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From Overhead to Opportunity: Digitally Enabled Transformation

This is the third blog in a series of four aimed at transformation and change management – at the individual and organizational levels.  The first blog addressed now and near-term expense management; the second blog outlined eleven IT-enabled revenue generation strategies beginning now and extending into the future.  The aim of these four blogs is to help health leaders improve the financial well-being of their organizations and find both short and long-term, practical, and pragmatic solutions to satisfy the goals of the Quintuple Aim.  It is crucial to start laying the groundwork for these actions now, regardless of the timeframe involved.

Digital Transformation in Healthcare Provider Organizations

Successful digital transformations create a state of profound new personal and enterprise behavior.  Fundamental changes of this magnitude yield a wide range of benefits that can significantly improve patient care, operational efficiency, overall organizational performance while increasing stakeholder satisfaction, and can further the objectives associated with diversity, equity, and inclusion (DEI) efforts.  These benefits are closely aligned with the Quintuple Aim[1].

Your shared corporate goal should be to “Hardwire the Quintuple Aim.”  Here are some key benefits.

1. Enhanced patient experience: Use digital tools and processes to enable healthcare providers to offer more convenient, personalized patient experiences. Allow patients to access their medical records online, schedule appointments, receive appointment reminders, and communicate securely with healthcare professionals.

2. Improved patient care and outcomes: Empower healthcare providers to make more informed decisions, track patient progress, and deliver more effective treatments via the use of myriad available tools such as electronic health records (EHRs), data analytics, and telemedicine.

3. Streamlined operations: Focus on optimizing administrative and operational processes to reduce paperwork, streamline workflows, and maximize resource allocation. Use (or expand) automation of tasks like appointment scheduling, billing, and claims processing to enhance efficiency and reduce the risk of errors.

4. Data-driven insights: Analyze data collected from various sources, including patient records, wearables, and medical devices.  Initiate or expand your analytics functions to study data generated during routine care as input to some version of a virtuous PCDA (Plan-Do-Check-Act) cycle to become or improve as a high-functioning learning health system.

Identify best practices.  Combine routine person-level data with social determinants of health (SDOH) elements using data from external sources, e.g., public health agencies, the census bureau, weather forecasts.  Insights from combined data sets can lead to improved personalized care plans for individuals, better population health management, and early disease detection.  Use a variety of analytics to improve outcomes and lower costs by identifying high-risk patients and populations.  Intervene before a crisis occurs.

Communicate your findings locally and nationally.  Sharing best practices improves your community and your brand.  It can ignite innovation that adds to the greater good.

In your studies, you will find many areas where health inequities exist.  You must first acknowledge and then address these complex and challenging issues, none of which can be resolved quickly.  CMS and some private payers are working on regulations, processes, and incentives to encourage healthcare organizations to embrace DEI initiatives.

5. Cost savings: While the initial investment in digital transformation can be substantial, it can lead to long-term cost savings. See the first blog in this series for a list of cost-saving ideas.

6. Interoperability and collaboration: Contractually require your digital technology vendors to adhere to industry standards to facilitate data exchange and improve care coordination between and among all stakeholders on the care continuum. Digital exchange improves data integrity.

7. Artificial intelligence: AI has been around for a long time and is evolving more rapidly than ever. Computerization of medical records has created data that fuels AI engines.  When managed well, AI can help drive transformation efforts toward efficiency,   efficacy, and equity.  Explore how the various types[2] of AI can be deployed safely using familiar techniques used in developing new drugs and administering clinical trials.

8. Telemedicine and remote care: Implement or expand telemedicine and remote care services to reach patients where they are.

9. Regulatory compliance: Ensure contractually that your digital systems are designed to comply with healthcare regulations and data security standards. Require vendors to provide updates to stay compliant with laws like the Health Insurance Portability and Accountability Act (HIPAA) and make sure they hold your organization harmless for their failures to address regulatory issues.

10. Employee and staff satisfaction: Changes will impact the care delivery staff and those who support them. Involve affected employees and staff in digital system design decision-making.  Employees and staff who are engaged in making changes in their workflows are less likely to leave.  Use automation and process optimization to simplify routine tasks so that healthcare professionals can focus more on patient care and clinical decision-making.

AI, particularly generative AI, is a hot topic which has caused a lot of confusion and concern.  Bring employee and staff thought leaders together to talk about the impact on people – employees, staff, patients, and families – when AI is deployed.  Be transparent.  Transition is the hardest part of transformation and can be painful.  Share your plans in clear, unambiguous terms.

11. Competitive advantage: Digital technologies are table stakes now. Early adopters will gain a competitive advantage.  Patients are increasingly seeking providers who offer convenient and technology-driven healthcare services.

As was stated above, successful digital transformation creates a state of profound new personal and enterprise behavior.  Synchronizing change at the individual and corporate level is essential.  If either party is not part of the change, the transformation will fail.

To see options and practical suggestions for change management, watch for the fourth blog in this series of four coming soon: “From Overhead to Opportunity: Change Management.”

[1] The Quintuple Aim includes 1) improve patient experience, better outcomes, lower costs, clinician well-being (or satisfaction), and health equity.  The first 3 were identified in 2007; the next, in 2014; the last, in 2021.

[2] Artificial, Augmented, Ambient, Generative, Symbiotic, Assistive, Synthetic, Composite (aka Multidisciplinary), Adaptive, Conversational, and Automated are representative but not necessarily all types of AI.

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