“We have the data. What are we doing to do with it?”
It’s a question that has soared to the top of the list for healthcare leaders, particularly given the “wave of consumerism” the industry has experienced in recent years.
The answer, of course, can differ significantly based on myriad factors, from the size of the organization (and its resource pool) to the needs of its patient population.
For Holyoke Medical Center, a 219-bed facility located in western Massachusetts that “sits in the shadows” of larger systems like UMass Memorial Health and Baystate Health, it’s all about the people. “Our community is tightly connected to us as a health system,” said Joe Diver, who took on the CIO role at Holyoke in February 2023. And therefore, it has become a key priority to develop tools and programs aimed at managing diabetes and hypertension, which affect a high percentage of the population.
That focus, he said, was a “driving force” in his decision to come to Holyoke. “Our CEO and board see digital therapeutics and digital health as an opportunity to improve the health of our community while maximizing the opportunity within value-based care incentive arrangements.” The challenge, he noted, is to find ways to “stay ahead of the curve.”
During a recent interview, Diver opened up about how his team is leveraging data to identify the most critical needs among patients in the Pioneer Valley area and take steps to move the needle. He also spoke about the importance of developing strong partnerships — with vendors as well as other health systems; the unique challenges faced by community hospitals; and the collaborative that he believes will position organizations like Holyoke for success in the future.
The “Next Horizon”
One of the most important steps in Holyoke’s digital journey happened a few weeks prior to Diver’s arrival, when the organization was awarded a $75,000 grant from Blue Cross Blue Shield of Massachusetts to “extend care into the community and minimize disruptions to access,” according to a press release. Through the funding, the organization has been able to stand up a metabolic clinic and more effectively capture social determinants of health (SDoH) data and learn more about patients.
Some of the insights they’ve obtained so far include the following:
- 3 percent of the patient population doesn’t identify as either male or female
- 32 percent are in need of interpreters
- 26 percent have difficulty doing errands (such as buying groceries or picking up prescriptions)
And that’s just the beginning. “Now that we know this, we’re stepping back and asking, how can we develop other programs? How can we connect to social services and communicate that through the patient’s journey?” Diver noted. “That’s our next horizon in the data capture process. It’s been a really interesting transition to bring our team members through that and begin to have this digital front door experience.”
Importantly, he emphasized, the aim isn’t to try to “solve every problem in the world,” but rather, how to move forward with the data they’ve collected.
Digital therapeutics
One way is through digital therapeutics, a strategy that goes beyond merely monitoring conditions such as hypertension to actually track progress and help minimize variability in glucose levels. In doing so, digital therapeutics “becomes part of the care plan between the provider and patient,” said Diver.
An example he cited involved an OB physician who wanted to monitor women at high-risk for preeclampsia during the early days of Covid (at Baystate, where Diver served as Director of Digital Transformation for five years). By enabling physicians to track blood pressure and provide education and therapy for those at risk, the staff was able to prevent early deliveries and NICU stays for two different families. “We put in a program where patients can have support between visits and adjust their care plans as needed,” he said.
The hope is to create a “digital formulary” that houses “all of the digital apps that are validated by medical leadership and approved for our population,” he added. “It’s an exciting space. It’s early, but it’s exciting.”
A similar guiding philosophy is in place at the metabolic clinic, where a key objective is to leverage data to help patients better manage diabetes by understanding the impact of nutritional and behavioral choices. As a result, 20 percent of patients were able to stop taking diabetes medications. And although the sample size is relatively small (around 120 individuals), it’s still extremely encouraging, said Diver, citing improved health outcomes along with significant cost savings.
“We have the ability to look at consumerism and the consumer journey in new ways,” he noted. “The whole thing is around human-centered design. And not just developing it in a bubble, but looking at your key stakeholders, including patients, and asking, ‘How can we leverage this technology together? What problem are we trying to solve?”
Partnerships
For community hospitals that run on “razor-thin margins, if we’re lucky,” those conversations are becoming increasingly critical, Diver said. Although it may seem counterintuitive, “You need to put the technology aside and work together to digest the problem.” It starts by asking potential vendors about their strategies and determining whether they align with those of the health system.
For Holyoke, one that certainly aligned was an initiative in which patients are observed, both in person and through monitors, by patient safety associates, enabling better coverage throughout the hospital. In April of last year, that coverage proved pivotal when one of those associates — who didn’t have a medical background — noticed a change in a patient’s condition and alerted the nurse. Because of his actions, the staff was able to immediately and successfully administer CPR. “It saved the patient’s life,” said Diver. “How do you attach a return on investment to that? How do you not do more of that?”
And, importantly, how can that be scaled? This is where leaders need to seek out “innovative partnerships” in which organizations like Holyoke are willing to put in the sweat equity, and vendors are willing to negotiate on pricing. “We bring a level of passion; how can we work with tech partners to go after these passionate problems we have” — but without breaking the bank, Diver asked.
This might mean asking vendors to change their economic models. For example, switching out annual subscription models and instead focusing on financial or clinical outcomes. “Let’s put value around that,” he said. “Let’s run at it a different way.”
Meditech collaboration
For Holyoke, the spirit of partnership isn’t limited to vendors or patients, although both are key stakeholders. Last year, it was one of 12 organizations to join the Meditech Interoperability and Data Collaborative, an initiative designed to build consensus around standards, data schemas and use cases to “advance data access for clinicians and patients.”
As a longtime Meditech customer and early adopter of Meditech Expanse, Holyoke is positioned to help other systems by sharing knowledge. “We’re all after the same things in healthcare when it comes to quality reporting and data interoperability,” said Diver. “How do we get reportable data into our EHR and make it more streamlined? These are the conversations we’re having.”
Gathering other Meditech clients — including Citizens Memorial Health and Steward Health Care System — together, he believes, creates “a huge opportunity” to learn from others and become better prepared for the future. “If we look down the road five years from now, what does the EHR look like? Is it going to be in the background running data analysis while other tools are outside of the EHR? And them you add AI into the mix — what does healthcare delivery look like?”
So much of that is yet to be determined, but one thing is for sure: “data interoperability will be a core part of that,” said Diver. “We’re excited about where things are going.”
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