Highlights:
Beth Israel Deaconess Medical Center (BIDMC), the academic medical center connected to Harvard Medical School, is a successful case study for the implementation of digital transformation strategies in healthcare. Digital transformation within healthcare has been slow since data privacy and integrity has to be done right. If a piece of data pertaining to a patient record is lost (i.e., past adverse drug reactions), it could have potentially fatal consequences. Hence, the stakes are high within healthcare to implement improvements on-the-go and while also having them work flawlessly from the start. However, there are large healthcare systems in the United States that have been successfully overhauling old processes, BIDMC being one. These organizations illustrate the approach and framework required to successfully implement digital strategies and achieve better patient outcomes.
Major Findings
The low reimbursement rate for procedures (from insurance companies and Medicare) within healthcare contributes to the narrow operating margins for patient-facing healthcare organizations (i.e., especially hospitals). Hence, the budget to undertake digital transformation projects is slim. At BDIMC, one of the leading hospital systems in the U.S. for digital and patient-provider model transformation, funding for the IT department is “1.9% of the operating budget,” according to the CIO.
Secondly, it is hard to attract IT talent into the healthcare field. The pay that health organizations offer cannot compete with the pay or benefits of most technology companies. This is compounded by many health organizations being not for profit. It was found to be hard to hire strong CIOs or tech leaders at hospital systems. These roles require people who are driven by the sense of mission and wanting to make a difference, more so than for money.
BIDMC has tried implementing many cutting-edge digital technologies to improve patient-doctor interactions and outcomes. However, some technology still is not at the level required for use in a healthcare setting. Technology used in this setting needs to work perfectly 100% of the time since the collateral cost is the wellbeing of a patient. Experiments with Google Glass had a lot of potential to improve data availability for doctor’s while diagnosing patients, however, technological insufficiency caused the hospital system to stop its use.
Empirical Basis for Findings
BIDMC is among the top three hospital systems in the United States in preventing waste and improving efficiency. They do this by passive data collection by patients. Research suggests that hospitals and clinics should implement more processes to be able to passively collect data by allowing patients collect and upload through the use of mobile apps, at-home monitoring devices, etc.
Moreover, BIDMC focuses on prevention – ensuring patients do not have to be admitted to the hospital in the first place through active lifestyle and health management. BDIMC was an early adopter of technology goals, hiring it’s CIO in 1999. They have experimented with many new technologies to find ways to improve the patient-doctor interaction as well as the overall health outcomes of their service. Some strategies have worked, while others have shown potential – the technology needed further refinement. Healthcare is a unique industry in which there is little lag time, and technology needs to work 100% of the time. As BIDMC's CIO says, “it’s like tweaking and flying a 747 at the same time.” Hence, digitization in healthcare will be slow, but BIDMC has been able to develop a digital transformation framework that works and other health systems can emulate.
Implications for Practice Management
There are a few principles that healthcare systems and health leaders should focus on when implementing digital transformation strategies. BIDMC successfully implemented the following:
Ensure that all organizations within a health system run on the same electronic records platform. Currently there are many different platforms and data gets separated as health systems acquire smaller systems or clinics, each using their own software platforms.
Make the switch to a cloud-native software platform for patient records as well as data management. This means using an EMR such as Athena, while also using a cloud platform such as AWS or Azure to manage data. This will improve agility and enable clinicians to use mobile and tablet devices since “the desktop is dying within healthcare."
Create a unified data lake from which general population trends and hospital patient population trends can be identified, enabling higher-level decision makers to more effectively allocate resources and solve large scale problems. Having a unified EMR with insights is only good at the doctor level for help with diagnosis, but it does not provide the bigger picture for management to make organizational decisions.
Develop working relationships with patients to facilitate importing data from their IoT devices into the EMR, providing clinicians with interval data recorded between patient visits.
Bibliography
Kane, Gerald C, and John Halamka. “How Digital Transformation Is Making Health Care Safer, Faster and Cheaper.” MIT Sloan Management Review 57.1 (2015). 57 – 67. Print.
Comments