How low-code platforms are driving digital transformation in value-based healthcare

Healthcare organizations face ample challenges when it comes to maintaining and meeting value-based care technology and information needs.

This content is sponsored by Appian.

Data integration is especially challenging in health systems. For one, healthcare data is fragmented over dozens or even hundreds of applications at most organizations. It's not atypical for larger organizations to routinely juggle information between 800-1,000 applications across disparate IT systems, according to some estimates. The majority of healthcare IT executives struggle to customize software solutions, make them work harmoniously with one another and integrate their respective sets. Leaders are left to endure substantial pain points on a daily basis with their existing enterprise software.

"Appian has a client with seven different medical records across their care continuum," says Fritz Haimberger, vice president and global industry lead of the healthcare provider business at Appian Corporation. "A patient in the same town can have three different medical records at three different facilities in that system. As organizations continue to acquire providers at different points in the continuum and affiliate with others, the need to have a digital relay that allows them to look at the whole patient record at once is paramount."

In addition, the rise of consumerism in medicine is leading many hospital systems to look for new ways to build brand awareness among current and prospective patients while meeting consumer demands for convenience, access and efficiency. Digital transformation initiatives, including patient-facing apps, are popular means for healthcare organizations to engage patients both within and outside the healthcare arena. Apps let patients schedule appointments, access medical records, locate the nearest care site or determine whether their symptoms even warrant a trip to the care site in the first place.

Finally, the slow speed of application creation, implementation, updates and maintenance, along with the lack of mobile offline/native capabilities, are no fit for health systems that must adapt to changing markets, strategy and patient needs. In fact, over 80 percent of executives have had to change a part of their business operations to match the way their software works.

Some healthcare organizations have responded to today's care demands by implementing low-code development platforms to meet the app development demands of digital transformation programs while reducing software maintenance costs, improving data integration and enhancing business agility. These organizations are fighting IT system sprawl by taking advantage of flexible, scalable, low-code enterprise solutions to create a single digital platform that consolidates and unifies healthcare content and gives organizations opportunities to more quickly build new solutions using technology they already own.

State of the Union: Digital Transformation in Healthcare

Stakeholders agree: Interoperability across clinical systems is crucial for physician decision-making and improved quality of care. Giving providers access to patient data from disparate sources enables each member of the care team to base clinical decisions on a comprehensive image of patient health, reducing chances for duplicate testing, gaps in care and medical error.

It's true healthcare providers have made some gains in interoperability in recent years. However, advances across the four domains of interoperability — finding, sending, receiving and integrating electronic information — have been uneven at best. It's worth noting most health systems have put greater emphasis on exchanging data than combining it. In fact, a 2017 Health Affairs study found providers' interoperability efforts have largely focused on developing skills related to sending and receiving data, rather than on integrating data into a single view.

Although data sharing is important to advance the adoption of value-based care models, uniting enterprise data from multiple information systems into a single access point is integral to making data usable where it counts — at the patient bedside. After all, data is only as valuable as the insights it yields. Nearly 50 percent of healthcare IT executives said improving data integration would reduce operational expenses and improve care delivery at their respective organizations.

"Data is everywhere, and yet there are no insights — millions of dollars are spent on software yet there isn't a holistic view of the health system or a 360 degree view of patients," Mr. Haimberger says. "A greater focus on integration, rather than on the sending and receiving of data, may help shift hospitals' focus to making data available at the point of care when it is clinically relevant."

IT sprawl is problematic for hospital staff beyond the IT department. In fact, the effects of poor data integration and system usability are felt most acutely by front-line providers, who rely on multiple systems and apps to accomplish daily tasks. Consider that physicians spend, on average, 50 percent of their work day entering data into EHRs, nearly twice as much as the 27 percent of work hours spent interacting with patients, according to a 2016 study in Annals of Internal Medicine.

Physicians have a right to harbor healthy skepticism of health IT. Excess time taken ticking EHR boxes has directly contributed to the rise in physician burnout, with nearly 50 percent of physicians reporting frequent or constant feelings of professional burnout in the past year. However, despite many physicians' frustration with current technology, they are interested in digital health tools they believe will improve clinical practices and patient safety. Physicians find digital apps that improve workflow efficiency, increase patient safety and improve diagnostic ability most appealing, according to a 2016 AMA study.

Low-Code Evolution: Democratizing data across the healthcare enterprise

Low-code platforms help healthcare organizations address IT sprawl and take control of their internal systems, addressing major pain points of traditional enterprise software.

In laymen's terms, low-code platforms are designed to allow nontechnical or "citizen" developers to easily build applications with point-and-click, drag-and-drop tools. This enables rapid delivery of business applications with minimal hand coding and upfront investment in setup, training and deployment.

Low-code platforms can be valuable to healthcare organizations for several reasons. By minimizing manual coding, these platforms speed delivery of apps that help to automate routine and/or laborious tasks, customize reporting and ease workflows for improved productivity and user satisfaction.

"Some applications will be consumer facing and others will help automate employee workflows and improve productivity," Mr. Haimberger says. "Some will be mobile-first experiences while others will address complex workflows requiring the integration of multiple enterprise data sources and external services. Many will address business processes that were developed around email and spreadsheets and never had formalized workflows."

Low-code enterprise solutions come with another enormous benefit: the ability to scale as regulatory and business requirements evolve. Organizations can add workflows and optimize business processes as needed without time-consuming recoding and IT assistance — helping IT staff stay focused on other projects while business users stay agile and make quick adjustments.

These improvements drive value throughout the entire organization, as staff and patients benefit from more accurate and timely information as well as accelerated business processes. Partnering with the right solution partner ensures organizations stay abreast of critical developments and software updates, making low-code platforms a future-proof solution in a fastpaced healthcare environment.

Opportunities for Low-Code Platforms in Health Systems

Mr. Haimberger discussed four opportunities for low-code platforms to enhance daily processes and catalyze digital transformation across healthcare enterprises.

1. More sophisticated data integration. The Appian low-code platform uses the concept of data "Records" to make viewing and storing data from disparate sources more seamless. A record aggregates data from different systems into a single view within an app. Records are built on the notion of views and actions, meaning they are designed to render information, whether that information is physically stored within the app or not. This allows end users to access data from third-party systems without directly copying data into the Appian app, mitigating security risks to sensitive patient data if a user's device is stolen or lost.

"Data doesn't mean all that much if it resides in silos," Mr. Haimberger says. "But when a digital platform can help collect and integrate data in an app, then it is transformed into actionable intelligence that can improve the health of patients."

2. Reduced ownership costs. Low-code platforms give healthcare organizations the opportunity to create custom apps improving workflow efficiency and consumer experience without devoting significant time and resources to the development process.

Traditionally, health organizations rely on contracting or hiring developers and programmers to create custom apps — a process that presents several costly downsides. For one, developers are in limited supply and high demand across all industries, not just healthcare. As a result, developers are extremely costly resources to employ. Moreover, the app development lifecycle can take several months, if not years, infringing upon an organization's ability to innovate and evolve quickly.

"Platforms like Appian's allow organizations to make real-time changes to business and clinical workflows as needed which saves organizations on time and cost," Mr. Haimberger says. "Health systems are able to design and deploy innovations where normally they would have to hire a consultant to develop the app, then worry about the security and the compliance, which is a difficult process for organizations just trying to improve patient care."

3. Emphasize patient and clinician experience. Digital platforms with the ability to help citizen users develop custom, standalone apps aid IT leaders in moving the needle on patient experience and physician satisfaction.

Specifically, low-code application development platforms enable healthcare organizations to produce apps for clinicians, patients and nonclinical members of healthcare staff closely tailored to their unique workflow preferences and needs. By employing clinicians and citizens for front-end development, organizations are more likely to produce an app designed in a way that is appealing to similar users. Using low-code and no-code platforms in a healthcare setting can help clinicians be more accepting of applications, allow organizations to produce a higher number of consumer-and internal-facing apps, and save money on hiring experienced developers.

Staying competitive in a digital landscape

Data integration is becoming more complicated as rising volumes of data and disparate data sources continue to flood healthcare systems. Healthcare organizations are seeking flexible solutions that can quickly process and integrate data so it can actively be accessed and used to treat patients. Having a single software system that can provide for standalone app development, bridge disparate systems and provide a digital overlay for improved data usability will be key to healthcare systems' success managing populations and improving patient experience in value-based medicine.

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