The COVID-19 pandemic has brought innovation in healthcare to the forefront through the industry’s effort to rapidly expand telehealth services, reminding many health systems of a key lesson: information technology (IT) has a catalytic role to play, but not necessarily as the protagonist in the play. Instead, IT should be a key facilitator bringing clinical and operational leadership together to identify the right “business” problems that need to be solved and the various alternatives to solving them.
During a recent interview, Steve Shirley, vice president of information technology and CIO at the Pueblo, Col.-based v and Sanjeev Agrawal, president and COO at healthcare solutions company LeanTaaS, discussed how technology can help health systems take risks that improve efficiencies through the use of technology. Below are excerpts of that discussion.
Steve, as you reflect on the past year, what’s been a key piece of success for Parkview Medical Center as the health system has leaned on technology throughout the pandemic?
Shirley: Improving efficiencies is something every healthcare organization should be doing in the wake of COVID-19, and we found that a collaborative approach with our physicians was the key to success. Physicians are collaborators and partners, not adversaries. I always say, it's not about me, it's about the physicians we get to work with. There is a common mindset of collaboration. We have a rule: we don’t do any IT projects in this hospital without a physician or other clinician at our side making the decisions. I think that's really important.
Partnership and governance are where the rubber meets the road in the decision-making process. We have a very consistent process for selection, implementation and use of systems. We don't allow for rogue purchases, which allows us to innovate in a very controlled atmosphere, while funneling limited dollars in the right channels and avoiding problems after the install. And, by the same token, IT never installs a piece of software and then says, okay, clinicians, figure out how to use it. That is the base of why we're successful, because it's an incredibly strong relationship.
You also have experience working in other industries, so how has the healthcare industry compared with the digital transformation that’s affecting all businesses today?
Shirley: There’s no doubt that healthcare has been slower to adopt digital technologies relative to other industries such as finance and manufacturing. However, upon joining Parkview Medical Center I quickly learned that banking was nowhere near as complex as all the systems put together to create the healthcare environment.
The number one thing I saw is that healthcare is much more difficult to bring into a digital space than banking. In banking, we were dealing with customers who require that we be savvy as far as our technological advancements, with people wanting to pay their bills online, and to do online banking of all sorts.
Agrawal: Steve’s observation is understandable. Imagine that your mobile app for your bank goes down for 10 minutes or even a day—nobody dies. The stakes are significantly higher in healthcare, but so are the rewards.
Steve also attributes Parkview’s success to his role in facilitating the selection, implementation and use of software. As he puts it, it’s the balancing of resources, timeline and scope. With this as their guiding principle, and working in tandem with clinician partners, they are able to select which projects will have the biggest impact for the organization.
How should IT engage clinicians when it comes to adopting new technology?
Shirley: Parkview Medical Center’s IT project management process includes a crucial first step: identifying the clinicians who are going to be part of the project. The clinicians literally drive the decisions. It's a multidisciplinary team.
Most of the major systems we've implemented in the last five years, the final decision has absolutely rested with our clinician partners. We ask them when we start a project, ‘Can you commit to be at the table, every single meeting? If you can commit that, we'll do this project. If you can't commit, we're not going to do the project until your time or your delegation of someone allows us to be successful.’ That's worked so well over all the years.
Developing and committing to an effective IT process isn’t the only innovation Parkview has developed. We also are working on operational improvement through the use of predictive analytics and the smarter use of data.
How does data impact technology integration for health systems?
Agrawal: Data in healthcare is growing at an unprecedented rate, partly because EHR systems are a relatively new thing for the ERP systems of healthcare. The EHR is truly the digital backbone of healthcare IT, but there are certain things that are still not enough.
One of the most critical elements to successfully utilizing healthcare data is to create systems along with EHR partnerships to make a physician’s work effective and efficient. Good data also leads to better reporting and reporting tools. It's garbage in garbage out, even if you have the best predictive models in the world. It’s all about giving physicians the tools they need to help them make more intelligent decisions.
Shirley: One of the frustrations we all have to overcome in healthcare is the abundance of data. Upon reviewing, the first thing we saw was that we did not have consistency. As an example, one year we reported three different numbers of births in the hospital, because three different groups put the data together. We were fortunate enough to create a data governance division of IT. What that's done for us is to get away from just mundanely gathering data and starting to move more into taking analytics to create some of this whole predictive capability or clinical decision support.
What’s a piece of advice that you would share with a health system CIO to help overcome some of the financial impacts of COVID-19?
Shirley: Like most hospitals, Parkview Medical Center was impacted by the cessation of elective surgeries at the beginning of COVID-19. When you think about the financial impact, our hospital alone lost double digit millions of dollars.
When you start to think about how precious block time is, you realize how difficult it is to try to always predict the length of the surgery. As a Level 2 trauma hospital, how do you predict when you're going to get a bad accident or something that brings an add-on surgery? You have to really think through the process. On top of it, the toughest part is the fact that you have a group of incredibly talented surgeons who are very protective of their block time for good reason. They want to be very effective and efficient with their time.
Agrawal: I liken it to what the airlines have done by way of increasing their load factors (pre-COVID) or what the airports have done to be able to accommodate more travelers as airline travel has really taken off in the last 20 years. If we don't do this with our hospital partners, there is a risk that not only will assets go underutilized, but providing high-quality care at a manageable cost to all Americans is going to become harder.
Increasing access to care in affordable ways is very important. Surgery is clearly the biggest driver of access and revenue for hospitals. The use of IT innovations has helped health systems start to rebound from the elective surgery backlog caused by COVID-19.
Sanjeev, can you share a prediction for how health systems might improve efficiencies through technology in the future?
Agrawal: Looking ahead to the future of health systems like Parkview Medical Center and the healthcare ecosystem in general, I see a future focused on patient engagement and population health. There is so much data to sift through to better understand the right way to engage patients. We really have to change how we deliver care, but also how the patient participates in and accepts care.
Innovation and technology backed by relationships, collaboration and engagement—a high-tech approach with “low tech” interventions. It’s how healthcare IT innovations are delivering results for Parkview Medical and its community.
