Episode 64: What Happens If Providers Don’t Embrace Digital?

A lot of provider organizations seem to be operating in fear or denial, but it turns out that they have some advantages over new entrants, according to Jason Lineen, SVP, Consulting Practice Leader at AVIA. In this episode, you’ll learn how innovation happens in smaller organizations, what types of digital transformation need to happen the most, and how vendors can start to build relationships with providers even during a downturn. This conversation is brought to you by Health Connective, custom marketing solutions for med tech and pharma.

Engage With Us

How to listen: shows.pippa.io/paradigm-shift-of-healthcare/howto

Archive of previous episodes: https://www.healthconnectivetech.com/paradigm-shift-of-healthcare/

Follow on Twitter: https://twitter.com/hlthconnective

Full Transcript

Announcer: It’s time to think differently about healthcare. But how do we keep up? The days of yesterday’s medicine are long gone and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans. And many of those humans have unbelievable stories to tell. Here, we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together and hear some amazing stories along the way. Ready for a breath of fresh air? It’s time for your paradigm shift.

Michael: Welcome to the “Paradigm Shift of Healthcare,” and thank you for listening. I’m Michael Roberts here today with my co-hosts Scott Zeitzer and Jared Johnson. On today’s episode, we’re talking with Jason Lineen. He’s the Senior Vice President, Consulting Practice Leader at AVIA. Jason, thanks so much for making time today and coming down to the show with us.

Jason: Wonderful to be here with you virtually. Thank you.

Michael: Absolutely. Absolutely. So, let’s start with a basic question because there’s lots and lots of different ways that people have been answering this, and obviously, people have a few different opinions on the topic. Why do healthcare organizations need to embrace digital transformation and why can’t they keep doing things the same way that they used to?

Jason: Yeah, it’s such a great question. And it’s one at AVIA that, you know, we have the privilege of asking and getting answers from with the many, many health systems across the U.S. that we have the privilege of working with. And, you know, so number one, when I ask hospital health system leadership teams about their digital transformation journey, obviously, they all say that the pandemic has dramatically accelerated their progress. And I’d say prior to the pandemic, most executives would say, “Yeah, we’re doing great. We’ve just implemented a multi-million dollar EMR system. You know, we spent the last decade at digitizing our processes.” Most would kind of stop there, and I’d say that’s just the beginning of the journey. And there’s so much more to be done. And the EMR really represents, obviously, the plumbing to enable true digital transformation.

And then the second and last point I’d say is that it’s really not just about the technology. It’s about the people, the process, the mindset, and the culture of, you know, pioneering new ways to deliver care across all populations and how to also run these immensely complex organizations that we call U.S. health system. So, yeah, at the end of the day, we like to think about digital transformation as, you know, if you were to start your healthcare organization, your health system from scratch today, how would it look like and how would it be different? And that tends to stimulate some interesting conversations.

Michael: So, digital transformation, obviously, can encompass a wide variety of topics there. I mean, you’ve listed off a couple of those things, but, you know, what thing do you see out of all those different ways that a health system can transform, which of those things are most needed? Which are the things that are so desperate to have happened right now? And are they these big massive changes that have to happen or are we looking at a lot of small changes?

Jason: I’ve got an answer and a prediction. So where there’s been the most interest and energy in this topic of digital, I’d say for the last few years has been around enabling the consumer-patient experience. You know, help me find care, help me get care, and do it in a very frictionless way. Everybody wants to deliver the Amazon-like experience for healthcare. We all know that healthcare is immensely more complex than, you know, buying some toys on Black Friday online. So, it’s easy to say, hard to execute. So, the focus on the consumer or the patient has been, you know, very much front and center. Obviously, with the pandemic, every system is trying to deliver care virtually as best as possible.

But to your point, there are many, many other chapters. And my prediction, I’d say the chapter that needs to be developed and will be in earnest is how can we leverage digital technology to enhance life for clinicians, for physicians, for nurses that we’ve asked this year and continue in the middle of this surge right now to do just heroic acts on the day-to-day? And if you’re running a large health system and you’re not building a strategy to enable technology, to reduce administrative burden, to reduce, you know, things like pajama time that we talk about where clinicians are still doing their charting and documentation in the wee hours of the night at home, and, and, and, there’s just immense potential for these new digital technologies to make life better for caregivers.

And I think that we’re going to see lots and lots of investments come in that area on the heels of the pandemic because it’s needed. And there’s so much opportunity for these technologies to really finally chip away and address some of the key challenges that have been driving the topic that we’ve been calling, you know, physician burnout, which was a problem even before the pandemic hit, which obviously has only been really, really exacerbated this year.

Scott: Yeah, it certainly has. I think about the plumbing that was necessary, EMRs, EHRs, and how I’ve spoken to so many providers about, “Oh, you know, I have to do this with the EMR. I have to do this with the EHR.” And I’m kind of excited about the thought process about like, “Okay, now that the plumbing’s in place, you know, what can we do now to make life better for the care provider as well as the patient?” But a lot of provider organizations seem to be operating in fear, you know, or denial maybe based on how hard that transition for EMR and EHRs were. Do you believe, though, that some of these organizations have some advantages over new entrants to the market?

Jason: Yeah. Well, it’s a great question. Well, number one, I’d say there’s probably still a healthy skepticism in U.S. healthcare that technology can be part of the answer. Because if you unpack the burnout challenge, the physician burnout, I think a lot of folks would point to the clunky user interfaces of the EMR that has been a key factor driving burnout. And then, you know, why we had great ambitions for the benefit of digitizing paper records. We’ve actually unintended, but I think given the complexity of our system, you know, we turned clinicians into kind of data clerks and data entry folks clicking and scrolling during what really needs to be a human-to-human interaction during that moment of delivering care in an exam room or in a hospital bed and patient room setting. So, there’s a little bit of skepticism that technology can deliver on the promise.

But I think again, if you see every other area of our lives and how technology has dramatically helped and make life easier, whether it’s doing your banking, managing your portfolio, whether it’s, you know, booking travel, and, and, and, we’ve seen how technology has just made things easier and more accessible. And I think that that’s what this decade will have. And I think there’s clearly a lot of disruptors emerging, you know, whether it’s big tech with their war chest that they’re spending to get into this industry or whether it’s venture-backed companies.

I think the interesting thing is that in my experience and obvious experience, most of those companies, they actually want to partner with the health system because the health systems have something that is incredibly valuable. They have the trust and the presence in a local community. And so, you know, a lot of health systems that we’re working with at AVIA, whether it’s through our membership network where we try to harness ideas and best practices across a collaborative network of like-minded health systems and leadership teams, or whether it’s through our consulting work, here we’re trying to help sort through those really naughty, complex, strategic issues around do I try to build this type of capability on my own? Do I partner? Do I go it alone? And those can be complex decisions for leadership teams to make, but it’s the right discussion to be having, you know, right now at this point in time.

Scott: Yeah. I couldn’t agree more. You know, you talked about how COVID has kind of exacerbated some problems and I think that hopefully, will be a positive outcome of a lot of this that it’s forced people to kind of stop and say, “Wow, you know, we can’t allow this to happen again. We’ve got to think bigger picture.” Because I’m sure that conversation comes up a lot. Like, hey, I’d love to do this. I’d love to think about this, whatever this is, but right now I’m just too busy.

Jason: Yeah, no, absolutely. I call that the tyranny of the day-to-day. You know, and again, I think the average person on the street, maybe this year appreciates it a little bit more when you walk by your local hospital or health system. These literally are the most complex organizations on the face of the earth to run and operate on any given day. And if you layer on, you know, a once in a 100-year pandemic, you know, the job gets that much harder. And as a leadership team member, they really are forced to…they’ve been at launching, you know, incident command centers. And so, you know, just think about what those teams are dealing with right now. So, they’re dealing with a second surge where their bed capacity is basically running out in most markets.

And so, half of their day or more than half of their day is spent dealing with the challenges of the day-to-day. Then the other half there, right now, they’re thinking about how to distribute and administer a vaccine that’s, you know, on its way that requires, you know, a whole host of other challenges to be solved like cold storage and things. So, and this environment today where we’re sitting, it’s kind of a luxury for leadership teams to be able to carve out the time and step back and think longer-term or more strategically about what the organization needs to be prioritizing in a year or two.

Scott: I couldn’t agree with you more. That being said, I hope people are going to take the time, maybe when things start to settle back down about the importance of taking the time to take a look at the bigger picture. I have a friend of mine, a marketing person who I just loved the line he said that, “I keep thinking about trying to work and be in 2022, but they keep pulling me back to 2020.”

Jason: Yeah. It is hard to talk about silver linings in such a tough year. But again, at AVIA, we work with all these health systems that are…and we work with the chief digital officers, the chief strategy officers, chief innovation officers that are really the ambassadors of these new technologies. And, you know, we started the year pre-pandemic where folks had, you know, 5 and 10-year plans to try to drive adoption of telehealth or e-visit capabilities. And all those goals that were 5, 10-year goals have been achieved in five months, right? So, there is this amazing opportunity because just about every health system in the country now has tens of thousands of new digital relationships with their patients, newly engaged digitally. You know, whether it’s even just a sign up from their patient portal, you know, that’s digital engagement, or whether it’s downloading a virtual visit app and, and, and. And so, there’s a tremendous opportunity to now engage all these new digitally-engaged consumers that are really looking for relationships with their providers.

I think the myths that we’ve bumped up against prior to this year that, well, the senior population is not necessarily digitally savvy enough or the poor and vulnerable. I think we finally dispelled all those myths that everybody, regardless of, you know, your age, your insurance type, is really digitally savvy and eager to engage in these new types of technologies to better manage their health or their chronic illness. The flip side though, is we also have to be mindful about bias and equity, and that there is a digital divide, and that there are large parts of the country that still don’t have access to good broadband connections, or the right devices, or a stable Wi-Fi like we’re using now to do this podcast. And so, I think it really needs to be serious thought by political leaders in health systems to really address the digital divide so that as we innovate, we don’t just kind of exacerbate disparities in health and access to health that would exist in the analog world. We want to address those in the digital world as well.

Scott: Yeah. I couldn’t agree with you more. I was thinking about from a demographic perspective, when I first started doing a lot of just basic websites and online marketing, there was always this comeback of like, “Well, there’s just, you know, old people won’t be able to go online. They don’t know how to use a computer.” And I kind of laugh at that because I think I’m an old person now. And that being said, any grandparent that can afford to be online is working really hard to go say hi to their grandchildren. And magically, they figured out how to get online and, you know, FaceTime, Zoom, etc.

But you are right about that income disparity part. It’s a bigger picture kind of thing. It is getting a lot of different people involved in terms of just getting access to this, to all of this that you’re talking about, and I keep calling it “this” because it really does run the gambit. When you think about… You had brought up something really interesting, which was like, you know, if you were going to magically, you know, start your hospital or start your organization tomorrow, how would you get started? You know what I mean? Like, you can just start fresh. You don’t have to, you know, engineer something and patch something, etc. What kind of things would you say to look at for some of those smaller providers?

Jason: Well, we don’t have to have a crystal ball to answer that question. It’s a great one. What we tend to do to stimulate some thinking is to say, “Hey, let’s look at all these amazing venture-backed startups that are reimagining, you know, just take one example, what primary care is?” From venture-backed startups to Amazon, you know, launching what they’re calling Amazon Care and through Amazon Fashion, they’re perfecting Amazon Care with their employee base. And if you think about their ability to scale, right, how many Amazon Prime members are there in the U.S.? You know, something like 60% of households, you know, with a switch, Alexa can say, “Would you like to spend 10 more dollars a year or a month to participate in Amazon Care and have access to a virtual health professional?” You know, just say, yes, it’s as simple as that for them to scale a solution nationally or globally if they want to.

So, you can think about the path to scale, and you can think about the digitally-enabled services and offerings that are emerging to see what consumers and what patients will have access to in the not too distant future. And some of these solutions are out there as well. I think primary care is really the first stop, I think, on the path towards reimagining care models. And then you can really unpack just about every clinical service line from mother/baby to orthopedics, where there will be a digital-first approach.

I’ll give you another good example. There are a bunch of companies and I won’t name names, but there are companies called digital musculoskeletal programs. They’re selling their solution not necessarily direct to consumer, but they’re going direct to employer. And they’re saying, “hey, you know, large employer, probably, you know, maybe half of your employee base on any given year has joint, or back, or neck, or spine issues. Rather than sending them to in-person PT, rather than sending them to maybe an orthopedic group where they might go for a high-cost surgical solution, sign up your employee for an 8 to 10-month kind of virtual course of therapy, where we’ll provide virtual PT, we’ll provide virtual health coaching, etc., and we’ll try to resolve that employee’s pain. And we’ll also address maybe some of the psychosocial or behavioral health challenges that are associated with kind of chronic kind of joint pain, or back, or neck pain.”

And those solutions are scaling really, really quickly. Their value proposition to a large employer is pretty clear that if they can reduce the total medical expense for that population and have them avoid a high-cost surgical encounter, that’s a pretty compelling value proposition. And I think, again, this is another example of where the pandemic has just accelerated these new business models, because folks maybe would be much happier at home going through virtual physical therapy this year than going out to an in-person clinic, a PT clinic where, you know, they might be exposed to COVID. So, you know, lots and lots of examples of kind of digitally-enabled care models that are starting to gain some real traction in the marketplace in an accelerated way because of the pandemic.

Jared: That’s so true. And Jason, when you think about that acceleration happening, I feel like that’s one of the bright spots. It really is. You mentioned that as kind of one of the silver linings. And it is easy to point to. I don’t know anyone who thinks that greater access to more options are bad things. We want people to have the access they need. And when you think about the other aspect of that, really all the things we’ve been talking about transformation itself, but especially when we really get down to new models of care, we’re talking about provider relationships throughout the center of nearly everything and they take time to develop. And usually, they take in-person contact, or, you know, phone calls, or other things which are why this year has certainly been a curveball in that process. When we think about provider relationships, especially for a company like yours or just for anyone out there who is trying to help kind of steer healthcare in a new direction, how do those vendors start to build relationships with providers?

Jason: Yeah, it’s such a great question and a complicated one. For sure, this year, given everything that we talked about earlier, a few things. So, you know, I think number one, you need to start with empathy. You need to really understand folks sitting across the other side of the table or, in this case, you know, sitting across the other side of the Zoom. So, try to empathize and understand what the day-to-day challenges are of a health system or provider organization leadership team that you’re trying to build the relationship with. You can’t properly articulate a value proposition for whatever your solution is or whatever your offering is if you don’t really empathize and understand the problem to be solved or the problem of the day.

You know, and then two, I think you have to do your homework. In non-profit healthcare, there are so many rich sources to understand the local market dynamics that that organization is facing. And that kind of a vanilla approach to building relationships or business development is just not going to work because we have this incredibly rich tapestry of the U.S. healthcare system. And the challenge is in the way an organization is run on the West Coast, where there’s a lot more capitation and there’s delegated risks to provider groups, it’s obviously a very different conversation about what their needs are in terms of a digital solution, or a consulting solution, or what have you than the needs of an organization that is still, you know, solidly in the fee-for-service environment. And there could be two completely different conversations with those leadership teams because they’re just completely different needs.

One other trend that I’ve spotted is that it has been interesting to see that the organizations that have their reimbursement a little bit more linked to capitation or partial capitation, they haven’t had a traumatic disruption in their finances like the organizations that are really still linked to the fee-for-service mode. And obviously, if you’re linked to fee-for-service, you’re linked to volumes. And when those volumes just drop because of an emergency declaration and you’re shutting down your OR suites to free up capacity, that has been a jarring financial jolt that obviously was unpredictable as folks were drawing up their budgets for this year. And so, it’s not lost on me and I think a lot of others in the industry that the systems that had more revenue at risk and partial or full capitation certainly, at least financially, they’ve been able to weather this year much, much better than most.

Jared: So, if you help us understand the role of the vendor in creating that relationship, this sound like you’re seeing how instrumental that is in the success of both sides of this, of the provider ultimately succeeding and providing better care for the patient, but also the provider of that technology, the vendor themselves, the Medtech company, whoever it might be, for both sides to recognize that a relationship is at the core of this. That’s what I’m hearing you say is that there are so many different parts of that, and just recognizing that that is a role in the whole process is key, and if not before than it is even more now.

Jason: Absolutely. Relationship building is I think immensely important. Build trust, credibility. But again, also in respecting the time of folks and doing your homework. And that if you have, you know, a 30-minute window or an hour window to convey kind of what your solution is, you know, make the most of that time by doing your homework before those initial kind of interactions are explored to the right calls.

Michael: Yeah. I think all of us receive a deluge of LinkedIn requests and all that kind of stuff on a daily basis of here’s the solution that we have for you that you just completely know this is going to be a complete waste of our time. But before we wrap up, I want to go back to an idea and ask a little bit more about, you know, we’re talking about these very large health organizations and really interesting, you know, discrepancy that you’re talking about in terms of, like, whether they are funded this way or they’re funded that way and on how they can manage these kinds of things. And you see the way that organizations like Amazon can jump into healthcare, the people that have, I’ll just say stacks and stacks of cash on hand to jump into these kinds of things. What about these smaller organizations, the healthcare organizations that are out there, maybe the ones that are in rural areas or haven’t reached that size in scale yet. What does digital transformation look like in these kinds of groups?

Jason: Yeah, it’s such a great question. It’s one that we think a lot about at AVIA. And just to give you a quick kind of history of AVIA, really one of the reasons why AVIA was created, our co-founders acknowledge that, number one, you know, digital has disrupted every other industry but healthcare and it’s coming in healthcare, even if it’s on a little bit of a slower timeline. And the thought was, how can we create a company that can really help empower provider groups of all sizes, big and small, to participate and benefit from digital? And acknowledging that even the biggest hospitals and health systems to the smallest that are blessed with balance sheets, you know, like a Google or an Amazon where they can kind of spray capital around on moonshots and hope that a few pan out.

So, in that environment of really tight capital budgets, even tighter this year, building a membership network that can identify winning strategies, winning companies, winning digital solutions that really move the needle, that enhance the consumer experience, that enhance the experience for clinicians, that drive operational efficiency, etc., you know, that’s the goal. And I think that’s the path forward because there are so many tremendous innovations out there. But it’s really hard if you’re sitting in a small, critical access hospital and you have no staff, you have no budget to identify, you know, what’s the right strategy? What are the right set of solutions? I think the answer has gotta be collaboration in the industry. And we can serve in some small way at AVIA to help facilitate that collaboration and identify really the initiatives that can move the needle for those scarce capital dollars that provider organizations have available. That’s what we’re aiming to do.

Michael: Awesome. Awesome. I love it. Jason, thank you so much. We could go on and on about this stuff. I just really appreciate your time today. And we just thank everybody for listening today and have a great weekend everyone.

Jason: Pleasure to be on the podcast. Thank you.

Announcer: Thanks again for tuning into the “Paradigm Shift of Healthcare.” This program is brought to you by Health Connective, custom marketing solutions for Medtech and pharma. Subscribe on Apple Podcasts, Google Play, or anywhere you listen to podcasts.