How tech can solve healthcare issues, per 51 leaders

If hospital executives could wave a magic wand and eliminate only three vulnerabilities with technology, what would they prioritize?

These 51 industry leaders share which top pain points they would solve with technology.

The executives featured in this article are all speaking at Becker's 8th Annual Health IT, Digital Health + RCM Annual Meeting: The Future of Business and Clinical Technologies which will take place Oct. 3-6, 2023, at the Navy Pier in Chicago.

To learn more about this event, click here.

If you would like to join as a speaker, contact Randi Haseman at rhaseman@beckershealthcare.com.

As part of an ongoing series, Becker's is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.

Question: Given that there’s so much financial strain that hospitals are reporting every single day, what are your top three pain points that can be solved with technology?

 

Michelle Stansbury. Vice president for innovation and IT applications of Houston Methodist: Patient access continues to be a priority for us at Houston Methodist. We’ve found that utilizing conversational AI with our call center can help us with patient conversion, increased call-in capacity and cost reduction. Two examples where we have seen success is with our COVID-19 vaccine hotline and our main operator line. Another area of focus for Houston Methodist is using predictive analytics. While this area is still somewhat in its infancy, it’s helping physicians and staff understand how we can efficiently give our patients the best care, intervening in a timely manner for patients to have the most favorable outcomes. Staffing has always been a challenge in healthcare, but Houston Methodist has found incredible success through our virtual nursing program, which lifts the heavy documentation activities from bedside nurses so they can focus on providing high-touch patient care. Similarly, remote patient monitoring technology supports staff in the inpatient and outpatient setting by helping to collect vital sign information on a regular cadence or helping to prevent unnecessary readmission by catching issues sooner. While these are just a few examples of technology that have helped Houston Methodist improve the overall health care experience, we know that innovation and digital health technology will continue to evolve, and so will we in order to benefit our patients and staff.

Eric Smith. Senior vice president and chief digital officer of Memorial Hermann Health System (Houston): While technology can’t solve all the financial challenges faced by hospitals and health systems today, there are certainly areas in which digital capabilities can streamline processes and improve efficiency, thereby helping to lower the overall cost of care. Three of the top areas in which technology can have the biggest impact today are: digital engagement with patients, such as for appointment reminders to ensure optimized schedules and readiness; data discovery as it relates to gaps in patient care to maximize reimbursement opportunities; and multi-channel outreach, to help patients – together with their providers – better manage chronic conditions, leading to fewer, more expensive emergency room visits.

Sarah Poncelet. Division chair for strategy development of Mayo Clinic (Rochester, Minn.): The largest pain points in healthcare is likely our workforce shortages in critical to staff areas such as nursing and technologists. If the use of technology and automation (i.e. AI, robotics and process automation) can reduce administrative burden, we will be investing to reduce manual tasks for our clinical care teams. Clerical tasks such as automating discharge summaries, prioritizing patients for hospitalization and clinical notes are also an area we are better understanding if technology can support our physicians and nurses. Finally, investing in at-home hospital solutions and remote monitoring patients after they have been discharged is an opportunity for technology to support patients after they have been hospitalized.

Benjamin Hohmuth. Chief medical information officer of Geisinger (Danville, Pa.): The top three pain points for hospitals today include:

1. Managing total health – risk-stratifying populations and providing platforms to deliver care and manage utilization to drive value efficiently and effectively.
2. Improving access and ease of use – engaging and managing patients over time to improve outcomes and experience.
3. Addressing labor shortages - Even if we could afford current labor costs, our available labor pool is shrinking due to an aging population. Automating processes that are clearly defined, expanding the reach and impact of every employee, extending careers and expanding the labor pool beyond our market are all areas where technology can play a major role.

Richard Zane, MD. Chief innovation officer of UCHealth (Aurora, Colo.): At UCHealth, we are laser focused on thoughtfully and rationally developing and deploying technology to not only innovate the care we provide but also how we deliver care. It’s part of our DNA. By having everything; bot, line of code, etc., or person work to the top of scope and bring data-driven intelligence into workflows better informing decisions, we know we will do what is best for our patients while lowering cost.  Access, quality and patient experience are three examples of opportunity areas where technology has made significant and meaningful impacts to our patients and finances. Livy, our AI-powered virtual assistant has helped patients more easily schedule and navigate appointments, medication refills and even directions and parking without having to pick up the phone. We have embedded prescriptive analytics into our virtual care capabilities to reduce morbidity and mortality across the care continuum. From inpatient early recognition of sepsis and deterioration, fall and pressure injury prevention to remote surveillance of patients at home with complex or chronic medical conditions, the judicious use of technology has saved and improved lives and prevented expensive escalations of care.

Mona Baset, MBA. Vice president for digital services of Intermountain Healthcare (Salt Lake City): Rather than 'pain points,' I would describe tech tools as imperatives to help everyday operations. They are all about empowerment: empowering patients to manage their health on their time, giving caregivers the ability to focus on value-added work and allowing the organization to bring more efficiency into daily work. When these things are achieved, a positive impact to financials is expected because you reduce staff load and improve satisfaction across the board. Intelligent automation – including robotic process automation, generative AI, machine learning and similar tools – seems to offer promise in helping to accelerate and improve these efforts.

Kelly Black. Vice president for revenue cycle of Novant Health (Winston-Salem, N.C.): My answers are from a medical group volume perspective:

1. Remark/reason code standardization amount electronic remittances. While we have a large code set that is supposed to be 'standard,' payers use the codes differently as do their remittance vendors. This makes standardized denial workflows difficult, and we end up building endless rules for the remark and remittance codes down to the payer and CPT level to route them appropriately. Technology that would define how each payer and vendor is using the remittance codes and would allow us to seamlessly build denial logic without maintaining numerous rules would be extremely beneficial.
2. Our large complex health system gets more than 100,000 payer deposits monthly across numerous bank accounts. Yet we have still struggled to find a comprehensive reconciliation system that will properly reconcile each deposit with a remittance including accounting for recoupments and offsets and transaction fees. Furthermore, it is difficult to track and ensure that zero balance remittances are received and properly posted. Finally, a system that could search payer websites automatically for missing remittances would be the cherry on top!
3. A payment integrity system that would scan remittances for appropriate payment (allowed) amounts per payer contracts. We have our system's contract management system scanning for payments posted according to contract, but a system that would scan remittances for proper allowable compared to contract would be more valuable in my opinion to weed out posting errors and to help find non-compliant remittances causing the allowable (or contract CO45) amount to be quickly identified. 

Shweta Ponnappa. Senior vice president and chief marketing and digital experience officer of Providence (Renton, Wash.): A better digital experience can help alleviate financial strain for healthcare delivery systems. Here are three pain points that can be addressed with technology which can ultimately reduce financial strain:

1. Online appointment booking: Online scheduling platforms and mobile apps where patients can choose preferred dates, times and even specific doctors help connect patients to the care they need via self-service.
2. High no-show rates: Missed appointments result in patients not getting the care they need and wasted resources. We can address this through automated reminder systems using SMS, email or app notifications. Using predictive analytics to identify high-risk no-show patients and adjust scheduling or outreach efforts can take it a step further.
3. Patient loyalty: The complexity of healthcare can leave patients feeling like 'just a number' rather than a unique individual with specific needs. This can lead to decreased patient loyalty and retention. By investing in a branded patient engagement platform that remembers patient preferences and has features making transactional activities like booking appointments easy and uses predictive analytics for individualized care plans, we can build a true relationship.

Shakeeb Akhter. Senior vice president for chief digital & information officer of Children's Hospital of Philadelphia: In my observation of the market, financial strain on hospitals is being generated by two major factors: increased labor costs and increased supply costs. Given that labor accounts for a majority of hospital expenses, our strategy is focused on increasing efficiency and productivity of the labor force by doing the following:

Standardize & Automate: The hospital workforce are unnecessarily burdened by low-value tasks that reduce their efficiency and effectiveness. We are focusing on utilizing AI and robotic process automation to automate tasks that free up time for our staff, particularly clinicians, so that they can free up bandwidth to see more patients and/or practice at top-of-license. For example, we are piloting with Epic the ability to auto-draft responses to patient messages using Chat-GPT, which is likely to save our providers a considerable amount of time. Automation will likely lead to requiring less people to support existing processes, thereby reducing costs and improving margin.

Virtual Care: Applying new and/or existing technologies to healthcare can revolutionize the care delivery model. Virtual care offers an avenue for hospitals to develop new service lines, like care at home, virtual nursing/rounding, remote patient monitoring programs, that can drive growth at reduced cost than traditional 'brick and mortar' driven expansion.

Digital Access: Developing a seamless digital doors strategy that allows easy, convenient access to care will be a competitive advantage. Providers who can use mobile and websites to enable seamless, timely access to care will receive the majority share of patients driving increased growth and revenue.

Advanced Analytics: Applying advanced analytics and machine learning can significantly improve operational efficiency at hospitals. For example, predicting census and capacity accurately would allow hospitals to better staff to predicted volumes reducing potentially unnecessary labor costs.

Salim Saiyed, MD. Vice president and chief medical information officer and diplomate for clinical informatics of UPMC Central PA (Pittsburgh): 

1. Access: Patient access to healthcare remains a top pain point for health systems to solve. Health systems are increasingly turning to digital solutions to enhance and simplify patient access. Patients are increasingly looking and expecting innovations in consumerism for convenience and accessibility since the pandemic. Leading technologies are being leveraged to deploy digital front doors by healthcare institutions to enhance patient access. Digital health tools, such as provider finder, online scheduling, waitlists, patient reminders, two-way SMS, digital check in, chatbots, cost estimators, digital therapeutics and navigation solutions, that can improve access while empowering patients and engagement. 
2. Telehealth and remote patient monitoring: The widespread adoption of telemedicine has enabled health systems to reach patients remotely, reducing the barriers of physical distance and access to advanced specialty care. Focusing on maintaining and expanding telemedicine can help underserved populations, including those in rural areas or with limited mobility, access healthcare without the need for in-person visits, highlighting our commitment at UPMC to reduce digital health equity and enhancing patient access through technology-driven solutions. 
3. People and burnout: It's no secret that health systems have been facing significant challenges since the pandemic for staffing and burnout caused by it. Using newer technology such as AI and Chat GPT tools, we can enhance the documentation and reduce EHR burden. We are focused on creating a health system that is an attractive place to practice medicine. Using Abridge, we are giving our doctors the ability to convert medical conversions into clinical documentation, giving time and focus back to physician-patient encounters. 

Jody Reyes. Senior vice president and COO of Penn State Health Milton S. Hershey Medical Center: At Penn State Health, we are taking significant steps to expand our virtual healthcare services, including emergency and ICU support. Our leading-edge software employs advanced algorithms to deliver comprehensive patient data, not only enhancing the quality of care but also reducing the strain on our teams. These expansions have a dual effect: They improve overall operational efficiency and boost staff satisfaction. Our commitment to leveraging technology also extends to enhancing the patient experience. As an example, our food services department has introduced touch screen systems, streamlining the ordering process and significantly reducing wait times for our patients, guests and staff. In alignment with industry best practices, we are implementing electronic health records across our extensive network, encompassing five hospitals and 225 outpatient locations. This initiative aims to create synchronized systems that improve administrative processes, minimize errors and, ultimately, enhance the quality of our health care services.  

Phillip L. Coule, MD, MBA. Professor of emergency medicine and associate dean of clinical affairs of Medical College of Georgia at Augusta University and Chief medical officer of Wellstar MCG Health: 

1. Admission status and admission criteria documentation: Wellstar MCG Health Medical Center noted that we had difficulty with getting physicians and APPs to enter the correct admission status type and clearly document the admission criteria in the EMR. The incorrect admission status resulted in a significant amount of rework for the utilization review and revenue cycle team. We implemented a solution called admission care that guides the physician or advanced practice provider through the admission criteria using an integrated EMR workflow that has reduced denials and resulted in significant improvement in revenue cycle performance. 
2. Prior authorizations: Prior authorizations by insurers largely remain a cumbersome, time-consuming manual process and providers spend a significant amount of time on administrative tasks related to prior authorizations. Because each insurer is different, physicians are left guessing which insurer will cover which medicine or study requires prior authorization. According to the American Medical Association, administrative burdens were cited as a major contributor to physician burnout and fixing the process is a component of the AMA’s Recovery Plan for America’s Physicians. Technology solutions that improve information flow and better automate processes around these processes could ease this burden and reduce provider burnout and improve quality and efficiency of care.  
3. Data optimization: In the era of the modern EMR, the pendulum has swung from the brief handwritten illegible note to one where clinicians can be overwhelmed by the amount of data presented to them. This can have the effect of vital information hiding in the sea of less useful data elements. As we collect more data from connected medical devices and integrate more devices into the EMR, the ability to sift through these data and highlight important elements will become critical.

Judith Wolfe, MD. Enterprise associate chief experience officer and academic emergency physician of Cleveland Clinic: Operational friction is a barrier to care or frustration due to delays, waits and other service failures, and it significantly impacts patient loyalty to a healthcare system.  Technology that smooths throughput and helps transition patients from ED to bed and from bed to home is key to ensuring seamlessness of care. At the Cleveland Clinic, we leverage communication tools like Epic's Secure Chat to streamline communication. I couldn't work a successful ED shift at my large academic site without coordinating with pharmacy, nursing, and inpatient and outpatient teams. It's a game-changer.

Similarly, tools that communicate diagnosis and treatment plans and help patients understand their discharge plan and post-discharge care have the potential to reduce physician and nurse work burden and help families stay in step with the care team even if they are unavailable for daily meetings. Patients judge the quality of care on the basis of how we connect and communicate with them. They assume high clinical quality when they walk in the door and think about our brand. Whether we meet their expectations is dependent on how well we help them understand their condition and keep them and their families informed about their care process.

Jeff Cohen, MD. Chief physician executive for community health and innovation of Allegheny Health Network (Pennsylvania): The major pain point hospitals are experiencing relates to cost.   Identifying a breakthrough technology is low but not zero and more appropriate for early investors and not healthcare facilities. Focus on technologies and/or approaches that increase labor productivity. Technologies which identify the causation of losses are helpful in framing an approach. It’s one thing to cut costs and another to have a plan for the other side of a RIF. A realistic plan would allow for longer-term approaches (three to five years) addressing non-healthcare-related factors which are influencing costs.

The three points: Understand where the losses are coming from; avoid breakthrough technologies for the sake of differentiation/market share or revenue growth; and invest in solutions that augment labor specifically funded by a facility.

Sunit P. Jariwala, MD. Professor for medicine of Albert Einstein College of Medicine and medical director of digital transformation for faculty practice group of Montefiore Health System (New York City): In my roles as a practicing allergy/immunology clinician and researcher, clinical informaticist, and medical director of digital transformation at the Montefiore Health System, digital technologies have changed the game for our medical center in the following ways:1) enhancing patient self-management and shared decision-making while improving clinical outcomes and addressing health disparities surrounding chronic conditions (e.g. asthma, diabetes); 2) improving between-visit patient engagement and reducing outpatient no-show visit rates; and 3) enhancing at-home virtual care and post-discharge transitions of care through remote patient monitoring and telehealth visits.

Muhammad Siddiqui. CIO of Reid Health (Richmond, Ind.): One technological remedy is the implementation of advanced hospital information systems that incorporate AI and analytics. By doing so, hospitals can optimize their workflows and processes which not only reduces expenses but also enhances patient satisfaction. Secondly, effective revenue cycle management is essential to expedite claim settlements, enhance cash flow and automate processes to ensure accuracy. Lastly, telemedicine platforms can lessen hospital readmissions and related expenses. Remote monitoring can consistently keep track of the patient’s health, and doctors can provide consultation and diagnose from a distance.

Integrating strategic technology can have a tremendous impact on cost reduction, and hospitals can use the saved resources to allocate it elsewhere such as into research and development of cutting-edge treatments or better patient care. In the long run, hospitals that employ advanced technologies will stand a better chance of succeeding in an industry faced with significant financial headwinds.

Seth Jeremy Katz. Vice president for revenue cycle and health information management of University Health KC (Kansas City): While I don’t think that everything can be solved by technology, three areas where it could play a role would be (1) automation of manual tasks throughout your revenue cycle, (2) leveraging advanced analytics to support cost control and resource management, and (3) expanding the digital footprint of the organization beyond basic telehealth to include options for remote patient monitoring or chronic care management which could be new revenue streams.

Darrell Bodnar. CIO of North Country HealthCare (Flagstaff, Ariz.): The routine, redundant and remedial tasks prevalent in healthcare are overwhelming. Whether we are trying to get paid or meet a compliance directive, the volume of repetitive tasks that must be completed every day is incredible. The current explosion of technology advancements including all forms of AI (generative, predictive, interpretive, conversational, etc.) will have a significant and transformation impact on all forms of business, but I still believe it will be profound for healthcare. Automation of repetitive tasks is a pain point that we can immediately have an impact on. 

Technology's impact on data analysis to enable business decisions has matured and will continue to evolve. Intelligent systems will improve this process and enable financial and clinical decisions in near real time, so changes can be addressed before they become serious problems.

Finally, automation or systems will continue to move many functions to commodity services.  Systems and network automation will continue to grow and soon be commodity services.

Considering all the challenges with workforce resources and unprecedented growth, technological advances will be the solution for us to move forward, just like they have in the past. 

David Reich, MD. President of The Mount Sinai Hospital and Mount Sinai Queens (New York City): 

1. Avoiding adverse outcomes using clinical decision support tools that improve outcomes and decrease length of hospital stay
2. Redesigning workflows by automating back-office processes, such as billing and appointment scheduling, and by offering new workforce experiences, such as virtual nursing
3. Enhancing the digital 'front door' to the health system to improve access to tertiary and quaternary care

Zafar Chaudry, MD. Senior vice president and CIO of Seattle Children's: The top three pain points in hospitals that can be solved with technology are: (1) high administrative costs: Technology can help to automate tasks and streamline workflows such as using AI to automate tasks like billing and scheduling. (2) Inefficient patient care: Technology such as telemedicine can help to improve patient access to care. (3) Lack of data integration: Technology can help to integrate disparate systems and make it easier for caregivers to access the data they need to provide better holistic, informed care.

Gregory Bryant. CIO of Governor Juan F. Luis Hospital (St. Croix, US Virgin Islands): Pain points for us revolve around the patient experience so we feel the following helps in a financial sense: 

1. At check-in, we provide an express check-in kiosk to speed up the process and reduce the number of patients leaving without being seen. 
2. In patient accounting, we are implementing machine learning to complete tasks so the staff can focus on more complex tasks, reducing the hours used by FTEs.
3. We automate contact with patients post stay (for inpatient and outpatient) to engage patients to reduce readmissions which we would have to pay for. 

Stephen DelRossi. CFO and interim CEO of Northern Inyo Healthcare District (Bishop, Calif.): 

1. Registration and check-in
2. Denials management (coding and documentation)
3. AP – automated invoice matching for purchase orders and AI for non-purchase order invoices.

John Gaede. Director of information services of Sky Lakes Medical Center (Klamath Falls, Ore.): Three pain points that technology can assist in solving are: 1) Impact workforce management by providing self service features in our new HCM system. Sky Lakes will empower a new generation workforce with familiar mobile tools in managing their schedules; 2) Impact patient experience by providing self-service features in our EMR. Sky Lakes will enable flexibility in scheduling and questionnaires; 3) Automation by using various automation’s in workflows. Sky Lakes will reduce waste and streamline efficiencies in the organization.

Tarun Kapoor, MD, MBA. Senior vice president and chief digital transformation officer of Virtua Health (Marlton, N.J.): Nothing can be solved by technology alone. But if we’re willing change how we operate, technology can massively improve the current financial strain on health systems by:

1. Making healthcare bills more consumer friendly and easier for consumers to pay
2. Letting automation remove repetitive tasks that don’t require constant human intervention
3. Augmenting our most valuable resource, our employees, to more efficiently do what only humans can do

Rachel Bell. Senior director for digital experience and innovation of AtlantiCare (Atlantic City, N.J.): Health systems are challenged today to recruit and retain staff, from clinicians to providers to administrative staff. Digital technology can solve this by providing patients with options to utilize self-service for many of the routines, required steps that come with managing their health. These include the ability to self-schedule appointments and complete registration and medical intake processes digitally; thereby reducing the staff needed to administer these processes. In addition, technology can increase revenue collections through facilitating online bill pay processes and copay collections prior to time of service. The more we can meet our patients where they are digitally, with the technology processes they are used to utilizing in other facets of their lives, the more successful we will be as we continue to incorporate technology in the healthcare space.

Anthony Chang, MD. Chief medical intelligence and innovation officer of Children's Hospital of Orange County (Calif.): I think there are many pain points that can be partly or entirely solved with technology in single or multiple modes. 

One area is revenue cycle management that is often sub-optimally executed. There are multiple tasks within the revenue cycle management domain that can be intelligently automated with a combination of machine learning and robotic process automation. 

Another area is allocation of human resources. Clinicians are often not the best at predicting the vacillations in volume of patients in the various sectors in the hospital, and good use of machine learning can help healthcare leaders to improve their ability to maximize efficiency. 

A final area that is in need of technology to improve is communication in its myriad of forms. The exciting advent of robust large language models like ChatGPT and GPT-4 can help with the escalating burden of communications amongst clinicians as well as to patients and families. 

Reed Smith. Chief consumer officer of Ardent Health Services & Brad Hoyt, MD. Chief medical information officer of Ardent Health Services (Nashville, Tenn.):

1. Reduce the administrative burden on clinicians. Generative AI, for example, allows for the automation of routine tasks like chart summaries, drafting responses for patients or even translating content into other languages.
2. Helping solve the labor shortage. Using technology to aid and supplement the in person clinician is critical. Programs like virtual nursing or AI-driven solutions like chatbots can help the consumer either answer their own questions or get the care they need in a timely manner.
3. Inform and predict the future need and demand. With so much data at our disposal, technology can help us understand where to focus our resources and how to plan for the future. Gone are the days of looking at historical trend lines, we need to focus on modeling and predictive analytics.

Lora Niazov, MBA. Director for enterprise program management office of University Hospitals (Cleveland): From a pain point perspective, there are three things that come to mind: provider billing/coding, maximizing nursing and provider time, and accelerating access for patients to get care. In an environment that is flooded by AI jargon and every bell and whistle, the safest bet that a financially stressed system can get is to double down on the use of their EPIC EHR if they have it. Reducing the use of third-party systems, that are expensive to implement and maintain, will allow for maximized benefits. Given EPIC’s future release plans, they are your best bet to provide the highest quality software that one can attain. Question yourself if you are on the latest version, if you’ve combed all the available features and if you have turned on the ones that can solve your pain and put in the right operating processes to make the most of the software investment. If not, then a third-party system will just add an extra layer of unnecessary complexity. With UH’s implementation of EPIC this year, we are looking to target the pain points mentioned above and have already seen success with our go lives.

Amber Fencl. Digital health executive: Across the care continuum, healthcare technology can play a pivotal role in extending and accessing high quality care into communities through a variety of digital modalities. There is no shortage of digital health solutions available on the market. In today’s economic climate, the challenge is health systems having the capital to make the investment and the resources to support.

The best ROI in today’s landscape will be found through digital enablement that supports the clinical workforce and team members. The right technology investments help team members work smarter. In turn, the patient will be a downstream benefactor (happy provider = happy patient). The healthcare labor shortage is real, and using technology will open capacity, reduce administrative burdens and improve the well-being of team members. For example, utilizing robotics, such as Diligent Robotics Moxi, for routine tasks, like medication or equipment delivery (think of the nurses running telemetry boxes room to room), frees bedside nursing staff to focus on the patient instead and fill the non-clinical staffing voids like runners.

Second, lightening the administrative workload of care teams is paramount. Well-proven ambient and AI innovations, like Nuance’s DAX solution, offer game changing solutions to counter the increasing documentation requirements of providers. The provider’s day is full of patient encounters leaving them no choice but either face their computer typing during a patient visit (patient dissatisfier) or complete documentation on nights and weekends (provider burnout.) Proven AI technologies that do the heavy lifting for administrative tasks not only improve physician well-being, but they also result in consistent clinical recordkeeping where data can be further utilized for valuable predictive and generative AI use cases.

Third, introducing digital first solutions, like Amazon’s Just Walk Out (JWO) or Cedar’s RCM platform, increase efficiency and experience for both patients and team members. Amazon’s JWO offers 24/7 access to quality foods and sundries inside hospitals is a satisfier and saver for both tired visitors and busy hospital staff while maintaining operational budget. Cedar delivers a high value RCM platform not only offering a frictionless, self-service patient experience but also increasing revenue for systems and automating revenue cycle processing.

These are just a few examples of worthy technology investments that are also force multipliers impacting ROI, increasing the efficiency and capacity of team members, and improving both patient and provider satisfaction. The common thread here is using technology where it makes sense to optimize the workforce. Workforce optimization is a pain point across the healthcare ecosystem.

Marcus Speaker, MD. Associate chief medical information officer of Carilion Clinic (Roanoke, Va.): While technology plays a pivotal role in alleviating financial challenges faced by healthcare institutions, it is not the complete solution and cannot solve challenges without changes in both people and processes. Here are three of our pain points where technological solutions can be harnessed.

The first and perhaps most pressing is prioritizing clinician or provider wellness. The well-being of healthcare providers, encompassing physicians, nurses and support staff, is of paramount importance. Addressing burnout and combating high turnover rates among healthcare professionals is imperative to mitigate operational costs and provide excellent patient care. The deployment of AI-driven scheduling and workload management tools aids in optimizing staffing levels, reducing overtime expenses and cultivating a healthier work-life equilibrium for clinicians. Additionally, the design of EHRs with user-friendly interfaces reduces administrative burdens. Investing in technology to support clinician wellness is an investment in staff retention, cost reduction associated with recruitment and the advancement of exceptional patient care standards.

Next, as I have mentioned previously, is enhancing revenue cycle management. Hospitals grapple with intricate revenue cycles that are susceptible to errors. Leveraging technology, specifically through automated billing, coding and claims processing, can streamline RCM workflows. The integration of AI-powered tools can be instrumental in detecting coding discrepancies, thereby ensuring precise reimbursement. Additionally, employing advanced analytics enables hospitals to forecast revenue trends and fine-tune pricing strategies, ultimately bolstering revenue streams while concurrently reducing administrative expenditures.

Lastly, we must consider telemedicine and remote patient monitoring. The onset of the COVID-19 pandemic accelerated the integration and implementation of telemedicine which continues to be an asset for hospitals from a financial standpoint. Telemedicine facilitates the delivery of care remotely, thereby mitigating the need for physical infrastructure and an extensive workforce. Furthermore, the incorporation of remote patient monitoring solutions empowers hospitals to proactively manage chronic conditions which translates to a reduction in costly hospital readmissions and emergency department visits. The strategic integration of these technologies not only delivers substantial cost savings but also promotes patient-centric care.

Addressing these areas through strategic technology adoption empowers clinics and hospitals to enhance their financial sustainability, reduce operational overheads and elevate the quality of patient care while reducing provider burnout. However, it is vital to acknowledge that the successful implementation of these solutions demands investment not only in technology infrastructure but also in people and processes.

Sheldon Pink. Vice president for revenue cycle of Luminis Health (Annapolis, Md.): I will acknowledge that the same pain points are not universal to all hospitals; however, we can garner from our experience that every health system in the country is exploring technological advancements to resolve its most concerning challenges. Workforce efficiency is at the top of my list. How can we manage the newly defined talents entering our workforce and utilize them more efficiently? The level of attrition and turnover has been at its peak for the past two years hindering our ability to manage technological change at its current pace. 'Keeping up with the Jones' is also straining health systems. Organizations must become more technologically advanced to maintain their market share and non-insured population. The digital front door, legislation and the patient becoming the 'new payer' have driven the need for technological advances within our current EHR environment resulting in additional financial pressures. Lastly, it’s workflow prioritization. Staffing shortages have increased in all areas of healthcare. We must ensure our team focuses on the most beneficial tasks for the organization to support.

Garrett Olin, MBA. CIO at Shasta Community Health Center (Redding, Calif.): I think the three that most can relate to are administration processes, telemedicine and remote monitoring, and predictive analytics based on utilization. Streamlining and/or automating administration processes around billing and claims, scheduling and records management would be a big benefit. Expansion of telemedicine and remote monitoring could reduce costs and improve access to care. Finally, being able to predict the needed resources based on utilization through analytics and machine learning can improve systems financially and provide quality care.

James Craven, MD. President for Franciscan Health Physicians of Franciscan Missionaries of Our Lady Health System (Baton Rouge, La.): As reported in a 2021 study, the U.S. spends nearly $4 trillion on healthcare annually with administrative costs accounting for a quarter of this. Even with the pandemic behind us, economic pressures and workforce challenges continue to strain the healthcare system, which is why FMOLHS is constantly looking to improve the patient and provider experience through advanced technology. 

Over 70 percent of clinicians have experienced some level of workplace burnout. In healthcare, AI technology can be used to lift the administrative burden of clerical work which is ultimately a driver of increased system costs. FMOLHS has teamed up with Suki, an AI voice assistant for healthcare, to tackle this head-on. Suki helps clinicians save time on tedious tasks, giving them more bandwidth thus resulting in higher ROI.

Technology also provides a unique opportunity within health systems to enhance patient experiences and outcomes by allowing providers to be able to detect medical conditions earlier. To do so, FMOLHS has created an AI-powered lung nodule program which identifies potentially cancerous lesions and allows for multidisciplinary review. Providers have the ability to identify lung cancer at earlier stages, drastically improving survival rates.

FMOLHS’ goal is to be the number one provider of choice in every market we serve. So any technology that helps achieve this goal in a fiscally responsive way while also enhancing the provider and patient experiences, we are willing to explore

Carol Yarbrough. Business operations manager for telehealth resource center of UCSF Health System (San Francisco): 

1. Communication – federal and state regulatory billing and reimbursement updates, as well as private payor updates, are still a siloed and a hit or miss process. Denials are the way policy updates are primarily transmitted. If an enterprise had energy directed to a centralized – even AI enhanced update gathering type of system – revenue delayed by denials could be waylaid up front.
2. Individual people are still key to solving problems and are dependent on individuals within an enterprise to supply information. A centralized 'Q&A' filter would be great, maybe managed through something like a ServiceNow program.
3. Utilization of ChatGPT-type programs to survey solutions already implemented elsewhere instead of reinventing a process wheel would be good too. The time savings would enhance billing to reimbursement fixes.

April Giard, DNP, MSN. Senior vice president of Northern Light Health; chief digital & innovation officer, client relationship executive and vice president of Optum; and client relationship executive and Cerner strategist supporting Northern Light Health (Brewer, Maine): Building agile analytic capabilities to support operating needs to drive clinical and business outcomes. Operating performance is critical for sustainability for any healthcare system today and in the future. Advancing efforts to redesign workflows to better align with workforce realities. AI, automation and other capabilities allow us to maximize our workforce. We have many technology and digital tools deployed with key and strong benefits to drive our business and address our pain points. Most important and often not discussed as much is the need for broad adoption of the tools and new ways of doing business is required to benefit from the technologies. Northern Light Health is committed to focus and improve on this for the future year, so we can get the value realization of our investments.

Raymond Lowe. Senior vice president and CIO of AltaMed (Los Angeles):

1. Patient engagement efforts to allow patients to better engage with the providers in an omni-channel, culturally sensitive approach. For example, leveraging MyChart and other patient portals that enable patients to make appointments, pay bills, refill prescriptions, auto check-in, view their test results or leverage symptom checkers and interactions with health systems for wayfinding. Allowing the patient to have the ease and convenience to access to health care on their time and schedule is a significant improvement and one that will help achieve greater patient satisfaction as well.
2. Leveraging clinical data for risk stratification models, such as moving from reactive to prospective models that allow us to intervene with patients proactively as opposed to episodic care. Effectively, moving from volume – meaning seeing a number of patients per day – to value-based care where the care is a focused primary care model that is a holistic approach to health care.
3. Addressing health equity gaps and social determinants of care. At AltaMed, identifying vulnerable patients and connecting them with community resources is paramount to our work and care. We need to ensure that we are meeting the overall health care needs of our patients where we can provide resources to address both a patient’s social needs as well as their clinical needs.

Patrick Healy. IT director for digital engagement of Mount Sinai Health System (New York City): There are lots of opportunities for technology to help hospitals financially. Three pain points I’m particularly excited about are:

1. Physician and clinical staff burnout (clinical errors, turnover)
2. Automating low-value tasks
3. Patient engagement and compliance (no-shows, completing referrals, medical adherence, readmission reduction)

What is key for me is finding solutions that are simple, intuitive and 'just work.'

Jahmela Pech, DNP, RN. Executive director for quality management of Providence St. Joseph Hospital of Orange (Calif.): The top three pain points we are currently facing that can be solved with technology are: 1) delivery of simplified experience for our patients and consumers, 2) advance health equities and reduce health disparities, and 3) new models of care. 

Providence St. Joseph Hospital Orange continues to pave the way for our vision of better health through deconstruction, digitization and diversification of our operating model. We are currently deploying multiple recovery programs to address these challenges by simplifying operational and clinical structure, streamlining support services, managing program portfolio, strengthening community investments and optimizing value-based care.

Robert Poznanovich. Chief growth officer of Hazelden Betty Ford Foundation (Center City, Minn.): Following are the top three opportunities that can be solved with technology:

1. Disease management: patients with chronic health conditions, including substance use and mental health disorders, need on demand tools and resources every day and they need ways to build the interpersonal relationships that are important to recovery. Smartphone, phone applications, social media and web platforms continue to evolve and change the way we interact with one another and with the world around us for healthcare.
2. Assessment: The use of voice recognition in AI will expand to help identify mental health conditions that expand care and reimbursement.
3. Digital Interventions: There is research that shows that digital interventions for mental health may ease the stigma and reduce other barriers that are usually associated with going and seeking help for mental health in a traditional care environment. We will reach and serve more patients at a lower cost by expanding digital access to wellbeing portals that provide education, assessment, care navigation, interventions and recovery resources.

Shivani Kwatra, MD. Internal medicine of Kinwell Medical Group (Seattle):

1. Preventative medicine is the key to reducing the financial strain hospitals are reporting. By using technology in the forms of telemedicine, monitoring devices and early detection devices as a whole, healthcare providers are able to prevent unnecessary ER visits. This not only reduces financial strain by reducing unnecessary visits but also allows providers to focus resources and personnel on the patients that are in more critical condition. 
2. Providing resources such as DAX, AI-Automated clinical notes, will allow documentation to be completed in a more timely manner. This will allow providers the ability to spend more time with patients as well as provide care to more patients. 
3. Connected emergency response solutions is a wonderful way to enable more efficient and immediate communication giving providers the ability to already have data on hand prior to the arrival of the patient. 

Fred Cushner, MD. Lead orthopedic surgeon of Hospital for Special Surgery: New and innovative technologies, such as smart sensor implants, can potentially help with financial strain on hospitals by increasing efficiencies, cutting down unnecessary hospital visits for patients and detecting problems before they materialize. 

1. Increasing efficiencies: Cloud-based technologies can help hospitals do many things like monitor a post-op patient remotely in real-time while accurately tracking their recovery progress. This also helps make each patient-doctor visit more productive and convenient. As shown in previous studies, patient compliance rates significantly drop off over time when patients are fitted with a wearable device to track their post-op recovery following total knee replacement surgery. With Canary Medical’s implanted canturio tribal extension smart sensor technology, patient compliance rates are significantly higher compared to their wearable counterparts. 
2. Cutting down unnecessary visits: Enhancements in technology now allow doctors to monitor patients safely and accurately from the comfort of their own homes using innovative smart devices. This real-time data availability can also help aid in physician burnout potentially avoiding multiple patient visits and overtime expenditures while allowing physicians to prioritize appointments that do require an in-person visit.  
3. Detecting problems before they materialize: New technologies now have the capabilities to detect problems faster for patients and their doctors. For example, innovative orthopedic smart implants such as the Persona IQ total knee replacement in combination with Canary’s sensor capabilities enable remote patient monitoring post-surgery. These sensors could help doctors pinpoint the cause at its source allowing them to alter a patient’s recovery plan immediately as needed before growing into a larger issue. This could have the potential to transform healthcare by promoting doctor-patient engagement which may ultimately lead to better patient outcomes.

Tami McMasters Gomez. Director for coding and clinical documentation integrity services of health information management division and patient financial services of UC Davis Health (Sacramento, Calif.): When it comes to addressing financial strain in hospitals, technology can play a significant role in alleviating some of the pain points. There are three areas I would recommend focusing on. First, streamlining administrative processes and burden by implementing technology solutions with an emphasis on automation. Second, enhancing revenue cycle management, technology can help in this space by automating processes in coding, billing, claims processing, payment processing, etc. Third, implementation of telemedicine solutions and remote patient monitoring which can have a positive impact on healthcare costs. By embracing innovative solutions, hospitals can improve operational efficiency, financial performance and ultimately enhance patient care.

Jaideep Srivastava. Professor for computer science and engineering of University of Minnesota (Twin Cities, Minn.): Here are my thoughts on three ways that technology can help.

1. Hospitals have always faced a shortage of qualified nursing and other medical support staff. COVID-19 has exacerbated this shortage with many retiring or opting out of the profession due to physical and mental fatigue. Medical support staff has provided the critical role of both monitoring patient progress in hospitals as well as identifying when things are turning critical with a patient and helping with the triaging process. Both these tasks are highly stressful. Instrument-based monitoring and AI-based decision aids can help medical support staff perform both these tasks far more efficiently and in a scalable manner while simultaneously reducing stress for the staff.

2. Patients living at home with severe chronic conditions as well as patients just released to go home after a serious hospitalization need to be monitored. Nursing and other support staff often have to deal with the burden of both proactively contacting such patients and responding to patient calls. Given the shortage of medical support staff, these functions as well as the staff providing them are under stress. Lifestyle monitoring technologies, e.g. wearables, apps, etc. can help alleviate this problem since the hospital staff would get a continuous view of what is happening with a patient. Additionally, AI-based predictive tools can do early identification of problems before they get worse and also do triaging to help identify cases which are not severe. This will ensure that only the patients that need to go to the hospital do, and the ones who do are there well in time for preventive treatment and care.

3. Hospitals are places full of stress, especially for families and friends of hospitalized patients who do not understand the condition of their loved ones from a medical perspective. Often this stress gets transferred to the hospital staff through tough conversations, unnecessary urgency, etc., which in turn leads to less effective patient care. Generative AI technology like ChatGPT can help in creating patient communication that is more effective for the patient's friends and family and help them understand their loved one's condition better. With this load taken off them, the medical staff can focus better on what they have been trained for namely taking care of patients.

Rick Jiggens. Principal cybersecurity engineer of Kinwell Physician Network (Seattle): From a cybersecurity perspective within a healthcare organization, my top three pain points that can be mitigated with technology are:

1. Legacy systems in hospitals are often costly to maintain and vulnerable to attacks. Modernizing these systems can reduce costs and enhance security.
2. Ransomware attacks, which lead to operational disruptions and potential ransoms, can be curtailed with improved threat detection and staff training.
3. Manual processes, which are time-consuming and error-prone, can be streamlined and secured with the implementation of EHRs and automated solutions.

Ryan Thousand. Strategic advisor for the office of the CIO of Valley View Hospital (Glenwood Springs, Colo.): It’s hard to pick just three top pain points without first going into methodology. I honestly feel we often apply technology in places where it does not necessarily belong, but rather it has been applied in the past and has historical context to show that it might be a benefit to another organization. I’ve always been of the mindset that sometimes you need to take off your cape and use existing processes that leverage low cost, but high output technology. For example, utilization of email and fax machines in place of high dollar interfaces and new processes are often a better answer at least for the short term or proof of concept. So this leads me to my three answers in or top pain points I would solve.

1. Patient engagement: We need to focus on our customers. Putting them first will inertly create happy employees! Since much of the regulatory landscape around MIPS and MACRA are focused on patient engagement, it aligns well with this approach.
2. Provider and clinician satisfaction: Like the above, our customers in IT are also our providers and clinicians. We need to focus on reducing burnout and use innovations like FHIR and other interoperability platforms to truly reduce burden and steps and not ADD to them. We need to focus on the five rights of the provider! The right data presented at the right time and in the right format, so that clinicians can focus on the right diagnosis and right treatments for their patients!
3. Payer provider interoperability: With the data we have today and the rise of AI, we have the tools to fix the payer and provider integration. You can again couple this with the above items in the sense that payers have a lot more data than most providers. Using tools like claims analysis and structured claims risk data coupled with the clinical data we have in the EMRs, we can take health portability and interoperability to a new level.  We are all in this for one reason: healthcare; and now is the time for our payers to 'prove it' rather than profit.

Katie Boston-Leary, PhD, RN. Director for nursing programs of American Nurses Association: ANA partnered with McKinsey and published a time allocation study in June to understand nurses’ pain points and how technology enablement can help reduce their workload. Based on the study, there could be a net reduction of 10 to 20 percent of time spent on daily activities during a 12-hour shift that could be optimized through tech enablement. An investment in digital approaches that automate tasks either completely or partially, rather than simply redistributing workload, could potentially free up valuable time for nurses and could result in reduction of overtime hours, increase patient quality and reduce workload which could in turn improve retention. The top three issues identified in the study are EHR documentation, hunting and gathering (searching for individuals, supplies and information) and medication administration. It’s really tough to solve these issues without having to incur additional expenses or an investment upfront, but there is a likelihood that some technologies are already in place in certain areas or available to certain groups that can be expanded like scribes, device integration, voice enabled documentation, telehealth and turning and positioning patients.Creating a tech-friendly environment for nurses, providers, support and ancillary teams can be a recruitment and retention tool as technology has been as kind to these teams over the years (i.e. has not netted the efficiencies that were initially promised).

Thad Wilkins, MD, MBA. Associate chief medical officer of Wellstar MCG Health and professor of family and community medicine of Medical College of Georgia at Augusta University: When it comes to addressing the financial strain faced by hospitals, new and innovative technologies have the potential to alleviate several pain points. Here are three key areas where such technologies can make a significant difference:

1. Revenue cycle management: Managing the revenue cycle is a complex process involving patient registration, insurance verification, claims submission and reimbursement. Innovative technologies can streamline these processes and improve revenue collection. For example, artificial intelligence and machine learning algorithms can automate coding and billing processes, reducing errors and accelerating claim processing. Additionally, implementing advanced analytics tools can help identify potential revenue leakage points and optimize reimbursement strategies.

2. Operational efficiency and resource optimization: Hospitals often struggle with optimizing resources such as staff scheduling, bed management and inventory control. Innovative technologies can provide real-time insights and predictive analytics to enhance operational efficiency. For instance, internet of things devices and sensors can monitor bed occupancy, enabling efficient patient flow management and reducing wait times. Additionally, implementing workforce management solutions leveraging advanced data analytics can optimize staff scheduling based on patient demand, reducing overtime costs and improving productivity.

3. Remote patient monitoring and telemedicine: Embracing remote patient monitoring and telemedicine technologies can help hospitals extend care beyond their physical facilities, reducing costs and improving patient outcomes. Remote patient monitoring devices, wearable sensors and mobile health applications enable healthcare providers to monitor patients’ vital signs and health conditions remotely. Telemedicine platforms facilitate virtual consultations, reducing the need for in-person visits and associated costs.

These examples highlight how new and innovative technologies can address hospitals’ pain points and financial strain. By embracing AI, IoT and telemedicine solutions, healthcare organizations can enhance revenue cycle management, optimize operations and extend care beyond traditional boundaries. It is essential for hospitals to stay informed about emerging technologies, assess their specific needs and invest in innovative solutions that align with their goals and resources. Embracing innovation can lead to improved financial sustainability and better patient care.

Nick Patel, MD. Founder and CEO of Stealth Consulting and adjunct professor of USC School of Engineering (Los Angeles): Health systems current financial strains stem from three major areas: staffing costs, changes in reimbursement and rising overhead costs (supply chain). These challenges can be aided with a combination of emergent technologies such as: AI/automation tools to reduce mundane tasks and drive scale, digital health services to maximize patient volume, and platforms to catalyze real world evidence generation to improve clinical outcomes and reduce care variation.

John Prunskis, MD. CEO and medical director of Illinois Pain & Spine Institute (Elgin, Ill.):

1. Technology can eliminate most managerial positions at hospitals. Hospitals are currently top-heavy with management.
2. Hospitals should not be under financial strain. The salaries for many administrators have gotten to be exorbitant. With the utilization of technology, many or most administrative positions can be eliminated and existing salaries can be lowered.
3. Technology can increase efficiency and decrease the number of staff needed for multiple processes which would lower cost.

Alan M Reznik, MD, MBA. Associate professor of surgery of Netter School of Medicine for Quinnipiac University and assistant clinical professor of department of orthopaedic surgery & rehabilitation of Yale University (New Haven, Conn.):

1. The supply chain and the failure of just-in-time concepts in a shortage world
2. Putting doctors back in charge of medical care
3. The ethics of computerized protocols, patient choice and the interference with the doctor patient relationship for share decision-making 
4. Insurance pre-approval as de facto patient care without a medical license

Tony Das, MD. Founder and CEO of Connected Cardiovascular Care Associates and chief of cardiovascular strategic planning and development of Baylor Scott and White (Dallas):

1. Redundant tasks such as hospital credentialing can easily be automated and solved with technology, namely Blockchain. I believe a trusted ledger with verifiable information that is requested repeatedly could be automated with greater accuracy and efficiency. Additionally, this background technology could be used to create NFTs for credentialed providers that could be used over and over again once issued.
2. Data mining from within your own EMR with so many disparate forms of information can be solved with sophisticated natural language processing programs like Aspen insights. Using NLP can identify gaps in care, patients for research trials, patient loyalty through education and many other opportunities.
3. Remote patient monitoring and chronic care management with wearable devices and ioT devices to measure vital signs and assist in the safe migration of procedures from the inpatient to the outpatient setting. The Heart Hospital Baylor Plano is working with companies like BioIntelliSense and IntelliH to solve these problems. Additionally, at Connected Cardiovascular Care Associates, we have partnered with Medify Health to have a turnkey solution for RPM and CCM services which are complex and often labor intensive when trying to perform in house.