Health-tech KOL Janae Sharp serves up advice for cutting-edge healthcare leaders.
Leaders came to Health 2.0’s annual fall conference in California last week to learn. The message of the conference was aspirational and focused on the potential of healthcare to make major changes down the line. But healthcare leadership has some important technology decisions about its future to make today.
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Here are six takeaways from Health 2.0 that can help innovators and decision makers navigate the road ahead.
No one likes to have hard conversations. When people learn I have three children and ask what their father does, I consider my options: Sometimes I quickly say he passed away. I want to give space to respect if the other person has suffered loss. But sometimes I just want to move on in the conversation without having to say the word “suicide.”
In healthcare, there are many uncomfortable conversations we need to have about systemic discrimination. I was honored to join Robyn Simon and Paul Puri, M.D. on a panel about physician suicide. When my husband John — a physician — died by suicide, I was so angry about how people treated my children. They weren’t supported by the community with nearly as much love as I had hoped they would be. I wanted John’s family to be more involved in their lives, but I didn’t know how to have that conversation, and I wasn’t even sure if doing so would make things better for my kids.
This year, Health 2.0 featured Robyn Simon’s film, “Do No Harm,” about physician suicide and the culture of healthcare. The film forces us to ask these questions: Are we creating an emotionally healthy workforce for doctors? And are we perhaps avoiding dealing with the most difficult problems?
So many issues in healthcare, such as eating disorders, addiction and physician suicide, lie in a difficult space, forcing us to have conversations that are uncomfortable. But as a community, we don’t know how to start them. One of the things that healthcare leaders can learn from Health 2.0 is the importance of discussing topics that are “unmentionables.” Difficult conversations don’t have themselves.
Today we’ll dive into the “unacceptables” — frontier issues so heinous and relatively unaddressed that they demand greater attention, too #health2con pic.twitter.com/32U0ZpGtKw
— Lygeia Ricciardi (@Lygeia) September 18, 2018
On the Sunday evening of the conference, I was standing near the sushi table when I recognized Carla Smith, a HIMSS executive vice president involved with Women in Health IT event. She had a small plate with a few pieces of sushi on it. I noticed she didn’t eat what was on her plate as she came to join the small circle of healthcare startups that I was in, schmoozing. I watched how she networked: At the Startup Health event, she circulated through the crowd and asked attendees what they did and why. She approached a group called meiny mo, a Startup Health company, which is working on augmented reality medical solutions for children, and asked, “What are you passionate about?” Carla told them that she was there to learn from others. I saw her circulating through the crowd and asking for stories that night and later between sessions.
At Health 2.0, leadership from HIMSS and other organizations interacted in a more informal way than they have at other events I’ve attended. I enjoyed seeing Hal Wolff, president and CEO of HIMSS, connect with his new head of corporate messaging and meeting patients. At most conferences, leadership is very strategic about every minute of their time. The strategy of Heath 2.0 seemed to be listening.
There were so many leaders at Health 2.0 from Silicon Valley and healthcare investment. I was impressed with Wende Hutton from Canaan Partners, who has more than 20 years of experience in investing. I asked her why she attended, and she said that a key to leadership success is inviting the people whom you want to contribute to the table. Health 2.0 was full of leaders who wanted to learn. The leadership conversations not on the schedule are the most valuable part of a healthcare conference.
The Digital Doctor of the Future was in residence at Health 2.0.
Andrew Chacko, M.D., addressed the idea of the “physician of the future” during his panel, saying, “The real future for healthcare lies in the symbiotic relationship between clinicians and technology — where tech helps us to do our jobs even better and focus on what we enjoy — which is what patients really want.”
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HIMSS’ Smith said one of the great questions of Health 2.0 was how to ameliorate the workplace for physicians. There is so much dialogue about artificial intelligence and radiology, but these discussions are not new. With developments in technology and systems, the workforce will also change. What is healthcare doing to repurpose and retrain the talent we have? We don’t want to disincentivize smart people like radiologists to leave the system as fewer positions and more digital tools to identify disease become available; we need them to bring value. Smith asked, “Should we be training virtualists in medicine? We don’t want them to lose their jobs. We need smart people, and we need a lot of them — we just need them in different places.”
Innovation is necessary to retain talent in medicine and adjust to advances in technology. Healthcare is notorious for a lack of agility and being late adopters of technology. In cases like Theranos, we can see that this hesitation can be warranted. Progress and technology as a strategic imperative was a main takeaway from Health 2.0.
Rasu Shrestha, M.D., MBA, chief innovation officer for the University of Pittsburgh Medical Center, gave a keynote on the importance of innovation as a technology imperative: “Healthcare leaders should get real about innovation and how this aligns with the overall strategy of their organizations. Innovation is not just a cool thing to do anymore. It’s the only way to make meaningful progress and avoid becoming irrelevant.”
What is true innovation? Shahid Shah, publisher for Netspective Media, argued that healthcare doesn’t always know. “If I am already doing something today that is improving productivity, that is an operational excellences project. It should not be confused which innovation,” he said.
If you are already involved in a process but find a way to make it more effective, that is process improvement. Very little of what we see in the healthcare marketplace today moves beyond where it is now, to operational excellence. Innovation means that, if you fail, there is something you can’t do today, not that you are less effective in operations. Improving billing effectiveness doesn’t actually mean innovation. Healthcare is notoriously risk averse, but the questions boil down to whether we are willing to try truly new things and a new way of working together.
Productivity does not actually mean innovation. The only innovation happening in healthcare is in new business models. For example, if a hospital shuts down its brick-and-mortar primary care and instead provides these services through telemedicine, that is a new business model. A lot of hospitals are doing care coordination, but they are not the best care coordinators. They need to empower their physicians to do what they are best at, using technology and new business models that enable expertise. Big innovations in business models of care delivery are the future.
The vertical players in healthcare, like Cerner and Epic, and healthcare-specific analytics ventures — the ones doing custom solutions, working only in healthcare — are facing trouble. They have the most to worry about because horizontal players like Google, Apple and Verizon are starting to get their act together. In the past, healthcare has been insular. It’s been a mentality of, “we have what we have” with Healthcare Records, and tech companies have been unwilling to do government-regulated work.
Now, they are willing to move into an ONC-regulated and FDA-regulated environment. Everything, from storage to analytics to customer relationship management, like Salesforce, is moving into healthcare. Specialized software is going to challenge the status quo. Horizontal companies are willing to do the work of compliance, and Health IT decision makers and leaders need to recognize that the vertical players will move much more slowly and be more expensive than their horizontal partners. Horizontal partners’ tech will be cheaper and faster to install, but it will require more creative implementation; Google is going to move much quickly than anything our healthcare counterparts can do.
According to Shah, the question for healthcare leaders is: “Do I go with a healthcare vertical digital solution and believe that they can scale out and meet my technology needs faster than a horizontal company can learn our workflows?” Do we invest in the healthcare-specific vertical technologies or in horizontal technology that will require more creativity but has more ability to scale technology quickly?
“IT specialists well versed in healthcare workflows need to understand and quickly implement industry-neutral horizontal solutions because only we can do that. Non-industry professionals will often get the tech right but will miss key requirements driven by healthcare’s heavily intermediated business models.” — Shahid Shah, publisher, Netspective Media
Target today. We constantly target things for the future, but the future never arrives. If we say, “When we have interoperability, we will do this,” then we need to recognize where we are. There is so much we can do today. The horizon for what you need to implement should be weeks or months away — certainly not years. We don’t need to try to get to Mars today; we need to get binoculars and find the nearby mountains. We are all waiting for the magic to happen, suddenly making interoperability work, but that is not going to happen. Often, we are seeking solutions through our technology brethren within healthcare IT. That was useful a decade ago, when technology did not have many options, but today you can find someone who knows how to do mergers and acquisitions and can select technology and apply it. Attracting more business leaders who understand intermediation and working with multiple stakeholders and institutions while letting them lead will be the secret.
The future is too far away. Some business leaders are not encumbered by the past and antiquated techniques. “Stop wishfully thinking about the future. It never arrives. Focus on what you can accomplish today with existing tech and have a migration path to next generation solutions.” — Shahid Shah
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