The digital future of healthcare

Lehigh Valley Health Network set out to keep patients from dying of sepsis, a life-threatening complication that can result from an infection, and it planned to use its computer system to help.

The tech team at the Allentown, Penn.-based healthcare system worked with colleagues from the clinical side to create an application that takes best practices and patient workflows, leverages data sets and analytics technologies, to identify which patients are susceptible to the condition and then guide care teams on treatments.

The result was a 40 percent reduction in fatal sepsis cases within just five months, says LVHN Senior Vice President and CIO Michael Minear. He’s now working to build pathways for treating 55 conditions representing more than 80 percent of the problems that bring patients to the hospital, with 35 of those pathways already operational.

“We’re leveraging our digital infrastructure and using analytics to make sure we’re using best practices to care for patients,” Minear says.

With results like that, Minear and the 440 employees within LVHN’s IT department demonstrate how technology is transforming healthcare.

It’s a long time coming, not just at LVHN but for the industry as a whole.

The healthcare sector has lagged far behind others in finding ways to use information technologies to deliver more effective, more efficient and more engaging services to employees and customers (i.e. patients).

A 2018 study from the SAP Center for Business Insight and Oxford Economics, Digital Transformation in Healthcare: A Positive Prognosis, found that few healthcare organizations were digitally mature. The poll of 400 global healthcare executives found that only 2 percent completed their digital transformation initiatives across all areas, while 32 percent have completed them only in some areas. Another 54 percent were still piloting their transformation initiatives while 23 percent were in the planning stages.

That same study, however, found that healthcare leaders viewed transformation as critical to future success. Some 70 percent said modern technologies are essential to growth, competitive advantage and customer experience. And while 61 percent said digital transformation is mission critical for current success, 86 percent ranked it as mission critical to their success five years out.

Experts say such figures show that healthcare is catching up to the digital revolution that already disrupted other sectors. They now see healthcare executives ramping up investments in transformative technologies that promise to reshape how clinicians and patients interact.

“We’re now hitting the steep part of digital transformation curve,” says Tim van Biesen, a partner in Bain & Co.’s New York City office and leader of the firm’s global healthcare practice.

Now, as the industry continues to drive forward, seeking to overcome long-standing obstacles that have hindered an earlier digital transformation in this sector, the success stories coming out of the sector can provide guidance for CIOs in other areas to use as all executives grapple with how to further their own digitalization journeys.

Preparing to scale

The digitalization initiatives at LVHN illustrate this trend.

The healthcare system invested about $250 million several years ago to implement its current electronic health records (EHR) systems, according to Minear. Since it first went live, LVHN has used it to share approximately 6.1 million healthcare records with 630 other care providers to ensure patients’ medical information follows them regardless of where they receive treatment. The IT team also enables clinicians to order some 210,000 electronic prescriptions monthly. IT supports 250,000 patients as they access the organization’s patient portal, and it maintains the network that every day uploads 42 million data points from 1,400 clinical devices to its EHR.

That, though, is just the foundation, Minear says. LVHN is using its expanded digital footprint to rework how it delivers care, as its use of IT to reduce sepsis-related mortalities demonstrates. The organization also uses IT to remotely monitor the vital signs of patients recently released from inpatient care, with nurses in a call center who receive the data ready to step in should analyses indicate any problems. And Minear says his team is implementing another application that will analyze patient information to alert clinicians about genetic concerns that could influence prescription choices.

“The notion that healthcare is lagging is old news. The technology is largely there. We’ve done the investment in tech, we’ve had our learning cases, and now we’re scaling,” he says.

Barriers, challenges, opportunities

Robert M. Wachter, MD, a professor and chair of the Department of Medicine at the University of California, San Francisco, and author of the 2015 book, The Digital Doctor, is not as optimistic about the state of healthcare IT.

He says the sector still lags other industries, although he notes that he’s seeing “some early examples of innovation.”

“From a high level, healthcare was the last major industry to digitalize its core data collection and core processes of data collection and data movement, which is remarkable when you think about what we do. We’re a data-intensive industry that most people care deeply about,” he says, noting that healthcare CIOs spent the past decade laying the foundation for the innovations he’s now starting to see.

There are significant reasons why healthcare fell so far behind others, Wachter and other expert say.

Healthcare has had to contend with the same challenges that other sectors face as emerging technologies disrupt how business got done. Healthcare executives had to determine which IT investments got priority over technical, business and medical initiatives. They had to re-engineer workflows and manage those changes to ensure adoption and returns on their investments.

However, healthcare executives also had faced barriers unique to their sector. The misalignment of financial incentives, where clinicians get paid for individual services to treat sickness instead of being paid for keeping patients as well as possible, has been one of the biggest barriers to leveraging technology to work differently. The technology itself often created obstacles, too, as early versions of many applications created more work for clinicians and patients alike. Security and privacy concerns, along with related regulations, further stunted innovation as organizations moved cautiously to avoid any missteps that could jeopardize patient data.

As Wachter says: “The fail fast mantra may work for a restaurant app but may be not so good in healthcare where people’s lives are at stake.”

Moreover, those and other challenges remain. Healthcare CIOs must contend with wrangling data in one of the most complex, data-intensive industries there is and figure out how to share that data across multiple entities (even competitors). They must still compete for funding in a field where life-saving devices usually rank higher on the priority list. And they still have to navigate more typical challenges, such as finding qualified staff to implement and manage new technologies, setting strategy, getting buy-in and managing change.

On the other hand, the CIOs capable of doing all that are finding significant opportunities to bring new value to their organization. These CIOs are using cloud, data analytics and artificial intelligence to enable an integrated telemedicine experience where medical devices can transmit medical data from patients to remote physicians who then integrate it into the patients’ medical records for analysis. And they’re using analytics to find health patterns across patient populations and at the same time delivering more personalized medicine to each patient.

“The top technologies in the next five to 10 years in healthcare will be augmented intelligence, machine learning and natural language processing to gather information, predictive analytics, and technologies that allow data to stay at the source but still move in real time so there will be a single source of truth,” says David S. Muntz, principal at StarBridge Advisors.

Muntz says CIOs will support virtual reality labs where clinicians can practice complicated surgeries or where patients might work through treatments. They’ll support chatbots for both administrative functions as well as clinical care, such as soliciting responses from young patients. And they’ll implement more consumer-friendly technologies that allow patients more control over their healthcare experience by, for example, enabling them to electronically schedule appointments or connect with their physicians as easily as they interact with other service providers, such as their banks.

Providing a platform for service

John Henderson, vice president and CIO at Children’s Hospital of Orange County, says CHOC aims to be the leading destination for children’s health through excellent and innovative care, and leaders there see IT as a key element to successfully reaching that objective.

As such, Henderson says he and his team are looking at how they can use analytics to support CHOC’s population health efforts and what technologies they can use to better connect with patients and their families, and building a technology platform that ties patient-facing applications to back-end systems to create what he calls a unified digital experience. Henderson envisions building capabilities onto that platform so his IT staff won’t have to build from the ground up each time they introduce new functions and capabilities.

He has laid the groundwork for that vision, with an EHR system fully in place and more elements of the IT stack moving to the cloud to gain stability, resiliency and agility. IT also implemented a customer relationship management (CRM) system to better support administrative efforts as well as customer-related initiatives. And IT is driving forward with data programs to enable, among other capabilities, more predictive analytics for patient care.

“I think digital transformation in healthcare should really be about providing a one-stop shop where patients, patients’ families and providers can easily consume the services that we have to offer in a way that is convenient for them and that gives them value,” he says.

Biesen has a similar take on the current situation. He, like others, recognizes that many of the challenges that had kept digital transformation in healthcare at bay — such as fee-for-service funding, privacy regulations, resistance to change, the incredible complexity of the sector — remain. But Biesen says transformation is underway and will continue over the next decade, as healthcare CIOs and tech giants like Google and Apple seek to create a new model of patient-centered care.

‘A different thinking happening in healthcare’

Tressa Springmann, senior vice president and CIO at LifeBridge Health, is transforming care coordination and the patient experience at the Baltimore-based healthcare system. That has involved breaking down the traditional siloes that dominated, and still exist, in healthcare while also promoting a vision on how healthcare can better serve its users by leveraging infrastructure — people, process and technology — differently than in the past.

“I know in my organization that our real core objective is to bring technology to enable our strategy, and our strategy is a patient care issue and changing the health status of the community we serve,” she says. “And within my own organization, employment of digital tools allows a smoother experience and advances our strategy by reducing barriers for patients in how they access us. That requires collaboration and participation and data sharing and data exchange and getting data in the hands of patients, even if they move to another care setting.”

She talks about transforming healthcare IT into a platform, the way Amazon went from merely an online retailer to a platform that connects customers with many service providers.

“Digitalization in healthcare,” Springmann says, “is allowing us some of that same ability to eliminate again those very siloed locations of care that otherwise feel very disconnected from our patients.”

To that end, Springmann says LifeBridge is using or plans to leverage a range of technologies, from automation to a CRM, to become more efficient, effective and customer-centric. For example, her IT team implemented a mobile app for patients recently dismissed from in-patient care so its virtual hospital team can leverage technology to stay connected and guide their care in those critical post-discharge days.

“We need an infrastructure that’s finally honed to the needs and preferences of the patients. I’ve articulated that vision, and we’ve implemented elements with this vision in mind,” she says. “It represents the different thinking happening in healthcare.”