Digital health is a disruptive technology that can make anyone’s head spin. But if it’s strategically adopted, this emerging sector of healthcare can make the difference between life and death. Using analytics to drive healthcare, a hospital could potentially predict how likely it is that a person diagnosed with Chronic Obstructive Pulmonary Disorder will be readmitted to the hospital. Based on those analytics, providers could determine interventions at discharge to reduce that likelihood.
These possibilities are part of what Community Health Network’s chief knowledge and information officer, Dr. Ron Thieme, foresees with the recent rollout of a new digital-strategy initiative and the formation of a new company called Primaria Health. The Community Health Network’s (CHN) strategy stems from the ever-changing nature of healthcare technology and new laws that will change the financial model of the industry. One way Thieme will combat these changes will be through scenario planning.
“It stems from the idea that nobody can foretell the future,” Thieme says. Most companies that try to often end up over-investing in one area and under-investing in another. With scenario planning, the CHN team ideates a set of different futures that might happen. “Though none of these scenarios will unfold just like we expect them to, we’ve done the hard, intellectual work of examining what strategies we might need in each of these scenarios … It gives us the stability to shift more quickly as the future evolves and unfolds.”
Thieme has been with the company for about five years, and in his current role for roughly two. He’s been working on collecting data and using it to form actionable information and replicable knowledge for CHN. Doing that successfully, however, means being able to experiment with new technology and learn from its successes and failures. The best learning tools for new technology often come from such failures.
“The value of health data far exceeds the value of a social security number or a credit card.”
One specific instance occurred before Thieme joined the staff at CHN. The company launched an electronic medical records system that completely flopped. It was a piece of beta software, driven by the IT organization, which wasn’t ready and wasn’t fully understood by the executive leadership. CHN pulled the software and learned a valuable lesson: that EMR can’t be treated as an IT project, but has to be in the context of business and clinical transformation.
The key component of this recognition is that clinicians lead EMR. That’s how CHN eventually came upon Epic and Community Care Connect. They completed the $100 million project on time and under budget. Today, the system continues to bring business and clinical assets together from around the organization to provide clinical informatics and analytics capabilities that Thieme believes are second-to-none.
For Thieme, working with companies like Epic showcases the importance of partnership. “My most feared competitor is two college dropouts in a garage in Silicon Valley, who are going to invent the next disruptive technology in healthcare,” he says. “I say this a bit in jest, but those are the kinds of people we need to watch. I don’t see them so much as competitors but as potential partners. We want to find that kind of thinking, see those innovations, grab on to them, and disrupt ourselves rather than be disrupted.”
of IT-solutions staff are committed to digital-health initiatives.
of Community Health Network’s corporate strategies have a digital-health component.
One way CHN is disrupting itself is with the recently formed Primaria Health. The organization is a response to a bill that will change healthcare from a fee-from-service model to a pay-for-value system. In 2014, CHN had about 2,000,000 patient touches. Of those, about 50,000 patient touches occurred in the hospital—which resulted in 90 percent of the company’s profit. Under the pay-for-value model, that revenue opportunity would turn into a cost.
Primaria is the company’s entrance into the population-health marketplace. Thieme expects that 75 percent of the company’s revenue will be at risk in the population-health model within the next three years. “We are grabbing the bull by the horns, and we are going to drive change,” he says. The company will work with CHN physicians and independents to create risk-based contracts, focus on attribution and acuity, practice staffing patterns, and utilize analytic practices to keep patients healthy and establish success in a risk-based payment world.
CHN has also utilized the onset of telehealth in behavioral counseling programs. The videoconferencing capabilities, with emergency departments around the Indianapolis area, have been a major success because people in these situations often present primary or secondary behavioral health issues. With this program, patients can have an immediate behavioral-health consultation instead of having to wait for a counselor to arrive at the hospital. Thieme is looking to expand that program into other specialties in order to provide better patient care.
Despite the challenges CHN faces with data and information technology, Thieme keeps the company ahead of this relatively immature market. “Digital health is in its infancy,” he says. On top of this, information security is also a huge concern. “The value of health data far exceeds the value of a social security number or a credit card.”
The key is understanding that digital health has inherent challenges. Thieme’s role is to intercept the virtual and physical worlds by bringing together new and existing technologies that solve problems and create new opportunities. “If we walk into disruption with our eyes wide open,” he says, “then I think we have a better shot at managing our transition.”