has very, very little to do with the project. We've all done videoconferencing – it's a commodity technology, no different than email or text messaging. Everything about telemedicine is, how does the doctor see the patient? What are the right patient use cases? How do we bill for it?
So for the IT team to come in and lead the telemedicine project when most of the challenges are going to be associated with physician scheduling and physician buy-in doesn't make sense. Virtual visits should really be run by the business, by a physician, by a provider, with the support of IT.
On proving the value of IT
Shenenberger: The idea of investing in IT for IT's sake has long since passed. Just keeping lights on is no longer a sound strategy as an IT business leader. You need to be at the table, providing business value and demonstrating the value of those investments on a daily, weekly, monthly, and quarterly basis. Like any other vertical within the organization.
Chou: That's critical. We have to be able to articulate the value all the time. For example, even something as simple as a network infrastructure project, you can't explain it as a technology project. You're going to improve the clinical efficiencies of a nurse or a physician. So you really have to reframe some of these technology projects and be able to show the benefit for the organization.
VanTuyl: I think the highest impact is when we can show customer value. Our patients getting statements on time and accurately, knowing when their appointment is going to be and being able to do their acceptance-and-sign forms on an iPhone, not having to shuffle around paper anymore, getting intake packages electronically. I mean, those transitions, it's like you can hear a sigh and a thank-you in the air. And that's when the business starts to realize this is really helping the customer. I believe that is the big step that needs to happen for technology to get out of the closet, so to speak. It's never a smooth ride, but I think there's definitely a network effect once you show value in one area. And at a certain point, especially newer generations, they come in expecting technology to work like their iPhone.
Chou: We have to always be selling. Educating. Simplifying the complicated initiatives. That's a really critical thing for a CIO to do. And someone can't do that just because they grew up in a technology world. Now the CIO has to be a business leader, has to understand the business model, the industry, whether it's healthcare or anything else. For example, if sales can't really explain the revenue cycle or the supply-chain operations of a hospital, then they don't understand the business model; therefore they can't deliver the right impact.
Shenenberger: The key is having the conversations at the executive level to understand the business goals so we can come up with the right key performance indicators for technology initiatives. And IT needs to move away from the mindset that says, “Well, I turned it on, I'm done – we're live, I can walk away." I think both sides have to modify their behavior. And ultimately that modification is, why are we doing the project? What are the project outcomes? What are the business goals? Why did the organization undertake the investment? How do we all focus aggressively on the business objectives and the business outcomes and measure the success of the project based on those?
VanTuyl: We need to be making that connection between the ability of technology to create value at the highest-level business models. It shouldn't just be seen as something that lets us do things more efficiently. We can amplify and accelerate better outcomes and higher efficiencies by creating an innovative culture and the use of technology. It's a very different mindset.
Lia Novotny is contributing editor to athenaInsight.
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