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Healthcare's industrial delivery model and its underlying business
model are on the precipice of major change. In 2017, mega-mergers
involving systems with at least $1 billion in annual revenue more
than doubled — from four in 2016 to ten. The trend has continued
with additional deals of similar size and complexity in 2018.
Intensifying this changing market context is vertical integration
at an unprecedented pace, along with non-traditional market
entrants such as the Amazon, Berkshire Hathaway and JPMorgan Chase
partnership — all of which have the potential to reshape the
landscape and competition.
As these trends accelerate, providers may find them daunting. Yet,
they also hold great promise to help solve many of healthcare’s
most persistent challenges.
One thing is certain: providers' informatics and technology
platform is an essential tool to advance market position and move
the needle on care cost, quality, outcomes and experience.
Are You Overlooking the Power of Technology to Address Your
Mission- Critical Imperatives? Authors: Dan Coate, Jody Cervenak
and Shawna Schueller
DEC JAN FEB MAR
CVS Health
Aetna Aurora Health Care
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Are You Overlooking the Power of Technology to Address Your
Mission-Critical Imperatives?
Providers are facing new challenges, and the existing challenges
are intensifying with:
Providers must rethink how to leverage informatics and technology
to answer the pivotal strategic questions their organizations
face:
Redefining IT Value to Address Pivotal Strategic Questions in
Today’s Changing Landscape
Doing more of the same will not drive the necessary improvements in
cost, quality, outcomes and experience. Instead, it is vital to use
the power of data, analytics and informatics across all four
critical strategic imperatives.
Market pressures driven by consolidation, alliances and new
entrants that have the potential to reshape the nature of
competition.
Cost pressures related to reduced reimbursements and rate pressure,
value-based care payments and incentives, direct-to-employer
contracts and competition from low-cost alternatives.
Legacy care and operational models that are not well-suited to
transition towards value-based care and have resulted in unforeseen
levels of physician burnout.
Increased competition from disruptive, technology-enabled
competitors fueled by growing consumer expectations and demand for
and evidence of the efficacy of digital health for preventive
health, chronic care management and digital/virtual care
delivery.
How do we
in the market?
pressures?
FINANCIAL
CARE MODEL
and effectiveness?
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Are You Overlooking the Power of Technology to Address Your
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Four Levers to Harness the Power of Your Technology Platform Create
a bold vision for how informatics and technology can be a game
changer to your organization’s success and advancement of the
mission. Use these four levers to do so.
Leverage technology to win in the market.
Use technology to address growing financial pressures.
Create the underpinning of the next generation care model to drive
outcomes and value.
Capitalize on technology to improve operational performance and
effectiveness.
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Are You Overlooking the Power of Technology to Address Your
Mission-Critical Imperatives?
Ensuring effective M&A and partnership planning and integration
design to best
position the health system to accelerate synergies, scale and
efficiencies;
Extending the EHR platform to affiliates and regional partners to
improve care network design and management through improved
connectivity and information sharing;
Creating a pragmatic digital health strategy to increase
interactions and information exchange among caregivers
and patients;
modalities of care, self-service, service center planning
and design, and provider and customer relationship
management optimization; and
care;
and game changer to attract new patient populations, increase
access, find new revenue streams and reduce costs.
Leverage technology to win in the market.
Informatics, analytics and technology can materially extend reach
and drive market differentiation. They can be leveraged for
strategic growth, competitive position, differentiation, innovation
and scale by:
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Are You Overlooking the Power of Technology to Address Your
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University of Mississippi Medical Center’s telehealth program has
resulted in 500,000 encounters since 2003 with 200+ available
specialists across 35 specialties and 200+ locations and extending
the reach to Mississippi’s 82 counties, 53 of which are more than a
40-minute drive to specialty care.1
At Kaiser Permanente 52 percent of all patient interactions are now
through digital health services, ranging from online physician chat
to online drug refills, and daily digital transactions jumped 31
percent from 2016 to 2017. Additionally, they created market
differentiation through on-demand asynchronous text- based chat
launched November 2016 in Colorado and Washington in January 2018.
In addition to market differentiation and patient satisfaction
advantages, Kaiser Permanente has calculated chats to be 48 percent
the cost of a nurse call, 10 percent of competing video eVisits and
2 percent of an ER visit. 2, 3
The Mayo Clinic Care Network uses technology and physician
collaboration to deliver a full spectrum of medical expertise to
patients and communities across the country and throughout the
world, growing its membership to include 42 members covering 26
states and China, Mexico, the Philippines, Singapore and the United
Arab Emirates.4
INDUSTRY EXAMPLES
University of Mississippi Medical Center’s telehealth program has
resulted in
At Kaiser Permanente
physician chat to drug refills
%
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Are You Overlooking the Power of Technology to Address Your
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Meaningful financial improvements can be achieved and sustained
through informatics and technology. Technology can and should be
leveraged to identify, accelerate and realize sustainable cost
reductions by:
Accelerating M&A and partnership synergies and
efficiencies through IT integration, standardization and
interoperability;
Improving IT performance and cost efficiencies through
effective governance, portfolio and demand management, and
application and IT services management;
Enabling improvements in operational expense and clinical cost
management and revenue
performance with revenue cycle and ERP technology and
operating models.
to achieve and sustain enterprise margin improvement and IT
value
realization;
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Are You Overlooking the Power of Technology to Address Your
Mission-Critical Imperatives?
Advocate Health Care leveraged voice- to-text technology to
document findings in the electronic health record without keyboard
entry or telephone transcription, reducing transcription costs 50
percent in the first year, as well as improving physician
satisfaction.5
Novant Health realized over $100 million in savings by optimizing
their system, aligning revenue cycle and maximizing the use of
analytics.6
Henry Ford Health System realized a $200 million return on
investment on their clinical and revenue transformation program.
This was through the development of ongoing clinical and revenue
cycle-improvement playbooks and focusing on clinical efficiencies,
revenue capture and cost optimization.6
Memorial Hermann, by implementing a ventilator acquired pneumonia
bundle supported by clinical decision support, reduced preventable
events related to mechanical ventilation and estimated that more
than 100 lives were saved and cost avoidance of $48 million.7
INDUSTRY EXAMPLES Advocate Health Care
Memorial Hermann,
BY IMPLEMENTING A
reducing transcription costs
in the first year
S U P P O R T ED BY C L I N I C A L D EC I S I O N S U P P O R T,
reduced preventable events related to mechanical ventilation
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Are You Overlooking the Power of Technology to Address Your
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Create the underpinning of the next generation care model to drive
outcomes and value.
Advancing population health management through effective
cohort segmentation and management and streamlined patient
management and care
coordination;
capabilities to improve cost of care, quality and safety;
Using virtual care to extend and evolve the care management
model across primary care, chronic care, inpatient and post-
acute models;
Leveraging clinical variation management and clinical decision
support to guide
decision making and optimize the care pathways portfolio
real-time
for the entire system; and
Elevating the provider experience and enhancing
workflow, documentation and communication with patients
and other providers and ensuring top-of-licensure work;
Operationalizing innovation to integrate advances in patient
engagement and behavior platforms, digital therapy, robotics
and personalized medicine.
Health systems can leverage informatics and technology in service
of the next generation of care models by:
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Are You Overlooking the Power of Technology to Address Your
Mission-Critical Imperatives?
and lowering the
30-DAY readmission rate by
F O R T H E O -PAT PAT I EN T P O P U L AT I O N .
Geisinger Health System’s ProvenHealth Navigator model uses
electronic devices and telemonitoring protocols for high-risk
patients with certain diseases to support timely communication
between patients and providers. Results included 18.2 percent
reduction in risk-adjusted acute readmissions and 7.1 percent
reduction in the total cost of care.8,9
Intermountain Healthcare used evidence-based protocols to reduce
inappropriate induction from 28 percent to 2 percent, resulting in
a $50 million annual savings and creating capacity for 1,500
additional newborns per year without the addition of beds or
nurses.10
Parkland Health Hospital System used care at home to transform its
outpatient parenteral antibiotic therapy (O-PAT) to
self-administered care at home, saving $40 million, avoiding
27,000+ inpatient days and lowering the 30-day readmission rate by
47 percent for the O-PAT patient population.11
Nebraska Medicine leveraged its EHR to improve care outcomes and
value: saving 18 women from dying of breast cancer (cost avoidance:
$7.7 million), preventing 11 cases of pneumonia and five cases of
invasive pneumococcal disease (cost avoidance: $1.1 million), and
39 lives at less risk from colon cancer death (cost avoidance:
$26.5 million).12
INDUSTRY EXAMPLES Intermountain Healthcare
Parkland Health Hospital System
used evidence-based protocols to reduce inappropriate induction
from
used care at home to transform its outpatient parenteral antibiotic
therapy (O-PAT) to
self-administed care at home,
annual savings
creating capacity forR E S U LT I N G I N A
additional newborns per year without the addition of beds or
nurses.
avoiding 27,000+ inpatient days
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Are You Overlooking the Power of Technology to Address Your
Mission-Critical Imperatives?
Technology is foundational to achieving high performance and
operational effectiveness. Health systems can improve their
operational performance and effectiveness by:
Evolving IT performance to a next generation IT model,
where success is measured by how the organization achieves
efficiencies, higher performance and measurable value;
Organizing informatics programs to achieve system-
wide consistency in care delivery and documentation, quality
and
efficiency improvements and cost of care reductions;
Preparing organizations to perform at their highest levels
through effective change management and operational
readiness strategies for EHR and other deployments;
Laying a solid data governance and analytics structure to
create
confidence in the data and catalyze a culture of data-driven
performance measurement, monitoring and continuous
improvement; and
optimization to improve quality, outcomes and the experience;
Ensuring appropriate cybersecurity and risk
management to protect information assets.
Capitalize on technology to improve operational performance and
effectiveness.
Are You Overlooking the Power of Technology to Address Your
Mission-Critical Imperatives?
Johns Hopkins’ medical intensive care unit created an early
rehabilitation program with dedicated physical and occupational
therapists. Average length of stay decreased 23 percent, from 6.5
days to 5 days, resulting in a net cost savings for the hospital of
~$818,000 per year after the investment.13
Cleveland Clinic created an automated early warning system to
address high- acuity patients. Some facilities reduced the number
of patient hours at high acuity by one-third to one-half, and in
most cases, patients at risk were assessed 50-70 percent
sooner.14
Geisinger Health System used predictive analytics to tackle
capacity management, reducing the in-observation patient population
by 20 percent, decreasing LOS for observation patients to 16 hours,
creating a new ED at one hospital and expanding bed capacity at
another.15
INDUSTRY EXAMPLES Johns Hopkins’
Medical Intensive Care Unit created an early rehabilitation program
with dedicated physical and occupational therapists.
used predicitive analytics to tackle capacity management,
AVERAGE LENGTH OF STAY DECREASED
THE TIME IS NOW — leverage the sizable investments your
organization has made
and use informatics and technology as a game changer.
DAYS TO
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R E S U LT I N G I N A NET COST SAVINGS for the hospital of per
year after the investment.
hours,
creating a new ED at one hospital
decreasing LOS for observation patients to
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Are You Overlooking the Power of Technology to Address Your
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Sources 1 Adcock, M. (2018, March). Innovative Uses of Telehealth.
Presented at HIMSS18, Las Vegas, NV.
2 Melmed, A. (2018, March). Chat with a Doctor: On-Demand,
Asynchronous Physician Advice. Presented at HIMSS18, Las Vegas,
NV.
3 (2017, February). Daily Digital Transactions Jump 31% for Kaiser
Permanente. Digital Commerce 360.
4 (2018, April).
https://www.mayoclinic.org/about-mayo-clinic/care-network.
5 (2018, March). Leveraging Health IT to Achieve Patient, Physician
and Cost Benefits. Healthcare Information and Management Systems
Society.
6 Allard, D., Neaves, R., Patefield, A. and Patterson. G. (2018,
March). Enterprise-Wide Value Realization through IT: A Davies
Story. Presented at HIMSS18, Las Vegas, NV.
7 Hargrave, T., Logue, A., McInnis-Cole, T., Thomas, J. (2018,
March). Standardizing Use of Clinical Best Practice with
Information and Technology: A Davies Story. Presented at HIMSS18,
Las Vegas, NV.
8 Maeng, D., Khan, N., Tomcavage, J., Graf, T., Davis, D., Steele,
G. (2015). Aging & Health Reduced Acute Inpatient Care Was
Largest Savings Component Of Geisinger Health System’s
Patient-Centered Medical Home. Health Affairs, 34(4), 636-644. doi:
10.1377/hlthaff.2014.0855.
9 Tomcavage, J., & Graf, T., MD. (2013). ProvenHealth
Navigation at Geisinger Health System. HPOE. Retrieved March 20,
2018, from http://www.hpoe.org/resources/case-studies/1297.
10 James, B.C., & Savitz, L.A. (2011). How Intermountain
Trimmed Health Care Costs Through Robust Quality Improvement
Efforts. Health Affairs, 30(6), 1185-1191.
doi:10.1377/hlthaff.2011.0358. Retrieved March 20, 2018, from
https://www.ncbi.nlm.nih.gov/pubmed/21596758.
11 Castro, G.J., Humphry, J., Kull, M. and Longo, J. (2018, March).
Innovative Use of Technology in the Home to Improve Diagnosis and
Care: A Davies Story. Presented at HIMSS18, Las Vegas, NV.
12 Cloyed, D., Rohrbach, R., Thomas, M. and Winterboer, T. (2018,
March). Improving Quality Outcomes in a Risk-Based World: A Davies
Story. Presented at HIMSS18, Las Vegas, NV.
13 Lord, R.K., AB, Mayhew, C.R., BS, Korupolu, R., MBBS, MS,
Mantheiy, E.C., BA, Friedman, M.A., PT, MBA, Palmer, J.B., MD,
& Needham, D.M., FCA, MD, PhD. (2018). ICU Early Physical
Rehabilitation Programs: Financial Modeling of Cost Savings.
Critical Care Medicine, 41(3), 717-724. Retrieved March 20, 2018,
from https://journals.lww.com/ccmjournal/
Abstract/2013/03000/ICU_Early_Physical_Rehabilitation_Programs__.3.aspx.
14 Basit, M., Burns, K., Fink, S. and Willett D. (2018, March).
Using Data for Evidence Based Decision-Making: A Davies Story.
Presented at HIMSS18, Las Vegas, NV.
15 Reich, E. and Yin, S. (2018, March). Improving Hospital Capacity
Management Through Monte-Carlo Simulation. Presented at HIMSS18,
Las Vegas, NV.
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About the Authors
Dan Coate Director, I&T Practice 954.232.7422
[email protected]
Dan Coate is a Director with The Chartis Group and a Practice Lead
for Informatics and Technology. Mr. Coate has more than 25 years of
experience in healthcare strategy, performance improvement and
information technology. He advises clients on IT strategy and
special studies and leads and manages large-scale process and
technology programs. He has served large integrated delivery
systems, academic health systems and national payors. Mr. Coate
co-founded Aspen Advisors, a top healthcare IT advisory services
firm that joined The Chartis Group in 2014.
Jody Cervenak Director, I&T Practice 412.370.0995
[email protected]
Jody Cervenak is a Director with The Chartis Group and a Practice
Lead for Informatics and Technology. She has over 20 years of
health system information technology leadership and consulting
experience supporting academic medical centers, schools of
medicine, integrated health systems, hospitals, post-acute and
managed care organizations. Ms. Cervenak has led consulting
engagements in the areas of integrated strategic planning, digital
health strategy supporting operational and clinical process
transformation, enterprise EHR and revenue cycle system
implementation planning and value driven implementation.
Shawna Schueller I&T Practice Manager 612.850.0825
[email protected]
Shawna Schueller is a Practice Manager for The Chartis Group. She
is a leader in the Informatics and Technology practice area focused
on helping healthcare organizations leverage the power of
information and technology to advance market position and move the
needle on care cost, quality, outcomes and experience. Ms.
Schueller is a HIMSS Fellow and has been honored nationally with
both the HIMSS Chapter Leader of the Year and Advocacy Liaison
Roundtable Advocate of the Year awards.
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