5 Core Beliefs ("Sacred Cows") Blocking Digital Transformation In Health Systems

As market forces visibly disrupt healthcare (less access to cheap capital, reimbursement pressures, rising demand for services in the face of constrained supply), digitally transforming core processes is not merely an option any more. Every health system wants to get better in using digital technologies to improve the patient experience, increase access and lower cost. However almost everyone also faces a few significant roadblocks in achieving the success such transformation promises. These roadblocks fall into the same well known categories all change programs encounter: technology capabilities, culture and core beliefs, process shortfalls and people related (skills and incentives). 

Based on LeanTaaS's work with over 100 of the country’s largest health systems and conversations with dozens more, we have uncovered five core beliefs that currently prevent many health systems from rapidly innovating and achieving significant operational and clinical improvement. Here are the five core beliefs and why they need to be overcome for a successful transformation:

1. “Our EHR can do it all.”

EHRs are good at a lot of things but predicting and prescribing solutions to probabilistic events like schedule optimization and forecasting outcomes isn’t one of them. Yes, a lot of money has been spent on the EHR, and they serve a very specific and important purpose but they cannot solve all the required operational and clinical issues that create access and lower cost. EHRs are like "luxury cruise ships" with a lot of features that are hard to turn on a dime, what digital transformation needs is "speedboats".

2. “Analytics = EHR reports, maybe some Excel, Tableau, and homegrown dashboards. That’s all we need.”

Analytics is a lot more than dashboards and reports. Dashboards are like scales at the doctor’s office - they “admire the historical problem.” Weighing scales report on a known problem (“You need to lose 20 lbs") but do nothing to actually solve the issue. To truly achieve digital transformation requires investing in tools that predict future events and prescribe actions to achieve a better outcome. Like Waze rerouting you along a better path when it sees bad traffic ahead.

3. “Anything we need beyond the EHR we can build internally.”

Even a company as large as GM doesn’t build Microsoft Word simply because it can afford to hire 1,000 people to try and do so. It is easy to underestimate the investments and scaling needs of useful software. Just because a skunkworks project meets the needs of a small group of users, it does not mean it can scale to meet the needs of a larger group, or solve larger problems.  

4. “If I create an innovation team and invest in startups I will be able to innovate on my own.”

Innovation happens at the front lines in the weeds of the individual complex workflows such as scheduling, authorizations and revenue cycle management. For it to work, 98% of your organization should be excited and engaged in innovation, not just the 2%. It’s great to have an innovation team, but do they have a budget? Are the operating teams engaged? Is everyone empowered and tasked with the goal of transformations? Is there a reward system to align goals with behavior?

5. “The Cloud is Unsafe” and so we will stay client-server to protect information.”

Amazon, Google, Microsoft have spent billions of dollars building secure cloud infrastructure. The chances that any one health system can invest as much to achieve more security behind the firewall is close to zero. 

These shifts from the traditional mindset are necessary to achieve real progress in operational and clinical efficiency the healthcare industry so desperately needs.

This article first appeared in Forbes.