Junto Views From The Summit: Part 2
On June 14, Junto held its 2018 Summer Summit at Cornell Tech’s newly opened campus on Roosevelt Island. Summits are invite-only events that bring together over fifty senior executives, representing nearly forty organizations, for a full day of knowledge sharing, networking, and collaborative project development. These Summits reflect our view that many problems faced in the healthcare industry today will be solved only by breaking down organizational silos and working with complementary partners.
To help disseminate the best ideas from our community, we launched a series, “Junto Views from the Summit,” highlighting important concepts and actionable tips to use in your own organization.
Our first article in the series detailed how social determinants are being integrated into a new pilot program at NewYork- Presbyterian Hospital. Dr. Dodi Meyer and Isaac Kastenbaum, who created the initiative together, shared what they have come to learn as necessary ingredients for success of a large undertaking like theirs as well as major issues to keep in mind when implementing multi-partner programs.
For our second article, we are focusing on a presentation that was given by Dr. Mike Swiernik, Medical Informatics Leader at Kaiser Permanente, and David Haddad, CEO of Overlap Health. Read on to learn about the lessons they learned within the healthcare industry and the detailed insight they provided for anyone who is trying to increase efficiency within their organizations.
Fireside Chat: Learning from Failure
Dr. Swiernik and Haddad have been working together on integrating digital solutions into Kaiser Permanente’s network. At the Summit, they spoke about the three big lessons they learned to avoid future failures in the healthcare business and 4 key questions to ask yourself on the road to organizational improvement.
Dr. Swiernik and Haddad defined failures as “ideas in action that do not work. They may teach you something, but they will not get you closer to your goal.” Their thesis: failure is a natural part of experimentation, and while it is important to learn from failure, you should strive to fail less over time in order to remain close to your overall goals.
The failures they mentioned in their presentation are relatable to many healthcare systems and provider organizations. The lessons they take away from these failures, therefore, can be applied by many individuals.
Failure 1: Understanding Roles and Responsibilities
When healthcare companies and vendors do not define their respective roles and responsibilities at the start of a relationship, problems can arise quickly. Swiernik has experienced this firsthand and detailed how he encountered this issue when working with a vendor at Kaiser.
A vendor that wanted to work with them wanted to resell patient data despite their data use agreement with Kaiser specifically not allowing that. After months of discussion in an attempt to iron out these details, it became clear to Swiernik and others at the hospital that the basic misalignment of roles was not going to lead to a fruitful partnership and the contract discussions were terminated.
Key Takeaway: Although it may seem tedious, “you can never start too early discussing roles when integrating vendors for your system.” This saves you from getting into situations down the road that may lead to an end of the partnership.
Understanding the roles of each player within a health system is a crucial component of staying on top of everything within an organization. This is particularly important when there are many parts of an organization that are not necessarily talking to each other every day and therefore must trust that each department is doing what they are supposed to be doing by making sure a partnership is really going to work for both you and the vendor, rather than making compromises to push it through so you can save time, energy, and money.
Failure 2: Researching Before Implementation
Eventually, Dr. Swiernik also noticed that the current iteration of the EHR system that Kaiser had paired up with was not working for the needs of the company or its patients. A huge problem with the system was the user interface not working well for their patients. In addition, patients who did not speak English did not get language support because the system was never translated into any other language. Many of the patients were confused by the system and required help from Kaiser to learn how to use it. As a result, the EHR system was replaced, but not before time and money had already been wasted.
Key Takeaway: Although EHR systems are incredibly useful for both patients and providers, finding the right one can be difficult for many institutions. If the wrong EHR system is integrated without proper investigation beforehand to see if it is the right fit, time and money is wasted trying to fix it.
This inefficiency lead Dr. Swiernik and Haddad to their second lesson: it’s important to take your time researching new types of technology that will be incorporated into your organizations. “The expense of time to investigate technology and vendors before working with them is useful and, in the long run, will save the organization money.” In the case of Kaiser, where more than half of their visits are done online or through smartphone interactions, finding the right EHR system was critical to the success of the company.
Failure 3: Preventing Provider Burnout
As we all know, provider burnout is a common concern with large healthcare institutions. It is great that technology is being adapted by provider systems, but we are now beginning to see some drawbacks when it comes to implementation methods. Doctors who have to spend their own time now inputting data and fixing broken machinery have less time to see and treat patients.
In his own practice, Dr. Swiernik noted how he often found himself overwhelmed by the number of patients asking him how to navigate Kaiser’s healthcare payment system. While he wanted to help, doing so meant taking precious time away from his other patients who had yet to be treated. This lead to their third takeaway regarding the importance of being clear about the role of the physicians in the network.
Key Takeaway: Efficiency comes from being organized and making sure responsibilities are clearly defined for each job. In this case, Dr. Swiernik concluded, it would be more efficient if clinicians only focused on providing care, not helping patients utilize the telehealth software. Even though the platform is an important part of the care continuum, doctors should not be playing IT roles as it is a misuse of their skill set and time. If roles and work streams are clearly defined when it comes to the integration, and then utilization, of platforms and other health tech applications, we have avoid making physicians feel overwhelmed by the addition of extraneous responsibilities. This means that they will then be able to provide better quality of care for their patients. In the case of a healthcare providing system, where most of the budget is risk-based, providing better care is imperative to staying within budget. Even if you save money by implementing technology, you have to make sure those savings are not being negated by having physicians take on IT work.
At the end of their talk, Dr. Swiernik and Haddad gave the audience four key questions that people should be asking themselves when trying to run a successful and efficient healthcare department:
1. Have I chosen a use case to match what I am implementing and have I ironed out workflow?
2. Have the individuals within my workforce been assigned appropriate responsibilities? Are there any gaps in coverage?
3. Do I have a vendor-buying criteria that includes elements key to my health system such as language support for those who don’t speak English or details about the right to data analytics?
4. Am I continuously collecting data for projects to assess the efficiency of the money that is being spent?
While the goal of any health care organization is to reduce failure, organizations can learn from these experiences when they occur. While many at the Summit chose to focus on success, it was refreshing to hear Dr. Swiernik and Haddad speak openly about what did not work for their businesses and how they overcame those struggles.
There was no doubt that, because they had experienced these failures, both men understood how to make parts of their organizations run more efficiently. These lessons, taken from the experiences of working in a large healthcare system like Kaiser and a smaller startup like Overlap Health, can be applied to many different types of work environments and situations.