It’s hard to look back at this recent pandemic without thinking about the profound impact it’s had on our healthcare system. But in many ways, in particular with innovations in technology use, the crisis has led to opportunities for the industry. Healthcare has initiated some very positive transformations in services and operations spurred on by macro-level changes related to regulatory policy and shifts in technology paradigms.
In both policy and technology, many of the changes that were supposed to be short-term emergency measures, implemented only for the pandemic, have surprisingly endured into the post-pandemic era. With newfound courage, this has opened up previously unseen opportunities for large-scale innovation using the power of technology.
It’s argued here that in order to really seize upon these new, bold opportunities that are continually unfolding, healthcare CIOs have to readjust their primary focus—if they have not already done so in earnest—from the traditional “keep-the-lights-on” support. Instead, a healthcare CIO must now prioritize high-impact and business-valued innovation projects that are adopted at the speed of the business.
Paradigm shifts in healthcare spurred on by the pandemic
Since the pandemic, there have been two key technology-related changes in healthcare regulations, specifically around telemedicine and the sourcing of clinical skills. During the pandemic, for example, the Centers for Medicaid and Medicare Services (CMS) changed payment rules to allow providers “broad flexibilities” to furnish services using remote communications technology.” Most major private insurers followed suit in implementing similar rules for payment. As a result, telemedicine and telehealth services spiked almost overnight. Between 60% to 90% of all physicians were using such remote services during the pandemic, up from a pre-pandemic level of only 28%. And while many private insurers have since begun to roll back telehealth policies (despite rising demand), the CMS changes became permanent under the previous administration and have so far remained so under the current one.
Similarly, before the pandemic, most clinical teams for telemedicine services were restricted to being located in a single state. Early in the pandemic, many states relaxed policies that restricted licensed providers from practicing across state lines. As of April 2021, over 30 states joined the Interstate Medical Licensure Compact (IMLC), which enables providers to apply for licenses to practice in other states, and use of the compact spiked during the pandemic. These policy shifts are also reflected at the federal level, with the greater focus on telehealth. Now, clinical teams can combine technology to address more complex needs in remote areas. This has created a financial model for providers to not only expand their markets but provide more complex services in those underserved markets because of the flexibility in sourcing skilled clinicians from essentially anywhere in the US.
Healthcare providers are starting to see that these technology-enhanced remote service models have demonstrated that they work and are compelling for the business and the clinicians. On the patient side, patients all across the service spectrum are experiencing how convenient and cost-effective it is just to pick up the phone and talk to the doctor and receive basic care. In many cases, patients in rural areas no longer have to travel great distances to get access to care that was not available in their local areas without remote services and the assembly of highly skilled clinicians. Such paradigm shifts are making good sense for patients, clinicians, and businesses and are likely to stay in place and be improved upon with more technological innovations.
This sudden strong tilt towards a technology-focused provision of care paradigm is reflective of the direction healthcare was already headed with digital transformation efforts like the adoption of a comprehensive Electronic Health Record system. However, the crisis was a push (or perhaps a shove) in the right direction to accelerate technological innovation.
Before the shutdowns, healthcare providers were very skeptical and risk-averse about using new technologies. Senior leaders were like ice skaters skirting the edges around a freshly frozen pond, wary of fully venturing onto the ice, no matter how thick and secure that ice was likely to be. That is, they were hesitant to use technologies like telemedicine, cloud computing, and even artificial intelligence. Then, suddenly, the pandemic swooped in like a wind blowing them out onto the pond, and now they see the ice out there is firm. That is, they now see that such long-established technologies and practices like telehealth, remote working, and off-premise solutions are already quite sound and powerful to use strategically and innovate upon.
Just before the pandemic started, for instance, the hospital CIOs were primarily focused on things like on-premise systems and expanding their data centers. When it came to the cloud, they were still pretty risk-averse: What happens if there’s down time? What about security? The usual concerns and hesitations. But then the pandemic forced organizations to maintain their systems with remote teams, and it became clearer that they didn’t need a bunch of analysts and engineers sitting in data centers. Companies began to consider the cloud more seriously and to realize they could do it both securely and cheaply.
The services and the solutions that are now in the cloud are just phenomenal. The organizations that haven’t been moving in that space are going to get left behind because it’s simply going to become way too price-prohibitive, and it’s going to become much more challenging to ensure robust security.
C-suite and clinical leaders now better understand the power of technology for their success, are more open to cloud solutions and advanced technologies like artificial intelligence and robotic process automation. As such, they are demanding that healthcare CIOs come to the senior management table with innovative solutions that will address the biggest business needs and are aligned to the unfolding of new business strategies.
Leadership advice for healthcare CIOs in the post-pandemic environment
Even with these recent revelations within the C-suite, IT leaders still face organizational challenges in bringing new possibilities to life. The goal is to be recognized as more than a cost center and bring more value to our organizations. We’ve done enough of the “plumbing” already—that is, laying down the infrastructure to facilitate the five data “rights”: Getting the right information to the right person in the right format through the right channel at the right time. It’s now even more important to take that foundation and build upwards and outwards, and beyond the “four walls” that we’ve been used to in order to deliver more value for the business and end-patients.
So what does the acceleration of value-driven innovation mean for the CIO in the post-pandemic era? To help unpack that big question, let’s start by framing what healthcare CIOs focus on most across two dimensions: Tech and business-focused activities and internal and external focused activities. What that looks like is the diagram below, with some examples that fit into each of the quadrants.
The lower-left corner is where CIOs traditionally get stuck, focusing on internal and highly technical concerns like data centers and devices—complex maintenance items that are rarely understood outside of the IT department. In order to really be a leader for the business in the post-pandemic environment, you have to also move through the other three quadrants more readily and really focus on the upper-right-hand quadrant the most.
Walking through the other quadrants, we have on the upper left-hand side things like integration and interoperability that are enabling organizations to operate beyond the four walls of the hospital, but still very technical. Then, if we turn our focus to the lower right-hand quadrant, we have things like business intelligence and predictive analytics solutions that enable and move the business but are still very internally focused.
Now we come to the upper right-hand quadrant, where we focus on the external business activities. In healthcare, that means a focus on the patients, the patients’ families, local communities, payers, and suppliers. Think telemedicine, phone apps, and customer-based services. It’s in this upper right-hand quadrant that I recommend CIOs focus most of their time and money—if they can—in the post-pandemic era. It’s in this quadrant where large-scale innovation happens, where we start to bring strategies to life that directly impact customers, patients, and entire communities. This is where we build off of Martha Heller’s profound concept in her book, “Be the Business.” By focusing on this innovation quadrant, we can truly be the CIO leaders required of us in the post-pandemic era and make the largest impact on the business.
Purposefully steering the adoption of technology innovation
It’s not just one technology that will bring us the accelerated transformation—the true power will come from the convergence of things like artificial intelligence, machine learning, and blockchain. However, in order for us to start the convergence and create real value for the business, healthcare CIOs have to make sure the foundation of the data is there.
Right now, in 2021, I see that we are still in the middle of setting the foundation for the next phase, working towards our highly technology-enabled provisioning of care vision. It is now that we’re continuing to do things like expand interoperability with the Electronic Health Record systems and add Internet of Things (IoT) solutions that are hyper-connected inside and outside our organizations. We are also building hyper-automated solutions through technologies like robotic process automation (RPA) with an aim towards better, cheaper, and faster systems. Having these data and process automation building blocks in place is very important and will put us on a clear path to the next phase. But to really accelerate the transformation requires the convergence of existing and new technologies and its success will only come to those CIOs that are purposefully focused on the upper right-hand quadrant of innovation activities and have a keen eye on the horizon for new and emerging solutions.
Over and upward
The pandemic was a catalyst for sustainable change in the healthcare industry as it was in so many aspects of business. Recent macro-level regulatory changes and a renewed belief in technology from non-techies are two major factors in the healthcare industry’s transformation. Now, technology has once again become strategic and properly placed in senior leadership discussions. But in order to bring high-impact value to the business table, CIOs need to purposefully steer the adoption of technology innovation by owning the innovation quadrant with the same verve as we have owned the “keep-the-lights-on” quadrant for so long. The innovation quadrant can no longer be sub-optimized and delegated out to others as we focus on the lower-left quadrant—where the most money and time is being spent, where many of the big issues exist, and where many CIOs often feel the most comfortable. But that well-traveled lower-left quadrant by itself is not keeping up with the business nor providing what the business wants in the post-pandemic environment. We need to gain ground in the upper-right.
At this point, any healthcare CIO who’s not focused like a laser beam on the innovation quadrant is not only getting left behind, but they are getting left behind rapidly. There is a tsunami of challenges that is upon us, and we need to take the energy from that tsunami and harness it with innovation; otherwise, we could all just get washed away. So I say let’s ride the wave, skate in the middle of the pond with confidence, and “be the business” so that we can continue driving positive change for our industry.
Erik Kubinski, CIO, Encierro Technologies
Erik Kubinski is the CIO and Head of Technology Management at Encierro Technologies in Austin, Texas. He has over 25 years with hands-on technology implementation and senior IT management. He has run hospital IT departments in large and small hospitals all around the world. His expertise includes eHealth strategy, developing high-performing teams, and big-impact innovation.