Healthcare providers have made large investments into electronic systems designed to improve workflow and operations while enhancing patient relationships. But many providers haven’t yet realized that return on investment. To find out what is and isn’t working, and what can be done to generate positive ROI, we spoke with Kevin Montgomery, Chief Technology Officer for Relatient.
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Future Healthcare Today (FHT): Digital solutions are a big part of the transition to outcome-based healthcare. Are these tools delivering on their promise?
Kevin Montgomery (KM): I think we have to look at the solutions [in their] entirety. When you look at the tools and start asking the question: “Are the tools delivering on their promise,” what were you picking the tool to do? When you’re evaluating tools you have to look at ROI in three different phases—you have to look at clinical ROI, operational ROI, and financial ROI.
A good example of this is, let’s decide we’re going to hang a picture on the wall. Management goes out and buys a screwdriver but what they really needed was a hammer. It’s not the tool’s fault that it can’t drive the nail into the wall. The wrong tool is selected. And so that’s what healthcare gets into a lot of times. We’re trying to solve a problem and we’re quick to grab a tool, but not looking at how this tool plays into what we’re trying to solve from an overall perspective.
FHT: We want the tools to solve the problem, but we haven’t defined what the problem is.
KM: Yes, we see that a lot. We’re looking for tools instead of solutions. We run into this occasionally with health systems. We’ll get an RFP from them and it’ll be for one tool and we’ll start doing a demo and then we start seeing the light bulbs go off: “Wait a minute, you guys do this, and you do this, but we’ve really got this problem over here we’re trying to solve.”
And I think what happens in the healthcare space is they see an opportunity to fix something that they want to change, like with appointment reminders. The big thing is, everybody wants to drop their no-show rates. But, are there additional pieces of patient engagement that we missing? Are there other tools that you could fit together to make a better solution? We’re starting to see more of these patient experience talks pop up and so we’ve got to look at ROI across the board, not in silos.
You’ve got the financial impact of what you’re doing, you’ve got a clinical impact where you’re trying to change how you’re treating patients, and then you’re wanting this patient experience part, where the patients are feeling connected to you in a more consumerism-type setting.
So, I think that they’re looking at the tools individually instead of an overall solution.
FHT: Are health care providers expecting the tools to handle things that really should be handled person-to- person?
KM: It’s possible; just like in our daily lives, we look at technology to solve problems. We don’t often really dig through them and so we’re quick to replace something in our lives. “This doesn’t work, we’re going to replace it with something else because we think we’re going to have a better outcome.”
And it really gets into what the patient experience needs to be.
Is there a particular tool that helps the patient experience by speeding them through the process, so that you have more time to deal with them on the clinical side and really dig into their health care and make a change to their health care? There has to be a lot of different discussions when you’re evaluating what tools we’re going to pick to better healthcare, and our operation, and what we’re expecting the outcomes to be.
FHT: Short of switching to different EHR platforms, what are some ways that providers can reclaim a positive ROI?
KM: You have to evaluate, “What does each part or piece of the solution accomplish?” The EMR system is designed to be the clinical record. Is it doing a good job of that? Well, if it’s doing a good job of that, then switching it out may not solve the problem. There may be a particular item that you need to better address.
Patient engagement is a good example. Some vendors have built in patient engagement platforms, but it’s not their core business. And so, they’re not going to go to the same length that we do, or another vendor like us, goes to in building a patient engagement system. But, I wouldn’t think that they need to switch their EHR vendor out to get better patient engagement. There are a lot of different solutions out there they can plug in.
And when you look at what’s going on with the portal systems out there, everybody had to run and get a portal system because of Meaningful Use. They put portals in, but they’re realizing that there’s very low adoption rate on the portals. And that’s just because people don’t want to sign up for them, they don’t want to keep up yet another password, or they just don’t feel it necessary as part of their health care to engage with the provider in a portal scenario.
What we’re doing with our products is we’re wrapping around those items, so the people that want to use a portal, you engage them in that fashion. But we sit in there as a tool to message the patients that don’t want to engage through a portal. We act as a wrapper around their existing technology to iron out the edges.
FHT: It sounds like implementation is a big part of the equation. Maybe you’ve got the right tool, but you may not be using it in the most advantageous way. Is that something that you’ve seen going on in the industry?
KM: Yes, that does happen. I think, really, definition of the problem, defining your ROI— what you’re expecting to have as far as the outcome upfront, making sure that’s realistic—will help the implementation go smoother.
A lot of times we’ll have management come in say, “We want this tool, we want to have this thing for patients to use.” We get into implementation and realize that, when we get down to the practice manager level, that the management level didn’t think through how this affects them and how it integrates into the workflows. And so, implementation can affect the usability of that tool. If it just doesn’t fit into their workflow, if they can’t make it work and they’re going to have to spend two or three times as long to make this work for them, it’s just not going to have a positive ROI. This is where a strong partner can offer some perspective on workflows and integrations, and ensure the result we’re looking for will be possible, when it’s all said and done.
FHT: At the end of the day, how should success be measured?
KM: As I mentioned before, you need to define ROI across three areas: clinical, operational, and financial. Even if one of them may be negative, the ROI on one of the other areas may be so significant that you’re willing to accept that.
You’ve got to do the research. Google is your friend. You’re not the only one that’s going through these challenges, looking for these types of tools, trying to figure out how to solve this problem. One thing I do like about healthcare is we’re really quick to talk about all these new things we’re doing, new technology, but we’re also good at saying: “Hey, we didn’t really hit the ball out of the park with this one. And here’s why, here’s things we learned.”
One thing that we’ve also done around here that makes a lot of sense is doing ‘retrospects’ on projects: what did we learn through this process? What were the items that we didn’t think that would happen throughout this? How did we get around them and how do we prevent those from happening in the future?
Technology, a lot of times we think that it’s a destination, not a journey. It’s absolutely a journey. Things are going to change. We need to be able to adapt to them. We need to be able to understand that there are going to be problems with putting in this new technology. But, we’ve got to be open to changing processes and re-evaluating how that tool is going to fit in.
FHT: Any final thoughts for us?
KM: I think the biggest advice I could give anybody is to quit looking for vendors and start looking for partners. You need to find partners that have product mixes that will help you obtain overall goals, not just fixing a single problem. And align yourself with forward-thinking companies that adjust their solutions and can incorporate new technologies.
We often get asked about a roadmap, and I’m very open to sharing a roadmap with our customers because I want them to see where we’re headed with our technology, what we’re thinking about in the future, how we may be able to continue to be their partner in the future when technology changes.
A lot of the EHR vendors are out there creating marketplaces for partners like us and they’re putting tool sets out there. But they’re not really talking about how these tool sets can work together to create a solution.
So it’s really important that when you’re starting to look at vendors you need to find a vendor that’s got some depth to them. They have multiple products that you may be interested in. Because that way they’re not disconnected; they don’t seem like all these different items sitting out here. They can be they can be put together in a way that it creates a really good experience for your patients and a really good solution for your company.
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