Opening the Door: Stephanie Lahr on What It Takes to Build a Sustainable Digital Strategy

Over the past few years, we’ve all seen the tremendous impact digital tools can have on the way care is delivered. And although it’s understandable for organizations to want to ride that wave, there’s a critical question that must be asked – and answered – before any decisions are made: “What problem is it trying to solve,” said Stephanie Lahr, MD, CIO and CMIO at Monument Health.

If it is indeed aimed at fixing a specific issue, clinicians are much more apt to use it. But “if they no longer feel that way, they’re not going to be as engaged,” noted Lahr. During a recent interview, she spoke about why the topic is so important to her, and shared insights on what it takes to create a successful digital strategy.

At the upcoming CHIME21 Fall Forum, Lahr and Peter Durlach, Executive VP & Chief Strategy Officer with Nuance Communications, will discuss how they’re building an AI-powered patient engagement platform to deliver a better digital experience for patients, and will share lessons learned.

 

Defining the digital front door

Gamble:  We’re hearing the term ‘digital front door’ more often. What does it mean to you?

Lahr:  It’s a great question to pose because it means different things to different people. And that’s one of the challenges with creating some sort of commonality and information and idea sharing around digital front door. It’s a diverse topic and there’s a lot of subtopics within it. Some of which people are gravitating more towards than others.

From my perspective, I look at the digital front door as an opportunity for us to interact with patients and with our community. That includes everything from the patient portal to apps that are developed to messaging platforms that are leveraged. It’s that constellation of the various toolsets that allow our patients to transition from what has historically been a very person-to-person interaction — whether on the phone or in person — to one where they can engage with us in meaningful ways using digital tools.

 

“There’s a digital maturity that has to happen”

Gamble:  It’s interesting because the term ‘front door’ can give the impression that there’s one point of entry, which isn’t the case.

Lahr:  Right. Another element that’s a little bit tricky is that we need a digital front door, but we need a good old-fashioned front door too. Because not every person and every situation is going to be amenable to a digital platform that’s going to morph over time. And so we’re going to move in that direction. But there’s a digital maturity that needs to happen, which we’ll discuss in the session. Beyond the technical digital maturity that organizations have to go through, there’s a digital maturing — and acceptance — of our population that has to happen.

As you embark on that strategy, it has to be approached the right way. For example, if your entry point into that is telling patients with cancer, ‘instead of having an appointment, we’re going to have to you interact with a chatbot, which then will escalate to the doctor when needed, and you may not see or speak with a real person,’ most patients aren’t going to be ready for that.

However, we are at a place where we might be able to say, instead of waiting on hold for 30 minutes to schedule an appointment, we can have a text interaction with you in real time or a self-service interaction through our patient portal, or any digital platform that allows them to take some control.

One of the elements we use to gauge that readiness is what I call the clinical intimacy factor, which we’ll talk about.

 

Clinician adoption

Gamble:  During the past two years, digital adoption has really accelerated. We’ve heard a lot from the patient or consumer perspective, but what about clinicians? What have you seen in terms of willingness to adopt?

Lahr:  It depends. Our ambient clinical intelligence project, for example, allows very busy clinicians to stop thinking about documentation and focus more on the relationship with the patient; they love that. But when we tell them they still have to do everything they’re used to doing, including documentation, and we want them to telemedicine visits on top of that, it doesn’t resonate as much. Especially since we don’t have time to help figure out how all of this fits into the workflow, and how to manage a different type of patient interaction.

“Digital tools have to solve a problem”

The bottom line is that digital tools have to solve a problem. There are so many digital opportunities available — more than any of us could ever use. But the real question is, what problem is it trying to solve? When clinicians feel like it’s solving a problem, they’ll use it. And when they no longer feel that way, they’re not as engaged.

We have some specialties in clinical practice that are still widely adoptive of telemedicine, but they had specific problems that they were trying to solve. They had patients who were traveling long distances or had complex situations that might prevent them from coming in. They had tight clinic space and could only see a limited number of patients. Doing it virtually allowed them to create access and see more patients and help more people. And in those spaces, it stuck, because it fit a need.

When the pandemic first hit, and no one wanted to come to the hospital or clinic, everyone adopted it. But as the patient population migrated away from that, so did our clinicians. It was no longer truly solving a problem. With all of these tools, that should be the number one question we ask ourselves: what’s the problem we’re trying to solve? That way, it’s not just a shiny butterfly, but instead, it’s something that is really going to resonate for our clinicians and our patient population.

What that also does is create a structure that feels comprehensive and consistent. If we throw out a bunch of random digital tools to the clinicians and patients, it feels disjointed. The challenge for leaders is figuring out how to bring it all together in a package that feels purposeful and organized.

 

The banking/retail comparison

Gamble:  Healthcare is often compared with other industries in terms of customer experience, which may not seem fair, but that’s what patients have come to expect. What are your thoughts around that?

Lahr:  There is no doubt that healthcare is behind; we have a lot of work to do. And I believe that looking at what has made other industries successful and understanding how they’re interacting with their customer base can definitely give us some guidance.

“People don’t expect intimacy in their banking interactions”

There are two big factors that differentiate healthcare. One, people don’t expect intimacy in their banking or shopping interactions. Unlike in healthcare, there’s no exchange of information that makes people feel vulnerable, and feel the need for a true personal connection. We have to be cognizant of that. It doesn’t mean we can’t use some of the same tools; we just might use them in different ways or different situations.

The third player

The other piece is that in all of the other industries where digital has really taken off, there’s the buyer and the retailer. When you shop, there’s a buyer and a retailer. In hospitality, there’s a customer and the hotel chain. In healthcare, we have this whole other player in the middle, which is the payer. That that creates a challenge for organizations like Monument Health; we’re not an IDN with an insurance plan, and so some of the digital initiatives I’d like to do for our community don’t make sense from a cost perspective today, because there’s no reimbursement tied to it.

Organizations like Providence, Kaiser Permanente and Intermountain are doing some great work, and part of the reason is because they didn’t eliminate that third layer. They’re both payer and provider, which gives them an opportunity to invest, knowing that they’ll be able to reap the rewards down the road.

It’s similar to retail. If Nordstrom, for example, feels they’re at risk, they’re going to make some changes in how they interact with their consumers. And if they invest the right way, they win. On the other hand, we can take steps to make things for our patients and our communities, and we still may not win from a financial standpoint, which is a detriment to our viability.

So those are two things to keep in mind as we look at digital interactions: the intimacy factor, and that third layer sitting the middle. Both of those add some complexity to how these tools can be deployed and the success they’ll have.

 

Gamble:  When you look at the lineup of presentations at CHIME, you see that digital transformation is really permeated throughout, rather than the focus of a single session. I can imagine it’s satisfying to see that.

Lahr:  Absolutely. What that really means is we’re finally at a point where digital transformation isn’t a specific goal or destination, it’s really just one of the many tools that we are going to use to drive healthcare transformation.

Lahr will present Building Healthcare’s Digital Front Door on Thursday, Oct. 28 at 11:30 am PDT, along with co-panelist Peter Durlach, Executive VP & Chief Strategy Officer with Nuance Communications.