A CMIO’s Key Takeaways from DHIS 2021
I recently attended the excellent Digital Health Investment Symposium (DHIS) hosted by KLAS in the beautiful Stein Eriksen Lodge in Park City, Utah. Adam Gale set the stage by relating some of the history of the conference.
Like many of us, Jim Morman at OSF receives hundreds of calls and texts from vendors. Many of these are early-stage vendors who may have a great idea but very little track record. We can all relate to not wanting to spend hours each day talking to sales staff, but we also don't want to miss out on that one partner who can transform our enterprise. So a few years ago, Jim asked Adam, “How can KLAS help vet these early-stage vendors?” KLAS and DHIS want to help with that process.
I heard someone describe DHIS as sort of an anti-JP Morgan Healthcare Conference. DHIS is certainly a lot smaller and more intimate. I will admit that I have not attended the JP Morgan Healthcare Conference. However, based on what I have heard, DHIS suffers from less puffery, and there was attention to personal connection and mission.
Those who have worked with KLAS in the past know how this approach is part of KLAS’ culture. With that as a backdrop, Adam pointed out that our ultimate desire should be to keep the patient at the center of our activities. In the swirl of odd payment models and grand schemes many of us have, we tend to lose sight of that.
Learning From Patient Experiences
As a simple example, when we send a patient a reminder about an upcoming appointment, do we do that for us? Or do we do that for the patient?
Adam told a story about a voicemail from a physician's office who said he needed to call. There was no other information. No name. No context. Adam called back. No one in the office knew what he was talking about. He happened to physically go by the office on another errand and walked in. Still, no one knew what sort of information they needed to transmit to him. Finally, they resorted to having him hold the phone and the staff listened on speaker. "Oh, that's Stephanie!" Guess what? Stephanie wasn't there. Still no answers. Adam punctuated all this by asking us, "Is this [really] how healthcare should work in the 21st century?"
Think about it. If the patient decides they want to change their appointment, why do we burden them with all the responsibility for doing this? Why do we rely on 20th century tools like phone calls and fax machines? How can we make the basic things easy for the patient? How can we break this dysfunctional mold using technology?
Deciding on Priorities and a Preconference Survey
This poses a conundrum. There is so much we can and should do. How do we decide what the priorities are so we don't get lost in a swirl of diluted effort? To address this, KLAS sent out a preconference survey. This revealed a consensus on three main areas in our current system that are recognized as both important and particularly painful.
- How does a patient choose the right provider? I am a physician and healthcare executive, and I have a hard time navigating the system. How is the average consumer supposed to accomplish this?
- On a related note, how does a patient determine when they need to see the next provider, who that provider should be, or whether they need to see a provider at all?
- Finally, how do patients determine the right pre- and post-encounter care? I will confess that I have sent many patients out of the emergency department with discharge instructions and guidance that make an Ikea furniture assembly instruction booklet look simple.
Addressing Information Asymmetry
In simple terms, our patients need resources and tools so they can make informed decisions. In our discussion group, we latched on to the idea that this is an information-asymmetry problem, as are so many other issues in our healthcare system. The information is available, but it isn't available in a place, time, context, or format that makes a difference. Instead, we commonly rely on legacy themes of trust.
The trust issue is closely linked to the information-asymmetry problem. In fact, the asymmetry leads directly to the traditional ways we engender trust. People make decisions based on friends, contacts or other heuristics that may or may not be reliable, but at least they are available. But those traditional ways are not accurate or scalable, and they are not very democratized.
I just read David Feinberg's piece on why he does what he does at Cerner. It resonated with me and dovetailed with this concept because he described a well-connected family who was able to get their child good care because they “knew somebody." How can we make our system less dependent on "knowing somebody" using technology?
Beyond the usual vendor-client shuffling that occurs at these sorts of conferences, I was grateful that KLAS was able to impart on me and others this distillation. Ultimately, we were not there to sell, buy, or use technology. We were there to find ways to use technology to solve the information-asymmetry problem and create a seamless environment where patients and their families trust that they have the right information to choose which provider to see next and understand what the next best step in their care journey is.
Dr. John Lee is the CMIO at Allegheny Health Network.