Healthcare doesn’t just have a data problem; the industry is mired in an “epic game of chicken,” said Sara Vaezy, EVP and Chief Strategy and Digital Officer at Providence. “Everybody knows that the data is very powerful and worthwhile and useful,” she said during a recent interview. What healthcare organizations don’t seem to know is how to leverage the information they’ve been gathering digitally for the past several years to engage more effectively with individuals.
Providence Digital Innovation Group (DIG), however, took a major step toward achieving that goal with the recent launch of Praia, a platform designed to create more personalized online care experiences for patients. The technology aims to “marry clinical information with consumer information — enabling health systems to create digital experiences that show their whole relationship with the health system,” according to a statement from Providence DIG, the innovation arm of the 51-hospital integrated delivery system.
The ultimate goal, said Vaezy, is to “expand the lens through which we see individuals,” rather than focusing solely on a clinical transaction or episode, and “meet their needs in a more personalized way.” Recently, she spoke with Kate Gamble, Managing Editor at healthsystemCIO, about how and why Praia Health came about, as well as the biggest roadblocks her team faced, the strategy they’ve adopted, and what’s next for the latest incubated technology from DIG.
Q&A with Sara Vaezy, EVP & Chief Digital and Strategy Officer, Providence
The Core Objectives
Gamble: Hi Sara, it’s great to speak with you again. Thanks so much for giving us some time. Let’s start from the beginning. What was the impetus for creating this platform? What were you looking to accomplish?
Vaezy: The goal was to expand the lens through which we see individuals — meaning our patients and consumers — and center around more than just a specific clinical transaction or episode. We wanted to meet their needs in a more personalized, systematic way. Praia solves that problem for us. oes is it solves for that problem for us.
The first step we took in that direction was identity. And when we say ‘identity,’ historically that has been the patient record. But again, that limits your worldview to only clinical interactions. We said there needs to be an identity broader than that. Think of it like a Google credential that allows you to utilize all sorts of other services like Gmail or federate your login to other partners working with Google. You can use their photo application. You can have a personalized experience in Google Chrome.
In the context of healthcare, it’s a broad identity that allows for username and password creation, whether you are a patient or not. It allows verification, which is essential in healthcare, and lets you connect that to a clinical record (if needed) and connect to partners and federate it.
That becomes the foundation for a profile and a personalized experience that connects the dots for folks into a single access channel. On the backend, it provides tools and insights for providers so that we can ensure the programs are working, and that we’re only putting things in front of our patients that are meaningful to them and provide value. That’s a little history behind how this program came about and why we started building the platform.
“Tremendous” partnership with IS
Gamble: And it connects to the clinical record, which I would imagine means you need to be in close collaboration with IT to make sure everything is doing what it’s supposed to. Has that been the case?
Vaezy: Absolutely. Our IS partners are some of our closest collaborators within the organization. We work hand-in-glove with them. In a lot of organizations, the digital and IS teams are at odds with one another; for us, that’s not the case. They’re tremendous partners and great advocates. We’ve worked really well together to make sure we get this done.
That’s so important because every single login to our system flows through the Praia identity. It’s a full-blown enterprise production. It’s not something we’re just experimenting with on the side or with a thousand people. We have 4 million accounts within Providence.
Gamble: What was the strategy as far as piloting? Did you start small? Walk me through the approach your team used.
Vaezy: There were a couple different ways. The first thing was actually on the experience side. We started on one channel only, which was Mobile. That naturally meant a smaller population of folks. And we started it for very specific use cases. Initially, we only used it as the channel to surface things like our blog content and our on-demand care. The first step was to use it as a single access channel for limited use cases. And then we started expanding beyond that.
When we launched the identity portion of all of this, it was the new identity, which was not reliant upon the medical record identity. We never went with 100 percent of traffic or 100 percent of users. We would expose it to a subset of users, work out any of the things that needed to be refined and modified and fixed, and then expanded from there. And so, there are different dimensions to how we scaled it up, but it was relatively quick. We went from zero to 100 percent traffic in a matter of weeks, not months or years.
Linking clinical & nonclinical identities
Gamble: From what I’ve read, part of the focus with Praia is also on acquiring customers and focusing on those who aren’t yet patients. That hasn’t always been a priority in healthcare.
Vaezy: Exactly, and that has a lot of consequences, one of which is narrowing access. What do you do if don’t have an existing patient relationship as a patient? It limits the services that are available to you. It limits the information continuity that you could have across different care sites. And so, it’s really important to disaggregate or decouple those two. And that’s really hard to do, because electronic medical records have historically made it very challenging to link the clinical side of things to a nonclinical identity. That’s one of the big challenges we had to work through, both from a technical perspective and a philosophical perspective.
Gamble: That certainly aligns with what we’ve heard are some of the big hurdles with digital transformation. We’re dealing with complex data, and there are regulatory and privacy issues. How are you working through those challenges?
Vaezy: We’re still very early in that process. But there are certain things that we can do as it relates to ensuring that we are responsibly engaging with our patients and consumers around their data. Part of that is putting in terms and conditions and making sure they understand how and if their data is being used. And if they want to opt out, making sure they can. We’re being really careful with those types of things
Playing “chicken” around the data
We have all sorts of interoperability challenges; some of it may not be regulatory in nature. It’s almost like there is this epic game of chicken that we as different constituents or sectors within the healthcare environment have been playing with one another around the data, because everybody knows that the data is very powerful, very worthwhile, and very useful. We’re trying to really engage across an ecosystem to convey to folks the importance of that, and the value it brings for folks who are able to participate in a meaningful way. That’s the approach that we’ve taken. But from a regulatory standpoint, it’s really about informing and allowing the patient to opt out.
Digital health metrics
Gamble: That’s so important. And it relates to a discussion you participated in around driving value in digital health, and how important it is to realize and measure value with digital initiatives. How are you approaching that?
Vaezy: That’s critical. We’ve seen some organizations that are right-sizing their digital teams or reducing certain functions. I think the main reason for that has been the challenge associated with demonstrating value.
We’ve been very rigorous about it at Providence. I would say there are digital metrics that need to be tracked in order to show that something is of high utility to the patient. For instance, with digital transactions, how many folks are booking appointments online? How much traffic do you have on your digital assets? Monthly active usage is another big one. We’re trying to track engagement and repeat visits because there’s relevance to you as a person who consumes health and healthcare resources. So we look at monthly active use and weekly active use.
We also look at digital metrics. In some cases, it gets more granular where we have actual product metrics around how many people are interacting with X feature and how much time they spend using it.
It’s also important to pull through and ask, how do those digital measures generate economic and clinical value for the system? Because we know these folks and we have the identity in place, we can now ask, what channel did they come in? How much did they reengage with us? How does that compare to someone who is not engaging on a personalized platform? We can measure the data and we can actually say, ‘here’s how much economic value is flowing through this channel.’ We have actually spent a lot of time and resources to being able to do that in order to show that it’s material to the business.
And that’s not to say that, for instance, if the website went away, our volume would drop, or that all of the people who came in because they found us on our website would go away. A significant portion of them would probably find a different way. But even if you increase it by one or one or two points, it’s a significant opportunity. And increasingly, digital is going to play a more meaningful role in terms of driving that economic value. Right now, we’re measuring it and we’re able to translate it into what the value is economically and clinically for the system. And we anticipate that will continue to grow.
Digital flywheel concept
Gamble: Really interesting. Another thing I wanted to talk about is the flywheel concept. Can you talk about how that factors in?
Vaezy: Sure. First, I will say that I’m a big Jim Collins fan, and I think the concept of a business flywheel is great. There’s a lot of data and evidence supporting that. In the context of a digital flywheel, we’re basically going for the thing that keeps people coming back for more because it’s relevant to them; because they need that service.
But Praia itself is not the flywheel. It’s the key enabler of how you deliver personalized, engaged experiences to a user that will create that habit of them coming back.
A lot of other industries have their digital experiences wrapped with other things like points programs or loyalty programs. Of course, healthcare is a lot more complicated because we’ve got inducement and anti-kickback and all these other things that we need to be very mindful of. But if someone knows you and they can remember, okay, like, here are the things that you did last time and here’s what looks right for you in the future, then you’re more likely to build that relationship and come back again.
Next steps for Praia
Gamble: Sure. So, the final question I wanted to ask is around the next steps for Praia. What do you see happening there?
Vaezy: Our model, and what we plan to do with Praia, is to find an external entrepreneur CEO to fundraise for the company and spin it out. We’re in the process of doing that. In addition, expanding the customer base is critical because we’ve got a very small team. But we have a pretty healthy pipeline, even in a really difficult environment, for digital companies in healthcare. And so, we have to expand the customer base and continue to demonstrate a broad product market fit in the fundraising process. And then the company will be out there on its own. It’s the same thing we’ve done in the past with companies like DexCare, Xealth, and Wildflower, where they’ll be able to serve the whole market.
The reason we do that is there are more problems to solve than there are digital resources. And so, we can’t consume all of our resources on one or two platforms at a time. We need to keep innovating and keep applying it to the next set of things. This is our way to ensure we don’t use as many operating dollars, which are very scarce these days, and get alternative forms of capital to solve the problems that are most important to us.
Gamble: Great. Well, it sounds like you guys are doing some incredible work. Congratulations on the success so far, and I look forward to hearing more in the future.
Vaezy: Thank you, Kate.