Month: September 2021

Patient home is the new healthcare hub today

Season 3: Episode #97

Podcast with Amber Fencl, VP of Digital Health and Engagement, Novant Health

"Patient home is the new healthcare hub today"

paddy Hosted by Paddy Padmanabhan
bigunlock-podcast-homepage-banner-mic

Share

Share on facebook
Share on twitter
Share on linkedin
Share on email
To receive regular updates 

In this podcast, Amber Fencl, VP of Digital Health and Engagement at Novant Health, discusses how innovations in technology are driving healthcare and enabling its seamless, effective delivery into patients’ homes today. They are transforming the home into the new healthcare hub.

From drones that deliver medical supplies and AI-leveraged platforms that detect strokes to harnessing AI voice bots to answering patient questions on COVID vaccine and setting up the remotely monitored COVID-care at home, digital health tools have come a long way. Novant Health is the first healthcare system in the U.S. to get the FAA clearance to use drones for distributing medical supplies during the COVID-19 pandemic. In combination with invaluable consumer insights and when integrated with a robust EHR system, digital health care can only enhance patient-centric care delivery models.

Lastly, but not the least, start with what the consumers need and want to look for, because if you deliver something they’re not interested in, they will not use it. Take a listen.

Our Podcast Partners:    

Show Notes

00:40Brief overview of Novant Health and your role in the organization.
08:18Many health systems have roll-out chatbot program in the context of COVID-19 and looking to go beyond that. What do you think is possible with the chatbots in the next 6-12 months?
13:09 You are combining three different technology tools – chatbots, voice-enabled chatbots, and AI. In terms of the broad functional areas, what are the things that you are planning to roll out in the next year?
16:58 Hospital at home is a theme that we keep hearing a lot. How do you ensure that the experience is in no way degrade in any way by moving services from the hospital to the home? Also, how do you make technology choices in this context? What do you look for in a technology partner on this journey?
23:54 There's a vast amount of VC money being poured into small companies that are very young. If one of them goes under, how do de-risk yourself out of it? Can you share recommendations that you have based on your own experience?
27:48 How do you govern your digital initiatives in your digital health programs at Novant Health?
31:46 What have you learned personally on this journey that you've been on? Can you share that with our listeners and with your peers across the industry?

Q. Amber, can you give us an overview of Novant Health and your role there?

Amber: Novant Health is a not-for-profit, US$ 5.7 billion health system located in North Carolina, South Carolina and Georgia. We have around 15 outpatient and inpatient facilities, about 800 clinic, urgent care locations and over 2300 providers. So, we may be called Super Regional.

Q. We’ve hosted Angela Yochem, Chief Transformation and Digital Health Officer, Novant Health a while ago. Now, you’re handling digital patient engagement. Do share an overview of what’s changed in the last 18 months?

Amber: At Novant, we have been inundated with COVID-19 response to give our patients quick access to the care they want and need. In the last 18 months, that has been a priority for our communities.

However, we have also tried to continue our growth and innovation towards bringing technology into homes in such a way that is meaningful and creates a seamless experience. Before I came into this role, I was working on our consumer-facing product-side. It was a phone call from Angela about “How would you like to lead this team?” that got me thinking. It’s a very natural transition to go beyond just the consumer-facing experience to talk about our digital health experience and initiatives. They span innovations, such as, using drones.

So, we have a partnership with Zipline where we have instituted the delivery of supplies between our facilities. We were the first in the nation to receive FAA clearance to use a drone that is “sight unseen”. So, we lose sight of the drone, and it covers a 30 mile radius to deliver supplies. We are now exploring the next use case with Zipline, and that will be to deliver pharmaceuticals to our patients directly to their homes. So, a drone is going to take their medications and safely and securely, deliver that to their front yard.

We have also partnered with a company called Hyro AI. Hyro is a conversational voice bot technology that will respond to COVID-19 vaccination questions. It’s taken us about four weeks to develop a knowledge base of FAQs related to the vaccine so patients and community members who call-in have the option to speak with this voice Bot to learn more about the vaccine. In a five-month span, we deflected over 13,000 calls from our care connections, our customer service phone team to the bot for people just calling to get more information about the vaccine. So, that was a highly successful initiative with one of our key partners, Hyro.

We have also established what we call COVID-Care at Home, and it’s a great program to assess our inpatient COVID patients. Once they’re in a stable place, and we feel that they have met the selection criteria — an algorithm that confirms that they can recover at home — we will discharge them from our acute facility and send them a care package and remote patient monitoring devices to monitor oxygen levels, etc., so they can comfortably complete recovery at home. Thus, we are also able to alleviate some of the strain that’s on our acute care facilities with that program. And we are doing that across all of our footprints here at Novant Health.

One really cool thing we’ve done is use AI technology for stroke detection. If we have patients that present themselves with stroke symptoms in the ER while they’re in the CT Scanner, the Viz AI and incredible algorithm and technology can assess that patient in real-time, detect and save millions of brain cells per minute and reduce the time spent trying to discern what’s wrong with them. That technology enables us to take swift action within minutes — call in the Neurosurgeon, prepare the OR etc. — at much faster rates.

Q. While emerging technologies and chatbots will play a much bigger role going forward in health care, it looks like every health system has some kind of a program to roll-out now. Do share what you think is possible in the next six to 12 months.

Amber: We are working with our vendor of choice – Hyro — for our web and voice capabilities. I’d say that the chat bot space is becoming very interesting with some out-of-the-box products that you can turn-on and have a chat, instantaneously. What I would offer is if we just turn it on — take the patient, the consumer experience on the other side — just to say that chat and support experience really isn’t worth checking that box because it’s more frustrating. A lot of research here has shown us that about 60% of the digital consumers that we have surveyed, want to self-serve. Chatbots are a great way to self-serve. However, when they want to talk to a person, they still want to be able to get to a person. So, you need to think about that as an organization. What is that ability to still either chat live with the human or transfer them warmly to someone on the phone, if it’s not a webchat? So, yes, people want to self-serve and they want to engage digitally, on their terms, their time and on their mobile device. The majority also are engaging on mobile. So, that capability must be rich and meaningful information. Checking the box and turning it on may not be rewarding to the patient and that’s not going to buy you much either.

As an organization, you need to have robust knowledge. That means looking for technologies like Hyro, for example, that has conversational AI and the robust knowledge graph that is continuously learning, growing its nodes and building relationships with information such that it can constantly ingest and scrape all sorts of different ways to fill the knowledge base and grow it. We want to be able to do that in an effective, efficient, and elegant manner.

Chatbots are more workflow-based. I think they are narrowing and serve the purpose for a very small use case, and can’t grow with you. So, at Novant Health, we have implemented a chatbot with Hyro that serves to search our entire website, if needed. So, you may think you’re about to type in a search term for company information or perhaps you want to find a physician, but what you’re doing is engaging with the chatbot and it will begin a conversation with you, ask questions and narrow down what exactly it is that you’re looking to do. And the chatbot will be used to do that.

I will say that in the space of a chat in AI — here’s the piece that I think folks may not appreciate — we have thankfully begun to scratch the surface here. If you have a conversational AI, some type of natural language processing capability, you are getting consumer insights first-hand. They are typing in, voicing in their questions, so, if you take that that data and analyze it, that is first-hand consumer information for you to make decisions with. It is rich, robust and invaluable. The more we find entities implementing this type of technology and then, using that data to turn it into meaningful information, the more pivotal it will be for that entity to start making very different and customer-focused decisions.

Q. It’s great that you’re leveraging technology like this! In terms of broad functional areas, what are some of the things you’re planning to roll-out in the next year?

Amber: One of our biggest programs that we, along with many other healthcare systems, are exploring is hospital at home. The idea is to take remote patient monitoring — which has become a bit expected – and truly creating an inpatient experience with the same quality and care within the home. This idea is similar to what we did with the TELE-ICU. So, we have the stroke technology with AI. We’ve also created an experience for TELE-ICU where we have a command center of experts in the field to monitor it. And then we have our hospitalists that are there rounding. The hospital at home takes that to a much greater level. This healthcare at home is the new healthcare hub. And we are going to bring an experience into the patient’s home that will enable all their care management, whether it is behavioral health-related, pharmaceutical or some sort of integrative medicine.

It can be something that is more acute for those patients who are better suited to be in the comfort of their home and have the right home environment. It’s going to include labs, imaging, even the ability to do any type of paramedic services.

Let’s say someone’s running low on their oxygen. So, from our command center, we will be able to dispatch that paramedic to them immediately and through the monitoring, technology and the talent that is sitting in that command center offer necessary care. This will be the next great program that we really bring to life.

We began to do it already like in the COVID-Care at-Home program. But what we want to do is to take these individual experiences with a robust set of talent at the command center and stitch it together to take the hospital into the home and provide that level of care just as if they were inside our four walls. And the brick and mortar will have the same quality metrics. We will have the same expectations for our providers, but in a much more accessible and affordable modality to deliver care.

Q. The hospital at home is another theme that we keep hearing a lot — and it’s all work in progress. Question that arises is — how do you make it all seamless as a healthcare service provider? How do you ensure the experience is in no way degrading? How do you make technology choices in this context? What do you look for in a technology partner on this journey?

Amber: The seamless consumer experience is quite the challenge, and we see it on a daily basis. The healthcare technology field has been peppered with point solutions and a lot of good ones, really great ones that came out of COVID, as well. I was reading this weekend there was in the first half of 2021, NRC Health reported, US$ 14.7 billion in venture funding for health technology. That’s huge. It’s booming.

There’s a lot of great technology out there. But the stitching together is where the challenge comes in, and that’s what you alluded to and what I would offer to listeners is when you’re looking to solve a problem, you have to step-up and out to look across, obviously, the whole spectrum of your ecosystem. What we really have become very focused on doing, is looking at it from an ecosystem standpoint rather than a problem-solving standpoint.

So, I think one differentiator of how you first evaluate, then make decisions, think about the perspective in which you’re analyzing it and then, look at the ecosystem. For us, first and foremost to our core is the patient-centric model.

Our digital health is looking at the patient at the very center. I would think of these as concentric ellipses. There’s the patient in the center and then, there’s this provider enablement that has to wrap around that. That is an important point around your providers. You have clinical operations and then, there’s technology that’s wrapping all of that. For you to create a great patient experience and consumer experience, you have to remember that there’s a provider on the other side to deliver that service, whether it’s in a digital or an in-person format and that is a very difficult scale to balance. If it’s great for the patient, it might not always be so great for the provider and what they have to do. So, you really have to look at technology through both of those lenses and figure out what’s a nice compromise to meet in the middle.

Your clinical operations are so burdened right now from the volumes and the strain of COVID for sure. Certainly, people that are trying to get back in for delayed healthcare and then, there’s the potpourri of point solutions that we have brought into our clinical operations to try to solve problems. If we don’t consider how inefficient a new solution may be to the clinic, then, we’re doing those folks a disservice. So, the patients are going to have a bad experience. You really have to think about that piece as well.

As to the technology to wrap, how does Novant approach it? We are looking for a really strong, solid backbone of infrastructure to facilitate this. It has to be a strong foundation that’s going to allow for growth, stability but it must be scalable. So, as we expand that to the hospital at home or into a new digital medicine capability inside the four walls of Novant Health, it must easily integrate. That, too, is another differentiating factor when you’re looking at technology to bring in our eight-point solution. Question that arises then, is, what’s the integration factor here and how easy or hard is it going to be?

There’s also a call to our electronic health record systems to make integration easier. There are great things that better EHRs do and they do it well. But then there are some things that they really don’t. And we need to easily integrate into those spaces and that, today, isn’t so easy. You have to consider that in your evaluation, because the integration to the EHR is what matters for your clinical team.

Q. A few key points here — the integration piece is key. Without a robust integration infrastructure, you are not going to be able to create those seamless experiences. If you’re not able to capture the encounters properly, you won’t be able to bill for it. Plus, patient experience cannot be at the expense of the provider experience.

Now, there’s a vast amount of VC money being poured into very young companies. So, what does it take for them? Who is the risk taker? How do you do skills of tomorrow? If one of them goes under, how do you pull yourself out of it? Do share any one or two recommendations that you have based on your own experience.

Amber: Risk management and mitigation, planning and organizing work really thoughtfully is at the core of how I operate and I’m going to speak from my perspective and not necessarily as an enterprise or as an entity.

When I go to look at a new vendor, there are some challenging questions that I’m going to ask them. A lot of it is to figure out how reality versus the optimistic view that those providers are typically going to offer, the marketing and the sales pitch versus the reality of what it is. So, I will always double whatever they tell me unless it is a very seasoned software provider, service provider with a proven track record.

I’m going to start also managing expectations within my internal partners and my internal stakeholders.

The other thing that I do is bring in a variety of perspectives and talents to credibly challenge the pitch, the solution from a variety of angles. Certainly, there’s a financial conversation on how viable they are financially that we’re going to have to explore.

And then I look for honesty and transparency. The relationship that I start to form with folks that we’re courting, and discernment serves me well to realize where the pitch may be a little more mirrored than an actual reality. I will also have a score card and that is going to be different. We’re familiar with evaluation and score but that allows me to take away any subjectivity based on relationship or conversations, positive or negative. And that of my internal partners as well. So, when we sit down and compare company A with company B, the solutions may be relatively the same. But let’s say, culturally or financially, there’s a risk factors there that don’t align, so we have a more objective way to make that vision absolute.

Q. Coming to governance, how do you govern your digital initiatives in your digital health programs? How do you ensure that cross-functional leadership is involved and you’re prioritizing things the way they are meant to align with organizational needs or goals?

Amber: Its so important to have structure and governance in place. Novant Health has started at the very top with a very innovative, digitally focused CEO. My boss now, Angela Yochem — our Chief Digital and Transformation Officer — reports directly to the CEO. So, there’s a leadership structure in place to support digital growth, advancement and innovation. Having that support is monumental and I think, key to success. If you are an organization that hasn’t quite adopted that model, I would challenge you to think about it. The investment and the level of engagement from across your organization will change positively with that model.

That being said, we also realize that in the digital space, digital health is one thing and it actually used to sit within our medical group. A couple of years ago, it was realized that digital health spans far beyond just our normal clinical practices. So, it was lifted out and put within the digital products and services group which we’d set. That allows us to be surrounded with more technology and innovative tech skill sets, when we’re looking to solve our problems and introduce new things.

But from a governance standpoint, we have a Digital Care Steering Committee that comprises key stakeholders in the organization — financial partners, strategy partners, revenue growth partners, and most importantly, medical practice. That steering committee is where we bring forward new ideas. Certainly, those new ideas may be bumping up against some internal criteria but we also hear from the Committee the things that may be on their minds. We have a very close partnership with our medical group and outside of the Steering Committee, we have regular Cadence Reports out and touch base on key initiatives.

That Steering Committee’s really the glue that brings us all together where we very intentionally talk about what we want to do and where we want to go. Here’s the reality of what’s happening within the medical group from the front lines. Maybe we want to do it, but because of the surge, we have had to make some changes in priorities of the way because our clinical partners need to be serving our patients in the community. That is the forum. And that core group of individuals help us to make those decisions and to talk about it.

Our clinical partners embrace technology and the efficiencies that technology can bring. They also keep us very honest on the point that I’ve talked about before. And what is the lift and the impact to their clinical team members and not just our patients? It’s caring for the patient, giving him the best experience possible while also enabling that provider to do it effectively and efficiently.

Q. What have you learned personally on this journey that you’ve been on? Can you share that with our listeners and with your peers across the industry?

Amber: Yes, I have been impressed, surprised and educated through consumer insights — the level of detail and insights — that I was never privy to before. At Novant Health, we have a consumer patient-focused group called Community Voice. That function is a part of my digital health and engagement team and has about 6,000 volunteer patients, team members and community members that will take surveys that we send out because they are interested in providing us feedback.

And what we may think is a good idea or how we got to do this, may be a game changer and may be great for the patient but it may not be a big deal to the providers. So, we’ll test this concept with our Community Voice members. It’s a very diverse group of individuals. We create these surveys to get their feedback and we’ll find out something that we think may be the next great thing. But it may turn out that it’s really not that important, or what we thought was a great idea is good and the way we wanted to deliver it is not at all how that consumer would want to receive it.

My point is: Finding a way to glean those insights from your demographics in your community is critical and different and very important because it’s a part of your community. You know that it is impactful and it represents those who you are serving. If you are gaining your insights from a different source, that is interesting and absolutely can be a factor.

I have been impressed and find that our community members who participate and give us direct feedback allows us — sometimes it’s directionally the same as perhaps a national survey on a similar topic — but it’s typically different enough to make an impact on how Novant Health wants to choose to deliver that particular concept.

So, that is first and foremost, and what I mentioned earlier, is the insights that you can gain from digital interactions with your patients to predict behaviors, identify trends quick enough that you can react and respond to them so that either the experience is better or perhaps there is a new opportunity in those trends that is good for your system to explore.

For me in this role and the work that I’ve been doing at Novant Health the last couple of years, the access to meaningful insights to make decisions has been delightful and impactful and how we have made decisions that have been a part of that’s wonderful.

Q. So, the cool tech is where you start with really what the consumers need and want to look for. And if there happens to be a cool tech that can deliver what they need, even better.

Amber: Better and better. But if they’re not interested in it, you can have all the cool stuff you want. Nobody’s going to use it.

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

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

About our guest

As the VP of Digital Health & Engagement, Amber is responsible for leading game-changing digital health and digital medicine initiatives through advanced technologies so that Novant Health can deliver the most remarkable patient experience. Amber’s team strives to improve the quality of care for patients and community members; and ensure increased access to care through contemporary methods and technologies. She partners with physician and administrative leaders across the organization to develop and operationalize a robust, omni-channel digital health and innovative engagement product strategy.

Amber is a digital transformation leader with expertise in healthcare technology, software development, portfolio and project management, and risk mitigation. From start-ups to Fortune 500 companies, Amber has held leadership roles across technology, financial services, and healthcare with companies such as Unisys, Oracle, Wells Fargo, and Novant Health.

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

A lot of digital adoption is driven by demographics

Season 3: Episode #96

Podcast with Tony Ambrozie, SVP and Chief Digital Officer, Baptist Health South Florida

"A lot of digital adoption is driven by demographics"

paddy Hosted by Paddy Padmanabhan
bigunlock-podcast-homepage-banner-mic

Share

Share on facebook
Share on twitter
Share on linkedin
Share on email
To receive regular updates 

In this podcast, Tony Ambrozie, Chief Digital Officer of Baptist Health South Florida, shares his journey and learnings embracing digital in healthcare. Transformation in any sector requires sustained effort, a budget, a cohesive team and most importantly, a well-drafted communication plan.

Digital transformation is not easy – setbacks are inevitable. When digital health tools add to the physician’s workload, the rate of adoption slows down. When organizational processes and mindsets don’t adapt, mistakes are unavoidable.

With his deep background in consumer-oriented industry sectors, Tony brings a heightened appreciation of the gaps in digital patient engagement and how to approach the challenges. Take a listen.

Our Podcast Partners:    

Show Notes

01:18About Baptist Health and the current state of your digital health transformation initiatives.
04:55What were your initial impression of healthcare and where we are as a sector in terms of consumer enablement of digital experiences? What are your top priorities?
07:19 What do you see as stark examples of the difference between your previous experiences and healthcare? Are there structural issues with healthcare? If yes, why is it so broken?
10:17 When designing digital experiences, it’s imperative to consider the clinicians’ experiences. The biggest challenges here are increasing adoption and awareness. What can lead to better adoption among the traditional community?
14:58 In the last decade, some physicians have been worn down by the instrumentations and layers of technology sitting atop the charts and trends. Skepticism has increased especially if this adds to workloads because they don’t have enough time. How do you look at the technology solutions landscape when you're trying to address this?
21:48 What does the governance model for driving digital health at Baptist look like?
24:11 How do you make sure all stakeholders are working together in the same sandbox and driving organizational objectives?
25:08 What are the learnings you'd like to share with the audience?

Q. Please tell us about Baptist Health and the current state of your digital health transformation initiatives.

Tony: Baptist Health is a regional system provider in South Florida with about 10 hospitals and approx. 20,000 employees. It’s a really big presence in that community — I have people who work for Baptist and were born in Baptist Hospital!

In terms of going digital, the Baptist executive team and some of the influential members of the Board with experience in commerce and digital platforms, had been discussing digital and the sense of sustained and coherent efforts required for transformation, for some time. I was brought in into Baptist as the Digital Information Officer to ensure a laser focus on driving digital transformation for the entire organization and to work with clinical, operations and all the other constituencies.

About three months into my tenure, I put together a digital strategy and capabilities’ roadmap covering roughly the next 12 to 18 months. It’s important to have an overall strategy. If you don’t know where you’re going, you can’t tell where to turn. But that strategy cannot be all-consuming to the cost of executing. That’s why having a roadmap of capabilities and features, and executing it is very critical.

For us, the focus would be on consumer digital experiences, first, followed by clinical experiences and then, the digital experiences for operations and other groups. We started executing this 3-4 months ago and decided on dedicated funding for the program that was focused on building and rebuilding experiences regarding telehealth. Along the way, we learned and validated from the original assumptions that we didn’t know, and we needed to know in order to change. So, that’s roughly where we are, now. We are building momentum in terms of both, building capabilities and talking about digital transformation inside the organization.

Q. There are three aspects of your mandate — consumer digital experiences, caregiver experiences, and how to enable the organization, digitally. What were your initial impressions of healthcare and where we are as a sector in terms of consumer enablement of digital experiences? What are your top priorities?

Tony: I came into a consumer-focused company from Disney, Disney parks and before that, American Express. While these had very similar focus, clearly, healthcare providers, doctors, physicians, and nurses were more intensely focused on the medical care for patients. The pandemic has shown the relentless and ultimate dedication of medical providers to patients’ lives, well-being and health. However, we must note — compared to other industries — the digital experiences before the encounter, after the encounter, maybe even during the encounter.

Think about the Amazon shopping experience. Ordering a bottle of water on Amazon is nothing compared to healthcare. But still, think about this. If instead of this Amazon experience, you spend time putting down a list, then, get on a call, wait for 30 minutes, talk to somebody, spend another 30 minutes trying to explain on the phone what the problem is, what you want and then, wait another three weeks. All this to discover ultimately that you did not get what you actually wanted but something similar. That’s kind of where we are today because of the more than imperfect digital experiences.

Q. What do you see as stark examples of the difference between your previous experiences and healthcare? Are there structural issues with healthcare? If yes, why’s it so broken?

Tony: Great question and that’s something we’ve been asking ourselves because it’s a combination of factors. So, I’ll put the objective factors aside. You have this interesting dynamic between patients, providers, and payers — a kind of strange arrangement and buying or ordering things is impacted by that. You have to validate the insurance first, and therefore, it’s not as easy as it would’ve been if you’d used your American Express card. So that’s an objective factor. It’s part of the system but needs to be worked on to improve.

There are some things that we can do on the more subjective part — I don’t think this aspect has been focused on for the past few years and frankly, there are still some in the healthcare industry who maintain that patients don’t come here for the mobile app. While that’s absolutely true, it’s equally true that nobody goes to Disney just to use the mobile app. However, without that mobile app, probably they wouldn’t use American Express either. So, how we manage our services, the access to our services with the consumers is important.

At some point, it’s also competitive advantage. All other things considered equal, consumers and patients would choose and use your experience to a more difficult one. The expectations for the consumers have been changing for a while, and some of it is driven by their other experiences and their normal lives. And they want to be part of the focus or the center of the experience, want to have control and information to make decisions about their care. They expect the same type of experiences as elsewhere.

Q. When designing digital experiences, it’s imperative to consider the clinicians’ experiences. The biggest challenges here are increasing adoption and awareness. How can you drive this among the traditional community?

Tony: When I was talking about consumers earlier, to a certain extent I was also thinking about the clinicians having great digital experiences in addition to the normal ones. Do you want to go to the system that has horrible technology and is painful or would you prefer one that’s got all things considered? That’s the second focus aspect for us.

I would say that a lot of digital adoption is driven by demographics. Lifestyle and capabilities are equally crucial drivers. Clearly, the younger generations – those up to and in their 40s have experienced eCommerce – so adoption is basically natural with video calls for everything including a medical encounter subject to other limitations.

Some of the more senior folk whether they have the experience, knowledge or some form factor limitations, they’d also prefer a big screen versus a mobile. So, the life cycle is folk who are very much into the social media of this world. It feels natural; just another interaction and that’s true for both consumers and providers.

For the providers though, there’s a little twist. Digital in healthcare requires process changes to be able to provide benefits. Now, some individual providers probably don’t like these because they may not be convenient and so, they will stay away from the digital. Some provider systems will skew that process. Those process changes may simply be too difficult. There’s inertia and maybe politics. So, when digital is introduced, it’s probably is more work and hassle than it’s worth it. Think about the charts that really are problematic for physicians. When we speak of the third element, which is the quality of the experiences, I think, for both consumers and providers, the quality of the technology and the digital experience have been great but when we speak of the physicians, we all know how painful the charts are for them.

Q. In the last decade, some physicians have been worn down by the instrumentations and layers of technology sitting atop the charts and trends. Skepticism has increased especially if this adds to workloads because they don’t have enough time. As the CDO, how do you look at the technology solutions landscape when you’re trying to address this?

Tony: We don’t want to deal with something that makes more work for us and for physicians. Especially during crises, when things compound in terms of technology landscape, it’s interesting to see how the interactions shape up because you have some of the same type of players — the big tech, the established traditional technology players (distinct from big tech) and then, the older startups. There are some differences in interactions but it’s not very clear what their strategic plan is other than maybe selling more cloud and devices.

Take Google, for instance. They’re possibly reducing their efforts in healthcare or pulling back but while they’ve been in charge, I haven’t seen very much other than very marginal capabilities. If you also look at the Haven — the joint venture between JPMorgan, Amazon, and Berkshire — again, what they’re trying to do isn’t very clear. Apple, in contrast seems very focused on additional health capabilities and their devices, but it’s relatively limited. The Apple Watch is slightly different here. We like some of the health capabilities that provides in terms of established providers.

And in this category, I would say there are the EHR vendors, too. Some of them are very successful, but all of them have somewhat old technology stacks. They’re trying to be all things to all people and this is reminiscent of the ERP and MRP space. They’re slow to market and some of them are still dreaming of closed platforms with customer in. They’ll have to change simply because of the other two categories and the fact that the world is changing and finally talking about startups, lots of money, VC activity etc.

It’s somewhat probably scattered and that’s part of the way it works but I see two different and somewhat opposite categories here. On the one hand, there are some who are certainly trying to emulate OR to build a comprehensive but closed platform. They look at presumably the big vendors and what worked for them. They’ll try it for themselves — either buy the entire platform or their product. Probably in the best case, there’s a doubt about long-term financial viability. On the other hand, there are companies that are very narrowly focused and they don’t integrate very well into the ecosystem. They get the work done and product launched successfully but in an independent fashion.

However, now that we’re bringing in the identity/authentication, how does that work? I’m not going to force the consumers to put their data into a system just because I already have that data. So, it just doesn’t make sense as a realistic approach. I think the startups should focus on very specific capabilities and execute them well, but also have APIs to integrate at all levels in the rest of the ecosystem.

Q. You’ve got multiple stakeholder groups to work with and you have to drive change in the organization. What does the governance model for driving digital health at Baptist look like?

Tony: I structured the digital program as a place for everything to converge in a natural and structured way that has a strategy, scope, priorities and a roadmap for no more than 12 to 18 months. We also got dedicated funding for the program as a concept. In certain places, the digital investments may be very hard to manage but this was one program, so there’s a long-term funding bucket. We got the bucket and the money required, in tranches as we went along. There is a digital council that I chair with very select stakeholders and thought leaders from the organization — the clinical and operational sides etc. A very important and equally critical point is to have a very comprehensive and increasingly well-developed communication plan — whether with artifacts or internal wikis or live presentations and even demos to a variety of different constituents.

Q. How do you make sure all stakeholders are working together in the same sandbox and driving organizational objectives?

Tony: It’s important that digital transformation is not looked at as born-again. We have the digital council, but there’re also a number of other committees and boards that a number of us are on to try to ensure that cohesion. We operate on the premise that everything will be different tomorrow than today. So, as much as possible based on the strategy, some things are done by my team and some by others. As long as it seems coherent and the result is positive, everything is good. There’re a lot of conversations, but I think that’s natural.

Q. It’s been a year since you came into your new role. What are the one or two learnings that you’d like to share?

Tony: First and foremost, don’t debate whether you need to go digital because you do. Then, the final strategy we just described – know why that is important. So, everybody knows how to align, whether in spirit or in details. But don’t overspend on the details. I was never one to spend two years on a strategy and then, have to redo it because the world is different. I’d say, have the right stakeholders and thought leaders with you driving the bus. So, I’m driving the bus with them together. And thought leaders and influencers don’t always have fancy titles, but they’re valuable, nevertheless. This is the team that would do the implementations and drive the change. This is both, from a professional competence perspective, but also, a mindset. Learn from mistakes and know that mistakes will be made. It is important to be ready when these happen and have that team flexibility to turn around and fix them. Digital is not easy. The Amazons and Googles do it very well but it requires a lot of focus and attention to detail. For a successful digital, the organizational processes and the business processes do have to change.

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

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

 

About our guest

Tony-Ambrozie-profile

Tony Ambrozie is the Senior Vice President and Chief Digital Officer/Chief Information Officer for Baptist Health South Florida, the largest not-for-profit healthcare organization in South Florida. He is responsible for all technologies and customer experience as well as clinical digital and data transformation efforts.

Before joining Baptist Health, Mr. Ambrozie served as the Senior Vice President, Technology and Digital at The Walt Disney Company. In this role, he was responsible for a number of digital and core systems and technologies, engineering, data analytics and machine learning for Disney Parks, Consumer Products, Games and Publishing.

Prior to joining Disney in 2013, Mr. Ambrozie was Vice President for Digital Platform Technologies at American Express, where he was responsible for platform engineering, shared services development and application security, with previous roles focused on application architecture, development, engineering and performance.

He is a proven leader in the technology and digital space with a keen focus on using technology and data to enhance the consumer experience.

Prior to spending the past two decades focused on large business operations, he launched his technology career as the cofounder of a software development startup, specializing in building unique, small business applications.

Mr. Ambrozie holds a dual MBA and master’s degree in Information Management from the W.P. Carey School of Business at Arizona State University.

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

Competition in the market is forcing more collaboration between healthcare providers and payers

Season 3: Episode #95

Podcast with Jacob Sattelmair, Co-founder and CEO, Wellframe

"Competition in the market is forcing more collaboration between healthcare providers and payers"

paddy Hosted by Paddy Padmanabhan
bigunlock-podcast-homepage-banner-mic

Share

Share on facebook
Share on twitter
Share on linkedin
Share on email
To receive regular updates 

In this episode, Jacob Sattelmair, Co-Founder and CEO of Wellframe discusses how technology solution providers can collaborate with health plans to deliver impeccable quality care to people whenever and wherever they need it. With Telemedicine adoption rates gradually on the rise, it’s imperative to enhance investment in a digital concierge type service that puts the patient first, breaks down silos within the health plans, and facilitates improved collaboration between plans and providers vis a vis support.

Sattelmair maintains that leveraging “high-tech for high-touch support” is the way to go in a COVID-ravaged world. This will not only transform patient experiences and care management but will prompt people to better understand their health while smoothing the navigation around the healthcare system. Take a listen.

Our Podcast Partners:    

Show Notes

00:35Could you tell us about who Wellframe is and how you got to funding the company?
03:27What has the pandemic meant for your company and your consumers? How have the past 18 months been for the competitive landscape you operate in?
06:23 Who pays for your technology and services? How do your clients – health plans – justify an investment in a platform like yours?
11:07 Historically, providers and payers have not been great at collaboration. When will that change? Which parts of the market do you see as the opportunity areas to drive these collaborations to create value for the consumers / members / patients?
22:46 In the tech landscape, there are the big tech firms, the larger healthcare focused tech firms, and there's a whole range of digital health startups. What is your advice to the VCs who like to put money in them?
25:22 Recently, couple of the big tech firms have scaled back their investments in the healthcare market. What does it mean for the appetite in the marketplace for disruptive technology-led innovation models?

Q. Tell us about Wellframe and how you got funding for the company?

Jacob: Wellframe is a company that is partnering with healthcare organizations to drive digital transformation of experiences for members and patients. Primarily, we work with health plans and help them modernize the delivery of services and their members’ experiences. We started by digitally modernizing clinical support services for high-risk members and have expanded to help plans drive toward a more integrated and holistic service model. Think: a concierge or advocacy type of service that really transforms members’ experiences and positions plans to help people better understand their health and how best to navigate the healthcare system.

The company was founded in late 2011-early 2012 by a diverse group – an Epidemiologist by training together with a Primary Care Physician, a Computer Scientist, and a Data Scientist. What really drove us was the huge gap between the day-to-day needs of people — especially those living with chronic conditions or multiple chronic conditions — and all that people had to do to manage their health at home. We noted the pressure people were under to make good decisions about the levels of care, their increased stress, isolation and uncertainty and saw a well-endowed health care system struggling to comprehend how to help them — conveniently and on a bigger scale. At that time, some technology enablers – mobile phones and the Machine Learning techniques — were relatively new but they presented huge opportunities to better organize the resources of the health care system around the needs of people outside of the four walls of care delivery, the home and the community.

Motivated to make an impact, we brought our collective skills and expertise together to bridge that gap with technology while focusing on extending relationships and helping people feel supported and cared for during periods of need.

Q. Let’s talk about the macro-environment. What has the pandemic meant for your company and your consumers? How have the past 18 months been for the competitive landscape you operate in?

Jacob: This is a huge topic deserving time but here are a few highlights. Pre-COVID, there were some pretty significant temporal trends governing the market and consumer that were driving demand for what we were doing. Consumers looked to access care and support through digital channels — the mobile — while every other part of life started to take hold for large healthcare organizations. Those who purchased insurance or care, employers or state agencies, expected more from health plans — a more modern service model and experience for their constituents – and that increased the urgency for plans that could enable investments to digitally modernize their services.

Covid had a far-reaching impact — it bared some of the challenges inherent to traditional modes of communication and engagement. One was the absence of ways to communicate policy changes, offer support, guide people or even recommend action to them. These deficiencies became more glaring in light of minimal investment in modern channels to reach a lot of people.

Then, there was the acceleration of Telemedicine. Here, incentives were aligned among consumers or patients, providers, health plans and regulators. That was kind of a perfect storm to massively accelerate its adoption. It challenged a lot of the traditional paradigms that had kept virtual channels as a bit of a sidecar to the health care system. Not a lot of people get care or support through the digital media. And a lot of fairly risk-averse health care organizations had been pretty skeptical about value here. But Telemedicine elevated the stature of some of the things that we were doing. It hit the priority list of more and more health plans, leadership boards and expedited some expansions with our customers. It definitely put us on the radar of more and more plans that recognized that if now wasn’t the time to invest here, then, I don’t know when that could be.

Q. Who pays for your technology and services? Your clients are health plans, so how do they justify an investment in a platform like yours and by extension, any other digital health plan?

Jacob: Our target customer is any organization that’s holding some sort of risk around outcomes and investing resources in supporting and engaging people to improve outcomes to mitigate that risk. Historically, that’s largely been health plans. So, that constitutes the majority of our customers, today.

But the growing prevalence of risk-bearing providers that are hitting scale and investing in these types of services are all relevant for us, as well. So, the kind of business case or value for them is they’re spending money on services, today, that are trying to support and engage their members largely through telephonic interaction and home visits, etc. And the mobile presents a more intimate but scalable channel through which to extend these relationships of therapeutic support, very high touch and convenient manner as to reach more people in need. The aim is to be effective in delivery of services and support to enable people to manage their health at home and be aware of the choices they make about their care. That ultimately leads to higher quality and lower cost and a more competitive plan product. So, our motives are aligned with our health plan customers to deliver a better member experience, a more competitively priced plan product, innovate and differentiate in a market where there’s a growing amount of disruption from startup health plans or a third-party service provider and the expectations around how plans invest to engage and support their members.

We provide the technology and partner-up to catalyze modernization and transformation of these services to help our customers compete and meet their members and stakeholders’ needs.

Q. Messages and outreach campaigns from the provider and health plans both target the same thing — better health behavior and efficient management of chronic conditions. Who do I engage with first? What are you seeing and how does that dynamic play out in the way you position your platform with your services?

Jacob: We see that as an exciting opportunity on the horizon. As we’ve evolved from digitally modernizing care management to helping our customers deliver more holistic support, our first objective was helping break down some of the silos within the health plans to offer more integrated services, holistic support and focus on the needs of the member, first.

From there, we see considerable opportunities to help our customers facilitate greater collaboration between plan and provider as it relates to the provision of support. For the individual patient, remember, it’s not that I’m talking to the plan but I’m talking to the provider and there’s no crosstalk in between. So, digital channels and workflows that can be built around those present an exciting opportunity to facilitate greater collaboration and crosstalk between plan and provider.

That goes along with a growing trend toward vertical integration, value-based care arrangements, more collaboration from a financing and a risk-sharing perspective that creates incentives for this to happen across geographies and markets. We appreciate that.

 There’s no silver bullet and it’s not easy, but we have the building blocks — active strategies with all our plan partners around how to drive more provider collaboration and move more of what we’re doing closer to point of care — to enable this.

Q. Historically, providers and payers haven’t been great at collaboration. When will that change? Where do the opportunity areas to drive these collaborations and create value for the consumer/member/patients?

Jacob: I think that competition in the market will force more collaboration. Large plans that are vertically integrating with providers very aggressively, startup health plans engaging in joint ventures or close collaborations with provider systems are signs that your plan products are getting out there. They will have tight collaboration with providers and there will be benefits to consumers/members, and benefits from an efficiency perspective that can be derived from there. 

That will force everybody to rethink some of the traditional paradigms and relationships that may have been more contentious, historically. Now, we’ll have to figure out how to work collaboratively to deliver the best possible solutions to consumers at the highest value and the best experience. People that aren’t thinking that way will struggle to succeed and compete because the market will pass them by.

Q. Where does a firm like yours play in that equation to bring about this collaboration — Will you straddle both sectors? Will you be working with providers eventually and perhaps integrate both?

Jacob: We also work with providers and have been deployed in the provider context for over 7 years. There are many plans – some provider-owned and some they have partnered or have some sort of value-based care relationship with — that are actively deploying. These offer great learning, proof points and insights into how that model can be scaled across payment arrangements, geographies, lines of business and types of plans.

There are opportunities to work directly with providers that take the risk and hit a scale where they start to invest in their own services. There’re also the regulations around data interoperability and integration that are enabling consumers to share their data seamlessly and creating forcing functions for organizations to open up APIs to allow this data to flow.

So, the idea that we’d help facilitate the exchange of clinical and claims data on behalf of an individual that is both, a patient, and a member, in the coming years seems more possible now than five years ago. The government regulations are encouraging of this type of interoperability, and it plays into the strategy of our customers and what we’re doing, well.

Q. –Let’s talk about the competitive landscape. There are providers who’re doing what you do. Perhaps in very fragmented ways. There are many innovative solution providers, too. But the clients are struggling to make informed choices. On the flip side, the startups, in a bid to stand out are adopting different strategies to stay relevant. What’s your take from the perspective of either increasing surface area or enhancing your impact and going deeper or broader?

Jacob: There’s been a massive influx of investment capital into this space, which is enabling thousands of blossoms to bloom. This is catalyzing innovation in exciting ways to open new care models, solutions and offer a plethora of options to incumbents in terms of either disruptive or enabling forces.

The challenge with that is you run the risk of actually adding to fragmentation as opposed to countering it. There’re lots of point solutions that, for example, offer virtual care for diabetes, behavioral health, maternity and cardiac, which is great! But a lot of the people that have serious need don’t have one condition. They have four, five or six. So, how do you manage that?

We see that health plans are in a pretty unique position where they manage a network of all types of providers. And they capture data that, while not to the clinical depth, looks holistically across the care people are getting, often among multiple providers. And there’s an opportunity for health plans to facilitate integrations that allow people to access the resources they seek and help them navigate to the ones optimal for them.

We’re partnering with plans to help them establish a proactive relationship with their members by identifying their needs and helping them access high-value resources. This could imply finding the right person in customer service or care management on the planet, get them the right provider and network — whether that’s brick and mortar or virtual care – or zero-in on the right solution or third-party benefit that’s offered to them through the plan or employer.

If the plans invest in establishing more modern relationships with members, organize and curate this plethora of solutions, help evaluate the impact of these solutions and then, optimize their routing to connect people with what they seek, then, there’s tremendous opportunity.

What we’re doing can be meaningful in enabling that strategy. And then, as it relates to the provider-side of things, in a world where payments are evolving and risk is shifting, there’s certainly ambiguity in some situations about who’s responsible for what. Whereas historically, the risk was that a lot of people would have fallen between in the cracks, with neither their provider nor the plan paying attention to them, today, there may be situations where they’re being paid too much attention. That’s not ideal but it’s a swing in the right direction. More collaboration between plan and provider can help work that out.

There’s no simple solution – technology isn’t the only one — but there’s an earnest effort among our customers to work collaboratively between plan and provider to sort that out, increase communication and collaboration. That’s not easy nor simple but will pay off over the coming years.

Q. With regard to health care management and chronic conditions, you mention the comorbidities that the most intense cases represent. You’ve also talked about expanding into clinical areas. Are you heading toward becoming a one-stop shop as a company?

Jacob: That’s a critical part of our foundation. For instance, I’ll start with a condition and then, I’ll recognize existence of multiple conditions, and so, I’ll stack these – conditions and specific solutions — and try to cobble them together.

We purpose-built our platform from the start to enable holistic clinical support for people with multimorbidity and clinical complexity across both physical and behavioral health domains, recognizing that it’s the person managing multiple conditions and social drivers of health that tends to be the highest risk and among those, who are targeted for care management programs.

All our programs are modular. So, if there’s an individual with complicated Type 2 Diabetes, stage 2 heart failure and mild depression, they will need help with nutrition and finding a doctor. We can bring those modules together to offer holistic support to that individual in the context of an integrated care team that would include a nurse, a coach, a social worker, an expert peer, and a customer service representative. That’s really been the crux of our strategy from the start. It’s enabled us to help our customers target some of the most complex members that need nurse-led clinical services.

While many of the interventions that are framing themselves as care management are non-clinical coaching services, which can be incredibly valuable, there’s a different scope in terms of what they’re able to tackle and who they’re able to help. For health plans, for instance, while there’s been varying levels of appetite to in-source or out-source some of the less clinically intensive services, most plans have continued to own nurse-led care and case management throughout. 

Q. When it comes to the tech landscape, there are the Big Tech firms — some larger healthcare-focused tech firms and the digital health startups – with more emerging every day. What’s your advice to the newcomers and the VCs who like to invest in them?

Jacob: There’s a lot of money coming into this space. So, the concern or the skepticism is that we’re over-funding ahead of the market. However, there’s also evidence that the market is being disruptive and there are huge pockets of need and opportunity that are conducive to significant change. That change is probably not going to be driven entirely by incumbents. It’s going to be delivered through disruptive forces that push incumbents to change or companies like us that are enabling incumbents to modernize more quickly than they’d be able to do on their own. Given the huge need for improvement in the way care is delivered — the convenience, quality, accessibility, and cost — it’s hard to say that we’re putting too much money into the space.

In fact, even if some of this money is like “wasted,” it helps accelerate the improvements in care and helps expedite better outcomes, and improve quality of lives. There’s a long way to go to make care work for people in the way we all imagine it would.

So, money is coming into the space for a reason and some people will be successful. But that’s the venture model. For entrepreneurs coming in, I’d say, you really need to be passionate about the impact you’re making because nothing happens that quickly in healthcare, it does require significant persistence. But now is a good time to be part of that change. Things possible today wouldn’t have been imaginable 10 years ago.

Q. A couple of the mature big tech firms with deep pockets have recently scaled back their investments in the healthcare market. What does it mean for the appetite in the marketplace for disruptive technology-led innovation models? Is that just a blip or is there a broader message?

Jacob: It’s such a big space and there are so many opportunities that the large tech and retail players will continue to invest here. The idea that their pulling-back signals failure isn’t correct. Large organizations must be encouraged to invest, innovate, and take risks. When one does that, one takes risks to try do something new, and it doesn’t always work exactly the way one thought. So, you must pivot and adjust and its laudable what these players are doing that. I’d be very reticent to criticize such organizations for seeming to pull back or change their strategy. If you’re a startup, you’ll do that 10 times over before you hit your stride. So, I applaud them doing it to make an impact in such an important space.

Between the healthcare incumbents who have the appetite to improve and the commercial pressure that’s pushing the disruptive large tech and retail players and the venture- and private equity-backed startups, hopefully, all of them will meet in the middle and sort themselves out. That’s good for consumers and we’re privileged to be a part of that, but it doesn’t mean you’ll always win. If you can help move the ball forward and make things better for people, then that’s a goal worth working toward.

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

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

 

About our guest

Jacob-Sattelmair-profile-pic

Jake Sattelmair is the co-founder and CEO of Wellframe. Wellframe fixes the two biggest problems with American health insurance: The patient experience, and the rising cost of care.

About the host

Paddy is the co-author of Healthcare Digital Transformation – How Consumerism, Technology and Pandemic are Accelerating the Future (Taylor & Francis, Aug 2020), along with Edward W. Marx. Paddy is also the author of the best-selling book The Big Unlock – Harnessing Data and Growing Digital Health Businesses in a Value-based Care Era (Archway Publishing, 2017). He is the host of the highly subscribed The Big Unlock podcast on digital transformation in healthcare featuring C-level executives from the healthcare and technology sectors. He is widely published and has a by-lined column in CIO Magazine and other respected industry publications.

newsletter-blog-homepage-banner

THE HEALTHCARE DIGITAL TRANSFORMATION LEADER

Sign up to get Paddy’s Newsletter that is personally curated by Paddy along with analytical notes on the developments for the week.

newsletter-blog-homepage-banner

THE HEALTHCARE DIGITAL TRANSFORMATION LEADER

Sign up to get Paddy’s Newsletter that is personally curated by Paddy along with analytical notes on the developments for the week.

newsletter-blog-homepage-banner

THE HEALTHCARE DIGITAL TRANSFORMATION LEADER

Sign up to get Paddy’s Newsletter that is personally curated by Paddy along with analytical notes on the developments for the week.