Smaller tech 'tweaks' add up to make a big impact on clinical care

If the idea of replacing a health system's existing workflow with time-saving, results-oriented tech initiatives seems daunting, rest assured that smaller system updates can be just as effective as a total overhaul.

Take it from Joan Zoltanski, MD, chief experience officer of University Hospitals in Cleveland. Throughout her time in the position, rather than attempting to implement an all-encompassing digital solution to address any and all healthcare needs, Dr. Zoltanski has focused on introducing solutions that each tackle a single issue and, together, streamline patients' access to care.

Here, Dr. Zoltanski explains how taking a health system's tech updates step-by-step, while still undeniably challenging, can create big wins in clinical care.

Editor's note: Responses have been lightly edited for clarity and length.

 Question: What are some smaller "tweaks" an organization can make with technology to have a meaningful impact on patients?

Dr. Joan Zoltanski: Any time we simplify access to the digital content and solutions for our patients, we consider it a win. For example, the complex nature of healthcare means there are various digital solutions that are created for patients — self-scheduling, episode-of-care management, personal health record and the like. It is not possible to have one solution for all of your healthcare needs. However, we work on creating a "digital front door": one app that houses all of your digital solutions, such as personal health record, scheduling, virtual visits, wayfinding, and more. It is difficult to unify all digital solutions, but simplifying the "front door" and keeping the challenges of multiple digital solutions as a backstage process is our goal.

Q: And how do these tweaks impact clinicians?

JZ: We have the same goal for our providers: We want to help them provide better care while lessening the burden of the work. So we work on housing our provider solutions in one app as well. For example, we are a large regional healthcare system and we work to help providers stay connected over space and time. Our digital solutions are created to bring clinicians together, even though they may be practicing at different locations on different days of the week. We have solutions that allow doctors to see what other providers are working in the same building that day. So if I have a question for a cardiology colleague, I can open my provider app and see who is in my location, and then I can walk over to their office and talk with them! It also allows me to see what other providers in our system treat different diagnoses, along with their availability.

Many times, providers know whom to send a patient to, but in a large system, oftentimes there are specialists with whom we are not as familiar. The digital solution allows me to search by specific condition and appointment availability. If I need a patient to be seen in the next few days for a specific condition, I can help the patient with these choices. The same app also connects me to my secure messaging system so I can contact that doctor if I need to. There will never be a simple way to treat all patients, but if we can simplify that digital front door and make it easy for clinicians to access the solutions, that is impactful.

Q: What have been some of the most successful technology integrations at University Hospitals in recent months?

JZ: Every time we think about digital interactions, we want to ensure that any IT add improves care and lessens the burden on our patients and clinicians. Recently, we have added the ability for patients to self-schedule, including in many specialty areas. This is a favorite of our patients because they are able to get a view into their options of provider, location and time instead of that view being restricted to a call center.

This app is also used internally by our own team. When patients see the doctor and they are given referrals to see other providers, this app allows for University Hospitals employees, beyond the schedulers and call center, to help schedule appointments for patients. So, a referral appointment can be scheduled by the receptionist before you leave the doctor’s office. Or a referral can be scheduled by your discharging nurse before you leave the emergency room.

Q: What obstacles have you faced in implementing these tech initiatives?

JZ: Our challenge has been the sheer complexity of healthcare IT. The complexity of the individual patients and their needs, added to the many different and complex medical conditions we care for, added to governmental regulations, added to the various payer arrangements — how do you do consumerism in all of that? All of those forces make creating a simple and valuable solution for patients like trying to move Mount Everest.  

Q: Do you have any advice for health systems looking to improve the patient/clinician experience with new technology?

JZ: In the patient experience world, we work to create solutions that offer value but are intuitive and convenient. In the clinician experience world, the goals are the same: valuable, intuitive and convenient. If we do this, patients and clinicians will use the solutions and stay connected with us and each other. Creating connections is the timeless piece of medicine that matters — in person or digital.

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