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Becker’s Healthcare Podcast
From Digital Sprawl to Digital Strategy: How Health System Leaders Are Regaining Control of the Digital Ecosystem
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- [00:00]
A
Hi, everyone, this is Lucas Voss with Becker's Healthcare. Thanks so much for tuning in to the Becker's Healthcare podcast series. It's great to have you. Today we're talking about how health system leaders are regaining control of their digital ecosystem. And joining me for today's discussion, so excited to have him, is Dr. Ricky Choi. He's strategic medical advisor at Zealth, head of digital health at Samsung Electronics, and assistant clinical professor at Stanford University school of medicine. Dr. Choi, thanks so much for being here today. It's great to have you.
- [00:31]
B
It's a pleasure to be here. Thank you so much.
- [00:33]
A
I want to start us off just level setting the conversation a little bit. We know that health systems specifically in the last 10 years have significantly invested in digital tools. But again, we're also now dealing with the fact that they invested heavily. So there's a lot of different tools and sort of this term of digital sprawl seems to be appearing across the industry. What changed and why are we now rethinking the value of digital investments?
- [01:05]
B
Yeah, that's a great question. You know, I think that as with any kind of change or transformation, you know, there were early adopters who are willing to take risks and try new things. And I think that over time, you know, more and more health systems, a huge proportion of health systems now have really invested in and have tried to really address the many challenges they're seeing in healthcare delivery in the quadruple aim through digital tools. But I think what they found is that early on they were looking to solve specific problems. You know, there was a particular workflow, there is a particular disease process they're trying to address, and they were really focused narrowly on that solution, but really not thinking at a systematic level. And so you do that a few times and before you know it, you're at 10, 20, even 30 or 40 different solutions that not surprisingly now don't talk to each other and so creating a whole set of problems. Now, with my Samsung hat on as a participant of and a watcher of the market, you know, we have, we feel like that there has been a lot of progress. We're starting to see more and more roi, but we're definitely recognizing that there is now we're at a different phase where that data definitely needs to flow, you know, between solutions. There needs to be orchestration behind the scenes and we'll hear over and over again from all the stakeholders in health systems. It needs to fit in within the clinical workflow and it needs to be attractive for patients to use.
- [02:33]
A
I just Wanted to really quickly repeat those two numbers that you mentioned. Right. It's an estimate, of course, but 30 to 40 different solutions. Think about that for a second as the listeners here. Those numbers are incredible. You spent this morning here at the annual meeting at Beckers in Chicago with health system leaders talking about the cost of all of this and potentially the hidden cost that this all creates. I'd love to know what stuck with you in those conversations and what are some of the costs that leaders underestimate with all of this.
- [03:07]
B
So I think that, you know, health systems came at this really trying to address, you know, the quadrupling quality, access, cost, patient satisfaction, you know, clinician, you know, burnout and satisfaction as well. And just as you've emphasized, we went from, you know, a couple one off solutions to very quickly to now having tens of solutions. Actually, in the room we had earlier today, we had about 30 participants coming from a range of health systems. When asked, a good proportion of the room raised their hand when they said they had 20 solutions. Digital solutions, another smaller group, but a significant group had 40. We even had one health system that has said they have 200 different. So, you know, hospitals are not IT companies. Right. And so you can imagine how unwieldy it is for the IT and IS systems to manage. And so as hard as it is to get some of these things implemented, in some cases it may be just as hard to unwind. And so ironically, we end up with some of the same problems we start out with.
- [04:11]
A
Yeah.
- [04:11]
B
Which is workflow fragmentation, which is alert fatigue. And then now we add on vendor complexity and governance. And at the end of the day, we're all trying to achieve that roi and that gets muddled when we see that kind of fragmentation.
- [04:26]
A
Now let's turn this around.
- [04:27]
B
Right.
- [04:28]
A
We are trying to fix this. I think a lot of health systems are moving in the right direction. They are learning their understanding. But again, what does it actually mean to move from this collection of tools that you've just mentioned to a true digitally aligned strategy?
- [04:46]
B
Absolutely. I think that first of all, we need to move from point solutions in single digital interventions in the clinical setting to thinking more comprehensively. I think there's a couple of different ways we can do that, but I think one way approach certainly is to think about the overall patient experience, which often starts in the home. It's where they first notice that they may get sick or trying to manage their health condition. And so there are signals now that can be collected to understand that context, whether it be the way that they may Use technology in the home or some of the now kind of cutting edge wearable technologies. That technology you can imagine now starting to inform where patients go and providing a fuller picture for clinicians. And of course what you need to do is start to start to figure out how we're going to orchestrate those technologies, how to help those things start to work together and so that one can make the most of the technologies that have been implemented. It's been often said that, I'll say it again, you know, it would be an utter failure if we are basically digitizing the current flawed system. We need to really think about or complete redesign of healthcare.
- [05:49]
A
And I wanna talk a little bit about that process because again, we don't want to repeat this. And what makes this hard is that we now have a suite of tools, innovation when it comes to AI that's sort of entering the theater here, that's entering healthcare. Are health systems approaching AI differently than some of these other point solutions that we've seen in the past? Right. Or are we simply repeating some of the things that you've just outlined?
- [06:17]
B
Yeah, that's a great question. You know, I think that in our conversations, including the panel this morning, the roundtable that we had this morning, health systems are approaching it a little bit wiser, you know, you know, they are still fragmented, they still, there's still many challenges and process and to go through, but they're coming at it a little bit wiser from what they've learned from digital when they brought in digital tools. But they also kind of view that there's, that the risk profile is a little bit different when it comes to AI. I think that there is a little bit of, not a little bit. There is a significant black box here I think when it comes to especially generative AI. And so they're approaching it with much more caution. I think the health systems I've spoken to, you know, who are willing to really start to push those boundaries and recognize the value can create, are thinking about it more from the back office perspective, revenue, operations and etc. And then slowly dipping their toe and into now providing, you know, having interact directly with patients. I think we all see the opportunity, you know, when we think about having a staff member who spends their day calling patients all day long to try to get them to come back to address a care gap or a various need versus having an AI system that can contact hundreds at once. I think that, that, I think the opportunity just sounds absolutely tremendous. Now there's a lot of considerations there, but I think that Opportunity from a cost and frankly to deliver better care is really great. That being said, we need to have the right list of patients that can be contacted that just doesn't appear on itself. Veteran is a system connected to it that then feeds into that calling system. And great, you contacted all these people and people are going to come in. But how is the health system prepared to handle that inflow and from a technology perspective. So these cannot live on an island, cannot live in isolation. We need to think about how these things are integrated together, that overall orchestration and governance. I think that's we're now in that phase of technology maturity that health systems really need to think about.
- [08:18]
A
Yeah, we come back to the conversation about eliminating silos that we've talked so much about in healthcare so far. You've touched on this a little bit in our conversation here today, but you've also talked about this frequently across the board, which is the future of healthcare. Being at home. Home and being powered by continuous patient generated data that really at the end of the day again serves the patient which is the most important thing. What changes when care moves outside of the hospital?
- [08:47]
B
Yeah, I think that I would argue that care began outside the hospital and in fact in the home. We know that it's in the home that people first are overall managing their day to day health, their overall well being, the food that they eat, the way they spend their time, as well as with their loved ones. It's where they first notice and may discover they get sick and those signals may be unbeknownst to them that would only be detected through a wearable technology, for example, which nowadays can detect if you have atrial fibrillation or you have sleep apnea. It's about also managing conditions, encouraging people to live healthier, eat and stick to the diabetic diet, their heart healthy diet and et cetera. And we believe that those technologies can play a really important role to then really helping that clinician get a full picture and understanding the patients in terms of their health challenges, how they've been managing their overall health, but also getting them to the right side of care. We've talked to a number of academic and quaternary health systems and they want to deliver the best care possible. There are some things they are very, very good at, the best in the world at. And there are some things that are probably better off where care is delivered at a different part of their system or a partner system. And at the end of the day patients want their problem solved as expediently as possible. They're suffering. They have needs that need to be addressed. And so I think that with these signals that we may be able to collect in the home that we in fact can, I think there are opportunities to think about how do we address both of those needs.
- [10:15]
A
Yeah, I want to close this off with something that frequently comes up in healthcare, and you've actually mentioned this here today as well, which is the fact that data is at the heart of everything in terms of success. And we have the data, health systems have the data. It depends on the execution. Insights versus that action. How do we close the gap between insight and action?
- [10:41]
B
Yeah, I think that's a very complicated question, but at the same time a very simple point. And I almost want to say it may start with me. And I say myself as a clinician, you know, with the implementation of ehr, went from writing charts into now utilizing the electronic health record as and now, while I don't love it, none of us love it. We are comfortable with the constant software updates and those changes in that same way as we think about digital tools, apps, you know, services, AI and et cetera. If it helps my patient get better, if it helps the health system achieve its goals and our shared goals and the success of the organization, please make it as easy as possible for me to do, because I will be much more likely to follow through with that. You know, at Samson, we've been thinking a lot about how do we start making these things easier to do. In fact, you know, in clinical care too, my general mantra is how do we make the healthier thing the easiest thing to do? And in many ways, I think there are signals in the background that we just discussed that Samsung's been thinking about how do we then make it as easy as possible for doctors then to absorb and understand the health status of that patient so they can get going, starting to address those needs. I think there's a lot of opportunity there.
- [11:53]
A
It Warren's another podcast conversation, I believe. Dr. Choi, thank you so much for taking some time and being here today. What a fantastic conversation.
- [12:00]
B
Absolutely. Thank you so much.
- [12:01]
A
So great to have you. And we also want to thank our podcast sponsor, Zealth. You can tune into more podcasts from Becker's Healthcare by visiting our podcast page@beckershospitalreview.com.