technology’s role in achieving health system imperatives ......data center and application...

For weeks, CIOs and their teams have supported their health systems in preparing for and combating the COVID-19 pandemic. As many look beyond the initial surge, CIOs face a new stage of challenges as they consider how to best leverage technology to help their organizations survive and ultimately thrive in the “new normal.”

Indeed, a health system’s data, analytics and informatics platform must be an integral tool to meet five imperatives of the new COVID-19-impacted landscape, as described in our recently-published paper, “After the Surge: Five Health System Imperatives in the Age of COVID-19.” Below, we show the questions these imperatives present for technology executives.

Technology’s Role in Achieving Health System Imperatives in the Age of COVID-19

Five Technology Questions for Future Health System Success

Technology executives have an important role to play in developing and deploying a coordinated, timely and comprehensive technology plan that addresses these key questions. Doing so will be the lynchpin to elevate IT’s strategic role in the organization and demonstrate the function’s ability to catalyze systemic digital transformation and position the enterprise for the future.

The following pages provide actionable steps for technology leaders to address these questions, enabling their organizations to emerge leaner, stronger and better positioned for the future.

01 0503

02 04

How can technologysupport demand

recapture?

What are the technology levers to restructure the physi-

cian enterprise?

How can technology accelerate value creation for traditional & nontraditional partnerships?

How can technology enable clinical operating model transformation?

How can technology be leveraged to reduce the

health system’s cost base?

https://www.chartis.com/resources/files/After-the-Surge-Five-Health-System-Imperatives-in-the-Age-of-COVID-19.pdf

https://www.chartis.com/resources/files/After-the-Surge-Five-Health-System-Imperatives-in-the-Age-of-COVID-19.pdf


With much of the population deferring care over the last two months, technology will play a pivotal role in reaching and reengaging patients, building a platform for sustainable demand and fostering new referral channels to more rapidly approach pre-COVID-19 levels of patient activity and revenue.

Health system technology leaders should focus on four key technology enablers to rebuild volume and revenue:

z Use consumer segmentation and population health analytics to stratify and prioritize patient backlog, weighing factors such as patient acuity, need and willingness to receive care, among others, to identify potential new referral sources and growth channels.

z Leverage scalable digital outreach and engagement tools to reach large subsets of patients with customized messaging to reestablish consumer connectivity and educate patients on the availability of healthcare services relevant to their needs. Employing low-cost, digital solutions, in combination with selective use of inbound and outbound telephonic outreach, can be effective in targeting priority consumer segments and referring physicians.

z Create a unified “no contact” patient experience across clinical care settings to address new clinical and consumer safety expectations. This includes digital pre-visit forms, virtual waiting rooms, no-touch registration, digital self-rooming and wayfinding, electronic checkout (payment, follow-up, scheduling and result delivery) and post-op care navigation.

z Actively and aggressively promote virtual care to reestablish connectivity between patients and their care team. Focus initially on directing returning patients into virtual care settings, if appropriate, to ease their re-entry to the system, and consciously structure the clinical operating model such that clinicians can begin to seamlessly transition to a blended model of both virtual and physical care delivery.

How can technology support demand recapture?01


For many organizations, cash and margin needs are significant and immediate, and given the projected market shrinkage and degradation of payor mix, it is unlikely that volume recapture and growth strategies alone will restore required levels of liquidity or financial margin. Technology can create immediate and long-term opportunities to actively reduce and restructure the health system’s cost base.

Health system technology leaders should focus on targeted cost reduction measures that simplify the IT footprint and reduce the enterprise cost base. Key actions include:

z Actively manage the IT project portfolio and the project pipeline. Proactively review all active projects, eliminating or pausing non-essential projects and requests, and deploy an ROI-driven method for new project requests. Use cross-functional demand management to prioritize projects that support the highest clinical and operational priorities.

z Focus immediately on reducing operating expenses through contract review and workforce adjustments. Renegotiate high-priority IT contracts and align resources with the reprioritized portfolio and reduced budget.

z Develop sustainable models for an expanded remote workforce, driving out cost for physical assets, maintenance, onsite services, insurance and physical security.

z Restructure vendor agreements to align associated financial outlays to actual ROI realization, reducing upfront cash outlays and mitigating internal implementation risk.

z Simplify the IT environment to the greatest extent possible and avoid costly capital outlays by moving data center and application services to the cloud. Now is a great time to attain vendor discounts, and hosting/outsourcing is a viable option that both reduces the cost structure and promotes low touch/low interaction.

z Consider aggressive measures for application rationalization, consolidation and legacy solution decommissioning.

z Evaluate longer-term opportunities where technology, like cloud-based ERP solutions, can help influence cost control with hard returns in employee productivity, supply chain management and benefits administration.

z Leverage self-service and AI-enabled automation tools to eliminate time-consuming, manual functions/services (e.g., registration, billing, supply chain, HR, care management, scheduling, appointment and follow-up reminders, etc.) to support the highest and best use of operations personnel.

How can technology be leveraged to reduce the health system’s cost base?02


Health systems must restructure their “physician enterprise,” pivoting from physician-centric care delivery to physician-led integrated care teams by expanding the definition of the clinical workforce and deploying care team members in a fundamentally different manner. Technology will be pivotal to enabling the creation of new channels to this redefined care team and seamlessly coordinating interactions between patients and their care team and within the expanded care team itself.

Health system technology leaders should focus on five key technology enablers to restructure the physician enterprise, foster multi-disciplinary team communication and support the provider workforce:

z Stabilize the virtual care platform and expand access to all care team members (not just physicians), integrating it into clinical and technical (e.g., EHR) workflows. Ensure information sharing and access across all care sites (including care-at-home) and support the distributed care team with reliable and scalable infrastructure, mobile technology, biometric integration and training.

z Work with clinical leaders to develop and standardize digital care model protocols and care pathways in the EHR with clear assignments to each care team member. This should include documentation templates, standard order sets, order panels and clinical decision support for multi-disciplinary teams, expanded APP roles and PCP/specialist co-management.

z Simplify EHR documentation and improve usability to elevate the provider experience and foster more value-added use of provider time.

z Deploy patient progression and management tools that integrate multiple systems of record (e.g., EHR, CRM, ERP) and the supporting clinical communication channels and adoption strategies to enable and reinforce the new distributed, multi-disciplinary care model and integrated care team environment.

z Develop the reporting and analytic structure to support the new “provider enterprise” to monitor care team utilization and cost and extend beyond episodic patient interactions to monitor overall patient care progression, clinical quality outcomes, patient and provider satisfaction, and operational efficiency across care teams and venues.

What are the technology levers to restructure the physician enterprise?03


How can technology enable clinical operating model transformation?04

Health systems must be able to provide coexisting systems of care for COVID-19 and non-COVID-19 patients. This ranges from more detailed and defined clinical pathways and patient navigation models, service rationalization across locations, and designated access and entry points to more advanced capacity management, infection control and safe space maintenance for patients and staff. Technology will be an important enabler of the myriad of clinical operating requirements for effective, efficient and safe dual systems.

Health system technology leaders should focus on these key technology enablers for the clinical operating model transformation:

z Make EHR refinements to support longitudinal patient care progression and manage facilities and workflows in a mixed COVID-19/non-COVID-19 environment. Hard-wire the new COVID-19 and non-COVID-19 clinical pathways and patient protocols, triage and navigation models.

z Deploy digital patient engagement and progression tools, proactively promoting self-service. Optimize the digital front door, apps and patient portal to support clinical and other messaging, e-visits, virtual visits, scheduling for all care modalities, clinical questionnaires, form completion, bill pay, reminders, etc.

z Expand care settings to seamlessly include virtual and personal care (e.g., hospital-at-home, care-at-home, work, retail), ensuring coordination across synchronous, asynchronous, scheduled and on-demand care activities. Increase strategic utilization of physical assets and at-home self-diagnostics and care, diagnostic imaging prior to consult, virtual consultations, online health management and same-day discharge.

z Accelerate real-time, predictive and prescriptive analytics capabilities to improve capacity management, service rationalization across locations, and care cost, quality and safety for COVID-19 and non-COVID-19 patients and potential future surges. Leverage advanced analytics for bio surveillance and future surge planning.

z Rapidly evolve logistics and communication service center capabilities to improve patient and provider communication, capacity management, service rationalization and predictive care coordination. Create a unified consumer-oriented experience by integrating AI, chatbots and consumer relationship management (CRM) and provider relationship management (PRM) capabilities.

z Address new cyber-security vulnerabilities and HIPAA compliance risk related to hastened technology deployment for expanded care settings during surge and pre-surge planning.


As health systems assess their partnership portfolio, new traditional and nontraditional options may emerge from market shifts, or divestitures of under-performing assets may be needed. For health systems that have recently finalized or are currently in the process of partnership planning with another organization, integration to accelerate value will be increasingly important. Technology will be critical to a disciplined partnerships approach that expedites value creation.

Regardless of whether it is a traditional or nontraditional partnership, health system technology leaders must utilize these foundational techniques and the cost reduction methods outlined above to accelerate value creation:

How can technology accelerate value creation for traditional and nontraditional partnerships?05

z Understand all IT investments and cost implications, including staffing, contracts, assets and liabilities (e.g., cyber-security) and model a pro forma. Technology can be a massive cost impediment to realizing partnership value.

z If a divestiture, don’t underestimate the effort required from the divesting entity after Day One, and establish service level agreements and costs in an IT Transition Services Agreement with a focus on reducing services and associated costs in a timely and effective manner.

z Plan for a rapid transition to a common, integrated IT services platform to accelerate value creation. Streamlining support and standardizing processes are essential, especially when integrating new types of partners in addition to traditional partners.

z Establish an Integration Management Office (IMO) to orchestrate a well-coordinated enterprise and IT effort to expedite integration and value. Use application and contract inventories and scenario planning to ensure operations and IT together make scope and risk decisions required for IT plan design for Day One and post-Day One.

z Work in tight collaboration with operational leaders to define and execute on a benefits, change leadership, communication and operational readiness plan to get to a successful Day One go-live and drive value through post-Day One integration efforts.

z Develop a consistent yet adaptable transactional IT playbook that can be leveraged for future affiliations and will enable the team to be more efficient in their technology integration.

Expedited development of plans addressing each of these five imperatives is necessary for success and will need to be accomplished in a short timeframe to effectively capture the returning market and reduce costs. Industry leaders have noted with pride the rapid development and implementation of new innovations and solutions across their organizations in response to the pandemic. Technology leaders can sustain this agility by effectively enabling these imperatives.

After the Surge: Five Health System Imperatives in the Age of COVID-19

About the Authors

Parrish AharamDirector, Informatics & [email protected]

Parrish Aharam is a Director in the Informatics and Technology practice within The Chartis Group. He has 20 years of experience in consulting with a focus in both the provider and payor sides of healthcare. His range of experience includes large-scale IT implementation program management as well as strategy and planning initiatives and advisory services. His work experience includes premier academic medical centers, multi-facility/regional integrated delivery networks and the nation’s largest payors. Mr. Aharam’s recent work has focused on IT cost benchmarking and reduction, digital transformation, EHR selection and total cost of ownership analysis, IT strategic planning, portfolio planning, demand management and governance, enterprise project management office (PMO) design and advisory and application rationalization.

Tom KiesauDirector, Digital Health [email protected]

Thomas Kiesau is a Director with The Chartis Group and the Leader of Chartis Digital, the firm’s business unit dedicated to digital transformation planning and execution across the healthcare arena. Prior to assuming leadership of Chartis Digital, he led the firm’s Strategy Practice Area. With more than 20 years of experience, Mr. Kiesau has served as an advisor to many of the nation’s leading children’s hospitals, academic health centers, faculty practice groups, integrated health systems and community hospitals. He directs consulting engagements in the areas of digital transformation, enterprise strategic planning, clinical partnership development, next-generation service line growth strategy and economic alignment. Mr. Kiesau has also participated in the development of corporate strategy and product development strategy for multiple integrated business process and technology firms that serve the healthcare industry.

Shawna SchuellerSenior Practice Manager, Informatics & [email protected]

Shawna Schueller is a Senior Practice Manager for The Chartis Group. She is a leader in the Informatics and Technology practice focused on helping healthcare organizations leverage the power of information and technology to recapture demand, reduce the cost base, restructure the physician enterprise, transform the clinical operating model and partner with purpose. 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.

© 2020 The Chartis Group, LLC. All rights reserved. This content draws on the research and experience of Chartis consultants and other sources. It is for general information purposes only and should not be used as a substitute for consultation with professional advisors.

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About The Chartis Group

The Chartis Group® (Chartis) provides comprehensive advisory services and analytics to the healthcare industry. With an unparalleled depth of expertise in strategic planning, performance excellence, informatics and technology, and health analytics, Chartis helps leading academic medical centers, integrated delivery networks, children’s hospitals and healthcare service organizations achieve transformative results. Chartis has offices in Atlanta, Boston, Chicago, New York, Minneapolis and San Francisco. For more information, visit www.chartis.com.

technology’s role in achieving health system imperatives ......data center and application...

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