Sanjeev Agrawal

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As market forces visibly disrupt healthcare (less access to cheap capital, reimbursement pressures, rising demand for services in the face of constrained supply), digitally transforming core processes is not merely an option any more. Every health system wants to get better in using digital technologies to improve the patient experience, increase access and lower cost. 

However, almost everyone also faces a few significant roadblocks in achieving the success such transformation promises. These roadblocks fall into the same well known categories all change programs encounter: technology capabilities, culture and core beliefs, process shortfalls and people related (skills and incentives).

Based on our work with over 100 of the country’s largest health systems and conversations with dozens more, we have uncovered five core beliefs that currently prevent many health systems from rapidly innovating and achieving significant operational and clinical improvement. Here are the five core beliefs and why they need to be overcome for a successful transformation:

EHRs are good at a lot of things but predicting and prescribing solutions to probabilistic events like schedule optimization and forecasting outcomes isn’t one of them. Yes, a lot of money has been spent on the EHR, and they serve a very specific and important purpose but they cannot solve all the required operational and clinical issues that create access and lower cost.

2. “Analytics = EHR reports, maybe some Excel, Tableau, and homegrown dashboards. That’s all we need.”

Analytics is a lot more than dashboards and reports. Dashboards are like scales at the doctor’s office - they “admire the historical problem.” Weighing scales report on a known problem (“You need to lose 20 lbs) but do nothing to actually solve the issue. To truly achieve digital transformation requires investing in tools that predict future events and prescribe actions to achieve a better outcome. Like Waze rerouting you along a better path when it sees bad traffic ahead.

3. “Anything we need beyond the EHR we can build internally.”

Even a company as large as GM doesn’t build Microsoft Word simply because it can afford to hire 1,000 people to try and do so. It is easy to underestimate the investments and scaling needs of useful software. Just because a skunkworks project meets the needs of a small group of users, it does not mean it can scale to meet the needs of a larger group, or solve larger problems.

4. “If I create an innovation team and invest in startups I will be able to innovate on my own.”

Innovation happens at the front lines. For it to work, 98% of your organization should be excited and engaged in innovation, not just the 2%. It’s great to have an innovation team, but do they have a budget? Are the operating teams engaged? Is everyone empowered and tasked with the goal of transformations? Is there a reward system to align goals with behavior?

5. “The Cloud is Unsafe” and so we will stay client-server to protect information.”

Amazon, Google, Microsoft have spent billions of dollars building secure cloud infrastructure. The chances that any one health system can invest as much to achieve more security behind the firewall is close to zero.

Articles

As market forces visibly disrupt healthcare (less access to cheap capital, reimbursement pressures, rising demand for services in the face of constrained supply), digitally transforming core processes is not merely an option any more. 

5 Core Beliefs Blocking Digital Transformation in Health Systems 

	The winds of change swept through healthcare in 2017, leaving in their path more uncertainty than perhaps ever before.

	With my window seat view via 40-plus leading health systems with which we work all over the country, here’s my take on what managed care executives and other industry constituents can expect:

	Leveraging clinical and data analytics has been cited as the top challenge for healthcare executives.  I agree with those industry experts who expect that half of all healthcare companies will have dedicated resources to accessing, sharing and analyzing real-world evidence for use across their organizations by 2019. On top of that, I assert that the focus in 2018 will be in operational analytics that improve operational performance-not clinical outcomes. We saw an early indication of this with UCHealth; they were able to increase annual revenue from their operating rooms by more than $10 million largely by improving the method by which operating room block time is released or requested.

		In 2018, health systems should begin to see the need to re-evaluate the mathematical foundation used to manage their day-to-day operations-and upon which the quality of the patient experience relies. All the macro forces in healthcare (more patients, older patients, higher incidence of chronic illnesses, lower reimbursements, push toward value-based care, and tighter operating and capital budgets) indicate an urgent need to be able to do more with existing assets without upsetting patient flow. A strong mathematical foundation will enable a level of operational excellence to help health systems increase their effective capacity for treating more patients while simultaneously improving the overall flow and reducing wait time.

	In 2018, more managed care execs will pilot blockchain-based solutions as a way to streamline secure medical record sharing, protect sensitive data from hackers and give patients more control over their health records. Blockchain-based solutions are already in the prototype stage and represent the first step in providing patients “with one-stop-shop access to their medical history across multiple providers.” One prototype uses blockchain technology to manage authentication, confidentiality, accountability and data sharing (data such as blood work records, vaccination history, prescriptions, and other therapeutic treatments).

	Last year, I predicted that the now-abandoned mega mergers of Anthem with Cigna and Aetna with Humana would usher in a period of more mergers and acquisition. The termination of both of those deals-on the same day, no less-under the cloud of antitrust seemed to dampen the market’s interest. Nonetheless, this year, I predict continued consolidation and contraction, especially in the pharmaceutical space as billions worth of patents for drugs begin to expire. Pharmaceutical companies will look closely at smaller companies, from whom the next generation of “blockbuster” drugs are just now coming to market.

	If 2017 taught us anything, it is this: 2018 will be another year where managed care executives, payers, providers, and pharmaceutical and life sciences organizations face continued legislative and regulatory upheaval as consumers demand more, better access. Healthcare providers will continue to feel pressure to accelerate their companies’ transformations using advanced data science and mobile technologies.

	I believe those who invest in health IT ahead of the curve, focus on better utilizing the mountains of data they strain to secure and look to connect systems as never before will emerge from an uncertain year better positioned to succeed and prosper.

Sanjeev Agrawal is president and chief marketing officer of 

 a Silicon Valley-based innovator of predictive analytics solutions to healthcare’s biggest operational challenges. 

The winds of change swept through healthcare in 2017. Here’s what 2018 could bring. 

Sanjeev Agrawal

Articles

5 Core Beliefs Blocking Digital Transformation in Health Systems

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