Wed. Nov 30th, 2022

There’s a lot of buzz about digital health right now, with many organizations wanting to get their piece of the digital health pie, but what is the end goal of digital transformation? Radio Advisory’s Rachel Woods sat down with Advisory Board‘s John League to talk about what digital health actually means and what the goals behind it are.

There’s a lot of buzz about digital health right now, with many organizations wanting to get their piece of the digital health pie, but what is the end goal of digital transformation?

Radio Advisory’s Rachel Woods sat down with Advisory Board‘s John League to talk about what digital health actually means and what the goals behind it are.

Read a lightly edited excerpt from the interview below and download the episode for the full conversation.

Rachel Woods: If the market doesn’t have a clear goal for their technological efforts, as well intentioned as they might be, what is the end goal? What does digital transformation look like?

John League: We think it’s five things. And if you remember only one thing about this from the podcast, remember that digitally enabled care is end-to-end, it’s omnichannel, it uses technology and data, and it is both proactive and holistic.

Woods: Okay, well, we clearly need to dive into each of these elements. What does end-to-end mean?

League: It means that we have to think about the entirety of a patient consumer member journey when they interact with health care. That means longitudinally, so how does this person interact and receive care across their entire relationship with an organization?

But at the same time, it also means what are all of the upstream and downstream pieces of a single encounter that go beyond what happens when they’re in front of a clinician or in a facility?

Woods: So it’s not just digitizing a single point solution, but thinking of about the whole experience, maybe even the experience when someone’s not a patient. Like when they’re searching for care, or when they’ve left the four walls of a health care organization and need to, I don’t know, pay their bill.

League: Absolutely. It means all of those things. Certainly, Rae, if I know that you always pay your bill when I send you an email, why am I going to waste everybody’s time by sending bill in the mail? Having that kind of information about you and an understanding of your preferences matters. It matters a lot.

And we have historically in health care only focused on either the clinical interaction or from the plan perspective, the financial interaction. And it’s all of a piece, it’s scheduling, it’s billing, it’s follow up, it’s pharmacy, it’s navigation, all of those things matter.

And in as much as those seem like they are beyond the scope of the health care enterprise, we’re going to have to start thinking about that more as big retail starts to come to bear on all of these things and the influence that they have over how consumers perceive their health care options.

Woods: So step one is to think about digital transformation as being end-to-end. It’s the higher experience. But the second word you said to me was omnichannel. What does that mean?

League: Well, first of all, I kind of hate this word because we hear it thrown around a lot, right?

Woods: There’s a lot of buzz words in this conversation, which is why we’re going to be going into each one in detail.

League: Exactly. And apologies for the buzz wordiness. And I’m going to use another one to sort of give an example of this. So with omnichannel, you’ve heard of digital front door. Right?

Woods: Yes, oh, yes.

League: Yeah, so we’ve always known that the digital front door isn’t really what we’re talking about because most health care organization’s digital front door is actually Google. That’s where everyone finds out about what health care services or available to them.

But Google doesn’t necessarily deliver people looking for your services where you expect them to show up first, whether that’s on your website or to which page they go to. So people talk about things like I’ve heard the digital front porch, I’ve heard the digital back door. The point there is trying to be more inclusive, that’s where they want to be.

That said, omnichannel can’t just be about having a digital way to access individual health care services. It’s about people looking for care, being able to find that care no matter how they connect. And that one experience is unified. So all of the channels lead to the same place.

If I switch from one channel to the other, the same information is available both to me and to the organization. The worst thing is when we try to have patients, members self-serve. And tell me if you’ve ever experienced this Rae—you try to self-serve, you can’t really get the answer that you want online.

So what do you do? You call the number, the person answers the phone. You tell them what you’re trying to do. And far too often their answer is like, “Oh, well, I can’t see what you are seeing.” Because, reasons. There’s some reason that the information that flows to you does not flow to this person on the phone which is enormously frustrating and not the way that other industries have built their digital capabilities.

Woods: And to be clear, when we’re talking about omnichannel, one of the most important things you said is that all roads kind of lead back to each other. We’re not just adding and slapping an additional channel on top of things.

I will tell you from personal experience, this week I took my son to the pediatrician and we went to check in and they said, “Did you get a text message to check in for this appointment?” And we said, “No, we did not.” And they said, “Okay, we want you to download our new app that you need to add to your phone, to do the whole check-in experience, et cetera, completely separate from any of the other apps that we have, by the way, for our health care.” And my husband and I both looked at each other and we went, “Another thing? Seriously? This is making it harder, not easier. This is adding more friction to our health care experience. Not less.”

League: I think one of the interesting things about sort of the proliferation and the funding available to all of the new kinds of digital health applications, technologies, whatever you want out there. One of the perverse things, if you will, about it is how much of that is directed at lowering all already relatively minor barriers to care that people with insurance and access to care already have.

And that does a couple of things. One is that it ignores the people who are already underserved or ignored by the health care system, at the same time as it fragments care even more for people who already have access, it is the worst of both worlds.

Woodsb: So we’ve got end-to-end and we’ve got omnichannel. When you listed off your five things, you’ve mentioned two together, you said technology and data. Why do those things need to be connected?

League: Think there are two reasons for that, Rae. One is simply to frame the issue in the right way, to have the right mindset. It’s very easy, as you said, to be distracted by the shiny new app gadget platform, whatever. Your plan wants you to have one. Your provider wants you to have theirs. They want you to have the EMR app. They apparently want you to have the check-in app on your phone.

And then you’ve got whatever else you have that monitors whatever is going on with you. If you have a chronic condition, you’ve probably got some sort of management there. You’ve probably got some health and wellness app that you probably look at more or less regularly either because you’re really into it or because you feel guilt. It’s just all fragmented, and it’s very easy to be distracted by that.

What we really need to focus on is how does this technology serve up data more effectively to the person who needs that? Whether it is the patient, the clinician, the scheduler, the care manager, whoever, that is the thing we need to focus on rather than just getting the newest, shiniest, slickest thing out there.

Woods: So technology and data need to live together because technology is the thing, it’s the platform, it’s the watch, it’s the app. But we need to make sure that we’re not just these devices in silos, and we’re actually using the data that comes from it. And that’s why they have to live together.

League: Absolutely, because we can’t tie together those two things unless we have the technology and the data. It can’t be end-to-end. It can’t be omnichannel if we don’t have the data flowing across all of those things.

What I can already tell you, Rae, is that people listening to this are going, “John, that all sounds great, but how do we do that? How do we achieve that? That’s so hard for us.” And I get that. That is part of the reason why the definitions that we talked about earlier are so all over the place.

The biggest challenge is not really plugging the technology pieces together. I think it is having a genuinely patient centered mindset, as we think about what we’re trying to do to digitally. Because at the center of all, this is still the patient. No matter what other elements are involved, they have to be focused on the patient. Everyone agrees with that. But our incentives are not aligned to make that the case.

Woods: And to be patient centric we have to use digital transformation to be proactive and to be holistic, which are your last two points.

League: Exactly. And I think these are the things where all of the investments that you make in gaining that end-to-end view, in creating that omnichannel, openness to patients and clinicians, in marrying the technology and the data, this is where it pays off, because proactive is just not how our health system is structured today. It’s designed to be reactive. It responds to emergent needs.

That’s not how we want to manage our most chronic, complex patients. And that’s not what will keep our rising risk patients from becoming chronic, complex patients. It’s where the push towards valued based care leads. So this is a capability that we absolutely have to develop. We have to be able to use these tools to identify the interventions that we need before conditions deteriorate.

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