2019 health care it industry trends...sources: wachter r, “the digital doctor - hope, hype, and...

Health Care IT Advisor

2019 Health Care IT

Industry Trends

© 2019 Advisory Board • All rights reserved • advisory.com

2

Industry transformation took many forms in 2018

The threat of disruption is catalyzing and accelerating broader trends

Source: Health Care Advisory Board interviews and analysis.

Primary care

operator

Consumer-focused

technology platform

Global health care

logistics specialist

Employer

aggregator

Next-generation

retail pharmacy

Emerging themes in the efforts to disrupt the health care value chain

Commercial

payers at the

forefront

Heightened

focus on

input costs

Data-driven

utilization

management

Active steerage

over hands-off

delegation

The primacy

of the

independent

physician

http://www.advisory.com/


3

84 health care CIOs told us their 2019 top priorities1

Source: Health Care IT Advisor research and analysis.

1) Priorities are grouped according to similar areas of focus.

Foster a data-driven culture at my organization (e.g., data governance, self-service BI, physician trust in data)

Understand applications and use cases for emerging technologies and communicate challenges

Develop and prepare leadership for IT’s evolving role (e.g., roles, organizational structure)

Lay the foundation for innovation (e.g., funding, leadership, partnerships, innovation platform)

Build a mature analytics program that delivers better value in clinical and administrative settings

Develop an integrated platform to support the digitally-enabled patient (e.g., digital front door, mobile apps)

Use AI and machine learning to generate high quality predictions and automate processes

Prioritize and deploy emerging technologies (e.g., the “when, why, and how”)

Improve clinician experience and usability (e.g., workflow, burnout, training/education)

Accelerate value realization from major IT investments (e.g., application optimization, IT governance)



4

Three themes emerged from the top priorities

1Promote IT

organizational excellence

• Help the organization extract value from existing IT• Plan for next-stage optimization• Develop the IT workforce of the future

2Optimize care

delivery

• Leverage new data sources• Improve IT usability and the clinician experience• Build a digital platform for the “era of the connected patient”

3Embrace digital

disruption and innovation

• Embed digital transformation within strategy and culture• Understand the innovation landscape• Evaluate and deploy emerging technologies



5

Promote IT organizational excellence2019 health care IT industry trends

• Help the organization extract value from existing IT

• Plan for next-stage optimization

• Develop the IT workforce of the future

THEME

1



6

The “IT value equation”– to invest or not?

Ongoing efforts by non-IT and IT leaders are required to get “IT value”

Promote IT organizational excellence

Sources: Wachter R, “The Digital Doctor - Hope, Hype, and Harm at

the Dawn of Medicine's Computer Age,” New York: McGraw-Hill Education, 2015; Health Care IT Advisor research and analysis.

1) Return on investment.

Benefits

Costs (and time)

Automation,

point solutions

justif ied by ROI1

Enterprise apps and analytics,

focus on operational excellence

Centralization, standardization to

reduce IT spending grow th rate

Digitization, optimization,

interoperability, focus on digital

strategy enablement and

innovation at scale

Complexity created by multiple

point solutions

“Like a safe deposit box, unlocking IT’s potential requires the turning of two keys—the technology itself and the redesign of the surrounding environment.”

Dr. Robert M. Wachter, Professor and

Chair, Department of Medicine, UCSF



7

Most IT resources go to “keeping the lights on”


Sources: Hayward D, “Navigating Healthcare IT Transformation and

Economics,” Dell, Feb 29, 2016; Health Care IT Advisor research and analysis.

1) Keeping the lights on.

KTLO1 costs stifle digital innovation

KTLO cost contributors

Infrastructure operations and maintenance

Application operations and maintenance

Updates and capacity expansion

Leaving fewer resources for new initiatives and innovation

Up to 78%Of IT operations budget is often devoted to KTLO functions, with the remainder left for new projects

Architecture / infrastructure modernization

Includes cloud / virtualization, software-

defined everything, and networks

Application standardization

Simplify the application portfolio

Technology portfolio rationalization

Includes infrastructure, processes,

and technology

Sourcing

Leverage shadow IT and selective

outsourcing

Four ways to approach KTLO


https://blog.dellemc.com/en-us/navigating-healthcare-it-transformation-and-economics/


8

Technology is a vital tool for long-term cost control

But value requires effective governance


Source: Health Care IT Advisor interviews and analysis.

IT-enabled long-term cost control and connected benefits

• Identify variation in

inputs, w orkflow s,

processes

• Understand costs

and impact of

decisions

• Measure and track

outcomes, results,

progress

• Reduce care

variation

• Improve clinical

outcomes

• Reduce

administrative

burden on

clinicians

• Shift w ork to low er-

cost staff, to

consumers

• Automate processes

and decisions

• Reduce cognitive

burden

• Optimize space and

resource utilization

• Virtualize care,

collaboration, and

coordination

Identify,

quantify, and

measure

Improve and

transform care

delivery

Operate more

efficiently

• Function as

a virtually

integrated

enterprise

• Standardize,

centralize,

rationalize

Facilitate true

systemness

Strengthen IT

performance

• Extract and

demonstrate

greater value from

technology

investments

• Improve KTLO

costs and IT

performance

• Lay the foundation

for innovation



9

“Systemness” will continue to be crucial for success

Systemness is the willingness and ability to do hard things



Operational advantage

Degre

e o

f m

ark

et

advanta

ge

Degree of “systemness”

Productadvantage

Structural advantage

Transformational advantage

Cultural threshold:

Recognize and

pursue economies

of scale

Cultural threshold:

Work together

toward difficult but

common objectives

Cultural threshold:

Take actions that

benefit the system

as a whole even

when they may be

unattractive to

some of its parts

Cultural threshold:

Commit to change

that is broadly

disruptive when

that change is

necessary for

long-term success

• Centralized

business functions

• Supply chain

efficiencies

• Scalable process

eff iciencies

• Clinical

standardization

• Solution-oriented

product portfolio

• Footprint

rationalization

• Optimal capital

allocation

• Scalable population

health identity



10

The hospital of the future needs new rules

Business leaders must learn basic IT and analytics competencies



Manage IT as an expense (support function) Manage IT as an asset (core competence)

Operational excellence / stability Operational excellence / stability and agility

Use IT to automate manual processes Use IT to digitize (processes and patients)

Risk in leading, fast follow ing Risk in being “late to the party”

Failure is not an option Fail small and fast / learn / apply lessons

Develop detailed plans for your (big) bets Experiment, try lots of things w ithin big bets

Inside-out view of the organization Outside in (start w ith customer journeys)

Decisions by gut feel Decisions informed by data, big data

IT-f

ocused

Org

aniz

ational

Old rules New rules



11

Talent is critical to digital strategy success

Leverage your organization’s mission / vision to attract talent


Sources: “2018 Digital Transformation Readiness Survey,” Appian and

DevOps.com, https://www.appian.com/resources/2018-d igit al-transform ation-readiness-survey/; Health Care IT Advisor research and analysis.

Obtain and retain the needed skillsets

Are you seen as a potential employer for the skills you need? Do you have relationships with local universities?

Cultivate a digital innovation mindset

Is your staff appropriate for the digital maturity stage?

Encourage life-long learning

Are team members willing to continuously evolve their skills?

Appian Digital Transformation Readiness Survey

Of organizations can’t attract the quality and

quantity of softw are engineers they need to

feed the business w ith innovative technology

82%

Assess what you have today1

Forecast what you will need for the future2

Develop a plan for the future3


https://www.appian.com/resources/2018-digital-transformation-readiness-survey/


12

The CIO role is making headlines



- Healthcare IT News (November 2018)

“Role of CIO Is Changing and Growing in Importance, Say New Forbes Insights Studies”

“The Evolving Healthcare CIO: Innovation over Information”

“How Digital Transformation Is Changing the Jobs of CIOs and IT Pros”

“Healthcare CIOs See Roles Slip in Decentralized Analytics World”

- HealthITAnalyltics.com (November 2018)

- Healthcare Informatics (November 2018)

- Forbes (March 2018)



13

Analytics leadership shifts away from tech leaders

Surveys show a sharp rise in shared leadership over the past few years



43.8%

10.4%

8.3%

6.3%

6.3%

6.3%

4.2%

4.2%

2.1%

2.1%

2.1%

2.1%

2.1%

CIO

VP of Analytics (or similar title)

CMIO

COO

VP of Network Development/Strategy

CFO

CMO/CCO

CQO

CEO

VP of Contracting

Do not have anyone from the C-Suite

Shared leadership

No real leadership

C-suite executives leading analytics efforts in 2015 survey (n=48)

25.3%

21.5%

11.4%

7.6%

6.3%

6.3%

5.1%

5.1%

5.1%

5.1%

1.3%

Shared leadership

CIO, VP of IT

CFO

COO

CTO or similar VP

Other

CDO, CAO, or similar VP

CQO, CPO

CMO, CMIO, CNO, CNIO

No real leadership

CSO

C-suite executives leading analytics efforts in 2018 survey (n=79)



14

CIOs should adapt to the changing environment

New titles and responsibilities can complicate the picture



Chief Digital OfficerChief Information Officer

• Runs IT operations, enables digital

innovation

• Focuses on operational excellence, agility

• Has more of an internal, automation focus

• Addresses stability, risk mitigation

• Builds and supports IT infrastructure

• Manages technology vendors

• Leads digital innovation

• Focuses on big problems w ithout packaged

solutions

• Has more of an external, digitization focus

• Addresses speed, external threats,

organizational agility

• Builds and supports innovation capabilities

• Initiates and manages external partner

relationships

One example: How the roles of the CIO and CDO could tie together

IT leaders who succeed in this age of digital disruption will be those who act proactively and reinvent their own roles within the organization



15

Optimize care delivery2019 health care IT industry trends

• Leverage new data sources

• Improve IT usability and the clinician experience

• Build a digital platform for the “era of the connected patient”

THEME

2



16

Technology continues to drive the flood of data

Data erupts from smartphones, genomes, sensors, and other sources

Optimize care delivery

mHealth

Sensors /

Wearables

Internet of

things

Patient

history

Telemedicine/

Virtual v isitsSocioeconomic

factors

Connected health

Screenings /

Lab tests

Imaging

“Omics” data

Lifestyle /

Health

behav iors

Physical

env ironment

Pharmacy

data

Elements of connected health



17

New data sources surge since 2015 survey

Structured data still foundational to analytic models



1) N=43.

Included now

(2015)

Included now

(2018)1 Plan to add in 2019

Structured financial data 87% 88.4% 4.7%

Structured clinical data 89% 79.1% 9.3%

Clinical partner data 31% 70.7% 14.6%

Patient-reported data 26% 55.8% 23.3%

Unstructured clinical data 12% 45.2% 26.2%

Research data 23% 39.0% 19.5%

Unstructured nonclinical data 10% 36.6% 19.5%

Social determinants data N/A 34.1% 48.8%

Social media data 7% 20.0% 25.0%

Mobile or IoT dev ice data 10% 14.6% 31.7%

Genomic data 10% 2.5% 15.0%

Q: Which types of data are already included in your analytic models and which do you anticipate including in the future?



18

Time to think beyond the hospital’s four walls

Mainstream systems cover only a fraction of predictive power


Sources: Nash DB, “Population Health: Why It Matters,” Essentials in

Population Health, Children’s Hospital Association, Thomas Jefferson University, October 2016; Health Care IT Advisor research and analysis.

1) Remote patient monitoring.

EHR(s)

Lab systems

Pharmacy systems

Imaging

Medical claims

Prescription drug claims

Billing and supply chain

Scheduling systems

Medical care data

10%

Sensors / RPM1

mHealth apps

Patient-reported outcomes

Genetics

Socioeconomic data

Patient questionnaires

Human biology data

20%

Lifestyle and

behavior data50%

Social and environmental

data20%

Data sources by influence on health outcomes


https://www.childrenshospitals.org/-/media/Files/CHA/Main/Issues_and_Advocacy/Key_Issues/Child_Health/Population_Health/PopulationHealthWhyitMatters.pdf


19

Improving the clinician experience

The EHR continues to be a focal point for physician burnout


Sources: Peckham C, “Medscape Lifestyle Report 2017: Race and Ethnicity, Bias and

Burnout,” Medscape, January 2017; Health Care IT Advisor research and analysis.

Human factors

Human factors is a scientific discipline that aims to help people do their best work, improve resilience and overall system performance, and minimize errors.

Usability

Usability is the effectiveness, efficiency, and satisfaction with which specific users can achieve a specific set of tasks in a particular environment.

Two components influence EHR

user experience:

To learn more about this topic, Health Care IT

Advisor members can read our report How to

Reduce Physician Burnout During EHR

Optimization

Four tactics to reduce clinician burnout

during EHR optimization

Collect, analyze, and act on user

data to improve system usability

and safety

1

Address clinician needs w ith the

appropriate amount of special

configuration w ork via a managed process

2

Reexamine your clinician

education/training approach3

Give your vendor feedback4

A survey of 14,000 physicians found three of the top five causes of physician burnout were associated with spending too much time in the EHR


https://www.medscape.com/features/slideshow/lifestyle/2017/overview#page=4

https://www.advisory.com/research/health-care-it-advisor/research-reports/2018/how-to-reduce-physician-burnout-during-ehr-optimization


20

A vision for connected health


Sources: Aitken M, et al., “The Growing Value of Digital Health: Evidence and Impact on Human Health and the

Healthcare System,” IQVIA Institute for Human Data Science, November 2017, https://www.iqvia.com/institute/reports/the-growing-v alue- of-digita l-healt h; Health Care IT Advisor research and analysis.

Data from patients’ daily lives will support better health

outcomes for the individual and the population

Data generation

and capture

Tertiary use of data:

transform the health

care delivery system

Primary use of data:

support the patient

Secondary use of data:

improve the population

Symptom

onset

Patient experience

tools

• General health info

• Symptom checkers

• Clinician search

• Managing clinical /

financial info

• Social media

Diagnosis

Doctor may

recommend

app-supported

disease

mgmt. programs,

connected sensors

for RPM, or apps for

uses across the

patient journey

Treatment

Prescription filling

and compliance

• Prescription

discounts

• Prescription fi l ling

• Medication

management,

adherence

Wellness and

prevention

Wellness and

prev ention

• Exercise

• Diet and nutrition

• Lifestyle

• Stress mgmt.

• Sleep

Condition

management

Condition

education and

mgmt.

• Self-monitoring

• Rpm

• App-enabled

rehab programs


https://www.iqvia.com/institute/reports/the-growing-value-of-digital-health


21

Let’s not forget about the consumer / patient


Source: Health Care Advisory Board interviews and analysis.

“I need a

Rx refill”

“My child

has a fever”

“Am I healing

after surgery?”

Urgent care

E-visit

Retail clinic

Emergency department

“Do I need

stitches?”

“Is this mole a

problem?”

“I need a

flu shot”Primary

care

Asynchronous consult

Telephone consult

Loyalty platform

“Where do I go?”

Connected platforms reduce the risk of fragmentation



22

Mergers aim to rebuild the system’s “front door”

As disruption looms, incumbents race to lock up the market


Sources: Google Finance; Health Care Advisory Board interviews and analysis.

1) As of May 15, 2018.

$249.5B

$230.2B

$66.9B

$40B

$42.8B

$11.6B

$57.9B

$41.4B

Com

bin

ed m

ark

et

valu

ation

1

Potential industry disruption

Drivers of deal activity

Tax reform brings for-profit companies

an influx of cash

Margin pressure intensifies capital needs

in certain sectors

Shifting administrative priorities changes sources

of projected growth

Walmart

Express Scripts

Humana

Aetna

Optum

Cigna

CVS Health

DaVita Medical Group

UnitedHealth Group



23

Investing big in the consumer-driven future

PSJH1: Digital strategy tied to enterprise strategy


Source: Martin A, Vaezy S, “Digitally Transforming Providence St.

Joseph Health across 6 Digital Journeys,” GeekWire, Dec 2017.

1) Providence St. Joseph Health.

2) Emergency department.

Six digital journey domains

Access and personalization

Provide access to various care

modalities and deliver

personalized experiences

Simplifying care

Ease system navigation for

patients through digital pathw ays,

self-management and education

tools, virtual visits, simplif ied

billing, medication management,

and access to non-clinical services

Make caregiving easier

Increase provider quality of life

and focus on patient

encounters through automation

of documentation in the EHR

and inbox management

Better serve Medicaid

Improve navigation to avoid

unnecessary ED2 visits

Power behavioral health

Use digital tools to address stigma,

low supply of caregivers, and lack

of screening

Enable new revenue streams

Explore new clinical revenue

streams, product revenue, and

technology commercialization


https://www.geekwire.com/sponsor-post/digitally-transforming-providence-st-joseph-health-across-6-digital-journeys/


24

The rising bar for patient engagement

Must-have upgrades for the consumer-focused health system


Sources: Health Care Advisory Board research and analysis; Revenue

Cycle Advancement Center (RCAC) research and analysis.

1) RCAC survey of adult patients; Question: ““Which is most

important to you when choosing a hospital or health care provider to undergo a non-emergency surgery?” (n=1,000).

Status quo Must-have upgrade

One-size-fits-all Multimodal access network

Lack of attention to service quality

High-reliability production model

Premium pricing across the board

Competitive price point

Relationships purely transactional

Loyalty reward program

User-unfriendly Frictionless transactions

Patient survey: Most important factor on provider choice1

44% It’s easy to schedule

41% I know exactly w hat I ow e before getting care

15% I can pay using a payment plan



25

Embrace digital disruption and innovation2019 health care IT industry trends

• Embed digital transformation within strategy and culture

• Understand the innovation landscape

• Evaluate and deploy emerging technologies

THEME

3



26

Digital health systems: automation to digitization

Organizational strategies and digital strategies must converge

Embrace digital disruption and innovation


The focus of digital health

systems

Potential

value, people,

process, and

technology

change

1980s and 1990s

Current and future: Focus on digitization (fundamental rethink)

IT as a cost to be minimized

IT as an efficiency tool

IT-enabled strategies

Digital business and clinical

transformation, disruption, and

innovation

1990s and 2000s:Focus on automation(of manual processes)

Digital health systems take full advantage of digital technologies and IT-related capabilities to redefine business models; rethink processes, quality, and their cost structure; and identify and address customer or patient needs.



27

Digital health systems have become a necessity

Signs of transformation and disruption are prevalent



1) Accountable care organizations.

2) Centers of excellence.

Volumes to value and affordability

Passive recipients to active participants

“Find it, fix it” to predictive and preventive

Pricing and reimbursement• Transparent pricing

• Dynamic pricing

• Risk-based and

risk-adjusted payments

New products and services• ACOs1

• Episodes of care

• Referral management

• Navigation

• Wellness

Access

• Expanded hours, locations

• Lower-cost care sites

• Regional, national COEs2

• Virtual care

• Wearables, embedded sensors

• Smart, connected pill bottles, houses

• Predictive, “precision engagement”

• “Pay How You Live”

• Information symmetry

• Shared decision making

• Early detection

• Computer-assisted diagnosis, Tricorder

• Precision medicine

• Learning health care system

• Reduction of duplicationand w aste

Business models Care deliveryPatients / consumers

To explore this topic in more depth, Health Care IT

Advisor members can watch our webconference

recording Digital Health Systems: The Innovation

Journey Continues


https://www.advisory.com/research/health-care-it-advisor/events/webconferences/2018/health-care-it-advisor-virtual-summit-2018/digital-health-systems-journey-continues/ondemand


28

Digital health funding continues at a record pace

The industry is seeing more dollars and bigger deals


Source: StartUp Health Insights, “StartUp Health’s 2018 Insights Funding Report: A Record Year for Digital Health,” January

2019, https://hq.startuphealth.com/posts/startup-healths-2018-insights-funding-r eport- a-rec ord-y ear-for- digita l-healt h.

Digital health funding snapshot

(annual total in $B): 2010 to 2018

“2018 was the biggest year for digital health since StartUp Health began tracking the market in 2010. Digital health funding was 14 times more than what it was eight years ago, and from 2017 to 2018, average deal size grew by $6M.”

$1.2$2.0 $2.3

$2.9

$7.1$6.2

$8.2

$11.7

$14.6

2010 2011 2012 2013 2014 2015 2016 2017 2018

153

283

476

647608

568

684

851

765

Deal count


https://hq.startuphealth.com/posts/startup-healths-2018-insights-funding-report-a-record-year-for-digital-health


29

Big tech companies set their sights on health care


Sources: “Apple and Amazon’s moves in health signal a coming transformation,” The Economist, February 2018; “Top of Mind

for Top Health Systems 2019,” Center for Connected Medicine, November 2018, https://connectedmed.com/blog/content/top-of-mind-2019-interoperabil ity-cybersecurity-t elehealth; Health Care IT Advisor research and analysis.

Two routes into health care

Big five tech vendors in health care

• Health Records

• CareKit

• ResearchKit

• Apple Watch

EKG

• Medical clinics

• Berkshire

Hathaw ay/Chase

partnership

• Alexa virtual

assistant

• PillPack

• Verily – health

insurance, 3M

• Cityblock Health

• DeepMind

Health (AI)

• Behavioral

health detection

• Clinical trials

• AI-pow ered

virtual health

assistants

• HoloLens

• Walgreens

partnership

More powerful tools for a more receptive market?

Apple Amazon Google Facebook Microsoft

Do business w ith health systems and

companies in the existing systemUse tech platforms to create new health

care-delivery channels

Of surveyed health system executives are very or somewhat concerned about big tech companies entering the health care space (n=44)80%


https://www.economist.com/news/business/21736193-worlds-biggest-tech-firms-see-opportunity-health-care-which-could-mean-empowered

https://connectedmed.com/blog/content/top-of-mind-2019-interoperability-cybersecurity-telehealth


30

Emerging technologies poised to disrupt health care

Health care providers prepare to prioritize, fund, and deploy new IT


Source: Health Care IT Advisor interviews and analysis.

1) Natural language processing.

2) Medical body area network.

Dev ices• Bendable• Modular design

• 3D cameras• Wireless charging

Networks• 5G, HaLow,

MBAN,2 Li-Fi,

Satellite

Apps• More comprehensive• Products, not features

Precision medicine• Genetic screening, DNA

sequencing

• Personalized health• Pharmacogenomics

Medical dev ices• Miniaturization• Ingestibles

• DNA sequencers

Virtual and augmented reality• Surgical training with holograms• Exposure therapy

• Pain management• Patient education

3D printing• Prosthetic limbs• Preoperativ e planning

• Pharmaceuticals• Bioprinting

Advances in mobility

Virtual assistants and bots• Google Assistant• Amazon Alexa

• Microsof t Cortana

Blockchain• Single, shared records without the

need f or trusted intermediary

• Securely record contracts, value transf ers, and other data

Internet of things• Env ironmental sensors• Internet of nanothings

• Microelectromechanical sy stems (MEMS)

Artificial intelligence• Machine and deep learning• Language translation and NLP1



31

Majority of leaders have a positive view of AI

But a fair amount of uncertainty still exists



Q: Which of the following best describes your leadership team's views on the potential of artificial intelligence to advance organizational objectives? (n=114)

30.7%

5.3%

27.2%

36.8%

We believe AI will become a

transformative, essential

part of our health system

We don’t know what AI

can do or what role it

might play

We don't believe AI will

deliver significant value

We believe AI will deliver

incremental value

For more survey results,

w atch our w ebconference

recording 2018 Analytics

and AI Survey


https://www.advisory.com/research/health-care-it-advisor/events/webconferences/2018/2018-analytics-and-ai-survey/ondemand


32

Large organizations are the most optimistic about AI

While smaller organizations are less certain about AI’s potential



Q: Which of the following best describes your leadership team's views on the potential of artificial intelligence to advance organizational objectives?

45.2%

3.2%

22.6%

29.0%26.9%

5.8%

28.8%

38.5%

16.0%

8.0%

32.0%

44.0%

We believe AI will deliver

incremental value

We believe AI will become a

transformative, essential

part of our health system

We don't believe AI will

deliver significant value

We don’t know what

AI can do or what

role it might play

MediumSmall Large



33

Digital disruption and innovation won’t be easy

Plan for these challenges ahead of time



Business challenges Legal and ethical challenges

Complexity: Medical issues do not

appear in isolation and coordination

of care is diff icult.

Threat to human jobs : Strong fear

associated w ith technology displacing

human w orkers.

Workflow : How do solutions f it into

existing w orkflow s? How much effort

is required to use it? Does it interfere

or annoy unnecessarily?

Competing priorities: We are still in

the midst of installing basic and

foundational systems (e.g., EHRs)

w hile addressing regulatory and

other pressing PHM initiatives.

Regulation: Health IT regulations

are hotly debated at the national

level. Finding the right balance of

public health protection and fostering

innovation is key.

Legal: Juries still aw ard large sums

w hen health care is not applied

properly or expected outcomes are

not achieved.

Liability: How do w e deal w ith

computer failings? Even if AI

approaches are statistically better,

there may be liability w hen it fails.

Human touch: how w ill w e interact

w ith AI? How strongly w ill w e require

the human touch and human

compassion in health care?

Cost: The high costs for

developing, testing, certifying, and

implementing can be a barrier.



34

Cultural change is a key barrier to innovation

Culture Change


Sources: Friedman S, Thank You For Being Late, New York: Farrar, Straus

and Giroux, 2016; Shah S, et al., “Leading Change—A National Survey of Chief Innovation Officers in Health Systems,” Health Management Policy and

Innovation, 3, no. 1 (2018); Health Care IT Advisor research and analysis.

CIOs must lead IT culture change, contribute to organizational change

Rate of technological change exceeds

human capacity to adapt

Rate

of change

Time

Rate of technological change

Human capacity to change

(We are here)x

Organizational culture is a system of shared

assumptions, values, and beliefs, w hich

governs how people behave in organizations.64%

Of innovation executives said the

biggest barrier to innovation is

culture/organizational structure


https://hmpi.org/2018/03/14/leading-change-a-national-survey-of-chief-innovation-officers-in-health-systems/


35

Source: Pearl R, Mistreated: Why We Think We're Getting Good Health

Care and Why We're Usually Wrong, New York: PublicAffairs, 2017.

Invariably, people will resist the transformation of

health care…that’s why the true test of successful

leadership is best measured months or even years

later. It is defined by whether those who dragged

their feet at first would ever choose to go back to

how things were done before.”

Dr. Robert Pearl

Physician, professor, and author

Former CEO of The Permanente Medical Group



36

Next steps and key considerations2019 health care IT industry trends



37


Embrace digital disruption and

innovation

Promote IT organizational

excellence

A brief recap of topics we covered

Next steps and key considerations


• Leverage new data sources

• Improve IT usability and the clinician experience

• Build a digital platform for the “era of the connected patient”

• Help the organization extract value from existing IT

• Plan for next-stage optimization

• Develop the IT workforce of the future

• Embed digital transformation within strategy and culture

• Understand the innovation landscape

• Evaluate and deploy emerging technologies



38

Foundational competencies of digital health systems

“No regrets” enablers of digital strategy and innovation



Align IT-related activities with business needs through good governance and strategy processes

Manage “keeping the lights on” costs and provide a stable, reliable, scalable, and secure operational backbone

Build the capabilities to exploit technology assets (e.g., developing advanced analytics and interoperability capabilities)

Ensure availability of adequate skills and resources through talent management and partner management

Build upon existing skills to improve IT departmental and organizational agility and help change organizational culture

Digital strategy and innovation



39

Obtain and retain new skillsets and mindsets

Move to broad IT skills, build analytics and app development skills



Consider who should track emerging technologies and potential impacts on the business

Obtain skills

Retain skills

• Create an innovative, results-oriented, dynamic

environment

• Develop career paths that rew ard “makers,” not

just managers

• Provide flexible roles and organizational structures

• Encourage and expect lifelong learning

• Connect staff to organizational mission, emphasize

corporate social responsibility, and provide

opportunities to help educate the community

• Train w ithin IT and help non-IT people develop

needed IT-related skills

• Partner for skills

• Contract for skills: consider e-lancing / the

gig economy

• Hire: permit telecommuting and consider tools

to enable remote communication and w ork

Action

steps

Action

steps

Build a diversity of skills,

backgrounds, mindsets,

and decision-making

styles among your staff.



40

Leveraging new data sources for care delivery

ONC’s1 vision for PGHD through 2024


Source: “Conceptualizing a Data Infrastructure for the Capture, Use, and Sharing of Patient -Generated Health Data in Care Delivery and

Research through 2024,” Accenture Federal Services, January 2018, https://www.healthit.gov/sites/default/files/onc_pghd_f inal_white_paper.pdf .

1) Office of the National Coordinator for Health Information Technology.

Current state Future state

• Continuous electronic capture and

sharing of PGHD betw een patients,

caregivers, clinicians, and researchers

• Holistic perspective of the patient’s health

• Patients at the center of care delivery

• Balanced relationships betw een the

patient and clinicians/researchers

• Decisions typically based on data

collected in the clinical setting

• Isolated snapshots of patient health

• Patients are commonly the most

underutilized resources in health care

Relies heavily on episodic care A focus on value-based care,

enhanced with PGHD

Health care system

2016-2017 (Early adoption)

• Cutting-edge organizations

begin pilot testing and

researching use of PGHD for

specific chronic diseases

• Interest in precision medicine

and telehealth increase focus

on PGHD

2018-2023 (Growth)

• Increasing number of patients

will ing to capture/share PGHD with

clinicians and researchers

• PGHD interoperability standards

are adopted

• Clinicians easily able to store, retain,

and analyze large volumes of PGHD

with minimal concern for l iability

2024 (Maturity)

• PGHD seamlessly and securely

flow from patients to clinicians as

part of routine care

• Patient-provider relationship is

balanced and collaborative

• Patients actively engage in

monitoring health; make fewer

trips to the doctor


https://www.healthit.gov/sites/default/files/onc_pghd_final_white_paper.pdf


41

Leveraging new data sources for care delivery (cont.)

OCHIN’s1 conceptual model for SDH data in primary care


Sources: DeVoe JE, et al., “Perspectives in Primary Care: A Conceptual Framework and Path for Integrating

Social Determinants of Health Into Primary Care Practice,” Annals of Family Medicine, 14, No. 2 (March 2016): 104-108, http://www.annfammed.org/content/14/2/104; Health Care IT Advisor interviews and analysis.

1) Formally known as the Oregon Community Health Information Network.

Community vital signs data

Imported from public data sources

about community-level information

(e.g., US Census) matched to

patient address

Patient-reported data

Collected by asking patients direct

questions about their individual

circumstances (e.g., employment,

education, housing)

Panel management

Population of patients

Point-of-care

Individual patient care

Improved

health

outcomes

(+Research

and policy)

Collect and

organize

SDH data

1

Present and

integrate SDH

data into primary

care w orkflow s

2

SDH data triggers

automated support

and action

3

Referrals to social services, medical specialists

Clinical decision support

Patient engagement

Clinical and social services coordination


http://www.annfammed.org/content/14/2/104


42

Do not overlook potential partners

Even large organizations are not “going it alone”



1) Venture capital.

Do w e know w hat and how to measure?

What data w ill be shared?

Have w e identif ied the goals/desired

outcomes and w hat (initial) success looks

like for all partners?

What capabilities w ill have to be developed

or integrated?

Have w e scheduled regular checkpoints

w ith the right people?

Have w e assigned the right people?

Are they trained adequately?

Questions to evaluate partnerships

Have w e clearly identif ied roles,

responsibilities, and accountabilities?

Have w e addressed cybersecurity needs?

Strategic partner ecosystem

Start ups and VC1 firms

Traditional vendors (e.g., EHRs)

Non-traditional vendors (e.g., Google, Amazon, Apple, Microsoft, Facebook)

Payers

Partners in your health care delivery ecosystem (e.g., government agencies, YMCAs or churches)

Other providers



43

Use IT to improve the patient experience

IT will continue to play a role in building long-term consumer loyalty


Design a comprehensive loyalty strategy

Create a ROI for loyal consumers

Cultivate consumer champions

Establish a simplified consumer platform

• Integrated search, scheduling, and pricing

• Network of digital devices

• IT support for care navigators

• Simplified billing and payment

• Hospital navigation apps

• Rewards program software

• Premium IT for

subscription-based

services

• Customized provider search

• IT to support money-back

guarantee

• Shared decision-making

systems

• Database of consumer

information and preferences



44

Stakeholders cannot afford to be complacent!

Digital disruption and innovation is already happening



Don’t overhype but don’t

underestimate

the potential for digital

disruption by thinking strictly

linearly or implicitly assuming

that the past is a reliable

predictor of the future.

Look for opportunities

for incremental and

sustaining innovation and

potential threats from

disruptive innovation.

Develop and implement a plan

to build the foundational

competencies needed to

support digital transformation

and innovation.

If sustaining innovation is

an option, then

fundamentally rethink and

digitize key customer or

internal journeys—don’t just

automate manual processes.

Develop a shared vision for the

future of health care and IT—

and digital strategy enablement

and innovation. Rethink critical

functions such as strategy, IT

governance, and funding.

Capitalize on opportunities

to collaborate w ith non-IT

leaders and IT leaders about

changes in health care, in IT

and in IT’s role in health care.



45

Preview resources available with membership

Advisory Board members have access to national meetings featuring new research and netw orking

forums, research reports exploring industry trends and proven strategies, on-call expert

consultations, forecasting and benchmarking tools, live w ebconference presentations and an on-

demand w ebconference archive, expert-led presentations on the ground at your organization, and

expert blog posts on current health care topics.

Preview a few of the resources we’ve designed to help CIOs, IT leaders, and other C-suite

executives leverage IT as a strategic asset.

Infographic: Nine Ways to Harness the Internet of Things in Health Care

Wondering about the opportunities for the Internet of Things in health care? This

infographic identif ies data categories and representative measures you can start taking

advantage of today.

Executive Briefing: How to Get Started with Patient Generated Health Data for

Patient Monitoring

This research briefing review s essential considerations for incorporating patient-

generated health data into new or existing care programs.

Research Report: How to Address Physician Burnout through EHR Optimization

Learn w hat steps your organization can take to target EHR usability and safety issues

during EHR optimization.


https://www.advisory.com/research/health-care-it-advisor/resources/posters/2018/nine-ways-to-harness-the-internet-of-things

https://www.advisory.com/research/health-care-it-advisor/research-briefings/2018/how-to-get-started-with-patient-generated-health-data-for-patient-monitoring

https://www.advisory.com/research/health-care-it-advisor/research-reports/2018/how-to-reduce-physician-burnout-during-ehr-optimization

Thank you. For more information on how Advisory

Board can help you and your organization please

contact us at [email protected]

2445 M Street NW, Washington DC 20037

1-202-266-5600 │ advisory.com

https://www.advisory.com/

2019 health care it industry trends...sources: wachter r, “the digital doctor - hope, hype, and...

Documents