John Kravitz is CIO of Danville, Pa.-based Geisinger, a physician-led health system with 13 hospital campuses. The system also includes a 600,000-member health plan and the Geisinger Commonwealth School of Medicine.
Geisinger developed a program called ProvenCare®, which aims to improve value-based care delivery. Its ProvenExperience® program offers refunds for select procedures if patients are unsatisfied with their outcomes.
Kravitz is also slated to chair the College of Healthcare Information Management Executives in 2020, and he currently sits on the organization's board of trustees. Here, he discusses how Geisinger uses technology to improve the patient experience.
Question: How do you see consumerism in healthcare affecting IT for hospitals and health systems?
John Kravitz: Consumerism has affected healthcare in a big way. At Geisinger, we look at the rise of healthcare consumerism as a chance to set ourselves apart from the competition. We really need to differentiate from other health systems in our area, and competition is fierce. Consumerism is a driving force in disruption for healthcare, as well as other business sectors.
To meet these changes, we are leveraging patient portals, and we have a health plan with features based on the needs of our beneficiaries. We focus on the consumer ― whether it's the health plan subscriber, patient or medical student ― with our revamped patient portal that makes it easy for users to authenticate and log into their accounts.
About 40 percent of subscribers in our health plan receive care within the Geisinger system. Based on their roles, if subscribers receive care within our system, we can send them updates on their services. This opens up the ability to message providers, pay bills and receive test results through the patient portal.
We are also adding biometrics to mobile devices with scaled applications to support those efforts. If you have facial or fingerprint recognition set up on your mobile phone, you can use that to authenticate into our system. That makes access easier for the patient while keeping their information secure.
Q: What is Geisinger doing to improve the patient experience now, and what are you working on for the future?
JK: We have our technology behind the ProvenCare and ProvenExperience system that provides order sets and tools to support it. We take a prescriptive approach to medicine for high quality, guaranteed outcomes. If a patient is treated with the ProvenCare protocol and there’s a problem, we can correct that without billing the insurance company or the patient. However, we haven't had many instances where patients haven't achieved optimal outcomes.
For subscribers to our health plans, we provide a ProvenHealth Navigator® that can help those beneficiaries navigate services outside of our health system. That process works well.
Our latest system is ProvenRecovery, which supports clinicians and is beneficial for patients undergoing non-emergency surgical procedures. This protocol is designed to maintain the patient’s strength through proper nutrition before a surgical procedure. This allows the patient to optimize the recovery process and minimize the risk of readmission leading to a faster recovery.
To boost the patient experience in the future, we are doing an enterprise-wide implementation of Salesforce that will help us with customer relationship management. We can use the machine learning for communications with the patient; right now, we use it for scheduling, but eventually we can use it for all patient service requests.
Q: How do you approach cybersecurity?
JK: We have a layered approach to cybersecurity. We have tools in place for data loss prevention, and we work to protect the patient’s privacy, ensuring there aren't any HIPAA violations. We use secure email and text, all of which is encrypted by vendors. In addition to our traditional firewall, we have a service for attack prevention that segments our system. If hackers try to access our system and knock out internet communications, they will receive a denial of service. That way, we isolate the attack to just one part of our system.
We also have endpoint protections to prevent malware from spreading throughout our system. And we use multifactor authentication. In the event someone within our system gives up their primary credentials, they would require a second factor authentication on their mobile device to confirm access to our system.
Finally, we do password vaulting. If we do have malware that tries to take down the system, we have a password vault for added protection against a hacker attempt. We take a lot of preventive measures to protect all patients. This is a very serious priority at Geisinger.
Q: What is the best health IT investment you have made in the past year?
JK: We are implementing a single enterprise system, and that will have some impact on patient billing and all clinical services we provide. We currently have two EMRs, with some of our locations on Epic and others on Cerner. We will provide a unified billing system to both our Epic and Cerner EHR systems ― that's big.
We are also deploying an IT service management system that will affect the patient experience; it really touches everywhere in the system. This technology will help with change management, so when we have software updates, they will be controlled and tested thoroughly. Our staff members will be able to place orders for new equipment and expect delivery in five days or less. It will also help streamline all processes for our patients and health plan subscribers.