AVIA’s Guide to Scaling Healthcare Innovation
The numbers speak for themselves. Following Piedmont Healthcare’s implementation of Kyruus’ digital solutions for patient access—including provider data management, provider search, and consumer-directed scheduling—the health system experienced a surge in digital engagement among its patient populations.
As of Dec. 31, 2018, more than 100,000 online appointments were booked, putting the organization on pace for more than 200,000 online appointments for the fiscal year ending June 30, 2019. As impressive as the numbers look, Piedmont feels perhaps even more pride in the path it took to achieve those numbers—and what the organization learned along the way. The work has produced a set of best practices that can now be used to accelerate any number of digital initiatives. So while many case studies focus solely on results. Piedmont’s story focuses on the process, the learnings. And like many compelling stories, this one starts with “why?”
Many health systems talk about patients as consumers. Fewer have truly defined what exactly that concept entails and how it should drive action and behavior.
For example, does “patient as consumer” mean that a health system should broaden its scope of services to its community? Does it mean that the health system should even reconsider which populations comprise its community? Does it mean that patients should expect more from their healthcare experiences—and if so, how can any organization accomplish that in such a cost- and resource-strained environment? Piedmont Healthcare has considered all these questions, along with dozens more like them. But rather than getting overwhelmed by the mountain of seemingly unanswerable questions, Piedmont dug in. Rather than putting off decisions about consumer- and patient-facing issues that had no clear path forward, Piedmont formed a declarative framework for how it would deliver a differentiated consumer experience.
The organization calls it “The Piedmont Way.” These five guiding principles shape direction and decisions for how Piedmont aims to transform every interaction it has with the people of its community. Said Piedmont Chief Consumer Officer Matt Gove, “Your brand isn’t what you say about yourself. Your brand is the sum of the experiences that a customer has with your organization. That’s it. The Piedmont Way pushes us to think about that every day and help us build our brand by improving every aspect of our consumer experience.” Set against this backdrop, it becomes clearer how essential Piedmont considers each consumer interaction … as well as how crucial it is for the organization to integrate digital solutions correctly into its broader patient access strategy. For Piedmont, online provider search and seamless scheduling aren’t just features to add to the organization’s website; they’re building blocks in Piedmont’s ongoing work to create a fully connected health journey.
The work to implement and roll-out online provider search and scheduling at Piedmont has created two avenues of return for the organization. Most apparently, the health system sees this in the performance against the initiative’s stated metrics (see sidebar for more details). But Piedmont Healthcare Vice President of Experience Katie Logan also points to the key learnings for digital transformation that her team discovered along the way. Logan’s team can now adapt and apply these learnings toward future digital initiatives to increase the pace of change and the likelihood of success.
“Digital transformation is a constantly evolving discipline, with extraordinarily high expectations,” said Logan. “We’ll look for any advantage or repeatable methods that can lend a slight edge, because market competition is so fierce and the stakes so significant.”
Think strategy, not solutions. It’s easy to get enamored with the features—or even the value—that a solution can provide to stakeholders. And while a focus on value creation can help health systems demonstrate return on their digital investments, the arduous process of solution evaluation, prioritization, and selection must first start by tying the work to the organization’s broader strategies. In this case, enhancing convenient access across a clinically integrated network serves as an overarching goal at Piedmont. Closely tying the Kyruus implementation to that goal—and doing so in an EHR-agnostic way that could deliver value for affiliate and employed providers—ensured the right level of prioritization and commitment throughout the process.
“As fundamental as it sounds to success, the practice of linking an initiative to an organizational strategy can get easily pushed to the back burner if you’re not mindful about doing it,” said Logan. “Or, perhaps it’s easier to link an initiative to strategy at the beginning, when going through the initial evaluation and approval processes. Carry that mindset forward—keep the strategy front of mind to guide decision-making for your initiative, all the way through solution rollout.”
Governance is key to expanding the impact of initiatives across multiple functions. Logan’s title says that she’s responsible for the “Piedmont experience.” Her team works daily to transform the way consumers think about and interact with the health system. But because this purview is so broad, her team often finds itself needing to effect change in areas that extend beyond its direct responsibility. Logan saw this acutely in the online provider search and appointment scheduling initiative. To roll-out the solution successfully, Logan’s team needed accurate provider data across the entire organization, as well as enduring engagement by participating clinicians. That meant everything from capturing specific details about providers to include in their profiles, to convincing practices to streamline appointment types to create consistency of scheduling options for patient visits. Explained Logan, “Data and engagement power everything in a solution like this. We have to understand accurately what each practice and provider within the Piedmont system does before we can effectively match patients to provider options that address their needs. We have to get practices to engage in this and hold themselves accountable to the types and times of appointments set through the solution before we can use it to improve consumer access.”
Logan and her team addressed this primarily through the use of a clear governance structure that pulled together a cross-functional group of clinical leaders and technology professionals. United under a focused charter and with defined roles and responsibilities, the broader team provided expertise and representative voices that enabled Piedmont to tackle tough issues with stronger backing. For example, when setting up clinician profiles in the solution, what would be the source of truth for what details and credentials the profile should include? Or, how can the solution work seamlessly with the host of EHR solutions across Piedmont’s clinically integrated network? Or, what needs to happen to increase clinician participation?
The broader governance structure became a catalyst for speed and buy-in. “Work like this doesn’t just need to be an initiative that stays within a single department or functional area,” said Logan. “It can be so much more when we open it up to be more.”
Set success metrics early and refer to them often. “Be clear about what success looks like, and stay on top of that definition of success,” said Logan. Especially with new digital innovation, success metrics can be hard to define … and even harder to agree upon. That’s all the more reason to ensure that all stakeholders have awareness of the metrics used to determine the value of the solution at scale. For Piedmont’s Kyruus implementation, those metrics included measurement of the number of online searches; volume and diversity of participating providers and locations; number of total appointments and new patient acquisition. “We’re excited about the numbers we’ve achieved, but we’re even more excited about how those numbers relate to Piedmont’s growth objectives,” said Logan. “We know, for example, that a substantial number of our specialty care patients traditionally come through referrals from our primary care practices. Using this digital solution, we can now see how much we’re increasing the number of primary care appointments—and thus, how we’re also able to affect potential for specialty care growth.”