There is a fundamental problem in healthcare, and Saad Chaudhry wants to solve it. “While we are in the business of lengthening your existence, the industry at large also continues to quietly rob you of it in small — and sometimes, not-so-small — increments,” he wrote in a recent piece.
But it doesn’t have to be this way. Leaders have an opportunity to help turn the tide and “give back time,” whether it’s providing a safe and simple way for patients to schedule appointments and pay bills, or creating a “digital workplace” for employees. During a recent podcast interview with Kate Gamble, Managing Editor and Director of Social Media, Chaudry talked about why the concept of giving back time is so important to him and how it has “seeped into” his strategy at Luminis Health, where he was recently promoted to Chief Digital and Information Officer, and why he believes there is no ‘digital front door’ — just a digital door.
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- Using Epic Refuel, Luminis is conducting a “massive” reset of EHR components and modules across the organization that will help “give back time to both our users and our patients.”
- “I’ve stopped using the words ‘digital front door’ at this point because there are back doors and side doors.”
- By partnering with a vendor to integrate ambulatory and inpatient payment models, Luminis is bringing bill pay “into the modern age” and improving the consumer experience, Chaudhry said.
- One of the key considerations with improving workflow? Making sure it meets the needs of your workflow, which entails involving people from different generations. “I don’t want to do this in a vacuum.”
- Adding digital to a title is great, but “if you truly believe in digital transformation and you want to have a digital leader, you need the scope to go with it.”
Q&A with Saad Chaudhry, CDIO, Luminis Health, Part 2 [Click here to view Part 1].
Gamble: Can you talk more about the ‘true digital transformation’ projects that are going to change peoples’ job? It’s really fascinating.
Chaudhry: I’d like to talk about something a little bit more rote first: the EHR. That’s a known quantity; the cost of doing business. That’s not innovative in any way at this point. Everybody has one. We’re an Epic shop. We’ve been an Epic shop for 13-plus years. That means we have built up a lot of debt with workflows by not taking certain updates because we felt we had another system that did the job, and then missed out on a whole branch of Epic development that came out after it, and so on.
Epic has a project called Refuel, where they basically reset certain components of their EHR suite. We are doing it on a massive scale with a reset of the entire EHR; we use pretty much all of their modules. There are two layers to this. First, we reset the foundation; that’s the terminology that Epic uses for ‘out of the box,’ which is the best practice for that specific function. There are over 20 modules of Epic, and each has hundreds of functions. That’s the foundation.
However, because healthcare is complex and layered and differs from one state and one specialty to the next, Epic can’t know the best practice out of the box for everything, and they can’t just pre-program it. And so, the second layer is wherever there’s a need to configure, it will be based on a global best practice, and not on personal preference.
It has to be done in the most simplified way possible. It doesn’t matter if we upset our own clinicians, because this is what we’ve decided will give back time to both our users and our patients. People aren’t always happy about that, because it takes a long time to figure out the best workflow based on quality and research. But you’re not going to care about research papers when you’re on your deathbed, and neither will our patients. That’s a rote thing. That’s a rote mechanical thing, nothing innovative.
Gamble: Right. Let’s talk about some of the innovative things.
Chaudhry: There are things that our EHR does well, but because they are massive mega-suite, they can’t do everything very well. Epic as a corporation approaches certain things in certain timelines, and that’s okay. But there are certain areas where I want to give time back to patients today.
It’s strange to say, ‘I’ll give you time back in a few years.’ Frankly, we serve over a million people in our region, and some of them may not be around in a couple of years. I want to give time back today with things like online scheduling. Epic has online scheduling, but the way they do it can take time away. I want to give time back.
For example, if you go to Luminis Health, you can access open slots; it’s just like Open Table. You choose a specialty, enter your zip code, and hit ‘schedule care.’ That’s it. It puts you right in the middle of a scheduling workflow. I can’t currently do that from an EHR perspective — not that we won’t get there with Epic. We will, and when we do, I’ll gladly adopt it.
That’s the front end. I’ve stopped using the words ‘digital front door’ because it’s all digital doors at this point. There are side doors and back doors, because you have to pay your bills somehow. You have to get consultations, and there are all of these other doors. So now, it’s a digital door. Online scheduling is one of them.
And then there’s the back end. After you get care, you’re going to get all of these letters for the next six months. ‘This is a bill,’ ‘this is not a bill,’ etc. The whole spectrum. Then you receive bills for procedures you already paid for, and you call them but you’re on hold for 20 minutes. Talk about wasting your existence.
Bringing patient experience “into the modern age”
I’m partnering with a vendor that does this but not quite in the way that I want them to. This is going to completely bring together payment for ambulatory, inpatient, and all types of care and it’s going to bring them into the modern age where you get a text message with a URL that’s unique for you. We have your mobile number — that’s the first level of identification. You click on the URL, then we ask for your date of birth or something similar. That’s second-level identification. You pay your bill with Google Pay or Apple Pay, and you’re done.
“You don’t need an app”
Gamble: That’s how it should be.
Chaudhry: In doing this, I’m actually taking development away from the app. I don’t want you to download an app. You don’t need an app. I need to give you back those few seconds of existence that I’m stealing from you by opening an app, getting your use password, resetting your password, and calling the helpdesk to get your password reset. I need to give those minutes back to you. I will serve you up what you need in your context so you can do it faster, quicker and get back to actually living your life. That’s a strategy.
“I don’t want to do things in a vacuum”
Gamble: The need has been there, but I think that people weren’t really sure how to approach it. It seems like you guys are looking at the root of the problem.
Chaudhry: Yes. And this actually applies inwards as well. I need to give time back to our employees. I am looking at things that are not terribly sexy but give time back. I’m looking at how do we make it a more digital workplace. In a digital workplace, do you need an intranet website and if you do, what is that? Where are resources located? Why do you have to go searching on network drives?
I’m looking at all of that and I’m also trying to get educated myself on how the next generations operate. Because we could develop all of these things and realize we’re not actually giving time back to anybody because the new generation of workforce and patients do things differently. And so, I don’t want to do things in a vacuum because as passionate as I might be about this, I might be wrong.
The JEDI council
My CEO, who is fantastic and forward leaning, has me co-chairing some of our diversity items. We have a fantastic approach to diversity. We don’t call it DEI. At Luminis Health, we call it JEDI, that’s justice, equity, diversity, and inclusion. We believe it all starts with justice. Because justice is what creates an equitable environment. Everything else is fixing stuff as much as you can with what you’re given. Justice changes the entire environment itself. We start it with that.
Our CEO, Tori Bayless, is a huge Star Wars fan. And so, the governing body of diversity at our organization is the JEDI council.
I chair what we call Generation Now group, the business resource group. The whole goal of Generation Now is currently millennials and Gen Z, but we’ll keep building on it. What we’re trying to do is look through the lens of these upcoming generations when we make any changes, whether they are workforce changes or patient facing changes. That’s a very operational role that I play to make sure that even though time applies to every living thing, the changes to give back time are in line with what the generations expect.
Gamble: You hit on something big. We need realization that what we’re saying might not apply to others. We don’t know what the next generation is going to want. That acceptance is such a huge part of it.
Chaudhry: Right. Like I said before, I want to give back time on the digital door side, and we both think that sounds fantastic. But in a few years, Gen Z might not operate that way. They might say, ‘that was fantastic… 10 years ago.’ This has to be rooted in the current reality.
The other thing I don’t want to minimize is that all of this is pockmarked with mines. It’s a minefield. I’m taking a risk in many different ways, and it’s not just me; it’s my organization, my people, putting their trust in me, they’re taking a risk. My CEO is taking a risk.
From CIO to CDIO
Gamble: Can you talk a bit about having that new role of chief digital and information officer?
Chaudhry: Sure. I recently transitioned from being a CIO to a CDIO with the ‘D’ standing for digital. My CEO believes, just as I do, that there should never be an empty title change. If you truly as an organization believe in digital transformation and you want to have a digital leader, you need the scope to go with it. As an increase in scope, I have our marketing communications and public relations department, reporting up to me now. Our chief marketing communications officer reports up to me and I have a board that handles business ventures and investments for the organization.
These are very non classic IT things, and that’s the whole point. That’s exactly what digital is supposed to be. It’s supposed to not be about IT, it’s supposed to be about operations and how they are changing. All of this is risky. Putting me in a role like this, giving me oversight of operational items — it’s a risky endeavor for a CEO. But she believes in it. She puts her trust in me. She believes in the way that I’m looking at this. I need to step up and live up to that trust. I wouldn’t be doing that if I said, ‘I am right, this is the way it’s going to be forever.’ It needs to be rooted in some level of ground reality that is generation based.
Gamble: It’s so important having the CEO and others who are bought in and understand all the risks, and are willing to go for it. Do or not do, there is no try — I think that’s the quote from Yoda.
Chaudhry: That’s actually one of my boss’s favorite Star Wars quotes.
Gamble: Nice. But in all seriousness, this is such an important conversation. We hear stories about people who are diagnosed with cancer and can’t get an appointment for weeks. And then there are the billing nightmares. It’s clear that what we’ve been doing isn’t working. We need a different approach. What your team is doing might be able to finally get things moving in the right direction.
Chaudhry: You know I certainly hope so. It’s a simple thing. You can use a litmus test, which is, if you stop saying your health system’s name and you say ‘I work for a business that gets you your existence allowance’ and then ask the next question, you’ll know right then and there if you’re doing the right thing. You gave the example of cancer patients needing weeks to get that first appointment; imagine saying as the CEO of that organization, I work in the existence allowance business and it will take us two weeks to get your appointment. You can’t even say that sentence out loud. Your brain won’t let you.
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