Healthcare transformation: How hospital leaders are working to drive lasting change amid the COVID-19 crisis

While each day society and the healthcare industry wrestle with the consequences wrought by the COVID-19 pandemic, many hospital and health system leaders are also looking to future and drawing up plans to bring about lasting and necessary change in healthcare.

Becker's Hospital Review recently spoke with Anil Jain, MD, Vice President and Chief Health Information Officer at IBM Watson Health, about hospitals' current opportunity to drive positive change in the industry and the role technology will play in this transformation.

Before COVID-19, hospitals were wrestling with significant challenges

Before detailing the lasting changes that may come to healthcare as a result of COVID-19, Dr. Jain highlighted challenges that predate the pandemic, including the burden of unpacking insights locked within the wealth of data now captured by health systems.

Additionally, before the pandemic clinicians were experiencing alarming rates of burnout and psychological distress. These issues have been exacerbated by the pandemic. Many providers are facing the clinical challenges related to COVID-19 while relying on inefficient processes and outdated tools. Dr. Jain observed that clinicians are asked to step up and do heroic things but aren't necessarily provided the appropriate technologies to do their jobs as effectively and efficiently as possible.

Hospitals and health systems are also challenged with building relationships with patients even before they need care, sustaining these relationships throughout the care cycle and maintaining ongoing relationships after care has been completed.

Further, the pandemic has highlighted the healthcare system's structural and systemic flaws that result in some communities and vulnerable populations being disproportionately affected. This is not a new problem but has received increased attention due to the pandemic.

Dr. Jain posed the question, "How do we emerge out of COVID-19 stronger, more resilient and better able to address these vulnerabilities and systemic issues?"

The COVID-19 pandemic is likely to produce lasting changes along multiple dimensions

Despite the terrible consequences of COVID-19, Dr. Jain says the silver lining of the pandemic is that the entire health system will make large-scale, lasting changes. He highlighted three of these changes.

1. An acceleration of digital strategies and technology adoption. Digital strategies and technologies already play a key role within healthcare, with broad adoption of EMRs and other technologies. But with hospitals trying to do even more with fewer people, technology must play an even greater role in operations and care delivery.

Dr. Jain sees more health systems adopting virtual care models, including both telemedicine and telehealth as well as remote monitoring. He sees greater use of AI-assisted chatbots and virtual agents for patients, an increased focus on data gathering and analytics and even experimentation with drones and robots. These technologies are all focused on increasing a hospital's efficiency and enhancing the patient experience.

2. Modernization of regulatory processes. A positive development from the COVID-19 pandemic is that some regulations that have gotten in the way of innovation have been reinterpreted and relaxed. Examples cited by Dr. Jain include relaxation of some of the HIPAA rules and reimbursement for telemedicine. He is hopeful that efforts to create more agile regulatory processes will be long lasting. "Once the genie's out of the bottle, it's hard to put it back in," Dr. Jain said. He believes that the pandemic has altered the previously conservative mindset of regulators. "I think what COVID-19 has done," Dr. Jain, "is observed allow [regulators] to think about what are the levers that can be moved around to foster innovation."

3. Introspection about financial models. Dr. Jain sees the COVID-19 pandemic as forcing a great deal of financial introspection among hospital and health system leaders. He has heard the question raised, "How do I balance this ability to operate very, very efficiently with the need to be agile and resilient when something like a pandemic comes up?" Dr. Jain has heard from some hospital leaders who are reexamining their revenue cycle and others who are looking at their supply chain, with the thought of adding some locality to their supply chain to avoid kinks in the system.

He believes an increased focus on digital technologies, on more nimble regulation and on more robust financial models will continue far beyond the pandemic.

Many hospital leaders are struggling with how to prioritize their future technology investments

With many hospitals and health systems looking to improve operational efficiency and strengthen relationships with patients, Dr. Jain is frequently asked how hospitals should think about prioritizing and allocating technology investments.

He advises hospitals to "start with the basics." By this he means viewing technology as an enabler and aligning the people, processes and governance model around the organization's goals and strategy. He recommends that each organization develop an action plan and a technology roadmap that is focused on helping the organization execute its strategy. Dr. Jain offered the following advice, "You cannot do everything at once," and, "Not every roadmap will look the same." That's because hospitals are at different points in their digital maturity and have different goals and priorities.

Some hospitals are in a position to create their roadmap themselves. However, in Dr. Jain's experience, most organizations can benefit greatly by bring in an independent, external voice with this specific expertise. An external voice can be vital in shepherding the process. With so many opportunities to take advantage of digital transformation, Dr. Jain encourages hospitals to start by first working to improve back-office efficiency. This entails focusing on tasks mandated by regulation and using technology to improve the efficiency of these tasks, which may include collecting data, measuring results and producing reports.

Dr. Jain also sees significant opportunities for hospitals to leverage technology to strengthen relationships with patients. Examples such as patient portals and consumer chatbots can provide valuable assistance to patients in an efficient, cost-effective way.

Also, for hospitals that may have delayed investments in revenue cycle improvements can no longer wait. Improving the revenue cycle performance is now a top priority for every organization. Dr. Jain noted, "Revenue cycles are an area where we ask our clients to start focusing some of their digital transformation energy."

IBM is providing relevant, integrated technological solutions to some of health systems' most significant problems

In the current environment, hospital leaders are looking for technological solutions that can help improve efficiency, patient engagement, the revenue cycle and more. However, it's important that these solutions work together to optimize care, improve outcomes for patients and populations and enhance the patient experience.

To help succeed in this changing landscape, IBM helps hospitals and health systems create technological

roadmaps and action plans, and offers solutions that address some of today's most pressing healthcare problems. For example, IBM's Phytel solution identifies patients who have delayed or deferred routine care, such as an appointment for diabetes or high blood pressure.

After flagging these patients for an appointment, the outreach capabilities can engage patients, build trust, eliminate hesitancy and remind them of the need to receive regular care.

At Tulsa, Okla.-based Utica Park Clinic, leveraged this solution to help boost annual patient visits by 30 percent and decrease its no-show rates with automated, persistent multimodal appointment reminders. A representative from UPC said, "Providers needed to quickly identify gaps in care and perform outreach using up-to-date protocols, especially for individuals with complex, chronic conditions that require consistent, frequent care." Importantly, Phytel integrates seamlessly with UPC's Epic EHR software, making it easy to use.

Another key focus area is clinical decision support tools that provide evidence-based knowledge at the point of care. They support clinicians with a timely, curated, evidence-based understanding of how to manage specific patients. As one user said, "Front-line clinicians are looking for things like dosing information for different medications, IV compatibility, potential drug interactions, and my team needs to be able to deliver answers quickly, but we also need to be certain that they are accurate for each patient." IBM's Micromedex provides the knowledge that clinicians need when they need it.

Conclusion

Overall, despite the COVID-19 pandemic, Dr. Jain is optimistic about healthcare's future. He said, "Nowhere in my career have I seen the significant, accelerated advances that we are making in health and healthcare . . .  we may actually be collecting the data we'll need to answer some very basic questions about what works and what doesn't work in a learning healthcare system, where the word 'system' is starting to really mean a system and not silos of hospitals and doctors."

Dr. Jain continued, "I'm very optimistic that we're becoming much more data driven and that our pace of knowledge discovery is significantly accelerating . . . we have to be thinking about how healthcare takes advantage of this sandbox that we've been given and start to iterate around a digital transformation journey that will make us all better at what we're trying to do. I'm very optimistic."

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