Friday at Five
ViVE, a collaborative event sponsored by the College of Healthcare Information Executives (CHIME) and HLTH, attracts leaders from hospitals, health systems, and payers for a week of innovation and insights. This year’s affair, hosted by the Los Angeles Convention Center, was my second ViVE Event and perhaps my best.
Industry progress in virtual care, value-based care, and hospital room of the future was evident across the exhibit hall and in every panel session. It was clear at ViVE 2024 that the industry has shifted from what “can be” done to what “has been” done with real-world examples of technology’s maturity, scalability, and net revenue realization in healthcare. Even AI in healthcare is maturing with ambient voice technology companies like Corti and Abridge showing proven, real-world results to improve clinical conversations..
Here are five insights gleaned over my three days at ViVE.
1. Nurse-Led Innovation Is Here
The value of integrating nurses into technology projects is a known best practice. But ViVE 2024 took nursing participation to a new level with pre-conference sessions and an entire pavilion dedicated to nursing innovation.
New technologies must be designed to reduce nurses’ administrative burden and alert fatigue, not increase it. With this foundational truth in mind, here are four tenets to consider:
- Ensure nursing teams are ready for the innovation offered by IT departments.
- Expand solutions so nurses see the whole person, not just the patient’s current problem.
- Rewrite the narrative for what nurses can do to and build technology skills earlier.
- Empower your nurses collectively to create a stronger, more unified voice for innovation.
Heidi Christophersen, BSN, MBA, Director, Access and Experience Transformation at Tegria, suggests that organizations “empower nurses to work at the top of their license and focus on improving patient experience.” She emphasized the need for adequate staffing and the necessary patient data to meet quality outcomes.
2. Payers Play a Larger Role
Value-based care (VBC) programs continue to make steady progress toward displacing fee-for-service reimbursement. To fuel VBC initiatives and achieve care reduction goals, payers are taking a more aggressive role in clinical data exchange and preventive care.
According to Shawn Gremminger, CEO, National Alliance of Healthcare Purchaser Coalitions, “Total cost of care is the ultimate measure for payers.” Payers need timely, clean, and accurate data to continually monitor costs and evaluate the effectiveness of preventive care interventions over time and across member cohorts. “But there are many blind spots and payers don’t often get all the information they need,” added Omid Toloui, VP of Innovation at Elevance Health.
Toloui encourages innovation to build trust between payers and providers while improving member health and wellness to reduce the total cost of care. “Innovation is a team sport,” said Toloui. He suggests payers start with problems first, then find the right solutions.
One speaker, Piyush Khanna, VP of Clinical Services at CareFirst Blue Cross Blue Shield, partnered with MRO, a clinical data exchange company, to automate data collection, aggregation, and analysis across 30% of his provider community. The program builds more detailed member profiles and drives more efficient quality reporting for the health plan including HEDIS and Stars. For example, clinical teams at CareFirst now access the patient data they need within hours versus months, saving more than 17K staff hours annually. According to Khanna, “Data is the new currency for payers and health plans.”
In addition to cost management and quality reporting needs, “better data is the foundation for long-term VBC success” according to Carmen Peralta, MD, MAS, FASN, Chief Clinical Officer at Interwell, a value-based kidney care management company. As an example, Peralta explained how Interwell uses data to identify potential kidney disease members and deliver early care interventions, thereby reducing the high cost of end-stage kidney failure by moving from expensive rescue care to low-cost preventive care.
Interwell’s strategy combines member engagement, trusted relationships, data to segment populations, and preventive measures. “VBC opens new opportunities for health plans to deliver early interventions and prevent disease, and now these efforts are fully reimbursed,” concluded Peralta.
3. Continual Investment in Cybersecurity Is Mission Critical
The Cybersecurity Pavilion at ViVE 2024 was abuzz with activity as Change Healthcare’s massive cyberattack was announced. According to John Riggi, National Advisor for Cybersecurity and Risk at the American Hospital Association during his interview with CBS News, “The cyberattack has affected every hospital in the country one way or another.”
Similar to the AT&T cellular data outage a week prior, “The Change Healthcare breach reminds all of us how much we rely on our health IT vendors,” said Anthony Guerra, Founder and Editor in Chief at Healthsystemcio.com. “Cybersecurity is a risk management issue. You must have a plan B.”
John McDaniel, FACHDM, Chief Innovation and Digital Transformation Officer, reiterated the need for investment in more cybersecurity tools and better organization to support the privacy and security of patient data. “One of the most challenging jobs for healthcare CIOs is to ensure the organization is protected from unauthorized data penetration and risk from bad actors.”
4. AI, Interoperability, and Digital Transformation Reach Inflection Points
Scott Stuewe, President and CEO of DirectTrust, offered important observations. “Nearly every company at ViVE is doing something with AI or interoperability. I believe that AI erases the need for semantic interoperability, providers will no longer need to code outcomes, and the future promises a huge reduction in the administrative burdens of healthcare by using AI tools.”
While AI makes steady advancements in healthcare, it must remain safe and effective for patients and organizations. Lars Maaløe, Co-Founder and CTO at Corti, encouraged attendees to remain on the forefront of data integrity and AI regulation. AI solutions are only successful when they are built upon clean, accurate data—and real-world evidence is necessary for scalability. “Look at AI tools as you would a new expert on your team and demand the same level of quality and performance as solutions become more mature.”
A concluding general session on generative AI moderated by Sony Salzman, Coordinating Producer for ABC News, provided five takeaways:
- Note-taking is an excellent starting point for AI.
- Think of AI as a copilot and keep humans in the loop.
- Combine structured and unstructured data.
- Use AI to identify action points and triggers within the patient journey.
- Remember that AI is complex and there is a lot to do.
5. Rural Healthcare Matters Now More than Ever
According to U.S. Census Bureau, 15% of the US population lives in rural communities but only a small percentage of physicians practice there. During the Innovative Solutions in Rural Healthcare: Addressing the Challenges for Medicaid and Medicare Patients session, panelists emphasized the need to ensure access to healthcare in rural America through investments in IT initiatives, people, resources, and expertise. Furthermore, Patrick McGill, MD, MBA, Chief Transformation Officer for Community Health Network, stressed that technology doesn’t solve everything and patients must remain at the center of the rural healthcare ecosystem. “These patients also have unique challenges with transportation, skilled nursing care, and nutrition.”
Addressing community needs begins with greater access to data. Again, data is mentioned as the precursor to improvements in the healthcare industry. Three essential questions were raised.
- How do we get all relevant patient information into the hands of rural clinicians at the point of care?
- Is staff augmentation a sustainable solution as rural healthcare providers struggle to find the talent they need?
- Can we incorporate virtual care first, hospital at home, and other nascent delivery models while respecting local culture and ensuring technology changes don’t broaden health disparities?
Jeremiah Rothschild, Head of Corporate Product Strategy at TruBridge, suggests rural providers use technology to establish a hub and spoke model with their urban care partners. “In this model, patients travel to an academic medical center for major surgery but remain in their local community for all follow-up services such as chemotherapy, radiation, and physical therapy.”
Virtual care first and hospital at home were also discussed as ways to accommodate preferences for local care. Katherine Saunders, MD, Co-Founder at Intellihealth, shared the company’s approach to obesity care. “Health systems often can’t afford the time or resources to provide obesity care. By tapping virtual specialists, patients get the expertise they need while community hospitals keep patients in their network.”
Laura Rogers, CDH-E, Sr. Director of Healthcare Strategy at SHI International Inc., an IT services and consulting company, concluded with sage advice. “As an industry we must guarantee access to care for rural America without forgetting the need to protect our patients through expanded cybersecurity, stronger risk and governance, and by enabling virtual care.”
Inspiration and Challenge: Healthcare CIO Remains a Tough Job
The role of a healthcare CIO is increasingly challenging. Events like ViVE 2024 provide insight and inspiration for CIOs, but they also introduce new budget items and staffing demands. Healthcare transformation takes a long time. There’s no such thing as quick and easy.
“New IT projects must deliver solid and rapid return on investment for CIOs to obtain CFO approval,” said Matt Zubiller, CEO, e4health. It is critical to prioritize efforts to achieve value, and then continually measure return on investment as the solution is implemented across the organization.
Simultaneously, the lack of people power in healthcare remains a huge challenge in 2024, not only in nursing but also for operational and administrative tasks where cash is caught or lost. According to Zubiller, “These basement tasks present the greatest opportunity to optimize AI and deliver the net revenue realization CFOs need.”
CIOs should continue to expect more healthcare stakeholders demanding access to their patient data for AI projects, interoperability, and preventive care programs. While there is no shortage of great ideas, we must focus on what truly matters—our health IT outcomes.