A CCTO goes in-depth about how healthcare needs to rethink how it operates.
Rick van Pelt, MD, is the chief clinical transformation officer at Birmingham, Ala.-based UAB Medicine.
Dr. van Pelt will serve on the panel "How to be a Daredevil Innovator in Healthcare" at Becker's 7th Annual Health IT + Digital Health + RCM Annual Meeting: The Future of Business and Clinical Technologies. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place Oct. 4-7 in Chicago.
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Question: What are you most excited about right now?
Dr. Rick van Pelt: I'm most excited that we're in a setting of the profound need for change, where doing things in silos and around the edges is no longer adequate. I think we've been dealing within healthcare with a steady stream of challenges as long as I've been in healthcare.
Until now, it's been relatively easy to try and pick off particular areas without paying attention to the healthcare system as a whole. COVID-19, in particular, has created conditions where things that have been slowly in decline in different areas have accelerated and where we need to take a much more system-based comprehensive approach to identify solutions. It's no longer optional. So I think more than ever, there's this recognition that we have an opportunity and, essentially, an urgent need to make dramatic changes in healthcare if we're to course correct and improve the overall delivery of care.
Q: What challenges do you anticipate over the next two years?
RVP: There are several challenges in the context of what I've described, having been through two years of COVID-19. They relate to staffing shortages and the cost of staffing. There's a fundamental shift in our ability to staff the way we always have, whether nursing, ancillary, physician or provider services.
I think overall well-being burnout is also an enormous challenge that has always been there at low or lower levels but now has emerged as something substantial. It's a crisis in many larger hospitals and probably across the board. Again, that needs a massive amount of attention, particularly related to staffing and creating and improving the work environment and the care environment for patients, patients and families.
There are supply chain issues that everybody's dealing with. That's probably less in my domain. But certainly, the ability to have what's needed for care and better understand how we use different equipment, supplies and so forth is now at the forefront. There's also a real challenge around access to care, recognizing that we're starting to get the older baby-boomer generation coming through. With staffing and capacity constraints, we have to think about optimizing access to care, not only inpatient but also ambulatory, and connecting the whole thing.
Q: Where are the best opportunities for disruption in healthcare today?
RVP: I would start by saying that one of the most important opportunities is to rethink and take a harder look at how we problem-solve. I would say one of the fundamental needs and opportunities is to become much more of a system-based problem-solving industry. Hospitals and teams must try to move out of the firefighting mentality to get an integrated interdisciplinary team model together. Additionally, they need to start looking at things from a much broader point of view regarding the impact that changes or problems have if we're going to solve these things.
Also, staffing is another critical opportunity. Rethinking how we deploy our staffing, whether nursing or not, we have to get out of this mindset of more, better, different, and start thinking about new ways of deploying nurses and supporting nurses. Among other things, I believe telehealth, importantly, inpatient telehealth, will have a pretty important role to play. Still to be defined both at the level of sort of provider telehealth coverage, but also, importantly, nursing telehealth coverage.
Regarding access and throughput, other venues for care, such as hospitals at home, are models that we need to start thinking about. In improving post-acute care, we're reducing the length of stay; that would be an example model. So those are a couple of things that would come to mind.
Q: How is your role as a CCTO evolving? How are IT teams changing?
RVP: I came from consulting; I'm an anesthesiologist with a clinical background. I spent much time in the clinical space, consulting, doing care redesign, performance improvement, etc. Ultimately, when I came to UAB about four years ago now, my role was pretty undefined. There was a recognized need but a lack of clarity regarding how to deploy. Also, I moved from a solo adviser role to getting a team developed for me.
The role and responsibilities have evolved from what I would call nice-to-have to much more must-have. One of the profound changes or elements my role introduces is creating conditions for proactive problem-solving in a healthcare environment, typically reactive, in what I would call firefighting. We're offering an opportunity to take a system-based view of complex problem-solving. In the context of the daily firefight, it's creating space and opportunity for the organization and the teams that we create to start looking at these complex problems in a thoughtful system-based way so that we can essentially start to get these root-cause challenges. On top of that, technology and other things have key roles.
So, in terms of how IT has evolved, it has always been a responder to define needs that the hospital identifies in its strategic or tactical plans. We're incorporating them as part of the problem-solving team, right from the get-go, so that they have an active input into bringing the technologies that either are evolving or have been in place and repurposing them to actual need.
There's a different way of applying conventional technologies that are much more targeted to improve care delivery, much more performance-based, and much more meaningful measures instead of just reporting data and automating systems or processes that have traditionally been manual. So it's a total rethink, incorporation and exploration of how technologies, as they're evolving, can be applied in innovative new, needed ways.