How 12 digital execs streamline tech for clinicians

The healthcare industry is increasingly going digital, with artificial intelligence helping diagnose conditions and patients with wearable smart devices being cared for at home.

But are these digital health initiatives actually improving patient care? And are they contributing to an already stressful environment?

Becker's reached out to healthcare leaders on the IT and clinical sides to get their perspectives on how the industry's digital shift is affecting patients and providers. In part one of this two-part series, we asked executives how technology had improved the patient experience.

In this second installment, Becker's asked digital executives: 

How do you believe the clinical side perceives your organization's digital health initiatives, and what are you doing to ensure the initiatives are improving patient care?

Tony Ambrozie. Senior Vice President and Chief Digital and Information Officer for Baptist Health South Florida (Coral Gables): Physicians look after the well-being of patients — including easy access to care and medical information and overall good experiences. For example, getting into and out of an encounter. Digital experiences for consumers help with exactly that if A) they work well for patients and B) they preferably help clinicians in some way or another, but definitely do not create unnecessary challenges and overhead for them.

For digital experiences for physicians, there is a huge legitimate appetite for adoption to simplify their work, especially with EHR burnout and lack of specific collaboration tools. But again, the expectation is that any technology must solve real needs and must work well, which many solutions in the past have not done; as such, there is a healthy "trust but verify" skepticism until proven.

Sure, in the current challenging economic situation, with inflation and labor shortage challenges for all healthcare providers in the U.S., some digital investments have to be prioritized ahead of others, but involving everybody in that balanced prioritization is the way to gain support. 

Tom Andriola. Chief Digital Officer at University of California Irvine Health: The pandemic exposed medical professionals to many types of technology-enabled interactions, many out of necessity. Reactions have varied. Some want to continue those practices, and some want to put them in a drawer and return to the practices of 2019.

For leaders who are attuned to the changes going on in the U.S. healthcare market, they clearly see the opportunity to have a robust strategic discussion around how these new models for virtual care, remote patient-monitoring, "'hospital at home," etc., will impact both the patient experience as well as the healthcare delivery model as we move toward more value-based care contracting.

We're using the opportunity to take a step back, evaluating our digital health initiatives that were implemented during the pandemic and engaging in a process of strategic planning — thinking about the future of our health system strategically and operationally. The conversation has brought together clinical, business and administrative leaders discussing how digitally enabled care fits into our strategic plan for current delivery capabilities and the future services that we see being expanded or coming online. The conversation has always included balancing quality, cost and access.

But post-pandemic healthcare is now also working with new definitions — expectations — around patient preference and experience. We also are evaluating the impact artificial intelligence technologies will have. It has been a good exercise for the organization in that it has forced the discussion and allowed us to reexamine our assumptions.

Zafar Chaudry, MD. Senior Vice President, Chief Digital Officer and CIO at Seattle Children's: At Seattle Children's we follow two paths to ensure clinical, patient, parent and caregiver stakeholders are actively and consistently engaged, and we also measure the satisfaction of our IT services using the Net Promoter Score. Our current NPS is +38.

For clinicians, we have our digital patient access, care and engagement team that works directly with them to provide digital solutions to help with their workflows. We ensure patient care is improving by measuring clinical outcomes using real-time dashboards — built on Microsoft Power BI and underpinned with IBM Netezza data warehousing technology — while multiple improvement projects are driven by our data lakes.

For our patients, parents and caregivers, we have formed an advisory group known as Parent Partners IT Children's Hospital, or PPITCH, to help us define and drive our patient-facing digital strategy. This group, combined with IT staff members, meets regularly to collaborate on how we can improve the digital and technology experience for our patients and families.

Michael Hasselberg, PhD, RN. Chief Digital Health Officer at University of Rochester (N.Y.) Medical Center: One of the benefits of working at an academic medical center is the culture of inquisitiveness and creativity. We encourage our clinicians to bring forward the problems they are encountering, innovate and be part of the solution to advance care.

From the very beginning of our health system's digital transformation strategy, we made it a priority to include clinicians across many different disciplines in the governance process. It is our clinicians who prioritize our digital health initiatives and identify where early wins can be gained. In partnership with our informaticists, the front-line clinicians guide the integration of new digital tools into their current workflows and the electronic health record that they use daily.

Being data-driven and evidence-based are also pillars in academic medicine. To ensure that our digital health initiatives are actually improving patient care, we have invested significant data analytic resources around our strategy, while many of the researchers across our institution are studying the impact of these initiatives on health disparities and clinical outcomes. We have built data dashboards that provide feedback to our clinical, operational and technical teams that generate the insights needed to quickly iterate when we are not meeting our initiative goals. There is no question that healthcare is quickly moving into the digital age, and our clinicians at the University of Rochester Medical Center are engaged and excited for the future of patient care.

William Holland, MD. Senior Vice President of Care Management and Chief Medical Informatics Officer at Banner Health (Phoenix): Over the course of the first two years of the COVID-19 pandemic, we focused heavily on initiatives that helped support our goals of keeping our healthcare workers and patients safe. This included a significant increase in both inpatient and outpatient telehealth deployments, services and usage which allowed patients and clinicians to provide and receive care in the ways that worked best for them.

We are now in a different phase of the pandemic, one where we remain mindful of COVID-19 and also are intensely focused on driving organizational recovery from the impact of the pandemic. Our digital initiatives are transitioning from a COVID-19 focus to one of improving the overall experience of our clinicians through device integration, efficiency through documentation redesign, clinical improvements through advanced analytics and connectedness of care for our patients. Throughout all of this, we have been intentional about involving our front-line clinicians in identifying opportunities, leading and participating in design teams and creating an environment that welcomes open and transparent feedback.

We also leverage a combination of process, balance and outcome measures in each area to ensure that we are making progress in our work and that it has a meaningful and measurable impact on the quality and safety of care we provide.

Claus Jensen. Chief Innovation Officer of Teladoc Health: Traditional healthcare and digital health solutions are increasingly intertwined, and this is a trend that will be accelerating. Instead of asking which type of solution to use when, would it not be a better question to instead ask how we create a hybrid care model that brings the best of both and gives patients choice in a fully integrated and natively whole-person care model?

Our clinical leadership sees our digital health initiatives as the way to reach more people in more meaningful ways. And the way to make sure these initiatives improve patient care is quite simply to work closely together and ensure that we fuse clinical and digital science effectively. We jointly believe that health equity, clinical efficacy and cost-effectiveness can all be addressed by the right blend of care components and resources.

Aaron Miri. Senior Vice President and Chief Digital and Information Officer at Baptist Health (Jacksonville, Fla.): We just went live on a brand new Epic electronic health record which is the direct result of listening to our caregivers on what they need to keep elevating the level of healthcare delivery. That's on top of investments in modernizing the technology stacks across the health system and ensuring that we block and tackle as much as we pursue items like healthcare artificial intelligence, ambient voice technology and other whiz-bang new stuff that are all the rage.

What I appreciate about Baptist Health is the laser focus on delivering the very best patient care possible versus an alternative approach of trying to act like a healthcare product vendor that dabbles in patient care. When you operate with that type of focus where you listen, respect, and engage in providing the highest quality patient care, it's only then that you can strive toward very advanced digital medicine therapies.

Aaron Neinstein, MD. Vice President of Digital Health at University of California San Francisco Health and Senior Director of the UCSF Center for Digital Health Innovation: We view digital health as a set of tools in our care delivery tool kit at UCSF that can help us advance quality care, improve experience, improve access to care and be more efficient in operations, allowing us to serve patients better.

Our digital health team works as part of cross-functional teams that include roles like operations, marketing, design, data science, engineering and product management, giving each team the full complement of expertise and perspectives to design, develop and deploy solutions that will positively impact these outcomes.

For example, for specialty referrals and patient scheduling, by deploying an improved patient web and mobile experience and more efficient back-end operations for handling referrals, we simplified and removed barriers to patients accessing care. Or, in deploying virtual care programs in lung transplant, inflammatory bowel disease and cancer patients receiving chemotherapy, leveraging wearable devices and mobile symptom assessment, our teams aimed to improve patient experience, reduce their need to travel for in-person care and increase the frequency of touchpoints and engagement with care teams, which we hope will have measurable positive impacts on care quality outcomes.

One major advantage of thinking digitally is the goal of thoughtful and deliberate measurement built into every workflow and solution. So, a critical foundation for any of our programs is that each cross-functional team identifies the patient journey, builds in an ability to measure what is happening and continually analyzes those data so that we can see the outcomes and also see which points of friction the patient is experiencing that we can further optimize for. By baking detailed measurements into each program, we can also monitor the data on whether digital health tools are working as we hope, to reduce disparities in care, whether different populations are accessing or using the tools in different ways, or whether measurable gaps in use across populations appear.

Danny Sama. Vice President and Chief Digital Executive at Northwestern Medicine (Chicago): Our clinicians see the great opportunity for digital health to positively impact patients and themselves. However, they are wary about a potential added burden to their clinical workflows. We are constantly thinking about where and how to integrate digital tech into clinician workflows as seamlessly as possible. And every digital solution we consider is grounded in a value proposition to both patients and clinicians in the form of improved experience, increased efficiency or reduced risk.

Eric Smith. Senior Vice President and Chief Digital Officer at Memorial Hermann Health System (Houston): Our clinical providers are eager to adopt our digital initiatives, from online scheduling to virtual appointments — as long as the technology truly makes the experience better, easier and more efficient for our patients. With that in mind, we're working on initiatives designed to help patients have seamless, frustration-free experiences.

One of these is a platform that will allow patients to interact with us more digitally — by text, for instance — to remove the friction they might feel when trying to get information. We'll be able to remind them about preventive screenings, wellness exams and other regular appointments, encouraging them to schedule this routine care and follow up when necessary.

Finally, we're continuing to expand the options for patients to use our enhanced virtual health services when it makes sense for them to do so — helping them get the care they need in the way that is most convenient and readily available to them.

Jason Szczuka. Chief Digital Officer for Bon Secours Mercy Health (Cincinnati): BSMH's digital business (Accrete Health Partners) is unique in that we closely partner with our clinical teams to prioritize, validate and scale our digital initiatives so that we can ensure we solve existing problems, complement our clinicians' workflows and facilitate better experiences for our patients. We are proud of how our clinicians positively perceive and lean into our initiatives.

Prat Vemana. Senior Vice President and Chief Digital Officer at Kaiser Permanente (Oakland, Calif.): At Kaiser Permanente, we are building on our strong foundation as an innovator and continuously expanding our digital platform to deliver more personalized, seamless experiences for our 12.6 million members. Our clinical teams at Kaiser Permanente view our digital health initiatives as an integrated effort. Digital is applied in every area of our organization — from consumer engagement, physician workflows and optimization, to the clinical care setting. Our physicians and clinical teams are involved in designing our digital patient experiences and applying digital to their work in order to provide exceptional, integrated patient care.

To ensure our digital health tools are improving patient care, stakeholders from both the digital and clinical sides are involved in the entire process when developing digital experiences for our members. Kaiser Permanente's unique integrated model facilitates this collaboration and ensures that the right experts are at the table to think about the patient digital experience holistically. Program management, product managers, experience designers, clinical experts and health plan experts are involved from strategy to execution, empowering them to design and deliver successful digital solutions for both the patient and physician. The partnership and collaboration between these groups is essential to ensuring our members' needs and preferences are addressed by digital tools.

Kaiser Permanente is using artificial intelligence and machine learning technology to improve the health outcomes for our members and patients. We are ahead of the curve on delivering machine learning-enabled solutions at the point of care. We gain rapid adoption of these solutions because we have cultivated strong relationships between our physicians, members and patients.

For example, our Advance Alert Monitor tool analyzes electronic health record data for medical-surgical inpatients, proactively identifies those with a high likelihood of clinical deterioration and activates a rapid response care team to develop a care plan. This is completed through a predictive model that uses algorithms created from machine learning and data from more than 1.5 million patients. A 2020 Kaiser Permanente study showed that our Advanced Alert Monitor tool is associated with statistically significant decreases in mortality [with between 550 to 3,020 lives saved over four years], hospital length of stay and intensive care unit length of stay, which shows us the positive impact our digital tools have in patient care and outcomes.

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