A Take on EY’s “Americas Board Priorities 2023: How to Build Resiliency in Uncertain Times” - Peter Waziri
Part 3: Enabling Innovation and Technology Transformation
A Take on EY’s “Americas Board Priorities 2023: How to Build Resiliency in Uncertain Times”
From a Healthcare Industry Perspective
The EY Center of Board Matters published an interesting report on building resiliency in uncertain times and highlighted 5 board priorities for 2023.
Reading this report from a healthcare industry perspective was interesting and gave me a lot to think about. I am sharing my thoughts in a series of five articles.
In this third article of the series, I will explore the topic of enabling innovation and technology transformation.
According to EY, leveraging modern technologies to boost self-initiated transformational changes preferably from a position of strength becomes more vital to companies. Therefore, thorough reviews need to be done on legacy business models that are vulnerable to competition and/or stifle growth and efficiency. Simultaneously, management should constantly examine and adapt new capabilities that anticipate, and proactively adapt to market shifts.
Healthcare company boards should consider:
The business of healthcare continues to face several evolving external challenges such as increasing costs trends, a more intensive competitive landscape, and regulation. Therefore, in addition to cost-cutting and investment, boards could engage management to switch up their strategies to include innovation and transformation efforts especially when it relates to patient care. While this is currently happening, the pace, scope, and consequences are becoming more urgent. For example, boards should be asking management about the extensive and continuous use of telehealth, virtual care, and remote patient monitoring (RPM) platforms. Continuous use of these platforms enables better and more efficient ways of monitoring patients. They can also facilitate better patient volume management and relief from intense workflow pressures. Furthermore, targeted use of RPMs in a financially sustainable manner could help reduce hospital emergency department (ED) use especially when targeted towards readmissions. Better readmission management is a mutual goal of both provider and health plan entities and one of the critical components of value-based care (VBC) arrangements.
Boards could engage management to further integrate innovation and digital technology into future treatment facilities to coalesce around the patient experience. For example, boards can help stress-test the future design of hospitals with digital architecture that provides a seamless experience for each patient. Such an environment may include pre-arrival patient registration and room assignments, and welcome screens showing patients’ clinical care team, so patients know who is coming in and out of their rooms. The ED could also do with digital enhancements that benefit both patients and clinicians. For example, boards could ask about a hospital’s digital identity strategy for clinicians as a replacement for multiple logins and authentication steps. This helps to improve patient care and balance efficiency with security in the long term. In short, any opportunity that positively automates patient experience along the care continuum should be considered.
Boards of health plans should also be having discussions about the future expectations of health plan members. Stand-alone health plans should ensure that changing member expectations are incorporated into their online capabilities, so members' experience are met with regard to provider selection, benefits, coverage, etc. Boards could also ask for a better line of sight into member experience regarding onboarding, benefit design, potential automation of explanation of benefits (EOBs), billing expectations, etc.
Provider-owned health plans should include all the above qualities plus additional guidance on how the organization model optimizes whole-person care through integration and coordination among all areas of the system. Provider-owned plans may even be able to leverage internal shared technological capabilities to achieve seamless communication between plans and treatment facilities and help reduce bifurcated obstacles.
Additional discussions could be had around the hybrid (virtual and physical) model of care.
The pandemic has made people more comfortable and accustomed to virtual health and boards should be discussing this with health plan management. It is now reasonable to expect members to consider changing health plans that do not cover virtual visits or provide online tools that help them ascertain the best financial options while making it easier to connect them with appropriate providers. Virtual and continuous alignment offerings with consumer preferences will become more pivotal.
Healthcare entities should be preparing for the next iteration of the internet (i.e., the metaverse). As such, boards should be questioning management to obtain greater awareness of plans to embrace a more immersive web experience. All these will help facilitate deeper engagements that provide new ways to interact with patients. As the center of care moves further away from inpatient towards ambulatory, RPMs, virtual and home care, these trends will become more need-to-have than nice-to-have. Boards can play a strategic role in helping management devise how best to embrace this trend with respect to employee care optimization, enhancing patient/member experience and communication, and overall conduct of care activities.
A risk that board members cannot ignore about this future work environment relates to data privacy and protected health information (PHI). This is regulated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the subsequent Privacy Rule (and Security Rule which governs ePHI). In addition to fines and penalties, a health entity’s brand image could be severely impacted hence the need for extra vigilance while evolving towards the metaverse.
Elevated board governance of healthcare R&D portfolio is also needed. They should be asking for updates on key technology investments while continuing to discuss other potentially transformative investments and practices and workplace culture. Hospital-based research entities are good examples here. Continued funding and collaboration for research on infectious diseases, prolonged symptoms of COVID-19, less invasive surgical techniques, and treatment of mental health conditions are all vital.
Boards should be aware that discussions around innovation, technology, and transformation would not be complete without focusing on the vast potential of artificial intelligence (AI) to help create robust automation systems that raise the standard, delivery, and management of care. For example, AI can upgrade efficiencies around automated care continuums, help spot inefficiencies in supply chain practices, help discover gaps in the coordination of care between diverse care teams, and can be deployed as a risk management tool in a health plan’s high-cost predictive analytic model. It can also be a useful tool for fighting fraud and defending against cyber-attacks.
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