In November, MedeAnalytics hosted the 2021 Impact Summit, an engaging and educational event held annually and designed exclusively for our clients. We are publishing extensively, re: the insights and actionable takeaways from the Impact Summit, and in today’s post I’m thrilled to highlight our incredible keynote speaker. We were honored to have Robert Wachter, MD, a practicing physician and Chair of the Department of Medicine at University of California, San Francisco (UCSF), inspire and inform our clients with his speech, ‘Data, analytics and AI in the post-COVID world.’
Dr. Wachter has written six books, including New York Times Bestseller, The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age.
His honors include selection as the most influential physician in the United States (Modern Healthcare Magazine, 2015), the Eisenberg award (nation’s top honor in patient safety, 2004), and election to the National Academy of Medicine (2020). In 2020-21, his tweets on COVID-19 were viewed over 250 million times by nearly 200,000 followers and served as a trusted source of information on the clinical, public health and policy issues surrounding the pandemic.
In his Impact Summit keynote, Dr. Wachter identified the four stages of digital transformation, discussed how COVID-19 influenced the healthcare industry’s digital development, and provided meaningful advice for how the industry can continue to make sustainable progress on this front.
Four Stages of Digital Transformation
1. Digitize the record
This step enables and determines how we collect, store and move information around.
2. Connecting all of the parts
Also known as interoperability, this step breaks down into two key parts:
- Create visibility across EHRs on different platforms and at various organizations
- Integrate third-party digital tools and patient-facing technology (e.g., digital glucometers, Apple Watches, pulse oximeters)
3. Glean meaningful information
In this step, this digitized, shareable information is used to better understand your own capabilities and your patients’ needs.
4. Convert insights into action
Finally, data serves as the basis for real change – powering improvements to healthcare value, quality, cost, experience and equity.
So, where is our industry in the process? The past decade or so in healthcare has focused on setting up and socializing the electronic health record (EHR). In 2007, fewer than one in 10 American hospitals and physician offices used EHRs. In 2017, fewer than one in 10 did not use EHRs. Now in 2021, digitization of the record can be considered complete.
In terms of interoperability, we have quite a long way to go. If hospitals use the same EHR platform, there is a decent chance they can access necessary data from each other. Add a different platform or setup to the equation though, and connection becomes significantly more complex, given proprietary systems and disparate data standards across healthcare.
Integrating patient-facing tools and tech is something consumers are beginning to push for – but there is a great deal of cost and friction involved. Importantly, we absolutely must have a strong workflow and operational model set up before inviting a steady flow of patient data into our systems. This may look like adding a layer of AI-enabled triage – some call this ‘care traffic control’ – into the system that can monitor patients fluctuating data and produce care recommendations without placing a large burden on already-busy clinicians and practices. There is a lot to consider there before it becomes a reality – from capabilities to liabilities – but it is almost certain to be a part of healthcare’s future.
Looking at stages three and four, we are barely scratching the surface of extracting meaningful information from the available data and applying that information to change our behaviors. Particularly compared to other industries – like professional sports – that use data to determine every strategy and predict every move, we have a very long way to go. Dr. Wachter referenced the use of analytics in baseball as an example, or Moneyball as it is often known, to show just how advanced other industries are in their use of analytics. Ultimately, we want to be in a place where data and insights are helping to determine how we take care of patients, manage ER hours, collaborate with other offices and networks, make financial decisions, and much more.
I think we can all agree that we wholeheartedly wish this pandemic never happened—but that we do see some silver linings and side effects to be grateful for. Dr. Wachter focused on one of the most impactful: advancements in acceptability and utilization of digital capabilities within healthcare.
He referenced that at his home hospital UCSF, virtual telehealth visits were at about 2% before March 2020. After spiking to 70% for months, they have now settled out at about 30% of interactions being held virtually. As Dr. Wachter says, “Fear turns out to be an incredibly powerful motivator.”
Most providers have experienced a very similar trend – and it has fundamentally changed the industry’s expectations and operations. Even as regulations and payments for virtual care are solidified, we will never see a return to the 2% telehealth utilization. Additionally, the fact that care is no longer geographically determined is very good news for underserved areas but potentially difficult news for local or regional hospitals now competing with national systems and disruptor brands for patient loyalty.
Dr. Wachter also discussed how the pandemic changed our dependence on and use of dashboards to inform decision-making. We had to keep up with COVID-19 in real-time to survive, and to do so we needed clear, comprehensive views of everything happening – the who, what, where, when, how, and why. Now that we have had a taste of what is possible, there is no going back to the old way. Clinicians and administrators alike now crave getting all critical data and information in a real-time, visually appealing, and actionable dashboard format.
Moving Forward Sustainably
Continuing to make progress on the digital front without getting ahead of ourselves requires a thoughtful, step-by-step strategy, including collaborative goals and shared investment in initiatives. Two key ideas Dr. Wachter suggested considering here:
- EHR platforms were not built to do it all – so do not try to force them to. Instead, think of the EHR as the foundation of the ecosystem and wrap robust digital tools around it that offer complex data analysis, AI-enabled decision-making, attractive patient-facing tools, and more.
- Know that healthcare is moving into a less institution-focused, geographically determined space that will revolve around delivering higher quality care to patients in a less expensive, more equitable manner. Build organization-wide objectives and long-term plans that align with and advance this movement.
The million-dollar question is: when will this happen? COVID-19 has inevitably sped up the timeline, but the industry still has a long way to go. We understand the theory of this digital transformation but have yet to put it all into practice. Dr. Wachter concluded by reinforcing his deep belief that these changes – if we get them right – will have an incredibly positive impact on the health and wellbeing of communities and populations across the nation.
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