The state of digital transformation in healthcare

Smarter use of data leads to better patient outcomes

As Asish Ramchandran lay in a hospital bed recovering from a punctured lung, his thoughts kept drifting to how the hospital used technology to improve his care. He couldn’t help it: As a principal in the technical services consulting practice at Deloitte, Ramchandran spends much of his time thinking about the digital future.

During his stay at Stanford Hospital, which had opened just weeks before, Ramchandran could order meals, turn off lights, adjust shades, and view test results and doctors’ notes—all from his phone.

But it wasn’t just the patient experience that blew him away.

If a machine in his room started beeping unnecessarily, his nurses could turn it off from their phones rather than schlep to the room to hit the reset button. The “handover management” process was completely automated so that at the end of a long shift, tired nurses didn’t have to spend another 20 minutes bringing their replacements up to speed.

Thanks to a new robotic prescription-filling system, pharmacists could spend more time using their expertise to consult with doctors. And when doctors appeared at Ramchandran’s bedside, their iPads already showed data relevant to their specialty.

“It was amazing,” says Ramchandran. “Executives in every industry can learn something from what’s going on there.”

While the COVID-19 crisis will surely strain corporate budgets, it will also challenge leaders to think differently about their digital bets. Today, millions of people around the world are experimenting with new digital tools and apps to get work done remotely, to find and buy necessary items, and to stay connected with friends and loved ones. When the crisis subsides, they won’t likely return to earlier tools and behavioral patterns.

“We’re having a worldwide crash course on how to temporarily become more digital,” says Sam Ransbotham, a professor at the Carroll School of Management at Boston College. “In many cases, temporary will become permanent.”

Turning more data into better care

No economic sector faces a higher degree of difficulty with digital transformation than the $3.6 trillion healthcare industry. The stakes are life and death. The regulatory requirements are byzantine. Processes for managing patient care, electronic health records, and billing are often fragmented, complex, and costly. Even before the COVID-19 pandemic, doctors were so fatigued that many were exiting the profession.

Technology is making a big difference: Healthcare organizations are more likely to use AI than other industries and lap the field many times over when it comes to adoption of robotic process automation, according to the ESI/ServiceNow survey.

“In healthcare, mission-critical means life-critical,” says Deloitte’s Ramchandran. “Whatever industry you’re in, you can learn a lot by looking at what leaders in healthcare are doing.”

Stanford Hospital spent 10 years and $2 billion planning and building its new state-of-the-art facility, which opened in late 2019. A secure messaging system lets doctors and clinicians reach one another, and sophisticated digital workflows ensure patients’ calls to the hospital are routed to the most appropriate clinician—saving hours of frustration and wasted dollars.The system proved valuable in the COVID-19 crisis, as callers fearing infection were quickly advised whether to stay at home, come by for drive-through testing, or prepare for an emergency room visit.

“These investments help us respond as fast as possible,” says Alpa Vyas, Stanford Health Care’s vice president of patient experience.

This sweeping rethink was partially the result of casting a wide net for expertise. The planning team, which included hundreds of experts ranging from architects to AI specialists, looked at age-old problems like how to reduce the risk of patients infecting each other (answer: big waiting rooms with lots of original art and play structures to keep people circulating) and how to reduce the incidence of sepsis (install infrared video cameras at ICU entrances to make sure clinicians wash their hands).

Still, the new Stanford Hospital is the exception, not the rule, in the healthcare industry. For example, just 20% of healthcare executives say their organizations have made major customer experience improvements, and only 8% say they’ve made major improvements to their employees’ experience, according to a recent ESI ThoughtLab/ServiceNow survey.

Some customer experiences today can be important eye-openers—for the wrong reasons. In the months before his death from pancreatic cancer in late 2018, Bart Wise got into the habit of taking photos of his test results when numbers flashed on lab-equipment displays. Although he was treated at a world-class Boston hospital, there was no real-time collaboration system, forcing doctors to try to stay in sync by communicating via countless email chains. Many caregivers came to rely on Wise’s snapshots for the latest information.

“More than one doctor told Bart, ‘what a great idea, I’m going to ask all my patients to do this,’” says his widow Nancy Wise, who runs Spring Street Exchange, a consultancy that helps healthcare systems implement digital technology.

This was just one of many missed chances to use technology to improve care and ease suffering for Bart. His experience was just one example of a problem in patient care that could have been—but wasn’t—solved with technology. “Every person involved with Bart’s care was trying to do the right thing,” says Nancy Wise. “But it’s hard for anyone to find the time to step back and rethink how care is delivered. Everybody’s back is always against the wall.”

Electronic health records (EHRs) are another nexus of frustration. Healthcare companies have spent hundreds of billions of dollars on systems to standardize collection and sharing of medical data in EHRs. All too often, they are mainly used to gather administrative data related to billing and payment.

While many doctors spend their evenings updating EHRs after long days, the information is rarely viewed again. That does little to improve care, says Atul Butte, chief data scientist for UC Health, a provider that oversees five academic medical centers in the University of California system.

To help put some of that information to better use, Butte led a project to gather data from nearly 500,000 UC students, employees, and other members of its health plans. Butte’s team organized the data to be easily accessible to analytics tools, which could help spot meaningful trends. For example, the team decided to look at which forms of the generic diabetes drug metformin doctors at various campuses were prescribing. UC Health mined data on the efficacy and cost of different brands, and then saved more than $1 million per year by standardizing on one.

“That was for just one drug,” Butte remarked at a recent industry panel. “We’re working on 15 others, from inhaled steroids to Allerest. This fruit is hanging so low, it’s almost spoiled.”