By Sheila Talton | October 10, 2018
Original Article

The healthcare ecosystem is on the verge of a tectonic shift. Hospital executives know it’s coming, but legacy systems are making it impossible to prepare.

Hospitals are on the fault line of a rapidly shifting healthcare landscape. They are treating patients who demand a more immediate and responsive experience, who are using digital devices for everything and expect the same from their physicians. They are dealing with payers who want better results and lower costs. And they feel the rumblings of tech giants threatening to disrupt the status quo.

What only a select few hospitals are doing is embracing a culture of change. That’s often because the rest are scared, and rightfully so. They have made massive investments over time in legacy systems that simply can’t keep up with the changes happening around them. And it’s not unique to the healthcare sector; it’s happening to banks and insurers and retail giants whose economies of scale are being outmatched by more agile and digitally savvy competitors.

The earthquake hasn’t hit yet, but it’s coming. Within a few years, a critical mass of patients, payers and partners will demand a new kind of care. Hospitals that adapt in time will remain standing, while those that try to ride out the storm with outdated systems will fall. But hospitals, like giants of other industries, face a perilous question. How do you overhaul existing systems without causing the whole operation to crash?

Many hospitals are inclined to spend millions on hiring an IT renovation team to create patches and add-ons in an ongoing effort to keep pace. But this is expensive at best and, in the end, futile. It takes too long to make changes, and at the heart of the system there is still a network of antiquated technology. The answer is not inside the hospital’s walls.

Forward-looking hospital executives are realizing that they are not equipped to go it alone in the digital age. There are digital native companies that can manage their data better, and offer actionable insight and recommendations that they simply cannot generate on their own. At Gray Matter Analytics, we have created the CoreTechs® MeasuresLibrary™ to do just that.

We understand that hospitals are drowning in data. And the waves keep coming. Wearables, electronic health records and interconnected data systems are feeding ever more information into hospitals. The great conundrum facing care providers is not how to collect more data, but how to use existing data to make progress toward the “Quadruple Aim” of improving patient experience and population health while reducing per capita cost of care and ensuring provider wellbeing.

The MeasureLibrary looks at the entirety of a hospital’s operation, taking in data from across departments to deliver comprehensive insights into clinical, financial and operational performance. We break down the walls between departments and their data silos to locate efficiencies and opportunities that are otherwise impossible to see.

It allows hospital leaders and physicians to prioritize focus areas, analyze the root cause of outcomes and understand the extent of influence of measures on each other’s performance. It empowers hospitals to see how social stressors that affect performance, identify potential areas of intervention and hone in on drivers of utilization. Hospitals can instantaneously query measures, get correlations or see change over time, without having to do the work internally. And because we are working with many hospitals dealing with the same pressure from payers, we can also facilitate more consistency (and potential for interoperability) by sharing effective measures between clients.

Crucially, the MeasuresLibrary gives providers a tool to stay ahead of what payers are doing to them. With our tools, providers are in position to sit down with payers and say you’ve identified the wrong measures; here’s how we are translating measures and why it’s better. Here’s the tools we are using to create our own intel and here’s how we know it’s working. Those conversations then lead to better contracts.

Eventually, we hope these tools will help bring down the wall between payers and providers. As it stands, payers can see how much customers are paying for different specialists, but can’t drill down into what exactly they are paying for. The view of providers, meanwhile, is often restricted to what’s happening in their own silos. We think both sides could be making much better decisions if information is shared, if there are common measures and a standardized translation layer between payers and providers, so that payers know where to look, and providers know what they need to be looking for.

At the end of the day, MeasuresLibrary allows hospitals to focus on delivering the best quality of care possible without being weighed down by the day-to-day struggle of managing a suboptimal data system. Hospitals realized long ago that they were better off outsourcing functions like real estate management, maintenance and food services. It’s time they accept that partnering with a specialized data company is a more efficient solution to their information needs.

The collaboration age

Hospital executives and their peers are not oblivious to the coming changes. A survey conducted last year by SAP and Oxford Economics found that almost 70 percent of healthcare leaders viewed IT tools as being “essential” for growth and improving consumer experience, while 75 percent planned on major investment in big data solutions to maintain their competitiveness in the field.

So if they recognize the challenge, why are hospitals struggling to adapt? My colleague Mala Anand, president of SAP Leonardo & Analytics, explores this question in depth in an article for Digitalist. She identifies three major trends: the economics reward treatment, not prevention; innovation is focused on hardware, not software; and systems are disconnected, meaning data is siloed.

Her solution? Everyone needs to work together, share data, and figure out how to best deploy all available resources to treat patients and save lives. “The challenge for us all is to embrace this concept of collaboration,” she writes.

Technology companies are an integral part of this effort. Some of the headlines coming out the health sector of late seem to strike fear into established players: Apple’s announcement that it will set up its own clinics and Amazon’s plan to move into the health insurance space. But I think the them-or-us mentality misses an immense opportunity right in front of us.

America has some of the best hospitals in the world and is home to the global hub of technological innovation. Hospitals have done a remarkable job in recent years of scaling up their data collection using state-of-the-art hardware, and tech companies have developed wearables that allow us to continue monitoring patients when they go home, ideally detecting problems before they become life-threatening.

But so much more can be done. If you look around, you can find seeds of the sort of collaborative change that we need. A company called Vericred is providing a universal platform for digital distribution of payer plan data; another called Zipari has launched a platform that integrates wearable data into payer customer experience. At Gray Matter Analytics, we envision a platform for healthcare data that would be used by providers and payers alike, so that both sides of the business can deliver a better customer experience.

That’s where we need to be going as physicians, insurance agents, hospital executives, technologists and data analysts. That’s the change that needs to happen so that the coming digital earthquake doesn’t shake public faith in our healthcare systems. Hospitals can’t hunker down, they need to reach out and find partners that can help them prepare and be ready.

Sheila Talton is President and CEO of Gray Matter Analytics and serves on the boards of companies and nonprofits including Deere & Co., Wintrust Financial Corp. and Chicago’s Northwestern Memorial Hospital Foundation.