Wolters Kluwer Health, Chief Executive Officer, Diana Nole in conversation with Paddy Padmanabhan, CEO of Damo Consulting on the Big Unlock Podcast – “Digital front door is just the start for digital transformation”

PP: Can you tell us a little bit about your healthcare business for the benefit of our audiences?

DN: We like to think of ourselves as a very helpful business. Our focus is around making sure every patient has the opportunity to benefit from the best evidence and data. We really focus on what prevents that and what causes variation. We start with education. We have a suite of education tools that continually evolves. As you think about how students get educated today, it’s very different than in the past. But then when they go into practice, as soon as they walk out of the door, they need to keep learning and be updated on what’s the latest practice techniques. As they continue their research and education, we stay with them throughout that. Again, really focusing on what causes breakdowns in clinical care, really caused by variation. So that’s a little bit about who we are and our suite of solutions really tailors towards that.

PP: Would you care to share your thoughts on the final ruling on the interoperability question made recently by the HHS?

DN: I think all of us are trying to digest it as I understand it. I think it’s over like twelve hundred pages. So, we will learn a lot. But I think at the core of this, we really are a supporter of needing to have good strong interoperability without sacrificing any issues relative to privacy or security. So we believe for the long term, if you really want to have the benefits of a digital system and digital ecosystem and be able to support things like AI and its ability to really alter and augment the intelligence that our clinicians need, you have to be able to do this. And we still struggle with that in many cases. And so, the aspect of standards and procedures and interoperability is very important. So, I look forward to, as does my team, really understanding how this may help advance that. I think it’s early days, but certainly we are positive that a ruling has come out and helps to put guidelines for all of us that are kind of working within the system of how to operate best.

PP: Did anything leap out at you when you saw the initial press release, anything at all?

PP: Yeah, I think that the interesting thing is, there’s always been this aspect of who owns the data and whether they have to pay for the data; so they clearly are saying patients should be able to get access to their data without any issues and without having to pay any fees. I think for us working within the ecosystem, it helps to understand how this will actually work as we interface and integrate it into, like the EHR systems. For us the most important thing on our clinical practice side is really how can we do this and how can we do this as quickly and efficiently as possible. So, I think there have been some things written in the document that kind of talks about from a contractual arrangement, things you can and can’t do that would sort of define you being information blocking or not. So, we think that will maybe actually help us in our arrangements with our EHRs. We were very critical and important to us.

PP: What is the current state of maturity of digital transformation as it’s defined broadly in the healthcare ecosystem, in your perspective?

DN: It’s a big question. And obviously you’ll get lots of opinions. But from my perspective, I think we’re beyond sort of the foundation building. I mean, things really are in digital format. We did talk just briefly now about the interoperability issue. We still are plagued by the fact that we can’t probably get data in and out of the system for all the various use cases that could potentially use it. So, I think we’re beyond the foundation building. I do think you’re seeing some nice basic enhancements to experiences on the patient side. You know, there’s pretty basic things, but you can see what your lab results are. You sort of have a place where all of your data is. If you’re in a certain system, you have the ability to do electronic check-ins. We see telemedicine kind of coming up and we’re starting to see some ability to see sort of AI and its application where we have large data sets of labeled things.

I came from the world of radiology. I think there’s a lot of thought that now that we have all of this labeled data, we could apply AI and AI could augment a radiologist role and understanding where there are issues. So, we’re still I would say sort of early on. I think that is really where I think the hope is. If you go back to our focus around variations in care, you still have a lot of handoffs that aren’t managed well within the digital ecosystem. Once the doctor sees the patient and they kind of decide on a treatment path, is it all carried out even out to the patient? I mean, a customer told me, you know, a simple thing is now we can tell whether a patient has actually picked up their medication or not. It’s a simple thing, but obviously goes into a lot of parameters around, OK. They didn’t pick it up. Should we reach out? Can we have a discussion with them? Can we understand what happened? Is it a cost issue? Is it an access issue? What is it?

I think we’re also in that stage where we’re starting to better appreciate what the true connection of digital health could mean for us. And I think that’s still you know, that’s the vision that we’re all kind of working toward. So still in the basics. But, you know, moving through and got a lot of good foundations laid.

PP: In another podcast, the CEO of Wolters Kluwer, Nancy McKinstry, talked about the massive digital transformation that you folks have gone through as a company. Can you share a little bit about what that feels like for your business and share some learnings from that?

DN: Yeah. So, in health, we’ve gone through a similar transformation in our content-oriented business. It’s very heavily curated, just like the rest of our businesses within Wolters Kluwer. And so, the first step was taking everything from what used to be in a printed format and getting in a digital, and 90 percent of all of our solutions now are in digital. We still do have books. People do like hard books and hard journals.

But now, just like we talked about the transformation, the EHR kind of gets everything into digital. We have gotten everything into digital. But now what we’re really focused on is something we referred to as expert solutions and expert solutions or more deeply embedded into the workflow, take into context the use cases of how they’re used. I’ll use as an example UpToDate. We have now gone to something referred to as UpToDate Pathways, and that is more than augmented or guided decision-making tool for specific things that have evidence that’s very strong but wide areas of variation. So, we are really starting to see the move from just taking something that was in print and moving into digital and now moving it into expert solutions. And that’s really where our focus is, where I think we’ll unlock a lot more value and being able to serve exactly the content that our customers need. Having them have to rely on the questions to ask to serve up the content is not the long-term goal. We want to be able to take the patient information from the EHR and provide what we think is most relevant and help them kind of walk through, especially for complex situations. The best way that they could consider a treatment for their patients. So, we also are in a transformation. It’s very exciting, though, because I think that’s really where you see significant impact on patient outcomes if you can do that.

PP: I imagine you use a lot of natural language processing because you’re a content-heavy business in order to curate the content and to get to answers faster than you would through conventional or traditional news. Are you also changing the way you deliver this content?

DN: So, in terms of digitizing it and delivering it in different ways, we’ve been thinking about what’s the interface. We are working on voice because we think voice will be one element of how you might want to get the content and then serving it up. I think what you’ll find is instead of lengthy textual things, you’ll see something either in a curated order or much smaller. We also have, just recently, even in our more patient oriented space, videos that interact with the patient to help them get prepared or help educate them on things that they’re experiencing. We definitely have found in that world we need to have smaller nuggets and to be able to kind of customize it more for the patient and allow them a little bit more flexibility. So, I think you’re right in the fact that the way we serve up the content will be very different, and different types of content, whether it’s video, whether you do it by voice; those things will continue. It’s all about the user experience now and how can you best use the most available technology? So, you hit on a great point there.

PP: Based on what we are seeing, the focus of digital transformation is on digital front doors and the consumer interface.  Do you think that is too narrow and limiting a definition? What are your thoughts on what else health systems should be looking at as we transform the entire system really?

DN: I think the digital front door is just the start. If you use that analogy, there’s so much more in the house that you want to be able to use. I think that we obviously had to have that window and you have to have that be some kind of an enhanced experience. So, people want to open that door. But if you think about it, the type of information I mentioned before, you can now get your lab results. But the lab results, most of us as consumers of that information, we don’t really quite understand what it would be. So if you think about moving more into how are you going to actually manage your health and how do you really get the patients to engage, especially those that really do need to engage and stay on very good pathways for their own health. That’s why we saw so much value and made the investment in the acquisition we did a few years ago. Emmi was really beyond just patient engagement, but it was shared decision making as well as really helping patients as they move into their home healthcare in a transitional environment. So that’s more of how do you stay connected with them? Get things like, register your sugar levels, how is your pain level doing and then how do you really get to understand how that patient wants to interact? And do you see the ability to see when a patient is going into rising risk such that you will outbound and outreach to them to help keep them in their home healthcare environment, which is probably the best situation for them? So, I see it much more oriented towards true engagement with the patient on a much more sophisticated level. But it’s easy to interface with not just the portal, if you will.

PP: You’re kind of at the intersection of education and healthcare. Education itself is going through a dramatic transformation in its own way. What are you seeing there that’s comparable to the kind of transformation the health systems are going through? And how are you enabling that transformation?

DN: Yeah. And it’s really interesting because I called on an academic and I think the professor said people don’t really come to the lectures anymore. And so, it’s sort of indicative of what a student wants, and a student wants to kind of mimic what they’re going to be asked to do outside in the real world. So, we definitely see virtual simulation for things like nursing labs. The interface with the EHRs so they practice within sort of a version of that. But more importantly, what we’ve also done is we’ve integrated technology around adaptive testing where the student can self-test themselves. You can’t game the system. It’s based on AI so it constantly kind of thinks about how you answer something and then serves up additional things. But it really understands if you are getting to the core of clinical judgment. Can you actually understand in these various scenarios how you would react? And we believe and there’s evidence that shows that they’re much more ready. They have higher scores on their high-risk test exams and they really then get out into the world and are ready to go and practice right off the bat.

So, I think that that’s one aspect at the initial education and then the subsequent things, we do a lot of education. We obviously have the ability to do continuing medical education within UpToDate. And then we also have the aspects of our product called Audio Digest, where you can actually continue to learn along the way in a setting that’s more indicative again. Listen in the car, listen while you’re working out, how do you just continue to kind of have those? So, the way people stay updated on the latest practices and how they get their clinical knowledge and judgment at the beginning has definitely changed. It’s much more exciting, I think, as well. Students react much better about getting in and really kind of looking at real life situations.

PP: There is also a component of the infrastructure that is required to support digital front doors and patient engagement and so on. What is your sense of where health systems are, especially as it relates to your solutions? Are the infrastructural components that you expect health systems to have in place and are they ready for what you are providing to them?

DN: Yeah, that’s a really big broad question because I would probably say we all think that there’s still things to invest in. The EHR kind of is the big road, right? The big pipes around the hospital system. But what you’re tending to see, which is typical of where we’re at in the stages, is you see digital solutions popping up. And it’s unclear to us sometimes that as a vendor exactly who will own that. Some of our systems have put in place, like a Digital Health Officer, but we still find that projects and initiatives seem to be owned and influenced in a particular area. And so, will the Chief Nursing Officer still be overly responsible for things that deal with patient experience, patient education, patient interface. I don’t know that we see the need for additional infrastructure to be built. I do think people are still very worried about the aspects of security and privacy and all of those. So, I think that will continue to be an evolving state of affairs.

In terms of the infrastructure, I think most of that is in place. I do also think that you’ll see these naturally have different types of solutions. But ultimately our customers are recognizing that the way a patient is cared for is kind of shifting from various pieces of the solution, like a doctor, a nurse, and a pharmacist to actually seeing the whole ecosystem of the care team. And that’s where we’re trying to work on our own solutions, of how to make sure that we start wherever possible, can populate our solutions with each other’s data. So, as an example, if you’re in UpToDate as a doctor, we do populate drug information and access that we will put Emmi videos in there so you can see what the patient might be prescribed as far as patient engagement. We’re just trying to make the user interface is consistent. So, we are trying to make our own sort of clinical decision support suite look like a suite, act like a suite, have information accessible to it so it can support the movement to the care team approach.

PP: You may have a Chief Digital Officer who is making decisions on certain types of solutions, but then there are other solutions for which functional leaders like the CNIO, for instance, are making the decision. Are you seeing this all converging in some way to some kind of an org model which is becoming a defacto standard like a digital transformation office, for example? Are you seeing that happening? Or do you anticipate that it will continue to be the way it is, which is that decision making will remain fragmented based on the type of solution that people are buying?

DN: We definitely are seeing decisions become more solution, holistic enterprise wide. I think the org models specifically are continuing to evolve. So even when organizations have put in place a Digital Health Officer, they themselves are still getting the lay of the land in terms of how to bring in the right influential clinical people to get to a decision. But we definitely have seen more and more decisions being made sort of enterprise wide, and consolidation sort of more structure around how the decisions are made, which ultimately I think is going to be a very good outcome while not sacrificing any particulars that may need to happen at a particular site. So, I think they’re being very thoughtful about it.

PP: We’re in the middle of the Coronavirus. How is your business coping with the impact and how are you helping your customers cope with the impact?

DN: Yeah. I really do truly hope that we’re more in the middle than it’s still at the beginning. Obviously, we have our own employees that we want to make sure that we have good care around them. And so, we always continue to make sure they’re in a safe environment and have flexibility for them in terms of working from home. In terms of our customers, we’ve made readily available whatever information we have on the situation. We’ve just posted it out there. We’ve posted access for patients. If you as a consumer want to understand what’s real and what’s the facts. We’ve made that available so that we try to put that out there to kind of depict fact versus, you know, maybe not facts.

In terms of our customers obviously, our customers are bearing the biggest burden of all of this right now. And so, we’ve been very flexible. I’ll give you some examples. From a sales call perspective, a support call perspective, if we had planned onsite visits, we’ve automatically called them and said, would you prefer us to just do it virtually. About 50 percent are doing virtual kind of conversations with us right now. And then we have a lot of relationships with societies and many of the societies have had to cancel their conferences. And so, we’re working with them on how we can get there. Very valuable information was going to be presented at those conferences, how can we still get it out? So, we’re kind of working with them on flexibility of trying to still sort of in a virtual environment, get to the objectives that they had for those things. So those are some of the things that we are doing in this current state.

We hope you enjoyed this podcast. Subscribe to our podcast series at www.thebigunlock.com and write to us at info@thebigunluck.com

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity.

Novant Health, Chief Digital and Technology Officer, Angela Yochem in conversation with Paddy Padmanabhan, CEO of Damo Consulting on the Big Unlock Podcast – “Digital care is about care delivery and enhancing traditional care models through digital means”

PP: Can you tell us a little bit about Novant Health and your role and perhaps also touch upon your unique org structure?

AY: Certainly. Novant Health is a $5.5 billion nonprofit integrated healthcare provider network. We have 15 major hospitals. We have between 650-700 clinics and physicians centers and about 30000 team members. As you can imagine, we’re focused on meeting our consumers’ needs by shaping new services and experiences that resonate with our consumers and the communities that we serve. Technology advances drive a lot of those expectations that our consumers have and certainly change the way we think about engaging with our patients. And, of course, our team members and the border communities. My position was added in late 2017. It was meant to provide a way to increase access to care through digital means and also to define how we can improve the quality of care by leveraging advanced technologies. And, of course, our unprecedented access to data that we enjoy in the healthcare space.

My teams, of course, helped the organization explore many ways that the digital capabilities that we provide can improve the health and the lives of our community members. I’m fortunate that I work for someone I would describe as a digital CEO, Carl Armato. This notion of a digital CEO I think is something that’s so important to so many industries today. Digital CEOs understand that advanced technology functions are essential to providing differentiated services and products regardless of industry and that the executive team for any company must have expertise in the tech field represented at the decision-making table so that they can identify those opportunities when they emerge. In my organization, we moved all of the roles, all of those related roles report to me. And that, of course, helps us reduce fragmentation and avoid conflicting investments or duplicative investments and technology and analytics space across the board. So my senior staff includes a Chief Information Officer, the Chief Technology Officer, our Chief Medical Informatics Officer, our CISO for cybersecurity, our Chief Data Officer and the Chief Digital Health and Engagement Officer, as well as an executive responsible for learning and research across the Digital Partner Services Group, which I believe is a strong, cohesive team of highly talented people from a variety of industries in a variety of backgrounds and credentials area. It’s been incredibly rewarding.

PP: There’s a fairly impressive set up there and we’ll talk about some of the initiatives that you mentioned. Novant Health is based in North Carolina. Is that right?

AY: It is. We’re headquartered in North Carolina. We operate primarily in three states and we have a footprint across five. And I guess what you’d call a super-regional.

PP: Angela, you came from outside the healthcare industry. What struck you the most when you came into healthcare and into this role? What is your assessment of the current state of maturity of digital transformation and digital health in the sector?

AY: Those are two very interesting questions. What struck me when I came here and in fact, one of the reasons I joined Novant Health is that the significance and the importance of the work being done in Novant Health, I mean, literally life and death work, right? Drives a tremendous appetite for adoption of the latest and greatest capabilities that would allow us to provide higher quality care, greater access to care, get better outcomes for our patients and communities. So, it’s that appetite and that ambition for improvement across the board and a passion that I think our team members bring, our clinicians bring at Novant Health that struck me that is so different than what I’ve seen in other industries. I had an opportunity to work with very, very smart, driven, amazing people across the other industries. But the life or death aspect of what it is that we do here just elevated that intensity and I’m the type of person that appreciates that intensity. So that’s one difference that I saw that I really appreciate it.

The other thing I’ll say in response to the second half of your question is that healthcare organizations have an opportunity to adopt more contemporary methods and technologies and architectures and philosophies related to engagement and the delivery of solutions sets to consumers and team members. And I’ll add that the window of opportunity for adopting more contemporary capabilities is closing rapidly. And I would say that based on the number of unconventional entrants that we’re seeing in the healthcare ecosystem.

PP: Defining digital health in terms of just digital front doors, is that too limiting? Should we be thinking about modernizing technology to your comment about bringing in contemporary technology and therefore expanding the scope of digital transformation? How are you defining digital transformation in your role?

AY: This is a fantastic point that you raise. Thinking about digital front doors and only that as being the scope of digital engagement is of course very, very narrow. At Novant Health, we define digital care in both the ways in which we use digital channels to offer care, which is what you’ve just described, but also in the ways in which we enhance our traditional models of care delivery through digital means. You see a lot of investment across the investor community in point solutions that are allowing us to provide as we adopt them. Unprecedented access to care using devices such as our on-demand TytoCare visits or, the ICU capability, tele-behavioral health, kiosks, and remote locations, community centers, and schools. All of these sorts of things are highly visible and they’re absolutely a real thing and a real focus area for us as well as for everybody else.

But to your point, we also focus very relentlessly on capabilities that increase the quality of care. I’ll give you a couple of examples. Earlier in 2019, we launched across all of our hospitals a stroke care solution. I’m sure that your listeners know what happens when a patient exhibiting stroke symptoms shows up in emergency department. But just for those who don’t, I will describe it very briefly. A stroke patient shows up, an emergency department whisks them back, puts them in a CT scanner. They get into a CT scanner, CT scanner runs. And then once the scan is complete, the images examined by the radiologist on call, who in turn might pass it along and see something that may need some care, some attention, will then pass along to the physician on call who then engages the neurosurgeon on call and somebody at some point ready for the operating room. And if there’s some sort of operable occlusion, the patient is treated in that operating room. My understanding is that the national average is somewhere in the mid-50s of minutes. So, between the time when the patient shows up to the time when the operation is being conducted, and if you think about a stroke patient losing a couple of million brain cells a minute, give or take, that’s a lot of minutes. It’s a lot of brain cells lost. So, we have partnered with a third party called Viz.aI who receives the CT scan data while the scan is still being conducted. So as soon as the patient goes into the CT scanner, in any of our hospitals, we stream the data into the Viz.aI environment and they apply AI-based algorithms to the streaming data as it comes through and they can identify an operable occlusion if it exists well before the scan is complete. And so, their solution actually sends the scan to the neurosurgeon on call and makes a notification to the OR so that we have treated patients in as few as 14 minutes from the time they show up to go and see department exhibiting stroke symptoms. Big deal. Our average amount of time with this AI solution in place is about somewhere between 22 and 25 minutes. Well below the national average.

Now coming back to an important point, between the time when we learned of the existence of this type of solution and the time we had it in all of our hospitals, its four months. So, it’s not just about adopting solutions that are truly life changing, life saving for our patients. Increasing the quality of care in this example in the stroke protocol. It’s also about preparing the environment so that you can adopt rapidly these sorts of solutions without the traditional sort of year-long analysis phase that might go on otherwise.

PP: Can you share any early learning, any data points that could benefit our listeners and all those who are implementing these kinds of tools for improving patient engagement?

AY: Absolutely. One of the things that was so interesting when we launched this digital health and engagement division, which is led by a practicing family physician and a strong team of people from a variety of backgrounds, is that the appetite in our patient community is so strong for helping us as we develop these solutions. Our strategy for everything we do at Novant Health starts with the patient. We want to know how we can eliminate their pain points, what do they need, how can we change to meet those needs, and so on. So, when we announced the creation of this division, we ended up having 7500 patients sign up to be members of this group we call ‘community voice’. So, this is a group of patients, community members, and caregivers who’ve agreed to be our focus group and sometimes a pilot group for new digital capability.

So, the learning that I would pass along to others is the appetite exists. And you can have a very, very large sample set of participants as you run experiments with new ways of engaging your patients digitally. I think you have to figure out how you’re going to manage that community, which we’ve done and obviously which can be done. It’s been a wonderful success. And the most recent example I’ll give you is our exclusive partnership with a company called TytoCare.

So, it’s just soft launched in North Carolina and it’s for On-Demand remote medical exam. We’ve had On-Demand video visits forever. TytoCare is a device that’s about the size of the palm of your hand and it has a variety of peripherals that plug into it. And these devices, when used by patients or caregivers, allow them to connect with a Novant Health provider who can virtually examine the heartbeat, the lungs, look at the breathing, look at the skin, look in the ears, look down the throat, look in the eyes, look at the nose, check the abdomen and so on, from wherever they are. And all of these examinations are not only being guided by remote provider but in the case where a patient might want to do the self-exam without a provider live, then the device itself will guide the patient through the process, analyzing the signals coming in from the advanced sensors and the device in real-time and using those signals to tell the patient how to adjust the device.

For example, if your patient is trying to capture a picture of his or her own eardrum, then the device will guide the patient until the image of the eardrums is collected and then it’s automatically, immediately saved in the electronic health record for that patient. So, a really interesting advancement in providing access to care. For anybody who’s ever had a child who suffers from multiple ear infections, if you can imagine, 10:30 at night your child exhibiting ear infection symptoms, wouldn’t it be great not to have to worry about taking off work the next day and trying to get the child an appointment and instead allowing an exam to happen right then, having the ear infection diagnosed right then and having the prescription called in right then and the child gets to start taking the treatment immediately before even going to bed that night. So, this is the sort of thing that the team is working on and doing some fairly groundbreaking work in our region.

PP: You’ve had great success in having your patients engage with the digital tools that you’re putting out and have thousands of patients sign up and be a part of it, willing to participate. Now you’ve got a self-triaging kind of a tool through the TytoCare device. So, it seems like that is a recurring theme that you’re getting patients engaged in their own care instead of having to push it out to them. And you’re getting a fair amount of success in the virtualizing care through advanced technologies. Am I getting it right? Would you agree with that assessment?

AY: I do agree with that assessment, but it’s a journey that goes on constantly. So, this is not a space in which we can rest on laurels. This is not a space that remains stagnant by any stretch. We have to continue to adjust to emerging patient expectations, the needs of our communities as they evolve. And those are the sorts of things that I think keep us on our toes. And that’s why we built these constructs that allow us to continually look for these opportunities and run experiments with some of the technologies so that we understand what the impacts would be and how to prioritize the work.

PP: Can you talk a little bit about what your goals are for the Institute of Innovation and AI and how you are harnessing data to drive these improved experiences? Talk a little bit about the institute itself and the goals, if you could.

AY: Sure. So, we launched the institute this past year. I co-founded it with Dr. Eric Eskioglu, who is our Chief Medical Officer. He happens to be a practicing neurosurgeon and before he was in medicine, before going to medical school, he was actually an aerospace engineer. So, he’s a rocket scientist. So really great partner to have as we think about things related to innovation and artificial intelligence and other advanced technologies that really need never be explained to him. He’s always there as a tremendous partner with me, as a digital leader. So, when we launched the institute, the goal was to identify these technologies that may not even be commercially available? How do we use them to accelerate solutions that allow us to provide the highest quality, highly personalized care.

The constructs allow us to work with our very engaged physician community, as well as other team members from across the system and partner very easily with a variety of third-party types. We partner with members of the startup community. We partner with universities and other research organizations, other healthcare organizations. A variety of unconventional partnerships tend to be crafted as part of the work that we do inside of the institute. And ultimately, this allows us to run rapid experiments with new solutions that understand impact based on real data that we can collect, not just, suppositions, better engage the broader community inside of Novant Health to get involved in making these game-changing advances for our patients and in our practices and also to best manage investment so that we’re not a naturally fragmented in the sorts of experiments that we run across the board. It’s been a great success in the sense that we’re able to do the work rapidly and with a feeling of having the right experts in the room at the right time.

PP: Can you give us the State of the Union on data interoperability and how are you really harnessing all the emerging datasets that we’ve talked about? We tend to talk a lot about EHR data, but there’s so many other emerging data sets. How are you actually harnessing the data for all the insights that you can potentially generate or some of your programs? Can you talk about that?

AY: Let’s break this down a little bit. So when we think about the broader state that we manage, what are our assets? What do we bring to the solutions that we define for the toughest problems that we’re facing in healthcare? Data is one of those assets. We have patient clinical data. We have consumer data. We have behavioral and trend data. We have our business’ master data. We have a variety of data from many, many sources. We have to have a place where the data can reside and we can apply functional capability to it.

Functional capability is expressed through a variety of solution sets. Some are homegrown, others are provided by various third parties. As we’ve discussed already, we have digital assets that provide care and other access related capabilities to our patients and our communities. We have capabilities that support the running of our business and other foundational elements. Many of these capabilities can and should be provided by a traditional healthcare vendor like an EHR vendor. It is about about data. It’s best for us to focus on creating an architecture that can allow for interoperability between solution sets and various third parties in a highly secure fashion. That’s how we get the most out of the unprecedented access to data that we have. This is what’s going to allow for rapid adoption of potentially differentiating services for our patients. This is what leads to that extreme personalization in all engagements with patients improving the quality of their care through faster diagnosis, breadth of treatment options and of course all the other advanced tech that we can apply to it.

With such extraordinary availability of data and the things that we know we can do within the existing constraints, and within our existing agreements that we have that patients for the usage of the data. We are watching with great interest this debate and the deliberations that are ongoing. And while I don’t have direct visibility into how those considerations are playing out, my hope is that the eventual ruling will benefit our patients. And meanwhile, the things that I can control are the architectural choices that I just mentioned. As long as I stand ready to be as interoperable as possible and as secure as possible across the board, then whatever the decision is, we will be best positioned to serve the patients and communities.

PP: Digital programs, in general, are in early stages of maturity and there’s a long way to go to your point earlier that it is a journey that is by no stretch it’s all done kind of thing. So how do you actually keep track? How do you measure progress? How do you keep score of whether a program is working or not?

Well, so we look at outcomes fairly consistently across the board. So, we measure the quality of our care through a variety of mechanisms. We measure the access to care, the ability that patients have to access care at Novant Health. We in the digital channel space have all of the usual measures that other industries have been using for engagement, for digital engagement, and we certainly track that because we are a business and we’re a rather large business. We track how we can continue to provide advanced capabilities to our patients and community still within an acceptable cost structure.

So, all of those sorts of things are measured as you’d expect them to be. I think that is the most important thing that is specific to digital capability to be able to measure and track progress. The nature of how we’ve defined progress outside of these broad buckets that I just mentioned would be different from case to case. But measurement is one of the most important things we can do post-launch. You’re not done when you’re launching a product or a solution. You are never done. The incorporation of the measures and the results that you’re getting should always feed into the next decision cycle and in our case that has a relatively short window of time.

So we continue to iterate on all of the services and products that we deliver to our communities as well as to our team members inside of Novant Health. As we think about how we are acting as stewards of the resource that our companies have that are so important to us ultimately to the health of our communities.

PP: Any final thoughts that you’d like to share with our listeners as it relates to how they could be looking at their digital programs or anything from your own experience as a best practice?

AY: One of the things that has been such an accelerator for us here is the creation of the chief data officer role and corresponding organization, which include the Cognitive Computing Group, which includes Enterprise Information Management Organization. These sort of constructs and the corresponding investment that allowed us to accelerate some of those foundational capabilities t are absolutely required in advance of being able to do any of the more exciting things we’ve talked about that are more functional in nature.

So, getting those foundations right is important. That doesn’t mean you have to take a couple of years to do it. It has been done in other industries. My advice to other healthcare systems is unless you are in need of additional health care expertise, don’t be afraid to pull people in from outside of healthcare because it’s a gift to allow them to participate in such a wonderful industry. And it will be a benefit to the industry to have diverse perspectives involved in solving some of our most complex problems.

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Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity.