Article by Mark Hagland on May 28th.
Pam Arlotto, CEO of the Atlanta-based Maestro Strategies consulting firm, notes that, “In our new book, Orchestrating Value: Population Health in the Digital Age, we suggest that part of the ‘two feet’ challenge is that value-based care and population health have been tacked onto the existing bricks and mortar delivery system. Our silo-based culture, hierarchical organization structures and conflicting incentives have created roadblocks and barriers to the transition.”
In that regard, Arlotto says, “Interestingly, times of crisis and chaos, force innovation and creativity. Rather than going back to business as usual, the healthcare industry has an opportunity to think differently as we go forward. COVID19 and its challenges drive collaboration across government, community, economic, care delivery and social sectors – ultimately, the very definition of population health. Arlotto notes that, “A recent survey by the National Association of ACOs (NAACOS) indicates that 94 percent of Medicare ACOs are “very or somewhat concerned” with COVID19’s impact on organizational performance. Many at-risk ACOS are weighing whether to quit the MSSP or Next Generation models. This could portend a very different business or operating model for the future.”
Indeed, Arlotto says, “Telehealth and digital health, for example, have already driven dramatic change in the ‘flatten the curve’ stage of the COVID19 crisis. As we move to the next stage, health systems will have to intentionally design hybrid (digital-plus-onsite) care delivery models in concert with regional plans that integrate public health, economic and social strategies to mitigate, manage and support patients and the broader population.”
Asked how she sees the issue playing out among hospital-based integrated systems in the next few years, Arlotto says, “We are working with a number of health systems to use advanced analytics strategies to inform their next stage hybrid strategies. Data provides insights on emerging patterns which can drive design of services, patient experiences and revenue implications. For most of our clients, this means combining traditional score cards with real time analytics and eventually moving into the predictive and prescriptive space – ultimately creating a new data ecosystem and platform.”
HIMSS16 – billed as the largest and most important healthcare IT conference in the United States occurred last week in Las Vegas. The message was loud and clear – something is different; the government mandate is over. Strategy is the new, new.
For years the HIT world has encouraged alignment of enterprise strategy and the IT plan. Alignment suggests two distinctly different things creating a linkage or connection. Healthcare enterprise strategy decisions such as which markets do we enter, who do we acquire, which service lines do we emphasize, and what capital investments do we make are explored at executive and board levels. Operations and financial decisions to support our hospitals and physician practices are made within organizational silos. Sometimes IT is at the table, but more often than not information systems professionals are called in after the fact to “implement” selected systems and tools. Sophisticated IT organizations have created IT Strategic Plans, IT Governance structures, IT Road Maps, and IT Champions/Customer Relationship Managers. Our challenge – separate, sometimes aligned but rarely one.
Uncertainty is the new normal. Strategies that take years to implement, vendor partners who are all vying for the same space and the challenges of mergers and acquisitions are driving us from 1.0 healthcare – where business as usual no longer is sustainable. We are at a cross roads. Those of us in transition must “pivot” our viewpoint from 1.0 volume based thinking to 2.0 and beyond.
We need fresh, new perspectives regarding the relationship between enterprise direction and the digital strategies required for the future. New harmonized strategies will:
- Vary by geographic market and depend on community progress toward clinical integration
- Necessitate partnerships, alliances and consolidations – no one can fund the investment alone and no one vendor will have all the solutions
- Require governance models that address horizontal, vertical and virtual decisions making and integrate change across multiple systems of care
- Move from an applications focus which emphasizes feature, functionality to a platform focus, producing highly configurable systems which will drive standardization and enable business strategies simultaneously
- Redesign our organization structures, leadership competencies and operating models in IT, Informatics, Analytics and Quality
- Acknowledge our work to create systems of documentation was foundational but not the end goal; systems of insight and behavioral change are the next stages in the evolution
- Result in convergence of people, process, information, change and technology to rationalize costs, manage risks, realize value and activate patients to become involved in their care
Based on dozens of interviews with health systems across the US and additional research, this report looks at where CHIOs and their teams are headed amid tumultuous change in healthcare. Originally seen as the stewards of CPOE and Meaningful Use — and known as the Chief Medical Informatics Officer — the Chief Health Information Officer is now tasked with ambitious information technology initiatives spanning the health continuum, retail health and consumer engagement, and population health management. Historically, limited in its authority and with few resources for support, this emerging role is a key player who must collaborate with Chief Innovation Officers, Chief Transformation Officers, and CIOs to drive clinical integration, care coordination and value realization.
To download your copy of the white paper, click here: From the Playing Field to the Press Box.