For almost 20 years, John D'Alesandro has been refining what he calls "the world's first performance design firm for hospitals."
Amplefi OPS, a company Mr. D'Alesandro founded in 2008, leverages a hospital's existing IT systems to drive safe, reliable care. For Mr. D'Alesandro, performance design starts with "systemically unlocking" the insights contained in a hospital's metadata to reduce the cognitive load on care teams, allowing staff to focus on patients. For example, encouraging nurses to stop juggling competing priorities, knowing that a performance system is constantly monitoring processes.
"The very best way to solve the operational dysfunction that begets poor performance is to avoid, or at least circumvent, situations that lead to bad outcomes," Mr. D'Alesandro says. "The entire hospital needs the ability to see the same forward picture. Not what has already happened, but what is about to happen."
Becker's Hospital Review caught up with Mr. D'Alesandro to discuss how Amplefi OPS applies predictive analytics to routine hospital operations without requiring clients to undertake extensive IT implementations.
Editor's note: This interview has been edited for length and clarity.
Question: What prompted you to found Amplefi OPS?
John D'Alesandro: The company has been evolving since the late '90s, when my high school buddy introduced me to problems he faced as an emergency doc — most of which involved getting patients out of the emergency department. I had an opportunity to meet his management team, who said they were looking for a "magic trick," or some best practice. I'm a manufacturing engineer by training, and I realized that even though a hospital might seem similar to a factory, it's not a factory. A hospital is full of people, not machines and conveyors. Unlike machines, people make decisions that change steps and sequences. Hospitals are different, so manufacturing solutions lack the power to take hospital operations to the next level. Performance breakthroughs are only possible in hospitals when we engage the people. We came up with this notion that we needed to amplify, or "Amplefi," people's ability to manage what's happening in the hospital.
Q: How does Amplefi OPS use predictive analytics to drive hospital performance?
JD: Hospital employees are multitaskers who are under time pressure, so for them, a useful form of predictive analytics is something that projects a forward picture of what's going on, what's likely to happen next and then help to dynamically prioritize the next actions. If they can see it coming, they can then side-step the situation that would have led to poor results, such as a patient who might have slipped through the cracks and waited for extra hours. When clinicians can avoid these waits, not only is the patient happier, but the load is also lighter for the staff. They can avoid the interruptions, complaints, questions, status updates and phone calls. It can lead to a myriad of unexpected benefits. An important difference also comes in our focus to boost human decision-making. I think people are falling in love with data and dashboards, but we are focusing on tools to boost reliability — people seeing forward, anticipating and acting on the best information available. Our analytics findings need to be both statistically valid and actionable.
Q: What challenges have you faced since the company's launch in 2008?
JD: My biggest challenge is our clients don't understand what we do until they're clients. Unfortunately, they have been told over and over that their problems can be only solved by big, expensive IT solutions — when just the opposite is true. I face hurdles in getting skeptics on board. Hospitals are not exactly filled with risk takers, and no one ever accuses us of being great marketers. Finding that quick explanation hasn't been easy for us. Very often what we do is initially perceived as something a hospital is already doing. When I say we're trying to build a reliable process for hospital operations and patient management, somebody else will say, "Isn't that patient flow? We're already doing patient flow." But it's not really patient flow. We have to persevere and win their confidence. It can be expensive and time consuming.
Q: What best practices have you learned when marketing Amplefi OPS to hospital executives?
JD: We use our own tools to quantify the hospitals that we think we can help. Before we visit them, we have a good idea of the potential impact we can help them achieve. Our best clients have often tried a different technology-fueled or process-improvement methodology. More often, this effort has been expensive, time consuming and hasn't delivered as advertised. We work to pinpoint an area where we can make a measurable impact within several weeks. Putting the benefits out front, with a common-sense plan to win, works best. It's approaching with a specific plan for a specific hospital, and saying let's increase market share, rather than "do a project." It involves more of a conversation, rather than a sales pitch.
Q: What is your No. 1 goal for 2018?
JD: I've been listening to the market very closely, and one thing I'm hearing over and over again from hospital executives is "no more technology investments." We are doubling effort on the educational side of our mission to help people understand what we mean by a "reliable hospital" and how to build one. Spending more time in the market coaching, rather than installing. When we work with a client, an important aspect of our approach is to drive out the fear that a big IT project is needed. In many cases, new tech is the opposite of reliability. Instead, we want to make use of the hospital's existing data sources. We are looking for a lot of chances to make a contribution, and I hope to have lots of engaged clients that we can mentor and monitor. Our goal for 2018 is to spread the word.