“There’s not a single part of our ecosystem that hasn’t been negatively impacted. There’s been disruption all the way to the core.”
It would be difficult to sum up 2020 more accurately. Healthcare, like most industries, was turned on its head, and those in leadership roles were forced to pivot quickly and find ways to continue to provide care through the most difficult of situations. They also figured out how to leverage that disruption to accelerate innovation, particularly in areas that had long lagged behind, including digital health and supply chain management.
With this “new normal,” however, comes a new set of challenges for leaders, according to Hal Wolf, president at CEO of HIMSS. During a recent interview, he talked about how the pandemic has affected not just health systems but vendors, the weakness that were exposed by Covid-19, and how HIMSS is working to turn those into opportunities as we move forward.
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- Supply chain is much more than procurement; “it’s an important source of information and care delivery” that requires a solid foundation.
- One of the most significant upsides to the pandemic? “The light came on for innovation and the integration of data back into the EMR to create an outside-in approach to care.”
- Achieving better outcomes requires three components: people, process, and technology. “You cannot put technology out and expect it to work.”
- Burnout is by no means limited to physicians; “the entire ecosystem has really been facing burnout,” including IT teams.
Q&A with Hal Wolf, Part 2 [Click here to view Part 1]
Gamble: Can you talk a little more about supply chain and what HIMSS is learning?
Wolf: What we’ve seen in talking to so many healthcare leaders is, number one, a recognition that it was forced on everyone. Then number two, what do I do about it? We address this in one of our maturity models called the HIMSS Clinically Integrated Supply Outcomes Model (CISOM). It offers a standard and strategic path forward to advance and support personalized care delivery models and health system quality and safety improvements. We started sharing it with folks to provide that foundational piece so they can start planning against it and tie it back to quality. I think that’s the biggest issue. That’s what lifts supply chain away from procurement, recognizing it as an important source of information and care delivery.
Gamble: Right. Another area I want to get into is the impact Covid-19 has had on the vendor community, and the substantial challenges a lot of vendors have faced. Some of them have been able to adapt, but it seems that their entire models have had to change dramatically.
Wolf: There’s not a single part of our ecosystem that hasn’t been negatively impacted. Of course, some have gotten a lift because they were focused on patient-at-home and telehealth capabilities. We’ve certainly seen a few of those do very well in meeting consumer needs.
But our strategies have been interrupted. Our anticipation in implementing new products and services that were laid out of the last couple years has been interrupted. Upgrades were put on the back shelf, because no one could take the risk of doing upgrades unless it was an absolute emergency. There’s definitely been disruption all the way through to the core.
At the other side of it — and we’re seeing this dramatically in a lot of the innovation sectors — the light came on for patient at home. The light came on for innovation of devices and the integration of data and information back into the EMR, creating an outside-in approach to care. We’re also seeing a feeding frenzy with acquisitions taking place, a lot of them in that particular arena. And so I think the industry is poised, as it comes back online and finds the new norm, to take a different look strategically at what they were going to do, and at least begin the nuances of adding more outside-in, patient-at-home, patient-centric, integrated care, thinking about it from the patient home back into the system, versus the system out again.
That’s where the balance is. We’re talking to the provider side of the house and those are the adjustments we’re seeing. There’s a lot of activity going on in the consulting world right now, as you can imagine. People are shifting rather quickly.
Here’s where it’s going to be difficult. Financially, 2020 was brutal for everybody. What can they do with the funds that they will have going into 2021, potentially thinking that by the end of the second quarter we’ll be headed toward a newer normal because of the delivery of the vaccines. And so with those limited funds, we have to be very strategic. We’re expecting a lot of focus on that at HIMSS21 in Las Vegas. And by 2022, it could be an entirely new environment we’re looking at. I think 2021 is going to be interesting to watch as all these things come to play.
Gamble: Agreed. One of the points that came up in some of the interviews we did is the relationship between CIOs and vendors. It seems like the pandemic created a new dynamic, which could end up being a good thing — or perhaps already has.
Wolf: I think so. I think disruption is needed to accelerate innovation. I’m sad that the COVID-19 crisis occurred. It’s terrible. It has created a massive disruption, and that disruption is putting pressure up and down the line for healthcare to change, and we all have to watch what our activities are accordingly. If there is a silver lining that comes out of this, I believe it will spark innovation and more responsiveness.
Gamble: Sure. I also wanted to talk about leadership. We’ve heard a lot about the importance of leading through not just tough times, but unprecedented times, which comes with a unique set of challenges. What are your thoughts around that?
Wolf: Let’s make an assumption for a moment that we recognize there’s a new norm in healthcare and we are bringing new technologies to bear. My training in life has always been very simple, which is that you accomplish these things through people, process, and technology. All three have to come together for us to accomplish change, to innovate, and to deploy. You cannot put technology out and expect it to work. The people side is about culture. If you’re resisting the use of telehealth or advanced innovations because you’re afraid or worried about its impact, that’s a people issue. How do you break through that? We just did that through a very forced situation — a burning platform.
Now I have to change the processes inside my organization in order to take advantage of the technologies and bring them to bear. And so I’ve got to lead not just a decision about innovation strategically in terms of what I’m going to do; I’ve got to retrain my workforce and focus on professional development — that’s going to be huge. And I have to rebuild the processes to think outside-in, versus inside out. That will not happen without absolute leadership at the top guiding their organizations along, and addressing some of the tougher areas that are going to be coming at them.
It’s going to be a huge leadership challenge. Leadership is tough, especially if you’re not a change management leader. The success of healthcare in the United States and globally is all about supporting, fostering, and driving that change. There’s a formula I have always used: OO plus NT equals COO, which stands for old organization plus new technology equals costly old organization. That gets back then to people, process, and technology — that’s how you make these things work. The reimbursement piece is coming; we know that’s going to be a change. We know we’ll get there. We know we’ll get the right reimbursement schedules. It might be happen in stages, but we’ll see that change. The consumer is demanding a change in services.
Finally, those who have resisted or were uncertain around change have realized that it saved us and our ability to take care of patients when we couldn’t see them. And so how do we incorporate that? That’s a big deal. I think our IT executives have done an amazing job, frankly, of bringing up all of these systems, and really been heroes in support of our frontline heroes. In the end, it all comes down to leadership.
Gamble: There’s no doubt that IT teams have really stepped up. But with all of this comes a higher risk for burnout, which is something I think leaders have to be cognizant around. What are your thoughts there?
Wolf: We started the conversation about three years ago seriously looking at physician burnout. Having grown up in a system that was using digital health and all of those components, we saw it starting in primary care and it worked its way up. But the reality is that all of these systems today are under such stress. It’s not physician burnout. It’s entire organizational burnout that’s going on. If you talk to any individual in any hospital setting — and it can be the person at the reception desk — they are under stress. It has been painful. The entire ecosystem has really been facing a burnout. I wish I had a magic wand to give each and every one of them a virtual hug. It’s just astounding what everyone has done.
To your point, the person that was leading the conversation I referenced earlier is Elena Sini, who is CIO of the largest chain of hospitals in Northern Italy. She has just done an astounding job. We’ve talked every other week during this process; she’s actually on the HIMSS Board of Directors. What they’ve gone through, and now they’re in their third wave in Italy, is not good. But now they paved the way for us quite a bit.
Early on in the pandemic, we had a special webinar where Elena and Henning Schneider, who is CIO at Asklepios Healthcare Group in Germany, were talking about what they had learned and how they had brought it forward. We have thousands of people from around the world listening to their guidance and their thought leadership exchange. That gets back to just one of the great things HIMSS does which is to try and connect people around the globe to share best practices. It was a real honor to have them on HIMSS television and have those interviews going on. People have been sharing info globally and it’s been a huge benefit.
Gamble: That’s been a significant silver lining. I was speaking to a CIO from New York City, and the fact that they were able to put aside the competition and share information can’t be highlighted.
Wolf: It’s been an astounding thing. Going back to that last point you just made, someone recently asked me, ‘Do you think competition will be reduced and Centers of Excellence will continue to exchange information?’ And I do. I think it’s going to take us a while; hopefully we won’t get back to the competitiveness per se, because as we take a view and get better information from a population standpoint, there’s more than enough demand to go around. You can be judicious about where we see Centers of Excellence, but I think different systems will adapt accordingly.
Again, this will come back to strategy. It will come back to investments and it will come back to leadership. But it’s an exciting time in the sense of what’s beginning to unfold. It’s a tragic time because of what happened and what we were still going through — and let’s be very clear, the next couple of months are going to be very difficult. But in the end, I think everyone has finally recognized that digital health will be even more integral to their long-term success. And of course, at HIMSS, we’re going to do everything we can to support that.