The biggest challenge facing healthcare? 'Embracing the embeddedness of IT,' says Bellevue CXO

Despite the billions invested in healthcare technology each year, actual tech adoption in hospitals and health systems has been disappointingly low: American healthcare professionals implement artificial intelligence and telehealth solutions, for example, at significantly lower rates than the global average, per a recent survey.

Healthcare providers have been undeniably slow in deploying digital strategies, but it is time to go all-in on tech — and quickly. There is no reason to fear or resist the transition, since digital health solutions hold the potential to produce not only better patient outcomes, but also greater clinician satisfaction, not to mention lowered costs across the entire industry.

Indeed, according to Linda C. Lombardi, PhD, chief strategy officer and chief experience officer at NYC Health + Hospitals | Bellevue, "IT is a vital and integral part of the patient and staff experience and will be a driving force as the healthcare delivery system is transformed into a more consumer-driven system that is focused on health, wellness and experience."

Bellevue, for example, has already gone full steam ahead in its many digitization efforts. Among these are the implementation of a new Epic EHR, the introduction of staff feedback-gathering stations and the development of programs such as the Mobile Insulin Titration Intervention Program, which sends patients text messages to help them control their diabetes, and which received a National Patient Safety Award in 2017.

Here, Dr. Lombardi discusses how taking a "continuous learning mindset" toward health tech is crucial for the future of healthcare.

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

Question: What is an ongoing or upcoming health IT initiative or investment that you are most excited about?

Dr. Linda Lombardi: NYC Health + Hospitals is implementing the Epic electronic medical record system across all facilities and we have recently implemented the system at Bellevue. This is, without doubt, the most exciting and needed IT investment. It offers the opportunity to communicate across facilities, offers both billing and clinical support and provides patients with access to their medical record through the My Portal function.

Another IT initiative that we are excited about is a software program that enables us to provide real-time feedback to staff about the patient experience. We developed short, six- to eight-question surveys that are administered to patients using tablets. Information from these surveys is shared with staff at huddles and is posted in their work areas. This allows for adjustments to improve the patient experience.

Q: As CXO, what do you believe is the biggest challenge currently facing healthcare? What are you doing to address it?

LL: We are in a transitional period in healthcare, moving out of a long period that focused on illness and disease and into a new phase that focuses on prevention and wellness. This new era is marked by patients who have access to healthcare information through the web and who are focused on health, wellness and the prevention of illness and disease. This transition is seismic in scale for both staff and patients.

For our workforce, adopting a continuous learning mindset is and will continue to be needed to adjust to the changing healthcare landscape. Staff will need to possess and continually refine competencies in IT in order to contribute and compete. For our patients, who will be expected to handle more self-care through IT capabilities, the need to develop comfort with wearables and using self-monitoring, AI and care management will be essential. In short, the biggest challenge facing healthcare will be in embracing the embeddedness of IT in all facets of the health care and the delivery system.

Many efforts are underway to ensure that we are incorporating IT into all facets of care. The Epic system is the most important effort underway for our system right now. Implementation of this system included major training efforts and is representative of the commitment to ongoing education and skills development that will be needed.

Other efforts include ongoing workforce skills development and enhancement in software applications. Developing systems that enable patients to live independently by using "smart" technology that allows for early identification of health issues, and so allows for early intervention, will continue to drive healthcare changes.

We are experimenting with the power and influence of improving the care experience by using real-time feedback meters (four-button devices with color-coded buttons ranging from red to green, dissatisfied to very satisfied) in key locations throughout our clinics. We also use these meters in staff areas and placed outside of staff meetings to gain feedback about staff satisfaction. This technology provides real-time feedback and allows us to make many small and rapid adjustments to ensure engagement.

Q: What are some health IT trends that you think will continue and grow even more important in the future?

LL: Continued progress toward connectivity and interoperability will be a major force in healthcare, and IT will be front and center in this effort. Connectivity will enable improved communication between patients and healthcare providers, and it will support efforts at prevention of illness and disease through open and accessible education and early intervention. It will continue to enable people to manage their health and care.

I also see precision medicine and personalized care as trends made possible by IT in the next five to 10 years and beyond. Communities of care will grow, too, as patients and staff embrace social media and gaming that will allow for sharing experience and knowledge more broadly, as staff and patient become partners in wellness and growth. It's an exciting time to be in healthcare: a field with the power to help and heal, and with boundless opportunities for those entering or working in the healthcare workforce.

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