The healthcare environment can be extremely stressful for patients, as well as their family members – but when the patient is a child, it becomes amplified. And yet, when it comes to digital innovation, pediatrics hasn’t traditionally been a targeted group. In fact, it has often been an afterthought, said Christopher Neuharth, VP of Experience and Digital Innovation at Children’s Wisconsin.
Fortunately, the tide has turned, thanks to the efforts of Children’s Wisconsin and other organizations that work to accelerate innovation by evaluating startups and participating in pilots. “If we can collaborate, hopefully we can get a number of startups off the ground and scaled, and make a difference,” according to Neuharth.
But it’s not just about working outside of the organization. Through its structure, in which digital innovation and experience are intertwined, Children’s is able to quickly evaluate the effectiveness of technologies, and if necessary, make changes, based on feedback from families. “It has really allowed us to be more nimble and agile in our development,” he noted during a recent interview with Kate Gamble, Managing Editor at healthsystemCIO.
In the conversation, Neuharth also talked about work his team is doing to create a better experience for both patients and families through its digital front door – and what it took to build it; how he benefited from his previous experience, particularly on the vendor side; and how his strategy changed after Covid.
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- On pediatrics & startups: That was one of our frustrations early on: there just wasn’t enough focus on digital health in pediatrics. A lot of the venture money was focused more on things like aging at home; pediatrics was sometimes more of an afterthought.
- On the mission: “Thinking about our families as consumers and always having the experience in mind takes a specialized skill set. It’s not just technical system,
- On measuring adoption: “We needed to know, if they used this digital health app or this piece of education, did that actually lead to the right outcomes and could we prescribe them and measure them in a unified way?
- On change management: “A lot of it is just rolling up the sleeves and doing a lot of at-the-elbow time with staff and looking at all of the features to enable that. So, there’s a lot of change management that went into boosting our MyChart adoption.
- On the power of collaboration: “To break into the healthcare space, a lot of times you need an early collaborator. You need a health system raise their hand and say, ‘yes, I will run a pilot project with you,’ or ‘I will collaborate on research around this.’”
Q&A with Christopher Neuharth, VP, Experience & Digital Innovation, Children’s Wisconsin
Gamble: Hi Chris, thanks so much for taking some time to speak with us today. Let’s start with a high-level overview of Children’s Wisconsin — what you have in terms of hospitals, where you’re located, things like that.
Neuharth: Children’s Wisconsin is located in the Milwaukee area and throughout Northeastern Wisconsin, what’s known as Fox Valley in the Green Bay and Appleton area. We have two hospitals and quite a big presence in ambulatory, specialty, and primary care with over 25 primary care offices. We’ve made a strong investment in community services, as well as mental and behavioral health. We’re trying to be that comprehensive provider for all things pediatrics in the state of Wisconsin.
Gamble: You’re the VP of Experience and Digital Innovation. How is that structured within the organization, and what are your key goals?
Neuharth: I’ve been at Children’s Wisconsin now for five years. And when I joined, it was really all about advancing our digital priorities. That’s how the role was created. It was a digital health team, and we were charged primarily with digital innovation and getting things like telemedicine, online scheduling, and some other different consumerism projects off the ground.
When we started that, it was built with the intent that we would look at some of these innovative offerings. We would be the team to help pilot them, get them to scale, and then basically, hand the keys back to the operational or IT area. What we’ve learned is that many of these things get to scale, but they still need a lot of support, whether it’s how you communicate with patients, how you deliver patient education through the pandemic, and all the infrastructure around telemedicine. And so, the role of the team has shifted a bit. We’re still a digital innovation team, but there are areas where we do a lot of digital operations as well.
Gamble: It makes sense — you can’t just hand these things over when there’s still so much to do.
Neuharth: Yes. There’s so much on a day-to-day basis just in working with everybody around the health system and what they’re doing — it takes dedicated focus on those. It’s also an acknowledgement that thinking about our families as consumers and always having the experience in mind takes a specialized skill set. It’s not just technical; it’s also understanding how we meet the needs of our families.
Early digital pilots
Gamble: And so, you came to Wisconsin Children’s about five years ago. At that point digital was starting to become more pervasive, but then things shifted quite a bit. Can you talk about the role of digital health in pediatric care and just how much that has evolved?
Neuharth: It’s been dramatic. When we started the program five years ago, we were really looking at early pilot projects with targeted use cases around telehealth, as an example. We launched online urgent care in 2019, and thank goodness we did, because that gave us a lot of the telehealth infrastructure we needed when the pandemic hit. There’s really been an explosion of new investment into that space from a pediatric digital health standpoint. We work with a national collaborative called KidsX, for which we’re working to pilot and incubate startups.
That was one of our frustrations early on: there just wasn’t enough focus on pediatrics in digital health. A lot of the venture money was focused more on things aging at home. Pediatrics was more of an afterthought. I think that’s shifted a bit, and we’re seeing a lot of really good innovators in that space now.
“One front door for our families”
Gamble: That’s something I definitely want to get into more. But first, can you talk about some of the initiatives you’re working on now?
Neuharth: We’ve got a few really big initiatives. Last year, we decided to launch our own branded Children’s Wisconsin app as a hub for everything for our families. We were able to consolidate the number of one-off apps. We have one for finding your way around the hospital, we for symptom checking, and one for telehealth. We decided that we really needed one front door for our families. And so, we’ve invested a lot of time and energy in bringing that together along with our medical record and granting access to our patient portal directly through that.
Continuing on the theme of platforms, we decided we needed something to orchestrate all of these technologies behind the scenes. We needed to know, if they used this digital health app or this piece of education, did that actually lead to the right outcomes? Could we prescribe them and measure them in a unified way to help our care teams? It’s hard to introduce these. It’s a lot of effort for providers and nurses. And so, as part of our platform, we use a technology called Zeel to help coordinate that. Between those projects and launching our remote patient monitoring platform, we have a lot going on in terms of digital health.
“A consolidated view of everything”
Gamble: The digital front door – that’s something a lot of organizations are looking at. Can you talk a little more about what went into that?
Neuharth: Actually, that process started probably a year or so, prior to us even launching that. We started with the premise that we don’t want to build an app. Let’s try to find the easiest way to solve the need. And so, we spent many hours with families co-designing solutions, and when we came to the end of that, we determined that there really was a need for a consolidated view of everything, especially in pediatrics. How do I find the right site of care at the right time for my child? How do I get the right information? We really need to bring this together, along with our patient portal, and spend the time to do this right so that there’s a more consistent way to access Children’s Wisconsin.
Gamble: And you have MyChart. What have you done to make sure your customers are getting the best experience?
Neuharth: Actually, that’s been a big focus of our team to boost the adoption of MyChart. But it’s not just about whether you have an account — are you using it to schedule your appointments? Are you using it to check in ahead of time? Over the past five years, we’ve had a lot of initiatives focused on, how do we make the process easier and more efficient for both our staff and our families? Today we have more than two-thirds of our families regularly using MyChart. It’s almost in the 70th or 80th percentile. And I think we’re in the top percentiles with both online scheduling and eCheck in rates for Epic customers. A lot of that is rolling up our sleeves, providing at-the-elbow support for the staff, and looking at all of the features to enable that. There’s a lot of change management that goes into boosting our MyChart adoption.
Bringing digital & experience together
Gamble: You mentioned that you work with groups to understand what patients and families are looking for. How do you do that? What’s your approach?
Neuharth: This is probably something I probably should’ve mentioned at the outset. We have a pretty unique organizational structure where both the digital innovation and experience functions are a part of the same group. We have regular family advisory committees that we’ve had for some time, and we also have our e-Advisory groups where we have hundreds of families that have raised their hand to say, ‘we’re willing to give feedback on things as you’re developing them or as you’re considering them.’ And creates a rapid cycle for us. Even with terminology, we can say, ‘we’re using this term internally. Does that make sense to you?’ It has allowed us to be a bit more nimble and agile in our development.
I think having access to that consumer voice helps de-risk technology investments, because it may point you in the direction of something simpler or just avoid a cumbersome project all together.
“A lot of different touchpoints”
Gamble: That makes a lot of sense. I think for a long time, we’ve seen patient experience or customer experience sitting outside of IT, and it doesn’t really make a lot of sense.
Neuharth: I think there are certain aspects obviously where not all patient experience is digital, and so there are components of both. We’re looking at the human experience of how you empathize and how you connect with families. But I think it’s a recognition that people have a lot of different touch points outside of what happens inside your doors and continuing that feeling and that experience in all of the touch points is really important moving forward, so that we don’t feel robotic or kind of cold. We want to extend that experience to every interaction we have.
Technologies that “fill the gaps”
Gamble: You mentioned at the outset that there’s a lot in addition to inpatient care, especially with these different conditions and specialists. It seems like it’s increasingly important to be able to tie that together.
Neuharth: It is. It’s also being able to tell the story about how these things all connect. It’s not just one moment in healthcare, especially as you manage complex conditions or just navigating care, there’s so much that goes into it. We want to make sure that we can offer technologies that help fill in the gaps of how do you prepare for surgery or what kind of questions you might have after you’ve been discharged from the hospital. Things like that can really make a big difference in your overall care journey.
Gamble: For sure. Now, what steps are you taking to make sure apps and other technologies are leading to the right outcomes?
Neuharth: Every time we look at a new technology, whether it’s for diabetes or asthma, we’ll have KPIs on that program. But if you’re not bringing that back and tying it into the medical record and having a consistent way of looking at those things, it’s not going to have an impact. It takes a lot of time and energy to do that.
There are also some blind spots where we print off materials and people end up going home with an after-visit summary with so many pages. But we actually don’t know what happens after that. How often is it actually read?
Now we have the opportunity to deliver that same material by text message and get information — did you see it? Did you not? How much of the video did you see? And then tie that into health engagement and outcomes in the long-term. It gives us a huge opportunity. That’s where we see all of this heading — to a place where we can say, ‘This piece of material or this app was more effective than the other.’ Just as we judge anything else in the healthcare space, that’s how we judge these digital care tools.
“No wasted time”
Gamble: When it comes to offerings like wayfinding, I feel like that’s something that has evolved a lot. It’s not just about finding things. What are you seeing there?
Neuharth: I think if you focus on physical wayfinding, like you mentioned, finding the location of service, that under sells the challenge. Oftentimes, people don’t know what they’re looking for. They’re in a moment of stress and anxiety around what’s happening with their child, and sometimes they need a bit more guidance in that process.
One example I’ll give is mental health, where we have a handful of different departments and services that all had some hand in that, whether it’s psychiatry or child development. But more often than not, the family doesn’t know where they need to go. And so, we added a group that actually helps navigate you to the right type of care when you call in. That way, there’s no wasted time. You’re not ending up waiting two months for an appointment in one area, and it turns out it was the wrong spot. Doing a little bit more work upfront can get you to the right place and get you the care quicker.
The “parent bag of tricks”
Gamble: That’s so important. Healthcare is always stressful, but even more so when you’re dealing with a child, and so there’s really a need to make it as user-friendly as possible.
Neuharth: For sure. I think that it’s an acknowledgement also that there are multiple customers there. It starts with what you’re doing from a medical perspective and treating that child. But it’s also helping the parent make decisions. The most important thing for parents is getting the right care for their child. But in our research, we also found that parents are often judging themselves. Did I overreact in this scenario? Did I underreact?
And so we have what we call the ‘the parent bag of tricks,’ which gives them the right tools to say, ‘all right, I know what to do in this scenario. I know to head to the urgent care or talk to my pediatrician.’ That’s so important.
KidsX – “You need an early collaborator”
Gamble: You also mentioned KidsX before — that’s really interesting to me, because I think that we’ve seen in the past that pediatric organizations tend to be very collaborative, but this takes it to a different level and looks at different technologies and sharing best practices. Can you talk a bit about what that collaboration has been for you guys?
Neuharth: We’ve been a part of KidsX since it started. I think it was an acknowledgment amongst all of us, and from the leadership of Children’s, to say, ‘we’re better together if we can evaluate a number of these in a structured way.’ We have limited time in our day-to-day to say, amongst all the new startups, what problems are they trying to solve? Where do they need help? I think it’s an acknowledgment that to break into the healthcare space, a lot of times you need an early collaborator. You need a health system raise their hand and say, ‘yes, I will run a pilot project with you,’ or ‘I will collaborate on research around this.’ Or maybe just giving validation to the business model and saying, ‘you’re thinking about it in a way that if we make a couple slight tweaks, we can really strengthen the idea.’ Because I think we all believe that we need that type of innovation in healthcare, and so if we can collaborate together, hopefully we can get a number of these off the ground and scaled and making a difference for kids.
Gamble: Are there different avenues for how leaders connect to discuss these ideas?
Neuharth: There is. We tend to see ourselves as the group that brings it to all of the various leaders. We look at these companies and say, ‘hey, I think this solves a potential problem you’ve talked about in your area’ — maybe it’s a quality, maybe it’s a certain condition or a social determinant of health, and we’ll try to make those connections back and then be the one to help incubate and pilot those. Because even if they’ve identified the problem and decided it will take two months to help pilot the technology, it’s just not realistic for a lot of those operational leaders that have a full schedule. And so, I think offering that supplemental help through an innovation group can really boost those efforts.
Working with startups
Gamble: What’s your philosophy in terms of working with startups or similar type companies? Are you willing to work with startups that might not have a lot of traction yet? How do you approach that?
Neuharth: You have to look at each of these one by one in terms of the problem they’re trying to solve. Obviously, if there’s a way we can solve it through a platform approach — for example, maybe we already have licensed technologies — that’s going to be our first look. From what we’ve seen, a lot of startups come from the clinical space, or they’re really invested in a certain area, and if we believe they’ve got a better way of looking at things, then we’ll spend a little more time working with those companies. We believe it’s important to be transparent and say, ‘hey, let’s come up with model that works for both of us, and we can help prove this out and then hopefully get this technology to scale together.’ There’s also a lot of guidance we have to provide on what it takes from an information security perspective. There’s a lot of effort that can be a burden on these startups.
Gamble: That’s a good point and I imagine that in your role there’s a good amount of interaction with cybersecurity.
Neuharth: Yes. When you look at the time spent with a start-up and getting it introduced to the health system, info security and cybersecurity is probably the number one thing we look at. We can’t have privacy or data breach risks.
Cybersecurity – “It’s one of the teams I work with most often”
Gamble: And aside from startups, I’m sure you need to create a strong relationship with cybersecurity.
Neuharth: Definitely. It’s one of the teams I work with most often and have a strong relationship with; we need them to be able to do what they do so that we don’t get into trouble and lose any trust with our families. It’s a balance to make sure we’re always doing that work, and also allowing ourselves to still pursue these technologies and try to find ways to innovate.
“Non-traditional” introduction to healthcare
Gamble: In terms of your career, you’ve been with the organization about five years. Prior to that, you weren’t necessarily on the health system side but had relevant experience, correct?
Neuharth: Yes, very true. I had a nontraditional introduction to healthcare. I actually started my career as a software developer. I led user experience teams, and eventually got more into the health insurance space in product strategy and product management work and similar things focused on innovating around problems.
We had some technologies that we were trying to introduce to health systems; what I discovered through my previous work experience was that the number one point of trust is with providers. And that’s where digital technologies and digital health tools needed to be introduced. They weren’t as effective being introduced by a health insurance company because you just don’t have the same brand affinity and trust that you do with your provider. And so, the opportunity in my career to go work directly in the care world was too exciting to pass up. I have definitely transitioned over the last five years, and I really love working in the healthcare space.
Experience “from both sides”
Gamble: I would think having a nontraditional background can be beneficial with a role like yours.
Neuharth: It’s very helpful. Having sate at both side of the table — being a vendor explaining things and trying to sell into health systems and health insurance companies, and now being on the other side — you can have more productive conversations. You can understand the technologies and the platform approaches, and that’s been really helpful. But I think probably more than anything, bringing the user experience and consumer experience lens to healthcare has been really helpful for me to think about problems in a different way.
Gamble: You mentioned the timing and being able to spend some time with the organization before Covid hit. I’m sure that was helpful given how much everything was turned on its access.
Neuharth: I am so thankful that we started when we did, because if we had to stand up these programs in March of 2020, I think we would have been dizzy from all the change — we already were. There was so much to do to be able to drive that rapid change, but we did have some of the infrastructure in place and some thinking in terms of how we’re going to do these things. It just moved faster, and that’s okay.
In the last couple of years, I would say it’s offered us an opportunity to assess that and say, ‘alright, is everything working well now?’ For example, our telehealth volumes are still very high. By looking at everything, it offers us a chance to mature programs and measure experience and outcomes rather than just trying to grow these things. They’re obviously no longer pilot programs.
Gamble: Right. Well, it certainly seems like you found the right place — not just being able to do digital transformation work, but also work with pediatric patients.
Neuharth: It’s so rewarding. I love what I do because there’s so many ways you can apply your technology brain to problems, but nothing more rewarding than improving the health of kids. I love what I do. It’s a constantly evolving world. It’s a good challenge.