Northwell Health

Chris Hutchins

Provider organizations across the country were moving towards digital transformation prior to the beginning of 2020 when COVID-19 disrupted everything. In most organizations there was a significant pause or slow down as the pandemic began to redefine priorities. This was true from a day-to-day perspective in terms of managing a sick population, as well as planning for digital and other organizational goals. As in any crisis, this provided an opportunity to evaluate preparedness and performance in every part of an organization. It exposed weaknesses in key areas like interoperability, availability of data, both internal to healthcare providers, and external from public health agencies at state and federal levels, and others. Perhaps the most significant learning is still unfolding. People were able to receive most basic needs through online interactions and adapted by necessity. How much of this persists as the public health crisis stage of the pandemic winds down remains to be seen. However, most organizations are either doing significant planning or are already moving towards digital transformation with an understanding that consumer expectations are evolving as are those of clinicians. As an organization embarks on this transformation, there are key considerations to account for.

Consumer/ Patient Expectations

As healthcare workers, we are also consumers and have an insider perspective and have a good understanding of expectations. While this is likely true in part, the majority of those who are receiving their care do not have the insider perspective and may have a very different expectation. Navigation for them is likely a considerable challenge. Obtaining the patient perspective is critical to the evaluation of any potential workflow designs, and ultimately technology deployments. This can prevent over or under engineering solutions or even deploying an unwanted solution. While technology is an enabler, the desire for human connection should not be ignored. I would recommend avoiding the Field of Dreams approach. (“If you build it, they will come”). The desired solutions aren’t always the obvious or easiest ones. In our industry we don’t often provide any real choices to our consumers. This approach will be a significant barrier to effective transformation. One recommendation is to collaborate closely with team members who analyze patient engagement data to gather reoccurring themes. Additionally, it is also good to work with the marketing team to conduct sentiment analysis. These can provide valuable insights for sure but there is still a need to test these observations prior to any significant development efforts.

"Obtaining the patient perspective is critical to the evaluation of any potential workflow designs, and ultimately technology deployments."

Build vs Buy

This is a frequently asked question. Answers are likely different from one organization to the next and for a variety of reasons. These reasons range from the number of applications/solutions that may be deployed in an organization, the cost of consolidation to common platforms, aggressive growth strategies, and development capabilities residing in or outside of any organization. There are other reasons for sure but one or all of these may exist in the same organization. There are a couple of areas that I believe should be considered. One is assessing the total cost of ownership (TCO). There can be a belief that internal development is much more cost effective. Where staffing cost is already accounted for in budgets, it often gets overlooked in comparisons. Solutions that are already in the marketplace will likely have some of this cost included. The time it takes to develop effective solutions must be part of the equation as does the operating tail that is required to support any solutions that are deployed. The operating tail is not usually less than fifteen percent of the initial spend on development of the first version. I recommend looking at a five-year TCO to ensure a true comparison to a licensed solution. Where the primary focus of a healthcare provider organization is care delivery, I think it is wise to evaluate products that are in the marketplace that have a proven track record. If the goal is to meet the expectations of the consumer, assessing the time to deploy a licensed solution is a key step to understand what can be delivered within an acceptable timeframe. An important question to ask is, are we delaying the delivery of functionality that consumers can get elsewhere within the current market? Cost is certainly a significant factor but the answer to this question should also be considered. Especially if it means that the capability is years away. Designing and building from the ground up is generally a very time-consuming effort and is frequently underestimated from a timing and cost perspective.

Risk Of Distraction

As organizations define their approach to digital transformation, it can be an overwhelming process to evaluate the tooling for enabling impactful solutions that will be meaningful to consumers. There are countless products in the marketplace that may have some, or perhaps most of the features that make sense to those with the inside healthcare view. This is where gaining perspective from consumers of our services is essential. It is easy to get enamored with cool technology solutions. Enabling smooth and easy interactions is likely more about communication and human interaction than it is about technology. I submit that people will point to a good human interaction with their healthcare provider when they discuss their experiences most often and will not likely point to the technology that was part of the experience.