42 changes to earn better results, per health IT and finance leaders

Running a successful healthcare organization requires constant innovation and adaptability. Forty-two healthcare leaders shared their best change in the past two years to attain amazing results. Will you be stealing one of these ideas? 

The executives featured in this article are all speaking at Becker's 9th Annual Health IT + Digital Health + RCM Meeting: The Future of Business and Clinical Technologies which will take place Oct. 1-4, 2024, at the Hyatt Regency in Chicago.

If you would like to join this event as a speaker, contact Randi Haseman at rhaseman@beckershealthcare.com.

As part of an ongoing series, Becker's is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.

Question: What is one change you made in the last two years that yielded the best results?

Bimal Desai, MD. Assistant vice president and chief health informatics officer at CHOP: We rapidly expanded our portfolio in remote patient management, going from one to two live programs to nearly a dozen today, reaching over 11 thousand patients per year. Importantly, we learned that there is tremendous value in being able to 'mix and match' styles of remote care.

For example, groups like our congenital heart disease program are combining daily mobile check-ins, weekly video visits and 'as needed' connected devices to create one-of-a-kind clinical interventions, tailored to the unique needs of our diverse patient population. This flexibility allows us to precisely tailor digital interventions for every use case, from chronic disease management, to care transitions, to post-operative care and beyond.

Omkar Kulkarni. Vice president, chief transformation officer and chief digital officer at Children's Hospital Los Angeles: Digital transformation requires the confluence of people, process and technology. As such, we have hired experts in process improvement (e.g. Lean, Six Sigma), product management and in human-centered design to partner with internal and external technology experts to drive transformation. By bringing together these experts in people, process and technology, we have been able to deliver more user-centric, value-creating products to the organization that are being adopted at higher rates and demonstrating transformational change.

Roberta Schwartz, PhD. Executive vice president and chief innovation officer at Houston Methodist: Houston Methodist has found incredible success in our telenursing program, which has helped lift the heavy documentation activities that occur during admission and discharge so nurses can focus on providing high quality, compassionate care at the bedside. We’ve received overwhelmingly positive feedback from our nurses as they are able to refocus their time on the areas where they can provide the most impact. Now, we are taking it a step further and incorporating additional innovations such as remote monitoring technology to help collect vital information on a regular cadence and putting cameras at the bedside to give other specialties advanced functionality for our virtual nurses to monitor and support our patients remotely. 

Keith Woeltje. Vice president and chief medical information officer at Froedtert & The Medical College of Wisconsin: I partnered with my IT counterpart (vice president over clinical applications) to revamp our clinical IT governance structure. We took some existing groups, as well as starting new groups, to engage clinical and operational leaders in clinical IT prioritization. This was tied to a revamped EHR enhancement request process, so that there was a clear process and escalation pathway to request and prioritize improvements in our Epic EHR.

D. Matthew Sullivan, MD. Chief medical information officer for the southeast region of Advocate Health: In a large hospital system, it is common to keep one's head down and work hard. When our two large healthcare systems merged, I changed my focus to help our teams come together in the best possible way with a single, unified vision and imagine what could be possible. It hasn't been easy, and 'best results' are hard to define, but it is clearer as time passes that the team is doing excellent work together.

Louis Jeansonne, MD. Chief medical information officer at Ochsner Health: Changing our patient portal menu to make it easier for patients to perform tasks like requesting refills and scheduling appointments. This has been a win for both clinicians and patients since the patients can get what they need faster, and it reduces unnecessary in basket messages.

Praveen Chopra. Chief digital and information officer at Emplify Health: We rebranded a reactive information services department to a value-driven information technology and digital services business unit. We reimagined and deployed a new agile operating model to become a solution- and product-centric organization to drive results in four focus areas – engagement, business outcomes, service excellence and enterprise risk management. We instituted a balanced scorecard process resulting in amazing outcomes across employees, customers, operations and finances quadrants of the scorecard.

Richard Clarke, PhD. Chief analytics officer at Highmark Health: Within our generative AI work at Highmark Health, we began with a strong focus on use-cases and almost immediately had a backlog of more than 200 ideas. We decided to stop focusing purely on use-cases and rather set sights on achieving distributed innovation by enabling safe and broad access to generative AI tools and empowering our team members to discover their own mini-use cases.  By doing so, we are able to focus on a concentrated number of transformational use-cases, but we also drive broad adoption, building generative AI skills in our team members’ daily work. 

Penni Kyte. Digital care strategy officer at Ballad Health: I have created a clinical command center that we are calling 'care traffic control.'  This center is responsible for the patient transfer center, communications center (EMS encoding and med flight), telemedicine and centralized bed placement for our 20 hospitals, our outpatient telemedicine practices and 150 schools with telemedicine. Within this care traffic control, we also have virtual nursing that includes tele-admissions, tele-discharge and virtual sepsis monitoring.

We have brought key areas from our hospitals and practices together under one leadership structure that has not only created efficiencies and standards across the system but also elevated and improved our care for high acuity patients. We have improved ensuring the patient is in the right level of care at the right time!

Tom Consalvo. Vice president and site CIO at Northwell Health: One change that I have made in the last two years that has yielded the best results is investing time in my leaders. I have focused a significant effort to not only get to know them better personally but also professionally: What drives and motivates them? What are their aspirations for this job? Where do they see themselves years from now? I also focused on their titles and compensation to find some were actually not in the right titles or being paid what they should be. 

This came back to me and the organization tenfold. They now know they have someone they work for and with who has their back, who is looking out for them and who believes in them. This will come back to save significant dollars in simple employee retention. It has strengthened my working relationship with them as well as theirs with the company. 

Ashis Barad, MD. Chief digital information officer at Allegheny Health Network: It’s been more about reimagining the processes and culture than any piece of technology. I have really worked with my team to spearhead a strategic emphasis on change management, innovative thinking and the implementation of cutting-edge tools such as ambient listening and virtual nursing programs. With a strong commitment to involving clinicians extensively in the decision-making process and workflow design, we have fostered a culture of collaboration and empowerment within our healthcare ecosystem. By prioritizing clinician involvement, we ensure that our initiatives are tailored to meet the unique needs of our healthcare professionals and ultimately drive enhanced patient outcomes and operational excellence.

Salim Saiyed, MD. Vice president and chief health information officer at Trinity Health: One impactful change that has yielded significant results over the past two years is the focus on patient access. The COVID-19 pandemic accelerated the adoption of telehealth, and optimizing this service can bring substantial benefits to both patients and health care providers. Expanding access to healthcare, including online appointments and telehealth, has helped patients in rural and underserved areas. The improvements have allowed patients to receive timely consultations, follow-ups and specialist advice without the need for long-distance travel. This will continue to be leveraged as we evolve into the next AI-fueled healthcare age.

Chris Bergman. Vice president and CFO of Dayton Children's Hospital: We created a strategic initiative called 'financial headwinds' to highlight the continued margin pressures we have been under and to bring more focus and attention to increasing our margins. We created a three-year plan to get back to where we were. Going into year two of the plan, we are tracking positively. Instead of assuming financial discipline should just be part of what we do on a daily basis, we felt like making it a key initiative would help as our past experience has shown we are pretty good at implementing our strategic initiatives.

C. William Hanson III, MD. Vice president and chief medical informatics officer at Penn Medicine: The most impactful work we have done in the last two years has been to develop a coordinated approach to the adoption of AI-enabled capabilities. Fully aware of the risks and benefits of AI, we developed a core group consisting of leaders from research, privacy, information services, data and analytics, and clinicians to establish a set of principles for the use of tools and data, internal governance and guidance. As an example, we developed an internal suite of large language model generative AI tools, and an 'inbox' for queries. Researchers, clinicians, administrators are all directed to the the right path for the task they are trying to accomplish safely and without exposing patient data externally in an unprotected fashion. 

Paul LePage. Executive director for revenue cycle operations at Banner Health: The one change that has yielded the best results in the past two years was focusing on our denials and write-offs and moving our denials approach to include denials mitigation. It is no secret that denials are at the forefront of administrative burden for health systems due to regulatory changes, payer guidelines and behavior, and unoptimized internal processes. Our teams have always focused on denials management but shifting to include denials mitigation in the overall strategy and identifying clear owners of denial categories allowed us to align our subject matter experts with the denials that they could provide the most benefit in reducing and affecting the most change. Because of this, we have seen drastic improvements in our write-off numbers because of more robust workflows, as well as decreases in our denials, specifically in medical necessity. This has led to increases in cash collections as well as better relationships with the payers.

Brian D'Anza, MD, FACS. Associate professor of otolaryngology department, head and neck surgery at Case Western Reserve University School of Medicine as well as system medical director for digital health at University Hospitals: We established a system-wide governance system for all digital health technologies. This has resulted in over 30 technologies being evaluated, vetted and facilitated to be more efficiently contracted, increased awareness, up-front evaluation and advice from ancillary depts (e.g. IT, marketing, revenue cycle), and generally better used across the system. As well, we have saved over $12M in technologies that were found to not meet the standards to be used within our system due to duplicity, lack of value or return on investment.

Erin Hodson. Vice president for medicine service line at Inova Health System: We have implemented Epic diagnoses supplements into our hospital medicine and critical care provider note templates resulting in a significant CMI and revenue lift. We have also standardized our critical care templates down from 50 to eight note types and decreased the time it takes to document from 42 minutes to 20 minutes with less characters typed. Last, we are piloting a note writing technology called Regard to further capture documentation, pull up key information the provider may have missed in the record and autogenerate notes when applicable. We have seen a 60% adoption rate of the new technology since our March 2024 implementation.

Jodi Coombs, MBA, BSN, RN. Executive vice president and COO at Children's Mercy Kansas City: I stood up and leveraged an ePMO to help put in place rigor around projects and accountability with execution to drive the desired results.

Stacey Benson. Director of revenue cycle operations at Houston Methodist Physician Organization: I have historically been close-minded about outsourcing accounts as I am a firm believer in leveraging our internal team, system and resources. However, I realized that worker’s compensation accounts are more complex than our internal team could manage. Due to this change in mindset, we took the leap and outsourced our worker’s comp accounts to a vendor that specializes solely in these claims. This change has been great! Our team now has more time to work accounts within their area of expertise while this company utilizes their expertise and relationships to get our worker’s comp claims worked timely. I still believe in leveraging internal systems first, but I also realize that we can’t do it all in our complex billing world, and it’s a true win to recognize where you need help and then find it.

Kerri Webster. Vice president and chief analytics officer at Children's Hospital Colorado: We recently adopted an internal-led learning series for our development team. We leverage the subject matter expertise of team members to develop and lead training, labs and knowledge checks on tools and technologies in the division. This model provided an opportunity for individuals to shine and expand their leadership skills while sharing knowledge and best practices. The outcome has been realized with the delivery of better data products and expansion of knowledge and tools for the entire division.

Thomas Maddox, MD. Vice president of digital products and innovation at BJC HealthCare and Washington University School of Medicine: Orienting our innovation teams to measurable results to achieve our objectives (using the objectives and key results framework) has been very useful. It allows teams to think about how their work meaningfully moves us towards measurable outcomes. It also allows teams to justify not doing things that are less associated with achieving those outcomes.

Mark Townsend, MD. Chief clinical innovation officer at Bon Secours Mercy Health: One change that we have been implementing in the last two years is to be intentional about listening to our organization. Top-down leadership can turn into a silo quickly; when one lives in a silo, it is easy to interpret the echoes of our own voices as validation or 'voices from on high.' As we lead the digital transformation of Bon Secours Mercy Health, we are intentional about listening to the voice of the customer. To that end, we launched a listening-tour where we physically travel to each of our regional markets and meet with our regional leaders. We also physically meet on a quarterly basis with our shared service leaders in a forum that includes our market presidents. We take the feedback that we solicit and aggregate it, and use it to inform our senior leaders and our boards.

Ebrahim Barkoudah, MD. System chief and regional CMO at Baystate Health: Over the past year, our strategic initiative to digitize safety and quality measures within inpatient units has led to substantial advancements. By deploying cutting-edge digital health technologies, we have significantly enhanced patient monitoring capabilities, addressed adverse events and optimized care coordination processes. This comprehensive digital transformation has not only elevated the quality of patient care but also bolstered operational efficiency across the board. Specifically, the implementation of real-time monitoring systems and predictive analytics has resulted in expedited discharges. Furthermore, digital tools for clinical decision support have driven an increase in adherence to evidence-based guidelines through standardization in admission protocols.

Amy Zolotow. Director of operations at Mercy Personal Physicians: In the last two years, identifying key pain points in healthcare operations and demonstrating how technology can address these issues was a pivotal change. By actively participating in speaking circles and conferences, I began educating and informing audiences about the transformative impact of innovative solutions like AI tools to alleviate the pain points I and other healthcare leaders experience every day. My advocacy efforts have fostered conversations and interest from healthcare professionals and leaders across the globe as to how we meet the moment given the challenges our health systems are currently facing. We cannot do this alone. The time to act is now.

Anjali Bhagra, MD, MBA. Medical director of automation at Mayo Clinic: Formalization of Mayo Clinic's intelligent automation and AI enablement infrastructure to accelerate our 'Bold. Forward.' strategy for healthcare transformation. We're integrating and scaling people-centered automation solutions that bring value to our patients, staff and the global healthcare community. Hundreds of initiatives are being piloted or already underway through internal collaborations and external partnerships. Our staff plays an essential role in helping to identify mission-critical automation opportunities that provide solutions to their greatest daily challenges, streamline repetitive tasks, help them better meet patients' needs and build organizational resilience.

Mandy McGowan. Director of home-based care programs at UWHealth: The biggest change that our health system has made in the last two years was aligning home-based care programs with population health. By building the newest home-based care programs (home-based primary care and home-based hospital care) using a population healthcare model approach, the programs have been focused on the quintuple aim and supported by targeted data and analytics. The care model framework allows for adaptability, flexibility and a continuous emphasis on process improvement. The result is a suite of home-based care programs with high quality outcomes, positive patient experience and human-centered care.

Novella W. Thompson, MBA. Hospital administrator of population health at University of Virginia Medical Center: Centralizing our remote patient monitoring programs for inpatient, ambulatory and pediatrics creates a connected transition of care process. It ensures patients receive individualized and coordinated care, access to resources, providers and other programs to comprehensively address healthcare needs, provide innovative technology solutions, and an improved patient and caregiver journey.  

Briana Rygg. Assistant vice president of information solutions and service at RUSH: As an early adopter of Epic’s Hello World text messaging, two use cases really improved RUSH’s operations and our patient’s digital experience. First, with real-time balance notifications, patients are immediately notified when a balance becomes due; no need to wait for an upcoming statement cycle which allows patients to pay their bills sooner (reducing aging) and saves on statement printing and follow-up. Second, texting fast pass offers allows us to get patients in sooner as they’re able to accept or decline offers with a simple keyword response rather than logging into their MyChart. This has resulted in a 25% increase in patient acceptance rate and an 8% decline in unfilled fast pass slots in the first nine months.

Nasim Eftekhari. Executive director of applied AI and data science at City of Hope: In the past two years, the applied AI team at City of Hope transitioned from juggling numerous projects to concentrating on a select few high-impact initiatives, encouraging team collaboration instead of individual project leadership. This change has yielded significant benefits: it improved strategic alignment with our organizational goals as we could channel our resources into high-impact areas. Additionally, fostering teamwork allowed us to leverage diverse skills and perspectives, leading to innovative solutions and higher-quality outcomes. This approach also facilitated professional growth, as team members learned from each other and developed new skills, enhancing both their core competencies and overall expertise.

Brendan Lloyd, MD. Chief administrative officer for Providence Clinical Network in southern California at Providence: In the last two years, my team and I have significantly invested in focusing on patient access by improving our data and reporting. It has been an immense success. We now know when and where to intervene to get patients to the right place at the right time to deliver high-quality, high-value care. We are also utilizing new tools and technologies to improve our schedules and open our communication channels with patients. We are at an all-time high when it comes to physician and caregiver engagement on the topic of access and patients are noticing. They are letting us know we are getting it right and the feedback has truly solidified our 'why' and how we approach work each day.

Brian Hoberman, MD. Executive vice president for information technology and CIO at The Permanente Federation: I sponsored the largest rollout of ambient listening technology in healthcare to more than 24,000 physicians across the Permanente medical groups. Ambient AI listening technology helps physicians write their clinic visit notes, whether visiting with a patient in-person or virtually, across any medical specialty. It frees the doctor from having to make notes about what the patient said. It captures not only what the patient said but the entire interaction, including things a doctor might miss. It then synthesizes that interaction into a pretty succinct professional medical note that captures the important points. Early data shows it is saving our physicians about an hour per day.

Joe Depa. Senior vice president, chief data and AI officer at Emory University and Emory Healthcare: When I joined as the inaugural chief data and AI officer for Emory University and Emory Healthcare, I saw an immediate opportunity for two short-term wins: 1) 'Meet our end users where they are' to drive adoption out of our existing data and technology investments and 2) leapfrog with AI to enable improved patient care and groundbreaking research.  

We started hosting 'data blitzes' where our teams met our 'end users where they are' with providers, researchers, faculty and staff, so they can apply data to make more informed decisions. I am impressed with the rapid increase in Epic data and AI adoption of more than 400% in just six months as our early adopters now have become data champions. This has resulted in improved workflow, reduced administrative time and a better patient experience. In addition, I am proud of the results from the creation of a large language model for the cancer registry where we achieved 97% accuracy and reduced administrative burden from more than 20 minutes to less than two minutes for each of our cancer registry patients. This will ultimately help improve our clinical trial matching and patient outcomes as the data becomes more accurate and timely. Finally, I am proud of our laser-like focus on enabling responsible and trustworthy AI in all we do. 

As we look forward, I’m most excited by the amazing team we have in place and our emphasis on developing a modern data foundation that will ultimately enable Emory’s physicians, researchers, clinical care teams and staff to improve lives and provide hope for our communities.  

Reid Stephan. Vice president and CIO at St. Luke's Health System: One of the most impactful changes I made in the last two years was striving to leverage both my vision and blind spots. Vision can provide a clear target to hit and energize the team while embracing blind spots can provide space for unconventional ideas to emerge and additional options to present themselves. In effect, this approach has allowed me to marry the problems we are trying to solve while dating the methods used to solve them, leading to more innovative and flexible solutions.

Michael Archuleta. CIO and HIPAA and information security officer at Mt. San Rafael Hospital: One change I made in the last two years that yielded the best results was the implementation of a comprehensive telehealth platform. This initiative was especially impactful for our rural health efforts, ensuring that every patient has access to high-quality care regardless of their background or zip code. By offering virtual consultations and follow-ups, we were able to reach patients in remote and underserved areas who previously faced significant barriers to accessing healthcare. The platform integrated seamlessly with our EHR, providing our healthcare providers with real-time access to patient data and enabling more coordinated and personalized care. As a result, we observed a substantial increase in patient satisfaction, a reduction in no-show rates, and improved overall operational efficiency. Most importantly, this change reinforced our commitment to equity in healthcare, ensuring that every patient has the chance to receive top-tier care.

Will Johnson. Vice president and CIO at Tidelands Health: We’ve made several significant changes recently, most notably the enhancement and consolidation of our EHR into a single EHR. Epic enables providers to work within a comprehensive and consolidated platform and better connects patients to their healthcare through our new My Tidelands Health app featuring MyChart. As part of our 18-month journey to Epic, we also implemented Workday to enhance management of our HR/supply functions. The technology is helping transform the delivery of healthcare in our region.

Nolan Chang, MD. Executive vice president of strategy, corporate development and finance at The Permanente Federation as well as medical director of business management at Southern California Permanente Medical Group: Following the peak of the pandemic, our organization pivoted quickly to meet the needs of our members by providing them with mechanisms to receive care from the comfort of their homes. Prior to the pandemic, much of the first line of care for our members involved dialing into a call center for an appointment, waiting in line and then seeing a care provider face-to-face. Now, our members can get first-level care through our proprietary platforms like e-visits and Get Care Now—a huge patient satisfier. And if appropriate, those visits are converted to in-person encounters. These innovations have helped us create capacity by providing new ways to deliver high-quality, ultra-convenient care to patients.

Stephen Parodi, MD. Associate executive vice president at Permanente Federation, Kaiser Permanente: We are especially excited about our new innovations regarding chronic complex case management. With the introduction of a predictive algorithm that uses machine learning capable of monitoring patient’s medical, social and behavioral health needs, our multidisciplinary care teams are now able to care for a larger number of patients. Through advanced alerts, our teams are able to identify and address patients' problems earlier which has reduced hospitalizations and emergency department visits in some of our highest risk patients. We are working to spread this program throughout the Kaiser Permanente system.

Hants Williams, PhD, RN. Clinical assistant professor of applied health informatics at Stony Brook University: Over the past two years, my colleagues and myself within our applied health informatics department at Stony Brook have initiated both a top-down and bottom-up approach to promote the internal development of solutions within our state-run hospital system. We believe this is unique, and not typical for state-run systems.

While we continue to purchase solutions, if we believe it's possible to build it ourselves, we now have the option to advocate for a build approach in addition to purchase. This is due in part to our continued efforts of integrating our education and training programs from the academic side and directly hiring students from these programs who are equipped with these skills required to build. By leveraging cloud technologies and development automation, these new specialists are creating customized solutions in-house. This initiative is still in its early stages but has already shown promising results.

Crystal Broj. Chief digital transformation officer at Medical University of South Carolina: One significant change we've made in the past two years that yielded the best results was building a strong team of individuals who are passionate about healthcare and digital transformation, possess excellent project management and strong personal communication skills. Additionally, we added a dedicated change manager and a business analyst to the team. This strategic enhancement not only streamlined our project workflows but also ensured smoother transitions and better alignment with our business objectives, ultimately driving more successful outcomes.

Benjamin Armfield. CFO at Sonoma Valley Hospital: We began having monthly departmental reviews with service managers. The format brings executives and front-line staff together to discuss issues affecting productivity, such as staffing, patient scheduling, billing and other operational factors. We began using more innovative analytic tools specifically designed for our small hospital size. The goal is 'drive the vehicle by looking through the front windshield, not the rear view.' In other words, the goal is to use these tools to improve communication and understanding related to service management and to respond quickly and precisely with needed operational adjustments, to preserve front-line cash flow and financial stability.

John Prunskis, MD. Medical director and principal at DxTx Pain & Spine: One change which yielded both improved clinical outcomes and financial benefit was the increased emphasis on increasing incorporation of advanced procedures into our interventional pain practice such as: spinal cord and peripheral stimulation, lateral transverse arthrodesis fusion procedure, treatment of symptomatic vertebral body modic changes, utilization of new technology bracing as well as sacroiliac joint fusion among other changes benefitting our patients.

Paul Capello, PMP. Corporate IS project manager at Shriners Hospitals for Children as well as adjunct instructor at University of South Florida: Since 2022, I have started teaching project management at the university level. It not only lends an additional outlet for me, but it also incorporates AI tools into my career. The immediate feedback I receive from classes makes me a more rounded project management professional. Incorporating new technologies like AI allows me to focus on the results-orientated project management I deliver my clients!

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