How to Make IT the Underpinning of the Enterprise Strategy

Transcription

1 How to Make IT the Underpinning of the Enterprise Strategy Session #146 February 22, John Ward, CIO TriHealth Bob Schwyn, Director The Chartis Group

2 Speaker Introductions John Ward, CIO Chief Information Officer TriHealth Bob Schwyn Director The Chartis Group 2

3 Conflict of Interest John Ward and Bob Schwyn: Have no real or apparent conflicts of interest to report. 3

4 Agenda A Case for Change: Making IT an Instrumental Underpinning of the Enterprise Strategy From Theory to Action A Case Study Lessons Learned and Key Considerations 4

5 Learning Objectives Describe how and why IT can and should become a leading component in setting an organization's business strategy. Explain why the process matters and describe the specific steps to take. Describe IT's role and key steps the CIO can take in guiding and steering strategy conversations. Use this case study example in one's own organization. 5

6 An Introduction of How Benefits Were Realized for the Value of Health IT Satisfaction: The experience and satisfaction of the patients, employees and physicians of the provider organization were addressed to ensure a level of preeminent satisfaction in TriHealth s market arena Treatment: Significant investment in EHR technology and the opportunity to build a high-performing informatics capability drove improvements in care delivery outcomes and reduced clinical variation Electronic Secure Data: TriHealth s positioning for a best practice security structure and environment was critical in developing the objectives of the plan Patient Engagement: Recognized the importance of analytics, technology-enabled patient engagement and EHR capabilities to support an aggressive movement into a value-based environment Savings: Ensured a strong value proposition to offset increased investments in technology to make certain the organization was making the right decisions at the right time, and at the lowest cost 6

7 Agenda A Case for Change: Making IT an Instrumental Underpinning of the Enterprise Strategy From Theory to Action A Case Study Lessons Learned and Key Considerations 7

8 Industry Point of View The healthcare industry is in the midst of a multi-faceted shift that is fundamentally changing the context in which providers deliver care. Rise of the Consumer Migration to Value Technology Advancements Strategic Implications The role of the provider is being transformed and will continue to evolve over the next 10 years. Business strategy and information and technology strategy are increasingly merging into one. 8

9 Access to Care Industry Point of View Expanding Role of the Healthcare Provider Care Needs Education Intervention Direct Care Wellness Care Chronic Care Acute Care Informatics & Technology Driven Informatics & Technology Enabled Expanded Provider Role: Proactive, health management oriented delivery of services and information Historic Provider Role: Reactive, illnessdriven delivery of services 9

10 An Illustrative Roadmap: Understanding where are we and where are we headed based on industry perspectives By investing in new initiatives to transform care delivery, provider organizations can build upon its core technologies to provide just-in-time, personalized care in any location. What are the strategic functions to the new business model? Just-In-time Personalized Care Patient Engagement EHR Touch Points Pop Care Circle of Support Clinical Decision Support Analytics Telehealth Efficient Operations * Roadmap reflects full scale production deployments and in many cases, pilots are underway pending development of enterprise strategies Strengthen core technologies Transform care delivery 10 Real-time, personalized care wherever the location

11 Foundational IT and Core Clinical Technologies Innovative Care Model Technologies Population Health Capabilities The Role of Health IT in Southwest OH Provider 1 Provider 2 Provider 3 Provider 4 Provider 5 Undeveloped Growing Competency Key Business Driver Consumer Engagement Tools IT Innovation 11

12 Agenda A Case for Change: Making IT an Instrumental Underpinning of the Enterprise Strategy From Theory to Action A Case Study Lessons Learned and Key Considerations 12

13 How We Did It The Process is Important System Strategic Plan Establish a shared understanding of the external environment, emerging healthcare trends and consumer dynamics, and TriHealth s current strategic positioning. Define a realistic set of future scenarios for the region over the next 5-10 years to identify and assess TriHealth s strategic options. Refine and clarify TriHealth s strategic vision, priorities and underlying business models to continue to advance our strategic position and effectively serve our communities in a rapidly-evolving healthcare landscape. IS Strategic Plan Assess the current state of TriHealth s IS environment including external market trends, future IS scenarios, and internal capabilities. Develop a long-range vision for IS that supports TriHealth s overarching strategic direction including IS mission, guiding principles, and priorities. Conduct a detailed review of IS organizational structure, governance structure, and management structure. Develop a multi-year IS strategic roadmap with prioritized initiatives to support the vision and identified investments, capabilities and timelines for each initiative. 13

14 IS Strategic Plan System Strategic Plan Timeline June July Aug Sept Oct Nov Dec Jan Feb Mar Current State & Env. Assessment Engagement Phase Future Scenarios & Strategic Options Strategy Formulation & Plan Design Major Activities Stakeholder interviews (combined) Macro-trends assessment Regional / competitive landscape Internal SWOT analysis Key questions for strategy development Future market scenarios and TH roles Case studies Options assessment and prioritization TriHealth preferred future state Strategic vision, enterprise goals and initiatives Financial model System Strategy Steering Committee #1 #2 #3 #4 #5 Board of Trustees Update 7/16 Update Nov. Bd Retreat Update Mar. Plan Approval Physician Strategy Advisory Council #1 #2 #3 #4 Work Groups WG A/B WG C/D #1 #2 #3 #4 #1 #2 #3 #4 Interviews Engagement Phase x x x x x x Mid-July through Mid-August IT Assessment Support IT Scenarios & Provide Education IT Strategy & Plan Development Major Activities IT current state assessment, including structure, governance, architecture, vendors and processes Support enterprise work groups Education / workshops IT vision, direction and principles Optimal IT Governance IT sourcing options and cost models Staffing, timeline and implications IS Steering Committee Initial ISSC ISSC #1 ISSC #2 ISSC #3 ISSC #4 Work Groups WG E/F #1 #2

15 The Evolving Market National Trends Growing consumer role in managing health, healthcare services and information Growing commoditization of healthcare Shift from defined benefit to defined contribution model and increased individual financial risk Evolution from volume-based to value-based/risk-based reimbursement models Payor-provider convergence Downward reimbursement and utilization trend Accelerating technological advances in diagnostics and therapeutics 15

16 The Evolving Market Highly fragmented market Slow to move from volume-based to value-based care Why Is This Important Favorable overall business environment Competitive payor environment Push the market increasingly toward value 16

17 Implications of the Evolving Market Likely Market Evolution Implications for TriHealth Payor market consolidation and downward reimbursement pressure High historical rate increases will not continue Shift towards value-based payments Accelerating downward trend in hospital utilization, shift in site of service towards lower-cost settings Movement from a highly-fragmented to consolidated provider landscape Fewer remaining accretive opportunities outside of largescale system-to-system partnerships or mergers Dramatic slowdown in physician consolidation activity Growing demand for consumer and digital capabilities Future growth of physician network will be more challenging Recognize IT is no longer just a business enabler but has significant potential to accelerate business strategy and differentiate services in the market 17

18 Key Areas of Focus Enterprise Strategic Plan Network Strategy Clinical Program Differentiation Consumer Engagement Care Model Innovation Population Health and Payor Strategy Telehealth Value Realization IS Strategic Plan IS Infrastructure IS Structure and Governance Service Management and Processes 18

19 Preparing for the Future How Will Our Future Strategy Be Different Than the Past? Strategy the Next 5 Years Population-based and cross-continuum care Risk-based payment environment Consumer-facing and patient-centric strategy The Future for IS Insightful, prescriptive business intelligence Care collaboration tools Increased data volume and complexity More dynamic information sharing agreements Predictive analytics Virtual care delivery via smartphones, Apple CareKit, Fitbits Robust security, performance Market relevance = high-value, efficient, and effective system of care Market relevance = quality of the Digital Health experience. Healthcare services via online and mobile (i.e., Yelp, Uber) 19

20 Integrated System of Care Securing Our Strength in the Current Environment While Transforming to Position For the Future Population Health Management Regional Market Strength TriHealth Innovation Consumer- Focused System Aligned & Engaged Physician Community High-Performing Patient-Centric Culture Operational Excellence Enabling IT Platform 20

21 Tactics Services Strategic Initiatives Vision Aligning IS Services Physicians, hospitals and communities working together to help you live better. Integrated System of Care Regional Market Strength Aligned & Engaged Physician Community Population Health Management Innovation Consumer-Focused System PMO Services Analytics/Data Integration Clinical Informatics Clinical Solutions Business/Finance Solutions Security Infrastructure Core Projects Foundation Projects Discretionary Projects Directly support TriHealth s strategic initiatives and pillars Required to maintain existing IS service levels All other projects not defined as Core or Foundation 21

22 Assessment Findings What We've Done Well Where the Opportunities Are Value Meaningful Use Project Management our IS strategic imperatives for the last Clinical Informatics Governance Consumerism 22

23 Supporting the Strategy: The IS Work Group Charge Focus Area Clinical Informatics Project Management Service Management BI & Analytics Governance Redesign Proposed Objective Develop plan and build CI program framework, including required capabilities and resources, and clarify CI processes and project prioritization. Develop plan and build project and portfolio management framework, including required capabilities and resources, and standardize IS project approach oriented around value achievement. Develop and implement a plan to improve service delivery within IS with focus on Incident and Problem Management, Continuity Management and Service Requests. Define approach to address gaps in enterprise analytics and information needs (e.g., full-patient view, cost-of-care analytics, claims, etc.) in collaboration with BI functions across the organization. Revise guiding principles with orientation toward value realization and review and refine work group charters, roles, and responsibilities to streamline IS governance. Building a High-Performing IS Leadership Team IS Roadmap (Project and service definitions; timing, budget, FTEs, etc.) 23

24 Focus on Realizing Value Strengthen IS foundation IS project portfolio alignment with strategic initiatives and pillars New IS projects now evaluated by business value The continued focus on business value is transitioned from project to operations Implementing robust IT Service Management program Build culture of excellence and innovation Create a robust planning process Integrated 2. Aligned & 3. Regional 4. Population 5. Innovation 6. Consumer- System of Care Engaged Market Strength Health Focused System 1.1 Operating model re-design 2.1 Development of a 3.1 Streamlined referral 4.1 Set in motion a multi-year 5.1 Develop the organizational 6.1 Prioritize key consumer regional, care continuum TriHealth system physician processes/transfer center to payor contract transition structure and operating model segments and conduct structure leadership council and our tertiary hospitals strategy from fee-for-service for the TriHealth Innovation research to understand expanded large-scale to value-based reimbursement Center motivations, needs and 1.2 Ambulatory care 2.2 TriHealth Physician 3.2 Differentiated site-specific 4.2. Develop incentive based 5.2 Elevate TriHealth s 6.2 Enhance consumers' partnership and alignment Partners (TPP) structure, tertiary programs (e.g., compensation design that research and education access to care, information strategy governance and operating Perinatal Services at Good meets current and future capabilities, including the and education, tailored to model, with supporting Samaritan and Multispecialty practice needs and aligns with Hatton Research Institute, meet their unique health 1.3 Create network of 2.3 Service line development 3.3 Deploy primary care and 4.3. Develop and implement a 5.3 Implement Director-Led 6.3 Develop and adopt virtual preferred post-acute care strategy including selected specialists at our bridge strategy for population Action Councils to engage our and on-demand care options partners development of multispecialty care models and ambulatory centers, and capabilities until (and if) and improvement from the community hospitals, health data analytics and IT workforce to drive innovation 1.4 Next-stage ambulatory 2.4. Use the TriHealth PHO to 3.4 Accelerate recruitment of 4.4. Organize all population 5.4 Prioritize and implement a 6.4 Provide transparent and development deploying a advance physician alignment primary care physicians and health management functions select set of care model redesign initiatives for satisfaction, and key accurate cost, patient scalable multi-specialty strategy with key remaining hard-to-find, high-demand into a re-designed Office of ambulatory model (e.g., independent physician groups specialists Population Health 2017 outcomes measures at the 1.5 Service excellence and 3.5 Enhance primary care 4.5. Align the Employee Health 5.5 Activate a system-wide 6.5 Expand wellness and patient experience initiative capacity through care model Program directly with leadership development preventative care resources and operations redesign Corporate Health and program (including use of advance population health programs 1.6 Retain and grow patients 3.6 Evaluate partnerships with 4.6 Align the Employee Health within TriHealth's Integrated local health systems and Program directly with Delivery System through providers looking for Corporate Health and referral management opportunities to expand or population health programs 1.7 Develop comprehensive 3.7 Gain access to new 4.7 Create and implement foundation of behavioral markets through direct-to-employer strategy health services regional/statewide targeted at regional employers relationships (e.g., CHI, 3.8 Effectively utilize 4.8 Redefine local market ambulatory surgery, joint contracting strategy procedural, and diagnostic articulating the role of HSN assets to provide accessible, and other potential system 3.9 Re-design specialist access 4.9 Continued evaluation of to accelerate growth and MHC relationship retain specialty care within the system 4.10 Develop Medicaid strategy

25 Foundational Technology Services An Evolving Illustrative IS Roadmap: Guiding the Organization Towards the Critical Technology Underpinnings of the Enterprise Strategy By investing in new initiatives to transform care delivery, provider organizations can build upon its core technologies to provide just-in-time, personalized care in any location. EHR, Ancillary Applications & Clinical Decision Support Standardized physician documentation Enterprise imaging strategy Surescripts Med Benefits coverage Analytics Patient 360, Operational 360 & Member 360 Pop Health 2.0 Data Governance NLP predictive analytics Physician briefing book Standardized leadership tools Telehealth Video visits EICU Virtual consults/ care expansion evisit expansion Mobility Rural telemedicine plan Efficient operations Big data Clinical Informatics Care model redesign Centralized contact center Clinical informatics program Epic credit card billing Operational improvement Enhanced Business Operating Model, Processes and Organization Patient Engagement Consumer engagement mobile development Patient portal IoT and device integration Family billing Expanded care access Telemedicine Physician finder and online scheduling Just-In-time Personalized Care Predictive and prescriptive analytics Care model redesigned Clinical trials Expanded interoperability Data center plan Enterprise master patient index (EMPI) Voice and network infrastructure upgrades; contact center support and ACD System refresh; zero client implementation IT service management Storage as a service IT governance and prioritization Cloud

26 Agenda A Case for Change: Making IT an Instrumental Underpinning of the Enterprise Strategy From Theory to Action A Case Study Lessons Learned and Key Considerations 26

27 Summary of Benefits IT incorporated as part of the enterprise plan Increased CIO role recognition at the leadership level Executive recognition of importance of IT planning Set a precedent and integrated framework for planning Enhanced education, innovation, industry perspectives Increased level of IT maturity 27

28 Capability Maturity Progression A comprehensive IS roadmap that was well vetted and aligned to the enterprise strategy A new clinical informatics structure with targeted objectives to improve care delivery Increased definition and measures for value achievement for each project An aligned analytics roadmap to support the evolving enterprise strategy Restructured the governance design to ensure the IS portfolio was focused on the right things at the right time, achieving the desired value Restructured the IS leadership team positioned to support the future demands and requirements of the organization 28

29 Capability Maturity SIGNIFICANT PROGRESS made in each area: = Start of the planning process = Today Focus Area IS Roadmap Clinical Informatics Project Management Service Management BI & Analytics Governance Redesign Building a High Performance IS Team Low Maturity - Opportunity High Maturity - Industry Leader 29

30 A Summary of How Benefits Were Realized for the Value of Health IT Satisfaction: The experience and satisfaction of the patients, employees and physicians of the provider organization were addressed to ensure a level of preeminent satisfaction in TriHealth s market arena Treatment: Significant investment in EHR technology and the opportunity to build a high-performing informatics capability drove improvements in care delivery outcomes and reduced clinical variation Electronic Secure Data: TriHealth s positioning for a best practice security structure and environment was critical in developing the objectives of the plan Patient Engagement: Recognized the importance of analytics, technology-enabled patient engagement and EHR capabilities to support an aggressive movement into a value-based environment Savings: Ensured a strong value proposition to offset increased investments in technology to make certain the organization was making the right decisions at the right time, and at the lowest cost 30