how to make it the underpinning - chartis · how to make it the underpinning of the enterprise...

1

How to Make IT the Underpinning of the Enterprise Strategy

Session #146

February 22, 2017

John Ward, CIO

TriHealth

Bob Schwyn, Director

The Chartis Group

2

John Ward, CIO Bob Schwyn

Chief Information Officer

TriHealth

Director

The Chartis Group

Speaker Introductions

3

Conflict of Interest

John Ward and Bob Schwyn:

Have no real or apparent conflicts of interest to report.

4

Agenda

A Case for Change: Making IT an Instrumental

Underpinning of the Enterprise Strategy

From Theory to Action – A Case Study

Lessons Learned and Key Considerations

5

Learning Objectives• Describe how and why IT can and should become a leading component in

setting an organization's business strategy.

• Explain why the process matters and describe the specific steps to take.

• Describe IT's role and key steps the CIO can take in guiding and steering

strategy conversations.

• Use this case study example in one's own organization.

6

Satisfaction: The experience and satisfaction of the patients, employees and physicians of the

provider organization were addressed to ensure a level of preeminent satisfaction in TriHealth’s

market arena

Treatment: Significant investment in EHR technology and the opportunity to build a high-performing

informatics capability drove improvements in care delivery outcomes and reduced clinical variation

Electronic Secure Data: TriHealth’s positioning for a best practice security structure and environment was

critical in developing the objectives of the plan

Patient Engagement: Recognized the importance of analytics, technology-enabled patient engagement

and EHR capabilities to support an aggressive movement into a value-based environment

Savings: Ensured a strong value proposition to offset increased investments in technology to

make certain the organization was making the right decisions at the right time, and at the lowest

cost

An Introduction of How Benefits Were Realized for the Value of Health IT

7



Agenda



8

Industry Point of View

The healthcare industry

is in the midst of a

multi-faceted shift that

is fundamentally changing

the context in which

providers deliver care.

The role of the provider is

being transformed and

will continue to evolve

over the next 10 years.

Business strategy and

information and technology

strategy are increasingly

merging into one.

Rise

of the

Consumer

Migration

to Value

Strategic

Implications

Technology

Advancements

9

Industry Point of ViewExpanding Role of the Healthcare Provider

Access to C

are

Care Needs

Education

Intervention

Direct Care

Wellness Care Chronic Care Acute Care

Informatics &

Technology

Enabled

Informatics &

Technology

DrivenHistoric

Provider Role:

Reactive, illness-

driven delivery of

services

Expanded

Provider Role:

Proactive, health

management

oriented delivery

of services and

information

10

An Illustrative Roadmap: Understanding where are we and where are we headed based on industry perspectives

By investing in new initiatives to transform care delivery, provider organizations can build upon its core technologies to provide just-in-time, personalized care in any location.

What are the strategic functions

to the new business model?

* Roadmap reflects full scale production deployments

and — in many cases, pilots are underway pending

development of enterprise strategies

Strengthen core technologies Transform care delivery Real-time, personalized

care wherever the location

EHR

Pop

Care Circle

of Support

Touch

Points

Clinical

Decision

Support Analytics

Telehealth

Efficient

Operations

Patient

Engagement

Just-In-time

Personalized Care

11

The Role of Health IT in Southwest OH

Undeveloped Growing Competency Key Business Driver

Foundational IT and Core

Clinical Technologies

Innovative Care Model

Technologies

Population Health

Capabilities

Consumer Engagement

Tools

IT Innovation

Provider 1 Provider 2 Provider 3 Provider 4 Provider 5

12


Agenda




13

How We Did It

System Strategic Plan IS Strategic Plan

• Establish a shared understanding of the external

environment, emerging healthcare trends and consumer

dynamics, and TriHealth’s current strategic positioning.

• Define a realistic set of future scenarios for the region over

the next 5-10 years – to identify and assess TriHealth’s

strategic options.

• Refine and clarify TriHealth’s strategic vision, priorities

and underlying business models to continue to advance

our strategic position and effectively serve our communities

in a rapidly-evolving healthcare landscape.

• Assess the current state of TriHealth’s IS environment –

including external market trends, future IS scenarios, and

internal capabilities.

• Develop a long-range vision for IS that supports

TriHealth’s overarching strategic direction – including IS

mission, guiding principles, and priorities.

• Conduct a detailed review of IS organizational structure,

governance structure, and management structure.

• Develop a multi-year IS strategic roadmap with prioritized

initiatives to support the vision and identified investments,

capabilities and timelines for each initiative.

The Process is Important

June July Aug Sept Oct Nov Dec Jan Feb Mar

System Strategy Steering Committee

Engagement Phase

Board of Trustees

Major Activities

Physician Strategy Advisory Council

Current State & Env. Assessment

Future Scenarios & Strategic Options

Strategy Formulation & Plan Design

#1

#2 #3

#4 #5

Nov. Bd Retreat

Mar. Plan Approval

• Stakeholder interviews (combined)• Macro-trends assessment• Regional / competitive landscape• Internal SWOT analysis

• Key questions for strategy development• Future market scenarios and TH roles• Case studies• Options assessment and prioritization

• TriHealth preferred “future state”• Strategic vision, enterprise goals and initiatives• Financial model

IS Steering

Committee

Engagement Phase

Major Activities

Work Groups

IT Assessment

Support IT Scenarios & Provide Education

IT Strategy & Plan Development

ISSC #2

• IT current state assessment, including

structure, governance, architecture,

vendors and processes

• IT vision, direction and principles

• Optimal IT Governance

• IT sourcing options and cost models

• Staffing, timeline and implications

#1 #2WG E/F

• Support enterprise work groups

• Education / workshops

#4

Work Groups#1 #2 #3 #4

#1 #2 #3 #4

WG A/B

WG C/D

Interviewsx x x

Mid-July through Mid-August

#3#2

Initial ISSC ISSC #1 ISSC #3 ISSC #4

UpdateUpdate

7/16Update

#1

x x x

IS S

tra

tegic

Pla

nS

yste

m S

tra

tegic

Pla

nTimeline

15

The Evolving MarketNational Trends

Growing consumer role in managing health, healthcare services and

information

Growing commoditization of healthcare

Shift from defined benefit to defined contribution model – and increased

individual financial risk

Evolution from volume-based to value-based/risk-based reimbursement models

Payor-provider convergence

Downward reimbursement and utilization trend

Accelerating technological advances in diagnostics

and therapeutics

16

Highly fragmented market

Slow to move from volume-based

to value-based care

Favorable overall business environment

Competitive payor environment

Push the market increasingly toward value

Why Is

This

Important

The Evolving Market

17

Implications of the Evolving MarketLikely Market Evolution Implications for TriHealth

Payor market consolidation and downward

reimbursement pressureHigh historical rate increases will not continue

Shift towards value-based paymentsAccelerating downward trend in hospital utilization, shift in

site of service towards lower-cost settings

Movement from a highly-fragmented to consolidated

provider landscape

Fewer remaining accretive opportunities outside of large-

scale system-to-system partnerships or mergers

Dramatic slowdown in physician consolidation activityFuture growth of physician network will be more

challenging

Growing demand for consumer and digital capabilities

Recognize IT is no longer just a business enabler but has

significant potential to accelerate business strategy and

differentiate services in the market

18

Key Areas of Focus

Consumer Engagement

Care Model Innovation

Population Health and Payor

Strategy

Telehealth

Value Realization

Network Strategy

Clinical Program

Differentiation

IS Infrastructure

IS Structure and

Governance

Service Management

and Processes

Enterprise

Strategic Plan

IS

Strategic Plan

19

Strategy the Next

5 Years The Future for IS

Population-based and cross-continuum care• Insightful, prescriptive business intelligence

• Care collaboration tools

Risk-based payment environment

• Increased data volume and complexity

• More dynamic information sharing agreements

• Predictive analytics

Consumer-facing and patient-centric strategy• Virtual care delivery via smartphones, Apple CareKit, Fitbits

• Robust security, performance

Market relevance = high-value, efficient, and

effective system of care

• Market relevance = quality of the Digital Health experience.

Healthcare services via online and mobile (i.e., Yelp, Uber)

Preparing for the FutureHow Will Our Future Strategy Be Different Than the Past?

20

Securing Our Strength in the Current EnvironmentWhile Transforming to Position For the Future

TriHealth

Integrated System of Care

Aligned & Engaged

Physician Community

Regional Market

Strength

Population HealthManagement

Consumer-Focused System

Innovation

High-Performing Patient-Centric Culture

Operational Excellence

Enabling IT Platform

21

Aligning IS Services

Str

ate

gic

In

itia

tive

sV

isio

nS

erv

ices

Physicians, hospitals and communities working together to help you live better.

Ta

cti

cs

Core Projects Foundation Projects Discretionary Projects

Directly support TriHealth’s strategic

initiatives and pillars

Required to maintain

existing IS service levels

All other projects not defined as

“Core” or “Foundation”

PMO ServicesAnalytics/Data

IntegrationClinical Informatics

Clinical SolutionsBusiness/Finance

SolutionsSecurity Infrastructure

Integrated System

of Care

Regional Market

Strength

Aligned & Engaged

Physician Community

Population Health

ManagementInnovation

Consumer-Focused

System

22

Assessment Findings

What We've Done Well Where the Opportunities Are

Value

Project Management

Consumerism

Clinical Informatics

Governance

our IS strategic

imperatives for the last

Meaningful Use

23

Supporting the Strategy: The IS Work Group Charge

Focus Area Proposed Objective

Clinical

Informatics

Develop plan and build CI program framework, including required capabilities and resources, and clarify CI processes and

project prioritization.

Project

Management

Develop plan and build project and portfolio management framework, including required capabilities and resources, and

standardize IS project approach oriented around value achievement.

Service

Management

Develop and implement a plan to improve service delivery within IS with focus on Incident and Problem Management,

Continuity Management and Service Requests.

BI &

Analytics

Define approach to address gaps in enterprise analytics and information needs (e.g., full-patient view, cost-of-care

analytics, claims, etc.) in collaboration with BI functions across the organization.

Governance

Redesign

Revise guiding principles with orientation toward value realization and review and refine work group charters, roles, and

responsibilities to streamline IS governance.

IS Roadmap(Project and service definitions; timing, budget, FTEs, etc.)

Building a High-Performing IS Leadership Team

24

Focus on Realizing Value• Strengthen IS foundation

• IS project portfolio alignment with strategic

initiatives and pillars

• New IS projects now evaluated

by business value

• The continued focus on business value is

transitioned from project to operations

• Implementing robust IT Service Management program

• Build culture of excellence and innovation

• Create a robust planning process

1. Integrated

System of Care

2. Aligned &

Engaged

Physician

3. Regional

Market Strength

4. Population

Health

Management

5. Innovation 6. Consumer-

Focused System1.1 Operating model re-design

– regional, care continuum

structure

2.1 Development of a

TriHealth system physician

leadership council and

expanded large-scale

3.1 Streamlined referral

processes/transfer center to

our tertiary hospitals

4.1 Set in motion a multi-year

payor contract transition

strategy from fee-for-service

to value-based reimbursement

5.1 Develop the organizational

structure and operating model

for the TriHealth Innovation

Center

6.1 Prioritize key consumer

segments and conduct

research to understand

motivations, needs and 1.2 Ambulatory care

partnership and alignment

strategy

2.2 TriHealth Physician

Partners (TPP) structure,

governance and operating

model, with supporting

3.2 Differentiated site-specific

tertiary programs (e.g.,

Perinatal Services at Good

Samaritan and Multispecialty

4.2. Develop incentive based

compensation design that

meets current and future

practice needs and aligns with

5.2 Elevate TriHealth’s

research and education

capabilities, including the

Hatton Research Institute,

6.2 Enhance consumers'

access to care, information

and education, tailored to

meet their unique health 1.3 Create network of

preferred post-acute care

partners

2.3 Service line development

strategy – including

development of multi-

specialty care models and

3.3 Deploy primary care and

selected specialists at our

community hospitals,

ambulatory centers, and

4.3. Develop and implement a

bridge strategy for population

health data analytics and IT

capabilities until (and if)

5.3 Implement Director-Led

Action Councils to engage our

workforce to drive innovation

and improvement from the

6.3 Develop and adopt virtual

and on-demand care options

1.4 Next-stage ambulatory

development – deploying a

scalable multi-specialty

ambulatory model (e.g.,

2.4. Use the TriHealth PHO to

advance physician alignment

strategy with key remaining

independent physician groups

3.4 Accelerate recruitment of

primary care physicians and

hard-to-find, high-demand

specialists

4.4. Organize all population

health management functions

into a re-designed Office of

Population Health

5.4 Prioritize and implement a

select set of care model re-

design initiatives for 2016-

2017

6.4 Provide transparent and

accurate cost, patient

satisfaction, and key

outcomes measures at the 1.5 Service excellence and

patient experience initiative

3.5 Enhance primary care

capacity through care model

and operations redesign

(including use of advance

4.5. Align the Employee Health

Program directly with

Corporate Health and

population health programs

5.5 Activate a system-wide

leadership development

program

6.5 Expand wellness and

preventative care resources

1.6 Retain and grow patients

within TriHealth's Integrated

Delivery System through

referral management

3.6 Evaluate partnerships with

local health systems and

providers looking for

opportunities to expand or

4.6 Align the Employee Health

Program directly with

Corporate Health and

population health programs 1.7 Develop comprehensive

foundation of behavioral

health services

3.7 Gain access to new

markets through

regional/statewide

relationships (e.g., CHI,

4.7 Create and implement

direct-to-employer strategy

targeted at regional employers

3.8 Effectively utilize

ambulatory surgery,

procedural, and diagnostic

assets to provide accessible,

4.8 Redefine local market

joint contracting strategy

articulating the role of HSN

and other potential system 3.9 Re-design specialist access

to accelerate growth and

retain specialty care within the

system

4.9 Continued evaluation of

MHC relationship

4.10 Develop Medicaid

strategy

An Evolving Illustrative IS Roadmap: Guiding the Organization Towards the Critical Technology Underpinnings of the Enterprise Strategy

By investing in new initiatives to transform care delivery, provider organizations can build upon its core technologies to provide just-in-time, personalized care in any location.

Expanded interoperability

Data center plan

Enterprise master patient index (EMPI)

Voice and network infrastructure upgrades; contact center support

and ACD

System refresh; zero client implementation

IT service management

Storage as a service

IT governance and prioritization

CloudFo

un

dati

on

al

Tech

no

log

y

Serv

ices

Enhanced Business Operating Model, Processes and Organization

EHR, Ancillary Applications

& Clinical Decision Support

Standardized physician

documentation

Enterprise imaging strategy

Surescripts Med

Benefits coverage

Patient Engagement

Consumer

engagement mobile

development

Patient portal IoT and

device integration

Family billing

Expanded care

access

Telemedicine

Physician finder and

online scheduling

Analytics

Patient 360, Operational

360 & Member 360

Pop Health 2.0

Data Governance

NLP predictive analytics

Physician briefing book

Standardized leadership

tools

Telehealth

Video visits

EICU

Virtual consults/

care expansion

eVisit expansion

Mobility

Rural telemedicine

plan

Efficient operations

Big data

Clinical Informatics

Care model redesign

Centralized contact

center

Clinical informatics

program

Epic credit card billing

Operational improvement

Just-In-time

Personalized Care

Predictive and

prescriptive

analytics

Care model

redesigned

Clinical trials

26


Agenda




27

IT incorporated as part of the enterprise plan

Increased CIO role recognition at the leadership level

Executive recognition of importance of IT planning

Set a precedent and integrated framework for planning

Enhanced education, innovation, industry perspectives

Increased level of IT maturity

Summary of Benefits

28

Capability Maturity Progression• A comprehensive IS roadmap that was well vetted and aligned to the enterprise

strategy

• A new clinical informatics structure with targeted objectives to improve care delivery

• Increased definition and measures for value achievement for each project

• An aligned analytics roadmap to support the evolving enterprise strategy

• Restructured the governance design to ensure the IS portfolio was focused on the right things at the right time, achieving the desired value

• Restructured the IS leadership team positioned to support the future demands and requirements of the organization

29

Capability MaturitySIGNIFICANT PROGRESS made in each area:

Focus Area

IS Roadmap

Clinical

Informatics

Project Management

Service Management

BI & Analytics

Governance

Redesign

Building a High

Performance

IS Team

High Maturity - Industry LeaderLow Maturity - Opportunity

= Start of the planning process = Today

30

Satisfaction: The experience and satisfaction of the patients, employees and physicians of the

provider organization were addressed to ensure a level of preeminent satisfaction in TriHealth’s

market arena

Treatment: Significant investment in EHR technology and the opportunity to build a high-performing

informatics capability drove improvements in care delivery outcomes and reduced clinical variation

Electronic Secure Data: TriHealth’s positioning for a best practice security structure and environment was

critical in developing the objectives of the plan

Patient Engagement: Recognized the importance of analytics, technology-enabled patient engagement

and EHR capabilities to support an aggressive movement into a value-based environment

Savings: Ensured a strong value proposition to offset increased investments in technology to

make certain the organization was making the right decisions at the right time, and at the lowest

cost

A Summary of How Benefits Were Realized for the Value of Health IT

how to make it the underpinning - chartis · how to make it the underpinning of the enterprise...

Documents