Health technology executives came together in panel sessions during the digital portion of the HIMSS22 conference in Orlando to talk about the impact of the pandemic on health system transformation and the acceleration in health equity efforts under way.
Rasu Shrestha, M.D., M.B.A., executive vice president & chief strategy and transformation officer for North Carolina-based Atrium Health, said the pandemic has highlighted how health systems need to change their focus. “We cannot afford anymore just to be focused in on the data components that we've traditionally been using to propel our respective business models forward,” he said. “The pandemic has really shown us that we need to broaden that aperture to more of a person-centered approach to care. That calls for us to bring in more data from outside of healthcare.”
Tina Esposito, system vice president and chief health information officer for Advocate Aurora Health in Illinois said health equity was a priority for Advocate Aurora before the pandemic, but during COVID it has become “very clear that we needed to act quickly and align ourselves before reaching out to our patients, but also communities as we support them in their healthcare journey,” she said. “Regardless of whatever condition you're looking at, whether it be COVID or heart failure or asthma, it tends to be the same communities that have gaps that we need to work on closing. For us, it's really been about using the data and analytics to identify those communities, and recognizing the need to partner. Clearly, this isn't just a healthcare play. We need to be very cognizant of understanding people as people, not just patients, and what might be driving that gap in those outcomes. Partnering with communities to help closing those gaps is definitely a priority for us.”
Sean Robbins, executive vice president of external affairs for the Blue Cross Blue Shield Association, said that “things we were working on already, the pandemic had a way of magnifying them and isolating them. One data point that jumped out to us that we've decided to make a meaningful difference on is the inequities that occur with Black women who are pregnant, who today are three times more likely to die from complications than their white female counterparts. That is an unacceptable data point in our healthcare system. We used it as a motivating force to commit to a five-year strategy for the Blues to reduce maternal health complications and disparities in this country, because it's just not an acceptable outcome.”
Looking ahead at the next few years, Shrestha highlighted three things: One is truly embracing a consumer-first mentality. “Second, I see a big role, even in the next two years of health systems as conveners, really orchestrating comprehensive health, all of the elements around the social determinants of health services and the social impact issues and the ramifications around population health. Third, I think it's going to be really important for us to hyper-focus on the future of work and talent. Forty-two percent of physicians reported feeling burned out last year, according to Medscape. At Atrium we're leading what we call our ‘Best Place to Care’ strategy that enables our clinicians to work at the top of their license through technology enablement, process redesign, and, and more of an integrated approach to team care.”
Looking ahead, Esposito said there is a danger in feeling like you are falling behind. “We had all these initiatives we had to pause as we redeployed people. Now we're getting back to a level of normalcy. You fall into this trap of saying we have all these things to get done. But maybe we need to rethink and focus our efforts,” she said. “What had been on a long list of initiatives — maybe they are not so important anymore, right? Maybe we have to think about the truly innovative ways we need to change, to ensure that we are meeting patient's needs and meeting community needs. Perhaps now we have to say what has changed and what should we prioritize, given what we've been through?”
“Following the pandemic, what I hope will become a relic of the last century's healthcare system is that we built these big institutions, and we put a lot of dollars and cents into brick and mortar and then forced the American public to come to the health care system, Blue Cross Blue Shield Association’s Robbins said. “But I think the pandemic accelerated a move that was already underway. It forced all of us to drop status quo approaches, processes, procedures, mindsets, and postures around that notion, and we had to go to people as a system, because we were physically forced to do it in a very short amount of time. And candidly, if there is a silver lining, from the pandemic, it's that it did force the system to set the typical ground rules aside for a period of time and go back to some basics and try to orient the system around meeting people where they are versus forcing people to meet us as a system where we are.”
In a separate panel discussion, John Glaser, executive in residence at Harvard Medical School and former senior vice president of population health at Cerner Corp., said it will take a couple of years for things to settle down because the pandemic has been such a shock to the system. A lot of people really accelerated plans to digitize their interaction with patients or to telework. The surge in telehealth has settled down to a more sustainable 20 percent, he noted. “A lot of the scaffolding that was put in place in a hurry was probably not the best scaffolding in terms of integration or workflow.” There is also a chance to move away from fee for service, he added. Many providers want to move to a more predictable per member per month capitated payment model.
Jodie Lesh is chief transformation officer at Kaiser Permanente. She operates as a cross-functional orchestrator of complex, disruptive initiatives, with a focus on how the organization’s large and complex delivery system evolves to meet changing care delivery models, consumer expectations and KP’s ambitious health equity goals. She oversees strategy, planning and design for KP’s $3.5 billion-per-year capital program in support of the organization’s evolving care delivery model. Lesh agreed with Glaser and used specifics from Kaiser to make her point. “We had been doing around 15 percent telehealth going into the pandemic. We were in a very, very good position in many ways, but in other ways, we were unprepared. Overnight, we started using remote patient monitoring to monitor COVID patients, which actually probably saved a lot of lives. It showed us what was possible. It was an incredible time of innovation. But I agree with John that it was not probably the ideal workflows, not necessarily the ideal technologies and not the ideal user experience.”
Glaser and Lesh also agreed that coming out of the pandemic, health systems will be transformed. “At the back end of this, we will have a completely different ecosystem,” Lesh said, “but it's hard to see that right now, because we're still in these incremental steps.”
