Six Digital Health Insights Revealed at CHIME Fall Forum 2022

Perhaps Ed Marx, CEO of Divurgent and serial health system CIO, said it best at CHIME Fall Forum 2022: “We are in an environment where it’s survival of the Digitalist. If health systems don’t take advantage of Digital Health solutions to thrive and survive, you may be acquired.”

With big tech now in the care delivery market (e.g. see Amazon’s acquisition of One Medical), I don’t think anyone at CHIME this year would disagree. There was endless chatter among CIOs, CDOs, CMIOs and other digital health leaders about how digital transformation is only going to accelerate from here.

Without further ado, here are six key insights from CHIME Fall Forum 2022:

1. 2023 Digital Health priorities: Security reigns supreme, with Quality and Patient Engagement close behind
2. Telemedicine is here to stay and consumer demand is growing, but reimbursement and user experience challenges must be overcome
3. Ambient voice technology is promising and strong organizational culture is key for addressing staff burnout
4. CIOs and CDOs must now be strategic leaders at the forefront of care delivery
5. Tech is the easy part of innovation. Culture and change management are the hard parts
6. Failure must be embraced in your organization’s innovation culture

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1. 2023 Digital Health priorities: Security reigns supreme, with Quality and Patient Engagement close behind

The 2022 CHIME Digital Health Most Wired Survey asked leaders at health systems what their Digital Health priorities are for 2023. The top four answers were:

1. Security
2. Clinical quality and safety
3. Infrastructure
4. Patient engagement

2. Telemedicine is here to stay and consumer demand is growing, but reimbursement and user experience challenges must be overcome

After the boom, regression and plateau of telemedicine in the past two years, digital leaders now have a more balanced perspective on where telemedicine fits in care delivery. Since 2020, we have learned that we cannot treat telehealth like a hammer and think every possible patient encounter should be a nail.

On this note, Dr. Stephanie Lahr, President of Artisight and previous CIO/CMIO of Monument Health argued that “telehealth for the sake of telehealth” is not a real strategy, and that we need to be intentional about using telehealth only for patient encounters where it makes the most sense. Dr. Lahr also brought to light how the current telemedicine experience is often underwhelming and not well-designed for the needs of our patients: “With telehealth we just took the clinic visit and added video. Perhaps we need to re-invent the virtual visit from the ground up to drive adoption and value.”

How do we get more providers and patients adopting telemedicine and digital health? Dr. CT Lin, CMIO of University of Colorado Health, pointed to the current reimbursement models as a barrier: “Fee for service is an obstacle to using telehealth and asynchronous virtual care in a meaningful way.” I have to say I agree with Dr. Lin - continued reliance on fee-for-service models and billing codes to drive digital encounters between providers and patients can create accessibility barriers for patients, or create misaligned incentives for providers.

Although some folks wondered how to get more physicians engaged with telemedicine, Dr. Lyle Berkowitz, CEO of virtual care startup Keycare, is more concerned with fulfilling growing demand: “The problem is not how do we get more doctors to do telehealth. The problem is how to meet consumer demand for virtual care.” Dr. Berkowitz is bullish on the future of telemedicine, and predicts a future where in the same way that we had the term “hospitalists” for inpatient physicians, we will soon have “virtualists” who only perform telemedicine!

3. Ambient voice technology is promising and strong organizational culture is key for addressing staff burnout

With staff shortage and clinician burnout concerns, digital leaders are the most open-minded they have ever been to innovations that improve clinical workflow efficiencies. Ambient voice technology - which most commonly refers to using AI and natural language processing to automate clinical documentation to save clinician time - was the most popular example discussed.

Dr. Alexander Petron, CMIO for Wellspan Health, shared how ambient voice technology has helped his organization improve physician satisfaction. This effort stemmed from Dr. Petron's ambitious vision for leaving technology in the background: “My dream is to get rid of the keyboard and mouse from the patient room. Let’s build the office environment around the provider and patient interaction.” That said, Dr. Petron clarified that while ambient voice technology has improved staff satisfaction and reduced burnout, any benefits to productivity are overstated - it is not as if ambient voice technology has dramatically increased patient throughput.

Beyond technology, the conversation highlighted how organizations that prioritize staff satisfaction in their culture will be the ones that succeed. Dr. Dan Nigrin, CIO for Maine Health, advocated for IT teams to do more in building a collaborative culture: “IT has to do a better job supporting nurses, and ensuring all team members truly feel like they are part of the team”. 

David Davis, President at KLAS Research, says their research among dozens of healthcare organizations finds a strong correlation between high performing cultures at health systems and lower staff turnover.

The importance of organizational culture makes sense. As Dr. Kevin Smith, CEO of UHN once told me: “Higher staff satisfaction leads to higher patient satisfaction.”

4. CIOs and CDOs must now be strategic leaders at the forefront of care delivery

The role of the CIO has evolved, and that’s come with a lot more letters, e.g. CDO, CDIO. In fact, I spoke with a digital leader a few months ago who said he is his organization’s CIO, CDIO and CMIO!

So how do you characterize this evolution? Jeff Sturman, CIO for Memorial Health System, spoke to how CIOs are no longer behind the scenes, and are now increasingly involved with care delivery: “20 years ago the CIO was a back office IT role, not very strategic. Today the CIO / CDO role has not only evolved by name, but has a much bigger focus on Digital, Strategy and Consumerism… Care delivery previously only involved clinicians, but now Digital has a seat at the table!”

How important could Digital be to the future of health systems? Donna Roach, CIO for University of Utah Health, pointed out that CIOs are now increasingly stepping into CEO and COO roles, and bringing their digital DNA with them.

What’s with the emergence of the Chief Digital Officer (CDO) title and role? Tony Ambrozie, Chief Digital and Information Officer for Baptist Health, unpacked how this shift has nothing to do with egos, but more to do with how technology and consumerism must be core competencies for health systems: “CIOs and CDOs are now more strategic leaders in health systems… Because technology is now fundamental to business transformation and care delivery… Digital is about consumer experiences, and the business models and technologies that enable those experiences.”

5. Tech is the easy part of innovation. Culture and change management are the hard parts

In 2021, Dr. Margaret Lozovatsky joined Novant Health as SVP and Chief Health Informatics Officer. So how did she build trust and a high performing culture for Digital Health innovation? In her presentation “Use the Culture to Change the Culture”, Dr. Lozovatsky explored how to build a culture of Digital Health innovation, which is hard to do since culture often varies between clinicians, IT personnel and health system administrators. She shared five steps to enable cultural change that drives healthcare innovation:

1. Surface the culture: Learn the historical context by building relationships and listening.
2. Touch the culture: Introduce low risk, high ROI solutions to old problems. Essentially get your feet wet and build trust.
3. Move the culture: Leverage feedback from initial success and pursue higher-risk, broad-scale efforts. 
4. Measure progress for the culture: Measure success through actual data on progress achieved. Move from being opinion-led to data-led.
5. Establish and nourish momentum: Use leadership and on-going training to keep momentum going.

To build a “digital mindset” in a health system’s culture, Tony Ambrozie, CDIO for Baptist Health, shared how leaders must evangelize digital transformation across the organization: “We must evangelize our strategy to the entire org. We must keep asking how Digital can augment existing processes.”

The importance of culture was echoed by a panel on “Culture Eats (Digital) Strategy for Breakfast” led by Donna Roach (CIO), Dr. Michael Strong (CMIO) and Laura Marquez (Sr. Director for Digital Transformation) from the University of Utah Health. Key to their Digital Health success has been:

1. Formation of a Digital Enablement Committee (DEC): which they (1) kept small, (2) had representation across professions, and (3) focused only on strategy (not tactics).
2. Caring about the total experience of ALL stakeholders: if patients are satisfied but clinicians are miserable, the initiative is not successful!
3. Creating “product teams”: these groups can operate their own “swim lanes” for a digital health initiative, allowing them to be agile and move quickly. However, these product teams still roll up to the Digital Enablement Committee for strategic alignment.

6. Failure must be embraced in your organization’s innovation culture

Most of us have a traditional resume of our successes, but how many of us keep a record of our failures to remind ourselves that success is never a linear path? Emphasizing that change management takes time, Dr. CT Lin, CMIO of University of Colorado Health, shared some brilliant nuggets in his talk “My Failure Resume”. “Resumes in medicine are often similar to social media-curated lives. But failure resumes show a realistic path to career growth", shared Dr. Lin. For example, it was a 16-year journey in change management for Dr. Lin to get his organization to successfully adopt OpenNotes, an initiative where patients can read everything written about them in their medical records.

In order to know if an innovation is failing, Dr. Keith Woeltje, CMIO of Froedtert, advised digital leaders to have clear success criteria, measure progress and act accordingly: “Have clarity on success metrics - and if the innovation is not working, it’s ok to turn it off!” I have a similar concept that I call the “anti-pilot” in healthcare innovation: if you are unsure if an innovation (or even general activity) is value-add, just pilot “turning it off” and see if losing the innovation made a difference - don’t forget, you can always turn it back on!

Especially in 2022 as health systems tackle unprecedented challenges with the pandemic, staff shortages and more, digital leaders must be comfortable switching directions quickly. Theresa Meadows, CIO of Cook Children’s Hospital and CHIME’s CIO of the Year, explained this perfectly: “It’s OK for priorities to change. If the whole team is bought-in to the big picture goal, it’s ok to put innovations on hold and focus on what matters most right now.”

Where will you take your organization’s Digital Health strategy in 2023?

I remain personally excited about the role Digital Care Journeys and Remote Patient Monitoring will play in improving patient engagement, quality and safety - while reducing burden on staff for patient education and keeping patients on track with care pathways. If those topics are top of mind for 2023, let’s connect!

If you’re Interested in learning how digital care journeys hold the key to delivering high-quality, lower-cost care, download our eBook The Role of Digital Care Journeys in a Health System’s Digital Front Door Strategy to read stories from the front lines highlighting how leading health systems are successfully optimizing the patient experience while shortening length of stay, reducing readmissions, and lowering costs.