Hal Wolf of HIMSS talks about hospitals, digital health and the future of healthcare

In the second part of an interview with Chief Healthcare Executive, he says he hopes health leaders are moving with urgency on their digital transformation.

Many hospitals and health systems say they expect to be in the planning stages of their digital transformation for years.

Hal Wolf, the president and chief executive officer of the Health Information and Management Systems Society (HIMSS), says he worries about the pace of some hospitals and health systems. More than half (54%) of U.S. health organizations expect to be in the planning stages of their digital transformation five years from now, while 46% said they expected to be implementing those changes, according to a recent HIMSS survey.

Undoubtedly, health systems will be planning and refining digital health strategies for years to come. Still, Wolf told Chief Healthcare Executive that he hopes hospital leaders are moving with urgency.

When asked about hospital leaders still planning their digital health transformation five years from now, Wolf said, “I worry extensively about systems that say that. I really do.”

“First of all, it’s very realistic, and systems have had incredibly difficult priorities over the last five years,” Wolf said. “There were a number of systems that were thinking about what we call digital transformation and it was disrupted during the pandemic, and a tremendous number of resources, appropriately so, were driven into that pandemic.

“Many systems had to go and create digital strategy on the fly, and they grabbed a hold of applications and solutions, if they could, and they threw them against the wall and whatever stuck they went with that,” Wolf said. “All systems now are coming out of the pandemic and saying, we need a more comprehensive strategy. So they’re picking the ball up from where they were before the pandemic, what they added to in the pandemic, and then taking a vision for it of how they’re going to play moving forward.”

(See excerpts of our conversation with Hal Wolf. The story continues below the video.)

Sharing and using data

Hospitals and health systems are undoubtedly in different stages of their digital journey. Wolf cited the familiar axiom in healthcare, “If you’ve seen one hospital, you’ve seen one hospital.”

While hospitals are still dealing with COVID-19, and the growing number of patients who deferred care in the pandemic, health system leaders must give thought to improving the share of information and using digital health tools to help their staff.

“You’re going to again find hospitals in completely different places in starting,” Wolf said. “My concern … we will continue to see appropriate pressure on reimbursement models, because that’s what payers do. We will see the need for investment.”

HIMSS has been stressing the importance of standardization of rules for exchanging information.

“We need to rapidly get to standardization so that we can minimize the cost,” Wolf said. “The biggest cost in any IT shop will tell you when they put something in is integration of the data infrastructure of a new application and integrating it into their system. That’s where a lot of the energy and the money goes. Imagine if we can reduce that. It’s going to give people more bang for the buck.”

Hospitals also need to work on integrating data from patients, Wolf said. “How do I begin to integrate the data from outside in? And how do I begin to take really important information that might be coming off my phone and work that into the system?”

“As we look at digital health becoming more and more prominent in identifying an individual who may be having an issue, an anomaly, if you would, we have to be able to integrate that data and know what to do with that information,” Wolf said. “When that data comes in, we have to turn it into information which then becomes actionable, and that’s really what the hospital has to be able to do.”

If hospitals are just undertaking their digital transformation efforts, they are facing a long road, but there are some advantages for those who have waited.

“Hospitals that are putting in EMRs today spend a heck of lot less than when we started putting them in 20 years ago, in terms of proportion of the money because they’re so much more advanced, and the quality,” Wolf said. “Sometimes starting late helps.”

However, Wolf said if hospital leaders are only beginning their planning, that’s problematic. “If it’s the beginning of your planning, that’s one statement,” Wolf said. “If it’s continuous planning, well that’s an entirely different statement.

“We’ll be planning digital health forever,” Wolf said. “I hope they’re not planning to start their digital health transformation in five years. That might be the nuance that I would put against that particular situation.”

The future of healthcare

Looking at the future of healthcare, Wolf said he sees digital health helping hospitals deal with shortage of doctors and nurses.

“It can be a supplement for physical staff,” Wolf said of digital health. “It has to be, because we do not have enough staff.

“We have an eight, eight-and-a-half-million clinician gap in the world today,” Wolf said. “The WHO is predicting 13, 13 and a half (million), in very short order. Talk to any hospital and just ask them, ‘How many nurses do you have standing around?’ And the answer is absolutely none. It’s just, it’s very difficult. As a supplement to workforce, digital health is a critical component.”

The future of healthcare increasingly involves the home, Wolf said.

More hospitals have been offering acute care programs in the home, as the federal government has eased restrictions on home hospital programs in the pandemic. Hospitals and health systems are also using remote patient monitoring to manage patients with chronic diseases.

“You will absolutely see and continue to see the shift of care from home,” Wolf said. “Whether that will show itself as devices that are monitoring individuals, and home monitoring is going to be huge, and continues to grow and you can see the investments that are starting to be made. If you look at the way the data will be collected and transported, it’s really critical.”

Hospitals and health systems are going to be using data to identify and treat patients earlier, ideally before they require longer and more costly hospital stays.

“Healthcare is an anomaly-based industry,” Wolf said. “What we do in health is we try to keep people healthy. If something goes wrong, we identify the anomaly. Once we identify the anomaly, we fix it, or attempt to fix it. That’s what healthcare does. The earlier we can identify an anomaly, prevent an anomaly or anticipate an anomaly due to projections of data and information over time, that’s what healthcare will do.

“It’s all about getting ahead of the curve and to be able to take care of people where they are, rather than forcing them to come into a physical domain of an encounter-based paradigm of brick and mortar,” he added.

Artificial intelligence is going to play an important role, as hospitals and health systems will eventually use AI to identify patients who could be helped with earlier interventions.

“The applications for AI will help in predictive modeling of what to use, where to anticipate diagnoses, how do we maximize the resources in communities,” Wolf said. “All of that is dependent upon the information that comes from the digital health domain, and ensuring that we have the right data foundation to build that information.”

Telemedicine is here to stay, Wolf said. Telehealth programs have surged during the COVID-19 pandemic, and healthcare leaders are pressing Washington to adopt reforms to allow providers to continue offering virtual care.

While Wolf said there will always be a need for in-person care, hospitals and health systems have shown the potential to improve care with telehealth.

“We made really great strides during the pandemic out of necessity,” Wolf said. “There are a whole bunch of systems that weren’t doing virtual care or care from home that turned to it, and a lot of proof points that show it was very effective.”

Telehealth is going to be a necessity as the health industry grapples with a shortage of doctors and nurses, he said.

“There’s a whole bunch of stuff we do in health and healthcare that can absolutely be done remotely,” Wolf added. “Mental health is part of that process. That’s where we’ve got to maximize those resources because in the end, they will cost less than building physical domains to be staffed by clinicians we don’t have.”