This article was originally published in Becker’s Hospital Review.

Across the health IT industry, leaders are balancing pressing concerns like increasing call volume and the need to maximize revenue with limited resources. And nice-to-have initiatives just don’t cut it anymore, with those that don’t drive revenue left on the cutting room floor. So how do you balance building for the long term with the pressures you’re managing right now? 

In the webcast Digital Health: On Air, leaders in a variety of roles have shared the challenges they’re facing – and the strategies they use to achieve success in spite of them. Here are some of their takeaways: 

Take an incremental approach 

In healthcare, “change can be very, very challenging,” says Arz Raheem, Sr. Director of Digital Transformation at Montefiore Health System. “[But] I think, after many years, healthcare is open to the change that is needed. And even if that’s iterative, that’s fine.” 

Investing in a large-scale transformation project might be off the table for your organization right now. That’s okay, according to Raheem and Tarun Kapoor, MD, Chief Digital Transformation Officer at Virtua Health. And it can even be an asset. 

“In our hypercompetitive market, speed to impact is worth a lot,” says Kapoor. “And so you have to think about, ‘What is the problem that the consumer is facing in this specific situation? How can I make them successful?’” 

At Virtua Health, Kapoor’s iterative approach created real clinical impact. Realizing that some patients weren’t responding to colonoscopy reminder outreach, he took a step back. “Traditionally, we say, ‘you have a care gap. Come into the office so we can talk to you about this care gap.’ Instead, we said, ‘we know you might not have time to come in right now. Can you do a Cologuard® test at home?” After this more tailored outreach to a specific subset of patients, Virtua Health got thousands of home tests back and found nearly 300 patients with positive results. 

Instead of taking months to work toward a larger project and hit a number of defined milestones, Raheem says, he’s also seen results from an agile approach where projects are smaller-scale and can be expanded later, if they’re successful. An important caveat: “Be brave enough to kill it if there’s no value.” 

Bring varied stakeholders to the table 

So, what’s the most important ingredient in this iterative approach?

“We try and find people from operations; finance; security; compliance and legal; who are open to change, who can be our champions,” says Raheem. “[Then] we can take good ideas from ideation to implementation and make sure that we’re creating value,” he says. 

Gathering this multi-stakeholder group and approaching challenges from this lens requires a culture shift, says Raheem, from the traditional health IT implementation model. 

“Technology has had, in my opinion, a culture of more preservation and maintenance. I say, ‘I’m going to try small things. I think I’m onto something and want to show you what I’ve got.’ But if you don’t have the right support, great ideas will die on the vine.” 

At the same time, this “coalition of the willing” across different areas of expertise is especially important for Raheem, who serves one of the country’s leading academic medical centers, to avoid introducing risk with an agile approach. 

“We’re agile, but we have to be extremely careful about how we implement change and how we’re introducing new technologies because we’re in an environment that is heavily regulated,” he says. So, “if you don’t have that support, then speed to impact doesn’t really happen.” 

Pinpoint your pain points 

Another way to create outsize success? Pinpoint very specific use cases for new technology, like Main Line Health. 

First, Main Line Health identified that their call volume was too high for staff to handle. Having already successfully transitioned to a centralized call center and offloaded some calls to an external resource, they needed another lever to help patients get to the right place without waiting on hold. 

Next, they identified that a majority of incoming calls were to schedule mammograms and DEXA scans. “The largest service line supported by central scheduling is radiology and imaging,” said Noreen Friel, Director of Call Center Operations. “And we’ve been trying to increase access to our digital front door and enable patients to schedule themselves.” With a defined scope of the types of calls they wanted to assist with self-service, they were able to quickly add a call-to-self service workflow for patients that would allow scheduling for mammograms and DEXA scans by SMS if the patient desired. 

Since adding in the self-service option for these types of calls, Main Line Health has saved 900+ hours in a single year while still getting patients what they need. Pointing to the success of the project, Friel says: “We already had self-scheduling, and we kept it pretty simple. So it was implemented very fast.” 

Look for hidden barriers

As your health system is evaluating what’s necessary for the short-term and where to focus for the long term, Elizabeth Woodcock, DrPH, MBA, FACMPE, CPC, founder and executive director of the Patient Access Collaborative, encourages looking for hidden access barriers. 

Hidden barriers, says Woodcock, exist throughout the patient experience and can often be resolved to create more equitable and smooth access to care. These barriers could include:

Better patient access or transformation of the experience doesn’t have to be out of reach if your health system is focused on containing costs through this year and next. Consider low-cost changes that could address these hidden barriers, such as: 

Woodcock says that the number one best tool leaders can have for transforming patient access is to “really, really listen.” And as part of this listening, understand that finding hidden barriers requires more creative thinking than simply consulting patient feedback surveys, as these are often a “biased sample” of only patients who have been reached in the right way and in the right language, Woodcock says. 

Ultimately, Woodcock points out, searching for and addressing hidden barriers is worth it. “Our most vulnerable patients’ voices are not being heard. And because of that, they’re fighting to get in our system.” 

Take a look at cybersecurity basics 

The rising threat of cyberattacks means it’s impossible to focus on iterative, impactful changes without a strong security infrastructure. And the very digital transformation that helps create these changes creates more risk, according to security expert Brent Williams. 

“Healthcare is a target-rich environment,” he says. “Think about the datasets that are out there – it’s really powerful in terms of stealing identities. In the last 10 years, malicious actors have definitely noticed that, as the digital aspect of the healthcare business continues to grow.”

A core component of a secure health system, according to Williams, is a company culture of security. “The term I use is ‘business as usual.’ Security, when it’s done well, should just be part of the fabric of your processes, your technology, your business,” he says. To enable this culture, he recommends: 

“It’s the same weaknesses over and over,” like unprotected VPN endpoints or login pages, that lead to significant cyberattacks, says Williams. “So I keep coming back to the basics.” And over time, Williams says, “the team starts to get a bias toward, ‘oh, this is working well.’” 

While the added scrutiny needed for cybersecurity at today’s health systems can be stressful, says Williams, this basic hygiene can protect against costly and disruptive cyberattacks and allow your health system to focus on other impactful initiatives. 

Conclusions 

The CIO is at the center of a number of challenges, from serving more patients with fewer staff to remaining competitive without overspending on expensive digital tools. But amidst these challenges, you’re still responsible for directing your organization toward long-term success. 

The experts featured in season 1 of Digital Health: On Air are creating immediate impact with long-term potential with: 

If you’re interested in topics like these or would like to hear more from these speakers, follow Digital Health: On Air on Spotify or subscribe for a monthly episode digest.

The statistics are unavoidable–the United States faces a healthcare talent shortage of up to 124,000 physicians by 2034 according to the Association of American Medical Colleges. According to a recent Definitive Healthcare report, since 2020, one in five healthcare workers have quit their jobs, suggesting “up to 47% of healthcare workers plan to leave their positions by 2025.” 

Recently, the Luma Health team met with Dr. Dan Vicencio, interim Chief Medical Officer and practicing physician at Near North Health, to learn more about how the Chicago-area FQHC system is navigating the current healthcare staffing shortage while maintaining mission-critical care. 

Luma Health: Near North has a mission to provide “culturally competent care.” What does that look like in practice? 

Dr. Dan Vicencio: To provide culturally competent care, we have a diverse staff, because it is important to have our care team and staff represent the community we serve. Second thing is to have information in multiple languages wherever possible. We have well over fifteen languages that we speak in the course of a given day with patients across Chicago – everything from Polish on the West Side, to Spanish, which is all over the city, to West African languages here in the South Side. 

LH: The state of Illinois’ official COVID-19 public health emergency status is officially ending next month, May 2023. What challenges are you facing post-pandemic?

DV: We are looking at getting a lot of our patients back into care. COVID-19 really disconnected us from our patients, and so we’re using many different avenues to get patients back into a system of care that they can trust and access readily. We find that a lot of our patients have been using telephones as their main mode of information. Letters are a thing of the past now.

Luma Health is one of the things that we’ve been using to get them back into care. The ability to reach all our patients on their phones is increasingly more important. 

LH: How have post-pandemic staffing shortages impacted Near North? 

DV: A good number of providers did not return to medicine after COVID because of burnout or not being in a place where they felt comfortable applying their trade as a healer. 

We as a healthcare system must find avenues to provide providers and staff with the time to just do what they do best, which is evaluate, diagnose, and treat patients.

We are trying to create that environment to better support providers and staff.  

LH: Does Luma help create that environment? 

DV: ​​Luma definitely helps address some of the staffing shortages that we’ve experienced. Not only does it help cut down on the amount of calls that go to our call center, but our patients now have access to reschedule and cancel those appointments any time of day. So instead of calling us after hours and getting a call center, they actually can get a text and a link from us to schedule.

In the old days, we would’ve had one person making phone call after phone call to reach patients. Now, Luma can reach out to a whole group of patients and give them the same message. And that consistent messaging is key, especially for attribution lists or gaps in care follow-ups. You don’t have that potential off-script variation in message that you would get with a person making manual calls.

Luma makes it as simple as possible to get our points across. The provider has another avenue to automatically reach the patient with important reminders like, “Hey, you need to come back for your three month checkup,” or “You need to make sure that you get your appropriate preventive care screenings.”

LH: What’s another Luma solution that has helped make life easier for your staff? 

DV: Broadcast! This is Chicago. We get a foot of snow sometimes.  With Luma, we can immediately reach out to staff and patients with weather closure information to keep everyone safe.  

Are you an FQHC interested in learning how Luma’s Patient Success Platform might integrate into your workflows? Schedule a 1:1 with a Luma squad member here.