I’ve always found it interesting how different organizations approach the implementation of new technology and services solutions. Especially as the solution becomes more complex and organizational culture inserts itself into the decision-making and implementation process. This is worth exploring because we’re approaching a critical juncture in healthcare. The costs are too huge to ignore, and our government is applying pressure with a variety of payment models that incentivize providers (with higher reimbursements or bonuses) for improved patient outcomes and lower costs. As a response, healthcare providers and payers are scrambling to set up population health platforms.
The purpose of this post is to highlight various issues and barriers healthcare organizations face when it comes to implementing new technology and services. I’ll also examine how new population health platforms face more complex implementations.
Who gets the cheese?
Imagine you have a variety of business owners in an organization. Each one competes for dollars to further their own strategic agenda. Some clearly have priority over others. Information Technology (IT) is a focus in healthcare because a great deal of the operation relies on IT infrastructure.
There is also pressure to minimize the cost generating side of the business and maximize the revenue generating side. If you work with enough of these clients, you see how this mindset impacts the ability to quickly implement new technology and services solutions. For example, if you keep cutting the IT budget, you can expect future implementation plans to be affected.
Cultural and Technical Issues
Let’s examine some cultural and technical issues in organizations that must be navigated when you’re trying to implement a new client solution. What follows is by no means an exhaustive list, but they represent information you need to effectively support the account.
- Are they strategically or procurement driven? Some organizations have senior leaders who recognize the strategic value of solutions and push them for implementation. Others are procurement driven, picking the cheapest solution or requiring a hard target for return on investment.
- Are they early adopters or laggards? Some organizations aren’t afraid to try something new and are willing to experience failure. Others wait for competitors to prove these solutions work and then act.
- What are their priorities? Remember business owners are fighting over available resources to implement the project they prefer. Does the organization have enough IT resources to move projects forward? Or do they run so lean new projects are delayed due to implementation issues with higher priority projects?
- How supportive are the people who will have to use the solution? Were they involved from the beginning? Did they get adequate training? Is there a process to track implementation and usage?
- How do you handle information consolidation? Each new organization added to a healthcare system has their own technology for EHR, communication, population health and more. Do you keep existing solutions? Or replace them? Both approaches create their own set of issues.
- How do you deal with data fragmentation? The healthcare industry still has significant data fragmentation. And population health solutions work best when they can analyze all patient data – not just a portion of it.
Not so complex
Once you navigate these issues and secure an agreement, you transition to actual implementation. However, if the solution is focused on one element of patient activity, you could argue it represents a point solution. The implementation for this type of solution is much more straightforward.
Typically, you deal with one business owner because this solution affects only one department. The training plan and monitoring is more defined and the resources for implementation are allocated effectively. And you likely have a better line of sight to the senior executive who will ensure project schedules are met. After all, they approved the solution and have a singular interest in making sure their department implements it efficiently and correctly.
Population health is more complex
Population health is a far newer collection of capabilities and the mix of business owners is more complex. You have administrators who want performance reporting, as well as clinical personnel who want information on undiagnosed and existing patients with the same chronic condition. Some of these platforms also offer capabilities in data analytics, data management, registry management and even patient communication – which means you could have additional departments involved.
Even more, vendor offerings range from all-encompassing platforms to point solutions addressing one specific chronic illness. Some vendors offer platforms that readily connect to third-party solutions, while others are more proprietary with little to no connectivity to outside solutions.
This is a really important point. Does the organization prefer to integrate a variety of solutions to create their population health platform? Or do they prefer to work with a vendor who has created an integrated platform? Given the healthcare industry consolidation that generates data and application fragmentation, you can argue these decisions are critical to a long-term approach for population health strategy.
The clock is ticking
Right now, the focus for health systems is remaining compliant with the payment models, so they concentrate on the operational and clinical elements of population health platforms. But it doesn’t take a rocket scientist to see the day will come when government payment models become more demanding. Identifying chronically ill patients, generating modest improvements, and reporting on them will not be enough.
Might we see bundled payments for chronically ill patients? How about fully capitated plans for certain higher risk patient categories?
The point is pressure will increase, not decrease. When you add in the additional complexity of a fully developed population health platform, the long-term transformation effort is significant.
Data will have to be consolidated and available to all. Applications supporting population health will have to be fully integrated into hospital operations. And these platforms will have to go beyond the current operational and clinical focus. Patient communication addressing language, education, cultural and socioeconomic barriers will become an absolute priority.
Because you can only squeeze so much efficiency out of the clinical environment. At some point, you must improve patient health literacy to significantly reduce usage. Population health platforms will have to equip patients with the knowledge and tools to make this happen. Given the installation and platform complexity of population health solutions, will health systems recognize this in time?
No Comments