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Healthcare Transformation: A Conversation with Josh Perkins

As many aspects of our lives become increasingly digital, entire industries are looking for new ways to leverage technology to solve problems and produce better outcomes for consumers. And after the strain that health systems and their employees have been under throughout the last few years, the healthcare industry in particular finds itself searching for new avenues for innovation.

We sat down with Josh Perkins, Director & Field CTO at AHEAD, to hear what he believes is in store for healthcare as well as which technologies are poised to have the biggest impact on the industry.

Digital transformation is a term that feels somewhat overused in virtually every industry, but often for good reason. What do you see within the healthcare space today that makes health systems so ripe for digital transformation?

So, I think it’s several things – first, I think that the healthcare industry, while pioneering in some areas, has yet to fully appreciate or explore the impact of technology on overall quality of care. There is a huge opportunity in terms of taking the vast amounts of information streaming in throughout those environments, examining it, evaluating it, and synthesizing it in different ways such that we observe new opportunities that individuals within healthcare systems – whether that’s clinicians, caregivers or even patients – cannot see currently. That access to the data and required analysis tools will unlock tremendous insights for all parties, and those insights will transform capabilities, expectations, and hopefully, outcomes.

Expectations of a new generation of patient and the next generation of clinicians are also driving digital experience expectations. In other words, a nurse in his or her 50s has different expectations of their interactions with the hospital system (the scheduling, the collaboration, the processes, and technology access) than a 23-year-old coming in straight from college right now. There’s a lot of opportunity in meeting that next generation of healthcare worker and next generation of patient with a technology experience aligned to what they see everywhere outside the health system — the goal being to use technology to enhance the quality of care and make their lives easier.

The last thing that I’d mention here is the access to care. Traditionally, we’re used to healthcare being a very localized game, where large hospitals in major metropolitan areas provide the highest quality of care because they have the greatest access to population, specialized clinicians, and latest equipment, so they become hubs for healthcare. What we’re now seeing is that there’s a significant opportunity to expand and deliver a higher quality of care through methods involving telehealth and telemedicine, but also in self-service areas for broader health systems spanning larger areas to provide consistent care to a larger population. I think that’s a massive change for what we’ll see moving forward.

This also naturally leads to the idea that a lot of these major hospital systems will further invest in their unique specializations. So, maybe a hospital system is particularly good at cardiology, versus one being particularly good at oncology. In the future, a patient can seek out critical care for their specific needs — not based solely on where they live or whether their income level allows them to travel to seek better care, but rather, based on the accessibility that they have to all the potential specialists and clinical capabilities of hospital systems distributed across the globe by virtual means.

In your opinion, what is the role of infrastructure in a health system’s ability to transform their organization? What should healthcare leaders consider before beginning an engagement to modernize their infrastructure?

I think that in a lot of ways, infrastructure gets mixed into this idea of ‘current state’ or ‘status quo’ within healthcare. A lot of this is furthered by the idea that much of their application landscape or commercial applications are relatively steady in the way that they are being delivered — or at least that the health system itself doesn’t control the future of how those applications are going to be serviced or delivered for their organization. This is made even more difficult when you include the lifecycle challenges posed by aging applications tied to aging infrastructure assets.

Teams need think of their future infrastructure as the foundation of their technology enablement upstream. Thus, it will be inextricably aligned to the future of their clinician experience and patient outcomes. That reliance will require more vigilance with respect to IT’s understanding of the application portfolio to avoid repeating some of the same challenges. Simplifying the legacy application portfolio and consolidating redundant applications will be a crucial step in the process. Adopting SaaS delivery for a larger portion of the portfolio should also help with some of the infrastructure challenges, but present, new needs as well.

So, while infrastructure today may very well be just the stuff that our critical applications are riding on, in the future, it will become critical to the actual care that we deliver and the responsiveness with which we deliver that care. This is especially true with the addition of countless IoT and IoMT devices and increasing use of robotics in clinical applications.

But that does present entirely new challenges. One of the biggest being that moving forward, security must be an integrated component of every decision that’s made at the infrastructure and application layers. So, regardless of where those applications become distributed or where the workloads live, we need to have a level of confidence and scrutiny applied around the security layer – especially as we allow that technology to infuse itself closer and closer to the actual patient in a clinical setting.

How do you see AI factoring into this equation? Which budding solutions related to artificial intelligence or machine learning should healthcare organizations be paying special attention to?

I tend to bucketize AI in a in a few different ways. I think that for health systems that are deeply involved in research, there are virtually endless applications in the life and health sciences areas where AI is going to significantly transform the way that we deal with huge volumes of information and interpret patterns in that information. So, I think on the research side, we can expect to see incredible impacts across a very wide variety of areas in the next decade.

In the near term, there are many impacts that we see on the hospital operations side—think things like improvements in scheduling algorithms, optimized patient routing, sepsis prevention, behavioral patterns analysis, pharmaceutical fraud, waste, abuse, revenue cycle optimization, and so many others. In addition to transforming the way we conduct research, we’re going to see areas where AI starts being applied to teach clinicians, to analyze and optimize surgeries, and hopefully, to ultimately reduce costs and produce better patient outcomes.

What do you see as the number one hurdle for healthcare organizations as they strive for digital maturity?

The life-critical nature of the business can often be an impediment to the infusion of new things. We tend to approach healthcare on a fairly conservative basis in the way that we change or introduce change because the services are so critical from a life-saving or life-altering perspective for patients. And so, the question becomes: ‘how do we balance the infusion of new technology and improvements to clinician and patient experience without degrading or negatively impacting our ability to care for patients?’ I think that’s a huge piece.

The other major hurdle for digital maturity is simply investment. The reality is that hospital systems outside of the top few operate at very thin margins, and financing projects that aren’t successful often generates unnecessary risk and can lead to huge losses in an industry that can’t afford huge losses, especially after the last couple of years. So, I think just getting over the hump and understanding how to rationalize or justify projects and measure the success of those projects—while also understanding the outcomes and how to scale those outcomes—are big challenges for healthcare moving forward.

What metrics should IT leaders in healthcare be looking for as hallmarks of a successful digital transformation effort?

It starts with the consumer. So, looking for feedback mechanisms directly or indirectly from patients in terms of the quality of care they believe that they’re receiving is a great place to start. In other words, I think we should be looking at metrics in terms of the actual healthcare itself. How are we applying digital technologies to not just improve the patient front-end (engagement, scheduling, etc.), but also the results of that care? Are we using it in ways that improve the output and efficiency of those efforts? Anything that can be done to measure that from a population health perspective can be really helpful. Then, operationally, there are metrics abound—whether that means improvements in efficiency, in cycle time, in clinician time with patients, etc. I think that there’s all sorts of potential metrics that exist; it just depends on whether you’re measuring something of an operational or clinical nature.

Further, healthcare leaders shouldn’t be afraid to try to look for those specific business or clinical outcomes to tie to those digital transformation efforts. I say that because all too often, we look at digital projects and we think about IT metrics or technology metrics. What is going to get the hospital system to really accelerate in these situations is to tie those technology or digital investments to patient, clinician, and/or operational improvement for the health system more broadly. Organizations need to align their digital investment more closely to their mission.

At the end of the day, the goal of a health system is to provide the highest possible quality of care to its patients. Which tools or technologies stand to have the greatest impact on the patient experience?

I’ll take three approaches to this.

First, improvements in self-service and scheduling mechanisms that give patients quicker access to in-person care and increase access to specialists will be very impactful. How quickly can a patient get to the specialists who are uniquely qualified to help them with their specific concern? I think the machine learning algorithms and scheduling tools that will be used in this space to provide that level of access will dramatically improve patient outcomes as a side effect of that access. It will also improve utilization and throughput for the hospital system.

Second, the broadening of telemedicine will have a huge implication on rural healthcare across the country. It will help level out access to care and quality of care for people that live beyond a 50-mile radius of a major metropolitan healthcare system.

Third, the explosion of artificial intelligence will generate major advances in precision medicine, reduce human errors, diagnose disease earlier, and dramatically expand our understanding of what is possible in terms of longevity. What may have sounded like science fiction only a couple of years ago may be a reality by 2030, and I couldn’t be more excited to see the impact on healthcare.

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