The Secret to Building Resiliency in a Fast-Changing Healthcare Landscape

Ginna Raahauge, Chief Technology Officer and SVP, Strategy & Innovation, Catholic Health Initiatives

It’s no surprise that 2017 is shaping up to be a year of uncertainty for healthcare. The future of the Affordable Care Act (ACA) will bring changes we don’t yet fully know; however, there are other trends on the horizon like the shift to value-based care, consumer-centered services, and the rapid growth of the IoT that most healthcare CIOs can foresee.

Anticipating these transformations, Catholic Health Initiatives (CHI) has begun evaluating its IT strategy in a more focused way. Looking beyond decisions about offshoring vs. on-shoring and cloud vs. on-premise, we are getting back to the basics of how IT delivers value while remaining resilient in times of change, uncertainty and innovation.

Should an IT strategy start from the ‘inside-out’ or ‘outside-in’?

As CIOs, we know the ins-and-outs of a good strategy. But good doesn’t have to be complex. Sometimes it’s helpful to use a simpler framework that evaluates the current state: what are our challenges, how prepared are we for future trends, and what market pressures might affect our ability to deliver high quality healthcare.

Starting from the ‘inside-out’ means implementing an IT architecture, strategy and processes that solve our internal challenges first. When we examine the user experience of clinicians and hospital administrators, it changes the lens of our understanding of the current state.

 The faster we improve the clinician's experience and productivity, the better we connect to our patients and consumers 

An ‘outside-in’ approach begins with listening to and studying our external customer’s (patient or consumer) needs and then identifying ways to increase demand and/or loyalty.

There is no right or wrong approach: each healthcare organization’s environment will determine whether an ‘inside-out,’ ‘outside-in,’ or blended approach works best.

Inside-out vs. Outside-in: Checklist

Over the past five years, CHI has added more than two dozen hospital care sites through joint operating agreements, acquisitions and investments. This growth has left us with disparate systems, data sources, operational processes and location-specific preferences.

Integrating these localized ways of working has put a great deal of pressure on our enterprise IT to deliver a uniform experience to our internal clinical staff across all locations. Using a simple checklist, we’ve determined where our strategic focus should be.

To align our IT strategy with the corporate growth strategy at CHI, we’ve taken an ‘inside-out’ approach that starts with:

1) The clinical staff experience and productivity
2) A resilient IT foundation
3) Planning for innovation hype cycles and digital transformations.

Clinical Staff Experience and Productivity

When we talk about ‘user experience’, it’s usually in the context of whether patients and their caregivers are ready and able to embrace new technology. In developing our strategy, we realized a necessary precursor to all patient-experience activities was the need to improve and simplify the clinician’s user experience first. That experience can influence the kind of care or bedside manner of any clinician on a good day or bad one.

Based on use cases, we identified the IT pain points that have the biggest impact on our clinical care teams: system lag times, multiple system login IDs and passwords, and provisioning churn. Unlike other industries with high volume and churn, ours is highly skilled and heavily regulated, especially in the areas of patient safety and privacy.

By identifying root causes, we have been able to quantify the impact of each of these in terms of lost patient time (productivity) and costs (accessibility, licensing, and support). Because our clinical staff is the face of CHI and IT experiences directly impact patient care, this data helps us improve IT from the inside-out. More importantly, as IT consumers, our clinical staff is entitled to the same positive user experience as our external IT consumers.

Building a Strong, Resilient Foundation: Identity Management and Data Strategy

While we’ve already seen data volumes multiply through electronic health records (EHR) and other sources, we are preparing for the emergence of IoT and connected medical devices to generate exponential data.

This growth presents new challenges and decisions for IT: which data do we retain, where do we store it, and how do we integrate that data with legacy data? Like any other IT organization, we’ve found that whether data is generated from our technologies or from wearables, our clinical staff and our consumers demand that data be highly available, accessible and secure.

To meet those demands, we’re upgrading our Identity Access Management (IAM) platform and our data strategy and governance framework:

• In 2016 we launched an enterprise-wide Identity Access Management (IAM) initiative to standardize employee access to all systems and better manage our internal digital identities. By focusing on consolidating our internal digital footprint, we can improve the clinician’s experience and position them for more agile growth in the future.

• We are also implementing a new data strategy to govern the systems we use, provide roadmaps to rationalize and consolidate applications, and to deliver tools that help us extract analytics to make our data accessible. Data analytics is truly the Holy Grail: if we’re able to analyze clinical data real-time and detect patterns and trends, we can positively affect the quality of care delivered.

Building for the Future: Innovation Hype Cycles and Digital Transformations

Lastly, at CHI, we’re looking at the healthcare landscape as it is now, and, as we think it will be three to five or even ten years from now. In 2016, we launched the CHI Advancement Center for Digital Innovations. The goal of this Center is to bring rapid prototyping capabilities in-house, and to test new products, technologies and processes early so we lower the risk from capital investments.

The Advancement Center will also analyze healthcare industry dynamics and identify potentially ‘disruptive’ digital trends. If we get this right, the Center can surface the next big idea in healthcare technology, giving our internal teams an opportunity to be an early responder or early adopter. The faster we improve the clinician’s experience and productivity, the better we connect to our patients and consumers. Ultimately, this is our way to speed up our continuous-improvement cycle.

The old expression “The only thing that is constant is change” is certainly true in healthcare IT. For CHI, we see the value in getting back to the basics and developing our strategy from the inside-out. It allows us to adapt to a dynamic landscape while delivering a positive user experience for our clinical teams, maintain a solid yet resilient IT architecture, and prepare for the next wave of digital innovations… whatever they may be.