John Gomez 1/11/12

Recently I developed a Leadership Cheat Sheet for clients and friends. The document provided guidance on how to evolve your leadership style and suggestions on avoiding common leadership mistakes. As we move into 2012 (wow,  2012 sounds so Buck Rogers, doesn’t it?) I started thinking about a cheat sheet for HIT executives that helps them evolve their strategies and hopefully avoid technological mistakes in the coming year. By no means is this cheat sheet a comprehensive end-all, be-all, but rather a high-level guide of what to consider in the coming year.

Let me start by saying that not everything in this article is going to be applicable to every organization. You may also find that some of the items in the article are not necessarily new or all that leading edge. In some ways, much of this is a return to the meat and potatoes of HIT. Yet there are some new fancy, out there, Star-Trek gizmos that most of us love to envision included for you mavericks. With that disclaimer, let’s get started.

If I were on the hospital side of the equation (not the vendor side,) I would see 2012 as year to rework foundations and drive strategies that grow revenue and/or margin. I believe these two things go hand in hand. Although it may seem obvious, I find that Meaningful Use has in some ways become a huge distractor to allowing HIT to build an organization’s margin and revenue.

In my eyes, all IT organizations — not just those in healthcare — should be indirect profit centers, able to demonstrate that their strategies are driving organizational growth and financial stability. To do this, many organizations need to consider their foundational systems and begin making bets on what to invest in during the coming year, so that over the next three years, they can demonstrate that IT is a strategic partner to the business, not just a cost center. Sounds rather basic, doesn’t it? Yet it is such as difficult thing to execute upon, and that challenge is the reason for this little cheat sheet.

OK, so first things first. You can’t really get around your continued MU efforts or ICD-10 adoption. Yes it is draining, taxing, distracting, painful, lethargic, and about as exciting and forward thinking as watching wall paper erode. Most of your resources are going to be tired up on MU/ICD-10, yet you need to really think about how you rebuild your technology foundation and drive corporate revenue growth. After all, healthcare is a business.

My first suggestion to you is to establish an “imagineering” team. This can be a small team (depending on your budget) comprised of multi-functional talent, empowered to make decisions, drive change, and most of all, execute upon their decisions. If you want further details on how-to build an imagineering team, let me know, but the key tenets are (a)small team; (b) self-learners; (b) self-starters (c) highly passionate; (d) cross-functional; (e) full-time assignment; and (e) only looking at changes that can be accomplished without the need for board or finance committee approval. The reason for that last item is that you don’t want this team to get bogged down with big, complex changes and projects. Secondly I believe you will see greater returns from smaller strategic investments than big multi-year projects.

The Cheat: Carve out some resources and create an imagineering team. Keep your MU/ICD-10 work moving forward and make progress on the little things that provide big returns.

Recently I had the opportunity to meet with some rather smart and very talented software developers. We were discussing a new product that they are trying to bring to market. The discussion quickly turned to object orientation, software as a service, cloud-based computing, etc. They were pretty shocked when I said that really doesn’t matter – it’s all just drivel. What matters, I said, is getting your product to market and solving the client’s problem, doing those things really, really well, better then anyone else. Why does that matter to you?

I believe in 2012 you need to really consider evolving your departmental systems. Why? Because there is gold hidden in those departments. Want to improve throughput? Lower costs? Drive better ROI? Deal with future challenges related to genomic and personalized medicine? Then you should evaluate your departmental solutions and start thinking about how upgrading or replacing them (yes, replacing) could yield much higher returns. Solving your client’s problems is what matters.

OB/GYN, cardiology, optometry, ED, oncology, pathology, lab, advanced surgical, and other lines of business are highly specific workflows. Although some of the EMR/EHR vendors do a good job at this, you will find that your return is much higher by going with niche vendors who have systems optimized for these areas. The landscape of offerings in these areas is changing and you may find great deals, with short implementation cycles that create huge downstream returns.

The key to improving your revenue and margin is lowering operating costs and seeing more patients (yes, a no-brainer.) Yet to make that happen, you need to consider new systems and consider looking at some of the smaller players in these spaces that are doing some truly amazing things with really new technology. This is the perfect type of project for an imagineering team.

The Cheat: Review your 2012 departmental portfolio to determine if by evolving or upgrading you can improve patient throughput and lower costs.

“You can’t get there from here,” said the farmer along the side of the road.

“Why not?” I asked.

“Because they ain’t built a road, you fool,” he snapped.

Are you building roads in 2012? In my eyes, the next three years will see a tremendous shift in technology within HIT. You can only embrace these changes by laying foundational infrastructure that allows you to not only take advantage of those shifts, but also assure that you can do so at a cost and pace that yields strong ROI.

Throughout 2012, you should come to terms with mobility, patient tracking, resource tracking, analytics, security, and data integration/exchange. I consider this your infrastructure portfolio. Just like you have a departmental portfolio, you should consider developing a portfolio of your infrastructure to better understand how you are positioned for the future. Each of these items in the portfolio should provide a set of “roadways” which allow you to digitally get to anything or anyone in your organization and system.

Key investments in RTLS, HIPAA compliance management, privacy and security management, and the other areas are critical. If you have not deployed directory services and EMPI systems, you need to get that done. Why? Because I believe that over the next three years, we will see more and more focus on the integration of devices and humans. This will drive a tremendous need for an underlying infrastructure that allows you to orchestrate an ecosystem. Evaluating and investing in your infrastructure portfolio is critical to long-term success, reducing costs and driving revenue.

The Cheat: Develop and evaluate your 2012 infrastructure portfolio. Develop key plans for at least RTLS, PRM, HIPAA compliance, and privacy and security. Focus on technologies that improve patient throughput, reduce costs, and drive long-term ROI. If you have not deployed directory services and EMPI, get on it.

Little by little, the world of retail is changing. More and more retailers are evaluating or deploying self-service systems that allow consumers to do more for themselves and get help from a sales associate only when they need or want help. Airlines are also embracing the self-service mentality for passengers and crews, providing access to tools that allow greater access to what was once complicated processes that required human intervention. Developing a “healthcare self-service” strategy in 2012, which puts more power in the hands of the patient, is a key means to drive greater throughput and gain financial upside for the healthcare organization. The self-service strategy should include patient relationship management, patient access, and other tools that allow the patient to take greater control. Although human interaction is vital to patient care, there are a variety of processes that patients can do for themselves and actually would champion to be allowed to do, if they had access to the tools.

The Cheat: Drive higher patient satisfaction, better patient throughput, and ROI through the development of a 2012 self-service strategy. Also consider how self-service can be applied to hospital employees.

“To boldly go where…” you know the rest of the line, I am sure. So what about the cool Star Trek stuff? Well, I do think that you will see subtle shifts in 2012 that have long-term implications, but I am not sure if we are going to remember 2012 as the year that changed the face of healthcare forever. That said, for those leading edge organizations out there, I do think that there are some things you can start evaluating.

Some of my things to watch are DDS (diagnostic decision support), healthcare gaming, robotic aides, and large-scale data analysis, as well as the application of social graphs to patient care and collaboration. Each of these has a backdrop of affecting patient throughput and managing costs. For instance, DDS can help drive better decision-making in shorter amounts of time, freeing up clinicians to see more patients or spend time with patients. Healthcare gaming provides the opportunity to reduce readmissions, improve wellness, and educate patients. Robotic aides will at some point help drive care, though challenges with battery life and size make this a long-term realization. Large-scale data analysis, social graphs, and related technologies are also very much in their infancy, but there is promise and opportunity for those organizations looking for leading-edge game changers.

The Cheat: Pick one or two leading edge technologies that can provide long term differentiation to your organization.

ACO, ACO, ACO. OK, so we are making some progress and little by little, it seems to be coming together. But what is coming together is still a mystery. Developing an ACO strategy is important and probably a good thing to do in 2012, but I would caution you that there are probably other items you can focus on that will drive higher returns. That said, there is some low-hanging fruit an imagineering team can go after in regards to the world of patient financials. That fruit includes asking your current patient financial vendor to outline their strategy to address patient financials over the next three years (not just ACO.) I would not suggest changing vendors unless you are either having serious issues with your current vendor or your current vendor has no strategy for the next three years. If your satisfied with your vendor strategy, then focus elsewhere and monitor the evolution of ACO and its impact to your organization. Wait for the dust to settle, learn from the mistakes of others, and take a crawl-walk-run approach. If you must change vendors or your vendor doesn’t offer a strategy, then this is a project way too big for an imagineering team.

There are a ton of more cheats I can offer and probably some things you might be surprised not to see in the article. My goal, though, isn’t to cover it all. I realize that many of you may find that much of this is already known, which is cool if you are already on it. My goal is to help you think about the little things you could be doing to move your organization forward while you and your team drive greater revenue and, hopefully, margins.

The Last Cheat: If you agree with each of the cheats in this article, you can copy them to a PowerPoint (just the cheats) and present them to your leadership team. You will have an instant outline of your key goals for 2012.

John Gomez is CEO of JGo Labs.