The Integration Imperative: Realizing a Vision for the Future of Health Care

Dr. Kevin Vigilante is chief medical officer at Booz Allen Hamilton. This article was co-authored with Angela Jones, Digital Health Transformation Program Manager at Booz Allen Hamilton.

In our last article, we noted that many health systems and federal health agencies have understandably become preoccupied with addressing the immediate priorities of the COVID-19 pandemic by accelerating their adoption of telehealth capabilities to circumvent physical limitations of care. in person.

We encouraged healthcare organizations to broaden their view of how today’s technological advances – not only in telehealth, but also in data analytics, digital sensor technologies, 5G networks , artificial intelligence and machine learning, genomic medicine and elsewhere – can transform healthcare as we know it. .

With the right mindset and planning, these rapidly evolving capabilities can transform today’s models of episodic institutional care into new paradigms of patient-centered, data-driven, predictive care delivery. , proactive, personalized and at a lower cost.

This vision of future health care will differ from one health system or agency to another due to the diversity of their missions and constituencies. But a critical key to success is for healthcare organizations to use integration as a key strategic pillar of their approach to modernization.

Why and what is integration in this context? Too often, people think narrowly about integration, seeing it only in technical terms: ensuring that a system can communicate with another system, or that this data can intermix with this data. That is certainly part of it. But it must be much more than that.

Simply put, onboarding is a methodical process that ensures that all aspects of a modernization – including key program offices and relevant stakeholders, clinical and business practices and workflows, technology components, as well as as data and security – are fully understood and optimized for maximum business and mission benefits.

Applying this process effectively will create and deploy new capabilities that enhance and integrate seamlessly with all aspects of their surrounding environments, while minimizing downstream risks and ensuring that modernization is closely aligned with business objectives. of the company.

The task of transformation, even under the best of circumstances, is complex and fraught with risk. Unless it is conducted considering the business needs and mission of all relevant stakeholders in an integrated manner – as well as the needs of the broader business – the benefits and value of the effort will be limited at best.

We believe having an integration mindset is the most critical as it applies to four categories:

Requirements of key stakeholders

The first place to introduce an inclusive mindset is at the point of defining a vision for the future. The successful deployment and integration of new capabilities into the fabric of an organization relies on developing a deep understanding of its systems and culture. This requires bringing all key stakeholders together when defining what the desired future state should look like. They will all have important perspectives and will play key roles in realizing the success of this vision.

Input and consensus from the field are also essential. This requires a user-centered approach to design in which the user, and user needs and wants, are the “north star” for all design and implementation efforts.

There are many users of telehealth and digital care tools. They include patients and their family members who care for them, as well as different members of the provider team – doctors, nurses and health coaches. A continued understanding of customer experience through revolutionized and more interactive real-time methods – such as customer journey maps, advanced data science and AI tools – should inform requirements as the process of transformation evolves.

Important goals here are knowing exactly who needs to be at the table to define requirements, capture the “moments that matter” in the customer journey, analyze and respond to customer experience data, and ensure the broadest degree of buy-in. possible to avoid unforeseen events. downstream impacts.

Clinical and business processes and workflows

The technologies needed to achieve transformational results are here today and are getting better and better. But they are not, on their own, sufficient. If clinical workflows are simply “lifted and moved” when implementing virtual care solutions, they will not realize the potential benefits, result in more work for end users, hinder adoption, and decrease return. on investment.

Healthcare agencies need to rethink clinical and operational pathways and re-choreograph workflows to optimize the benefits of new digital tools while creating more efficient and advanced models of care. This broader vision of patient-centric, data-driven, and value-based care should work seamlessly whether care is delivered in person, virtually, or some combination of the two.

Important goals here are the synchronization of workflows, data, policies, and training at the intersection of team medicine, virtual care, personal care, and traditional visit-based care. Clinical processes, research processes, medical record documentation, scheduling, staff roles and responsibilities, telehealth training, billing processes, and coordination with external partners and stakeholders are part of the processes and workflows that will need to be reviewed and perhaps redesigned.

This assessment should also inform the technical requirements to maintain a user-centric approach where the needs of patients, providers and staff are at the heart of the solution.

Legacy and new technologies

The proliferation of platforms, software, and devices has added complexity to an already tangled web of technology silos aimed at specific diseases and practice areas. Integrating these new technologies into existing IT environments requires a bimodal approach.

Often, innovators are experts in their own technologies but have little understanding of the legacy environments in which their new technology must operate. While new systems are developed and implemented, old systems must continue to provide essential services. A bimodal approach enables technical integrators to understand, support and operate legacy environments while new innovative systems and tools are developed, implemented and integrated.

Additionally, adhering to and developing new standards that promote integration between software, hardware, and large-scale computing platforms enable interoperability, create a seamless healthcare experience for employees and patients. and reduce barriers to the adoption of new innovations.

Important goals are to ensure that technology integration is considered and planned at all levels – from data center and cloud to end users at the point of service – and that it is scalable across the entire enterprise. ‘business. Steps such as integrating customer experience into system-level design; align various platforms through application programming interfaces; and managing new technologies through software development kits helps improve the likelihood of successful technology integration.

Data and information security

The Internet of Things, the foundation of virtual care, is the connectivity of sensors, mobile apps, and medical devices that provide real-time delivery of patient data to inform therapeutic and behavioral intervention. However, the proliferation of telehealth technologies increases the surface area for cyberattacks and introduces significant vulnerability.

In cybernetic language, we call each of these digital tools an “endpoint” and each endpoint is a door through which a cyber adversary can attack. Digital technologies, while bringing enormous benefits, also invite enormous vulnerability that will require much more robust end-to-end secure connected health solutions.

Another important consideration is data interoperability. Being able to harness patient-generated health data through telehealth technologies shifts the paradigm of care from episodic to longitudinal. The patient’s condition can now be assessed in real time, allowing preventive and immediate intervention.

Harnessing these vast amounts of data is essential to delivering the highest quality care, but requires the data to be integrated and standardized so that its value can be harnessed by the analytics and automation powers of machine learning, AI, robotic process automation and other emerging technologies.

Important goals here are the development of solutions with increased security, the adoption of threat-aware approaches in network systems and care delivery, the use of computer engineering and thorough laboratory testing, and applying the right data standards so that disparate data streams can be fully integrated.

In conclusion, onboarding is the process of assembling and realizing the end-to-end image of what you’re trying to achieve – not just the image of a new feature itself, but also of the value business and mission that the feature is intended to deliver. .

By mapping out the necessary integrations across these four areas, health systems and agencies can establish a roadmap that will dramatically improve the odds of successfully achieving the desired transformational goals.