Contrary to popular belief, innovation isn’t a buzzword — at least, not if an organization is doing it right, according to Hank Capps, MD, Chief Digital and Information Officer at Wellstar Health System.
Capps sees it as “part of the culture that’s going to drive the consumer experiences of the future,” he said during a recent interview. “When you lean into that environment where new ideas are percolating and being brought forward, you have an amazing opportunity to create leapfrog moments” through the enhancement of care quality and safety.” The key, he noted, is in the ability to formalize ideas and present a view of innovation that creates bandwidth and focus around solving problems.
During the interview, Dr. Capps talked about how his team is working to achieve this goal, all while dealing with the lingering effects of the Covid-19 pandemic, and how they’re addressing the digital divide in healthcare. He also shared lessons learned during his time at Novant Health as well as his clinical experience; why the ability to “be nimble and shift” is more important than ever; and what it’s like to lead during such an “exciting and humbling time” for the industry.
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- Wellstar, an 11-hospital system based in Marietta, Ga., is growing rapidly to more effectively provide “access to compassionate and high-quality care.”
- As CIDO, Capps leads the core technology function of the organization, which is structured “to be more of a tech company and less like a traditional healthcare IT company, with an emphasis on digital.”
- Although the implementation and optimization of EHRs is critical in supporting new care models, what’s even more important is having “a capability and product mindset” that can drive consumer needs.
- Healthcare is “headed to a place where there’s no longer going to be a distinction among acute, ambulatory and virtual; it’s going to be one care ecosystem.”
- The organizations that already had the infrastructure in place for virtual care merely had to scale when Covid hit. On the other hand, those that had not laid the groundwork were “building the airplane while flying it.”
Q&A with Dr. Hank Capps, Part 1
Gamble: Hi Dr. Capps, thank you so much for taking some time to speak with healthsystemCIO. Let’s start with a high-level overview — what you have in terms of hospitals and where you’re located, things like that?
Capps: Absolutely. It’s a pleasure to speak with you. Wellstar Health Systems is based out of Marietta, Ga. It’s one of the largest and most integrated health systems in the state. We have 11 hospitals, over 300 medical offices, and multiple other facilities across that large footprint. We also have one of the largest emergency departments in the nation, which was recently renovated and reopened. We’re a growing health system that focuses on access to compassionate care and high-quality care.
Gamble: And it’s a pretty populated area?
Capps: Absolutely. We have over a million patients actively engaged with us, including more than 700,000 who are engaged on our digital platforms. We do millions of encounters every year across that large footprint.
Gamble: In your role as chief information and digital officer, what do you consider to be your core objectives?
Capps: It is a really interesting area that, over the last 18 months, has radically altered the degree of focus and the need to meet our patients wherever they are. When the global pandemic was declared in March, we literally leaped years into the future, both in terms of what clinicians need and what patients and consumers demand. And so today, when you think about the construction of an information and digital officer role, it really has the core technology function of the organization, which we are organizing to be more like a tech company and less like a traditional healthcare IT company, with the emphasis on digital. We need to be able to deliver to meet patients wherever they’re at — even outside of the emergency situation in which we found ourselves last year.
As part of that tech company organization, we’re building out the experiences for consumers who then become patients inside our facilities, or become patients wherever they are, through these new digital workflows. Ultimately, it’s wrapping all of that with innovation and how we’re going to build out an innovative culture that delivers across technology, delivers across digital, and ultimately, delivers across the organization to bring healthcare models of the future to life.
We think of it in terms of building enhanced lives and communities by creating curated, personalized, and connected consumer, provider, and team member experiences in our broader digital ecosystem which is in development. That dynamic takes not just the technology organization, but the whole organization, rolling up their sleeves and making a difference for our patients — sometimes in ways we didn’t picture even a year ago.
Gamble: It’s interesting what you said about being designed more like a tech company. What’s the biggest benefit of that?
Capps: If you think of it in terms of how healthcare information technology has evolved, there was a sentinel event. There was a disruption to the way that care was delivered with the advent of the electronic health record, and then its mass adoption, which was brought about by regulatory actions. With that disruptive force of technology being layered in, you now had the ability to have information that spreads across all sites of care. That dynamic fundamentally changed how we deliver care. Healthcare IT organizations at that time shifted from becoming keepers of backend systems to designers and deliverers of electronic health records. In a lot of ways, it shifted from some of the development work that they did historically into configuring, rolling out, and integrating across large footprints. And so, for the last decade, healthcare IT shops have been fully focused on that EHR; implementing it and ultimately optimizing it around what the patient needs, and what the team members need to deliver care to patients.
The second “fundamental shift”
In 2020, we had another fundamental shift or generational disruption to our healthcare system with the global pandemic. In that context, the shift is toward more digital care, organized fully around the patient, rather than the physical locations and footprint.
And so, what will be important in the future is building out technology capabilities to support all of those new models of care more comprehensively. The EHR is a key component of that, but it’s more of a capability and product mindset that will drive what ultimately we have to deliver on, which is what our consumers need.
If you’re designed like a tech company, you’re focused on the internal customers, which are Wellstar team members, as well as our consumers and patients. That dynamic of capability-driven product management across the wide continuum using cross functional teams focused solely on the customer and consumer, rather than siloed components, is the future. And it’s what healthcare systems will need to be able to thrive in this environment of our new interim. There is no new normal at the moment, and so our ability to be nimble, shift, and build out what is needed by the customers in that type of mentality is going to be really important. Technology organizations within healthcare systems have to be more entrepreneurial in thinking about how we’re going to deliver more and more value.
‘Ecosystem’ of Care
Gamble: A lot of really good stuff there. One of the opportunities that has come to light through Covid is the ability for healthcare organizations to have an ongoing engagement with patients. What are your thoughts there?
Capps: When I became a physician some 20 years ago, the acute and ambulatory care settings were fairly distinct. They were built around the relationship with your doctor, who was often the connection between the two places. This model had been developed essentially to drive that care in those two predominant locations. Over the last 5 to 7 years post-EHR, we saw what you just alluded to; this dynamic of a virtual venue of care incorporated with acute and ambulatory.
And while the doctor is the common denominator between the different venues of care, they all overlap. The patient is flowing between acute facilities and ambulatory facilities and that virtual venue, which includes things like video visits or population health interventions and connected engagement. It includes things like online experiences and patient portals. And with that came not just a relationship, but information coming across all those different venues and a new continuity that patients expected. So not only did they expect the continuity with their doctor, they expected continuity with their information.
We were already projecting what the future would look like; that it was going to be more of an ecosystem with patients fluidly moving between those three different venues. And then the global pandemic hit, and immediately we were disintermediated in many different ways to deliver care wherever the patient is, with tools that people weren’t familiar with, at a demand that was so high. And now, it really is an ecosystem. It’s patients moving in their journey from step A to D then back to B, rather than the more linear design that had been in place before.
I think we’re headed to a place where there’s no longer going to be a distinction among acute, ambulatory and virtual; it’s going to be one care ecosystem and you’re going to have connected episodes. You’re going to have remote patient monitoring. You’re going to have data overlying all of it. You’re going to have digital connected into brick and mortar. And now with it being built around the patient’s expectation, it’s going to look and feel like a different experience for a high percentage of the time as patients are outside of traditional care settings. And then as you move into care settings, the expectation is that it’s all going to be seamless; that you know me. And that you’re able to pull digital interactions forward into physical interactions. That’s what the future looks like — it’s already here. The expectation is in place, and we’re having to design and deliver to that going forward.
Gamble: Because things happened the way they did with telehealth rates skyrocketing, were you ever concerned that things were moving too fast?
Capps: We need to consider some of the things that allowed it to move quickly. One, government regulations were immediately suspended or altered. The demand went through the roof. Medical boards altered their expectations and allowed more fluid care across the invisible state line boundaries that have been in place. And the payers begun paying for care in non-traditional settings at a higher frequency and more reliable mechanism than they had historically. Combine all that together, plus the fact that some of the innovation that had been busting at the seams was allowed to move forward.
And so I don’t think it went too quickly. I think it was ready to burst into how we deliver care. If it had not been assembled in all those different ways, it would have taken a longer period of time for that innovation to have taken hold essentially.
I think that rare convergence of the clinical crisis with the response to that crisis which encouraged the innovation, has certainly moved it forward in remarkable ways. At the same time, we’ve had to do all of the things we did before in the background to maintain the technology estate while rapidly accelerating in this digital space. It certainly has created challenges, but they’ve been ones that I think people have really leaned into because of the urgency around the clinical situation. And also because of the environment that now allowed that innovation to move forward faster.
Gamble: That’s a great point. And I’m guessing that having already had the pieces and the infrastructure in place was clearly a difference maker.
Capps: Absolutely. If you had built out the shell of this work, you were literally just scaling. On the other hand, if you had not ever emphasized the engagement with patients and consumers, you were building the airplane while flying it. We saw in the marketplace that some health systems reacted very quickly, and we saw a lot of companies that were already in disruptive stances accelerate their work, and in some cases, partner with health systems to be able to bring some of those services even faster. And so it’s not that you have to build everything yourself, it’s that you have to a portfolio of technology in that estate that you can rely on to consistently deliver these exciting new ways of delivering care.
Remember, nobody coming in to see us is having a good day. By definition, the people coming to see us are having a bad day. And so how do you create a positive experience? We have been relentlessly focused on delivering for our patients because we know that it has been so remarkably difficult for people. Over the last 18 months, the whole process of interacting with care has become more challenging.