Innovation before, during and after COVID-19: 4 Qs with Novant Health's digital transformation leader Angela Yochem

During a recent interview, Angela Yochem, executive vice president and chief transformation and digital officer at Charlotte, N.C.-based Novant Health, discussed her health system's approach to digital health and how she thinks creatively about innovation opportunities.

AYAngela works with leaders from across the organization, accelerating cross-functional initiatives and exploring new potential lines of business while driving transformation across the $8 billion health system. Here she shares some key learnings.

Question: Chief transformation officer is a role that's relatively rare in healthcare. How does your role and Novant's organizational structure empower you to drive change at scale?

Angela Yochem: I think the fact that a role called "chief transformation officer'' exists is indicative of the changes that are happening across our industry. Healthcare is undergoing a significant transformation, which has only been accelerated by the pandemic. But even before COVID-19, Novant Health was pushing the envelope and thinking creatively and aggressively about innovation. We've historically addressed issues of access, care quality and operational excellence with cutting edge technologies, truly unprecedented access to data and unconventional third-party partnerships.

At Novant, we believe innovation should be promoted across organizational bounds and requires out of the box thinking. That's one of the reasons why we don't have a stand-alone IT team — we merged that group into a broader "digital products and services" team. By making the IT team part of a broader transformational group and removing the "IT" name, we've unburdened them from the risk aversion that can lead to an unhealthy stagnation of IT organizations in healthcare systems. And with that stagnation often comes an unhealthy reliance on a single system like an EHR. We want all of our teams to be thinking big and boldly about the best ways to serve our communities. For example, we recently built a large cancer center and designed it purposefully with a very small waiting room because we want to create environments where patients receive treatments immediately. We were able to make this vision come to life because we decided to invest in technology with LeanTaaS and partner on this radical idea. We launched iQueue for Infusion Centers in June 2020 and soon saw a 41 percent reduction in the average infusion wait time, as well as almost a 10 percent decrease in the average drug wait time. Plus, we're managing capacity so well that our nurses can now actually take lunch breaks and are feeling less burnt out.

Q: How do you promote a culture of innovation and how do you decide what to build versus what to buy?

AY: Culture starts at the top, and our CEO, board, and clinical leaders are all incredibly focused on how we can leverage digital to help our communities. That focus helps us work quickly. There's an old saying that "elephants don't dance," but Novant Health is an exception. Our executive team is flexible and have built teams with a diversity of thought that can pivot and move fast. We don't believe in "experiments that fail," we believe in the scientific method. We carefully craft experiments to test our assumptions. We start with a hypothesis, test it and then learn from it and build that learning into future decisions. It's a very non-healthcare approach, but other industries like financial services do this all the time, and it's serving us — and most importantly our patients — very well.

We build, we buy, and we work in the gray area in between by doing a lot of cocreation work. If I'm weighing my choices between building a world class, essential software product or purchasing from a third party, I'm probably going to choose purchasing from a third party because my business and even my adjacent businesses are not about selling software. I also really enjoy cocreation, and we're working with a variety of third parties to build solutions that create a greater level of excellence in our operations or a higher quality of care for our patients.

Q: What did COVID-19 drive in terms of transformation and what's here to stay?

AY: COVID-19 became a forcing mechanism for us to invest in digital. Before the pandemic, we knew we had to solve our problem of surgical case backlog. Then COVID-19 hit and suddenly we had to postpone 8,000 surgical cases and figure out how to reschedule them. We took this opportunity to invest in technology, partnering with LeanTaaS to help us improve our OR capacity and provide surgeons with a tool that made OR time simple to view, access and share. We implemented iQueue for Operating Rooms immediately after the onset of COVID-19, in the spring of 2020. The tool proved vital in navigating the aftermath of the return of surgical cases. We increased case volume by 4 percent and cleared our entire backlog, which had accumulated over 75-90 days, in just a further 90 days. We've proved the case for transformation and we aren't looking back.

Q: What advice would you give your peers who might be struggling to innovate or advance transformation?

AY: The first is to define a set of formal constructs around which they can operate unconventionally. For example, if you want to try things that are outside of the traditional software acquisition process, then identify what that process looks like and short circuit as much of it as possible according to your own risk appetite.

Second, open your parameters and see what happens when you start to build unconventional partnerships with various entities. Reach out to the universities or incubators that may exist in your geography, talk to your own investment fund managers, and find other venture groups that may be investing in some really interesting early-stage companies. Become an active participant in technology scouting.

Finally, let go of your closely held beliefs about what third parties are doing to you and think more about what they can do for you. These are key important partners in the ecosystem that you are being given a chance to build with, and their strength will ultimately determine your own success — and the quality of care you provide your patients. Pressure test opportunities to co-create something. There may be new revenue stream opportunities in it for both of you. This requires a mindset shift, but we have to start thinking about ways in which we will not only stay alive but thrive in this new environment.

To gather more insights on healthcare transformation from Angela Yochem, register for Transform: Hospital Operations Virtual Summit and see her speak on December 7.

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