Over the past decade we have seen the focus of healthcare organizations evolve from the Triple Aim to population health and value based care to a consumer-centric approach to health.
We have been changing the labels, but not significantly changing the overall goals. As is true for many large endeavors, the devil is in the detail and the details reside in the multidisciplinary nature of addressing the challenges in the healthcare organization. The key leaders – the CMO, CIO, CFO, and the Chief Patient Experience Office (CPEO) – share many big goals, but whether it's the triple aim or pop health the consistent long-term challenge is sustained collaboration by these departments and their leaders as new programs are designed and implemented. This article will address common pitfalls and outline the key steps toward effective long-term collaboration.
Organizational silos and strategic drift during project selection are two of the main difficulties that prevent an enterprise from reaching their strategic imperatives and both are related to this lack of collaboration between the four key roles in the organization. Siloing includes not just the toxic political issues that arise in some organizations, but also the no less insidious day-to-day lack of communication and integration with other departments that undermine important initiatives. Strategic drift while projects are being evaluated for implementation is the second pitfall. When we are brought in to work on a project turnarounds, we often start with the consultant's classic question: "What is the problem we are trying to solve again?" All too often, we are met with blank stares or widely different answers that have no relation to the overall organization objectives.
Four Intertwined Roles in a Customer Centric Model
The key organizational leaders and their teams are inextricably intertwined, and the faster they collaborate, the better for the organization and the populations it serves. To meet patient experience, population health and value-based medicine goals, each of these groups plays a critical role: defining programs to address population health imperatives is largely the purview of the CMO; ensuring they are cost effective, have a clear a business case, and are reimbursable is the CFOs job, incorporating value-based medicine and creating a perception of value for the customer/patient is the CPEO's area of expertise, and technology and implementation are inseparable from any major effort, which makes the CIO an essential player as well.
To further illustrate the level of integration required between these roles, let's take a high-level look at how health systems address patient experience and engagement as it impacts patient outcomes, overall population health and the organization's finances:
• The CMO is a key component in understanding the patients' experience and interfacing with care providers to improve overall population health.
• The CPEO brings the perspective of how the patient defines value and communicates those requirements to peers.
• Because much of patient dissatisfaction driven by financial issues and patients are increasingly advocating for price transparency, the CFO is essential for helping patients and providers understand the price of care.
• The CIO must identify cost effective solutions, look for ways to leverage the external ecosystem, play an integral role in business case development, and is serve as a necessary communication hub across the other internal groups.
Eliminating Strategic/Project Drift
Once we acknowledge the strategic importance of the interconnection between the roles described above, and the absolute necessity of keeping these connections functioning properly to meet the population health and patient experience imperatives necessary for success, it is clear that a concerted effort to keep the lines of communication across silos open and to work together to keep projects on track is essential. The organizational structures and processes defined below will keep your projects aligned to your strategic objectives and force collaboration between all four key roles in the organization.
The Long-Term Vision
Each of the key roles defined above is necessary for the creation of the three to five-year customer experience driven business plan, which serves as an architectural blueprint for the future, with each major project fitting into this larger scheme. This plan serves as a primary communication tool as well as a guide to prevent strategic drift. The CMO and the CPEO will be critical to defining the customer/patient needs, the CIO will provide the technical vision, and the CFO will assist with the financial and budgeting process that will provide organizational funding.
Implementation and Governance Office
To ensure that the organization is working on the right projects, in the right sequence, and with the proper velocity, it is necessary to build a strong Implementation and Governance Office staffed by individuals that can represent all four key areas in the organization. This office should have responsibility for:
• Portfolio Management – Strategy implementation and execution from an investment perspective. This area will monitor and adjust to ensure that business objectives are being met.
• Program and Project Portfolio Management – Has responsibility for delivering business benefit by execution of an integrated network of projects.
• Project Management – Delivering on individual projects within the project portfolio
• Governance – A governance hierarchy should be established to keep communications open, and insure that the long-term vision remains viable and that each project supports that vision.
Executing on the vision will require the organizational structures above but it will also be necessary for the leadership team to critically analyze their readiness to execute. Areas such as staffing ability, vendor ecosystem, understanding the current book of work, and current culture will all need to be addressed.
Putting it All Together
According to Carol Majewski, MS, MHCDS, RN, and director of Dartmouth-Hitchcock's Office of Patient Experience, "Evidence shows that the better a person's relationship with his or her health care provider, the more engaged he or she is in their own health. To significantly improve population health, people have to want to come to us for care."
Patient experience is no longer just about the office visit or the surgery, and goes well beyond simple post-op follow-up. Deep meaningful engagement with patients can have a significant impact on overall population health, individual patient outcomes, and the bottom line. Patients need assistance in managing their care and their perception of value depends on them getting that assistance. To improve customer experience and population health it is imperative for the CMO, CFO, CPEO, and CIO to all work together in a meaningful, well organized, and sustained fashion to deliver value for the patient and bottom line results. By developing a cross functional long-term vision between the four key areas along with a strong governance model to insure adherence to the vision, while keeping communication lines open the desired outcomes can be realized.
Nick Vennaro, is an executive vice president and co-founder of Capto and a twenty-plus year healthcare industry veteran.
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