Digital Health Investment Symposium
Where Do We Need to Focus Future Healthcare Technology Investments?

Discussion Summary

Participants discussed population health, value-based care transformation, the current state of revenue cycle, and the impact that value-based care will have in this space. Additional discussion emerged around understanding the full picture of healthcare costs, including how health systems are trying to understand cost, patient engagement, wellness, and telehealth. Finally, the need for data aggregation and artificial-intelligence tools to inform business decisions and provide impactful insights was an important topic of discussion.

Key Findings from Pre-Symposium Poll

Group Discussions:
Top Challenges in Healthcare

During the symposium, members of the provider and investment communities were divided into nine groups for a roundtable discussion about industry problems. The goal of this exercise was to consolidate each community’s challenges and brainstorm solutions to help alleviate these problems. Each table was asked to provide a list of what they view as the most pressing challenges in healthcare.

The two most frequently mentioned topics were payment-model challenges and interoperability/integration, with all but one group identifying these two areas as primary pain points. A myriad of payment challenges were mentioned; these ranged from uncertainty about the future to difficulty straddling both the fee-for-service and value-based care worlds. The most striking theme was the lack of alignment between current payment structures and expected clinician behavior. As an example, one provider shared that some physicians at the provider's organization were unwilling to look at wound-care pictures provided by nurses because of the inability to bill for that work. One group of participants shared that, “Until reimbursement is changed, the adoption of new workflows and technology won’t drive change.”

The second major area of discussion, interoperability and integration, also encompassed a number of challenges, including data ownership, stagnant development due to lack of data access, care-coordination difficulties, and a lack of outcomes. Providers discussed how difficult it can be to make decisions without adequate access to information about a patient. Interoperability has been an industry-wide problem for years, and KLAS’ research indicates that few organizations today have achieved true interoperability. Unfortunately, as both the provider and investor communities pointed out, this is negatively impacting care delivery on a very broad scale: “Great opportunities exist for innovation,” one group explained, “but if we don’t have interoperable access to data sources, that mutes the innovation in big ways.”

A lack of patient engagement (e.g. through education, wellness initiatives, and data ownership) and data acquisition were the next challenges on the list. Both were identified as key challenges in the pre-symposium participant poll. In the case of data acquisition, difficulty making the acquired data actionable on both an organizational and an individual-physician level was brought up as challenge standing in the way of true care-delivery transformation. From a technology perspective, both providers and investors said IT systems need the ability to “frame knowledge at the point of care” as well as put “actionable data in the right hands and at the right time” to truly affect patient care and drive outcomes. Additionally, providers desire more guidance on how to use data they have. According to one provider, “Data by itself is meaningless. Genomic creates a ton of data, but we don’t know what to do with that data.”

The final major theme discussed by over half of the groups was the need for change management within healthcare organizations themselves. Beyond incentive/reimbursement alignment, a cultural shift needs to take place within healthcare. Individual departments and caregivers must feel connected to the mission of delivering value-based care and take individual responsibility for moving the needle. Participants felt that success in a value-based world will hinge on whether this cultural change takes place.

Additionally, KLAS has been conducting research in October 2017 to find out which emerging vendors and technologies have caught provider organizations’ attention and are gaining mindshare (see Emerging Companies 2017 for more details). The vendors identified in this report are also focused on addressing key challenges around patient engagement, the use of data, and improving the physician experience.

Group Discussions:
Solutions to Top Challenges in Healthcare

After discussing the top challenges, groups were asked to discuss and create a list of the primary solutions and areas of focus that will help mitigate pain points. Some of the suggested solutions will require broader industry changes; others can be implemented by individual health systems with support from healthcare IT vendors and the investment community.

Perhaps unsurprisingly, interoperability and the need for aligned payment incentives emerged as the two most pressing areas of focus. Participants favored an open-system mentality around interoperability, and one group even suggested providing financial incentives for moving to this model. Additionally, success in this realm will require healthcare organizations to build their infrastructure “in effective ways to prepare to receive critical data when it comes in.” Moving beyond providers, one group saw the opportunity for investors to help move the industry in the right direction: “Investors often see companies form and dream up optimistic tools. We don’t need more tools; we need to drive consolidated, integrated solutions. . . . There is a big opportunity for investors and [corporate development] to put companies together to do this.”

Participant suggestions for addressing misaligned payment incentives included incentivizing healthcare consumers through better health plans, taking steps to move out of the fee-for-service world, and timelier payer payments for appropriate care.

Participants also felt that additional focus on providers’ access to actionable data could benefit the industry. While it was not the most frequently discussed topic, the depth of discussion in this area underscores its importance. One of the ways through which improvements could be made is better physician education and use-case training. One group recommended “[i]mproved/reformed medical education for providers to understand what data they receive, how to use it, and how to focus on actionable pieces that directly affect patient care.” Another group added that providers “tend to get overwhelmed now with data coming in. How do we manage that and provide education for providers?” Groups agreed that one of the first steps organizations can take is to move beyond simply reporting measures: “There has to be an action item associated with the actions that we measure and report on.”

The key to making data actionable is making sure that the data and associated action steps are part of the physician workflow. One provider explained that “just having insights is not enough. We have to infuse the data into the workflow.” Workflow standardization was put forward by just over half of the groups as a solution to actionable data challenges. Additionally, it was suggested that standardizing workflows could help keep costs down and improve care coordination across the continuum.

Another solution to the challenges put forward primarily by the investor community was more robust value-based care strategy development. One participant recommended that healthcare organizations shouldn’t “try to bite off everything. . . . Look for use cases and understand the problem. Develop the strategy first and adopt the tools second.” In order to help develop strategy, groups suggested being more open to new technologies, open-market ideas, going outside organizations’ delivery networks, and leveraging experts outside of healthcare. Starting in a small, targeted area, such as an individual department, or with a specific disease was also mentioned as an effective way to develop and grow strategies.

Here again, participants pointed to change management as essential to the success of any strategy. Engaging clinicians in what they can control, giving all stakeholders a voice, clear communication of expectations, and the use of physicians as key influencers within an organization were all suggestions that groups put forward as ways to ensure successful change management.

More physician empowerment, patient engagement, broader industry collaboration, and a focus on nonacute-care delivery across the continuum were also identified as possible solutions to key healthcare challenges.

Summary

The intent of the symposium was to bring together some of healthcare’s most influential and innovative thinkers to explore the biggest challenges in healthcare and uncover possible solutions that will lead to meaningful change.

We would like to extend a special thanks to the approximately 100 thought leaders representing healthcare providers, healthcare payers, corporate development, and representatives from private equity firms, venture-capital firms, digital-health companies, health-system-incubator companies, and investment banks.

The intent of this white paper is to point corporate development and investors to the major challenges and solutions that emerged as key findings from the symposium.