PX: Preparing Your Health System for the Digital Transformation

There’s no turning back the tide of digitization in healthcare. So what can executives do to ensure they navigate the unfamiliar territory effectively, and avoid having it wash their health systems into irrelevance or bankruptcy?

Preparing Your Health System for the Digital Transformation

A Healthcare Analytics News® Peer Exchange®

Segment 12/13

Colin Hung, BaSC: I think to your question earlier, Kevin, one of the things that the system can do is allow time for this innovation, right?

Kevin R. Campbell, MD: Yes.

Colin Hung, BaSC: We see it at UPMC [University of Pittsburgh Medical Center], we see it at Mayo Clinic, and we see it at Kaiser. They allow almost that Google approach of, “Take five percent of your time where you don’t have to see patients, you don’t have to fill out paper work, and go and work with the innovation team over here to help give them the advice.”

Kevin R. Campbell, MD: That’s got to come from the hospital system because what my hospital system will say is, “Last month you implanted 35 defibrillators, so why did you only implant 25 this month?” Well, I was working on innovation with our EMR [electronic medical record] interface. And they’d say, “Well, we’re going to cut your salary if we review this for another month.” It comes from both sides, and that brings me to my next question. I think you alluded to it. What can and what must these healthcare organizations do to get ready for this, rather than just throw their hands up?

Colin Hung, BaSC: To me, it’s the time. Allow your clinicians of all types, whether they’re nurses or whether they’re doctors, the time to go work with these innovations that you’ve come up with internally, never mind the companies externally in partnering. Give them the time to go and do this and don’t penalize them for going to do it, like you just mentioned.

Geeta Nayyar, MD, MBA: Pay them for it.

Colin Hung, BaSC: Pay them for it.

Geeta Nayyar, MD, MBA: Just start a committee.

Kevin R. Campbell, MD: Then someone has got to assign an RVU, a relative value unit, for what we do when we’re not doing clinical time. No one is willing to do that because the bean counters are counting beans, and those beans are revenue that you drive to that hospital system.

Colin Hung, BaSC: But I will say with some of the new hybrid models, that is driving revenue.

Kevin R. Campbell, MD: I agree.

Colin Hung, BaSC: Some of these educational institutions have those innovation arms, where they’re monetizing their innovations. I think that model can help.

Kevin R. Campbell, MD: You’ve got the USC [University of Southern California] Center for Body Computing with Leslie Saxon. You’ve got Mintu Turakhia, MD, MAS, out at Stanford with his digital health center. That’s happening around us. We need it to be adopted outside of academia.

John Nosta, BA: It’s a blessing and a curse because right now, every pharmaceutical and life science company, including the ones that are tangential to let’s say prescription drugs, have a CEO who calls the director of whatever and says, “We need an accelerator, an incubator, or one of those collaboratories, whatever the hell that is.” Because there’s JLABS, there’s Mayo Clinic, and there are all of these places, and what they do is adopt the generic formula to seek innovation. They adopt the generic formula. They pull together a head of innovation who is usually the guy whose product is off-patent or who is conversing on Twitter. “Oh, give it to Bill, he’s on Twitter.” It’s not structured correctly. They pull together a generic constellation of people and say, “Let’s have a hackathon, and in 3 days let’s come up with a new idea.” That’s such a bad model.

Colin Hung, BaSC: It is, sure.

John Nosta, BA: And I see that happening time and time and time again. Why? Because it’s driven from the paranoid CEO who says, “Company X has a collaboratory, so we need one too.”

Jane Sarasohn-Kahn, MA, MHSA: Where this can work — healthcare being local most of the time, telehealth aside — is when you bring the regional payer together with the provider and with the innovator, where there’s even a community college that is training a lot of people on EHRs [electronic health records] in many smaller or mid-size markets. Come together with the Blues [Blue Cross/Blue Shield] or another regional payer/provider, integrated system, group of physicians in the market, and group of patients with a particular condition, and start to work together in that ecosystem way. It’s the only way we’re really going to move the needle on cost and quality in our local markets and access. That’s a role the hospital can play, and the payers have got to be part of this as well because that’s where the treasury function is for all of this.

To your point about getting the business model correct, if the leader of this academic medical center or a health system — the CEO maybe — is an MD, we see a lot of success in that model. Or, there’s a CMIO [chief medical informatics officer] like Rasu Shrestha at UPMC [University of Pittsburgh Medical Center]. Rasu is that rare MD MBA who got it together. This is where physician leadership has to stand up and say, “I know we can make this work in a monetizable return, investment way.” I think regionally, this can work because cultures are different from Miami to upstate New Jersey to Canada to Philadelphia. You have to figure out who the players are in that market. In North Carolina, in your market, it’s going to be different than further south in Alabama.

Kevin R. Campbell, MD: Absolutely.

Geeta Nayyar, MD, MBA: That’s right. Jane, you’re spot on. In Miami, at Nicklaus Children’s Hospital, Dr. Narendra Kini is a physician, the former health tech executive, and a pediatrician. They are doing all kinds of innovation in our region, and what they’re doing is actually amazing.

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