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CARE for the Digital Dragon
When Failure is not an Option
Willie Appel
VP and Executive Partner
Executive Services
Gartner
09 October 2014
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Gartner, Inc. or its affiliates. © 2014 Gartner, Inc. and/or its affiliates. All rights reserved.
Game Changers of Healthcare Reform Have
Become More Certain
Value-based
The principles by
which healthcare
providers are paid
Proximity
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Virtual
Activity-based
Physically Present
Incentives
The degree to which the
delivery of healthcare is
freed from the constraints
of physical proximity
The Preferred Model of Care Is Revealed
"Net present value of health …
locally."
Value-based
Centered Care
Physically Present
"When illness
overcomes inconvenience."
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"The doctor is in …
you."
Virtual
Activity-based
Herky-Jerky Care
Continuous Care
Convenient Care
"Your e-doctor will
see you now."
Multiple Technology Advances Are "Conspiring" to
Create High-Velocity Medicine
EHRs with real-time clinical
decision support and
interoperability
BI and enterprise data
warehouse platforms
Performance transparency
and clinical effectiveness research
Patient-direct
healthcare/telemed apps
Advanced sensor technologies
location, condition, correlation
Lifestyle, prevention and
persuasion research
Genomics and collaborative
medical discovery infrastructure
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Key Messages
CARE for the DIGITAL Dragon
onstruct your Vision
rchitect Solution
eassess your current state
xecute your decision
4
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Key Messages
CARE for the DIGITAL Dragon
onstruct your Vision
rchitect Solution
eassess your current state
xecute your decision
5
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Change Propels Us Toward a New Model:
The Real-Time Health System
A management paradigm that
advances effectiveness by using
timely information to remove delay
in the management/execution of
critical processes
• Entirely dependent on top-notch IT
of a higher grade than most health
systems have today
• Requires timely operational
awareness of key events
and risks
• Still about leadership and culture
change
*Source: U.S. Health System Strategic Plan Presentation, 2011-2015
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"This is the
strategic
initiative that
will most
significantly
define and
drive our IT
vision and
enterprise
architecture
over the next
few years.“*
Key Messages
CARE for the DIGITAL Dragon
onstruct your Vision
rchitect Solution
eassess your current state
xecute your decision
7
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The Real-Time Healthcare System (RTHS)
• Uses information and
communications to
disrupt the classic care
delivery model.
• Senses the need for
a change in process,
operations or strategy.
• Eliminates waste and
latency, accelerates
business processes,
and balances resources
and demand.
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Operationally intelligent
Balances resources
and demand
Transforms care delivery
Enhances the patient
experience
Optimizes care quality
The RTHS Is Aware
• Situational intelligence improves
decision making around care and
operations.
• Up-to-date information to remove
delays in critical workflows and
processes.
• Visibility into important patientrelated events.
Location and condition sensing
Awareness platforms
• Up-to-date patient context to
satisfy revenue, cost, quality and
patient experience expectations.
Universal medical device bus
Alerts and notifications
Nurse call integration
Positive patient identification
Unified communications
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The RTHS Is Adaptive
• IT infrastructure that collects
real-time patient-event data
and closely monitors critical
patient-related conditions.
• Situational intelligence to
anticipate and predict so
responses are proactive,
prompt and of higher-quality.
• Is more proactive and
less reactive.
Awareness platforms
Universal medical device bus
Location and condition sensing
Alerts and notifications
Nurse call integration
Positive patient identification
Unified communications
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The RTHS Is Collaborative
• Secure messaging at
a minimum.
• Increased reliance on clinical
communication and
collaboration systems.
• Physician engagements
platforms.
• Patient decision support tools
to enable shared decision
making.
Secure messaging
• Social media outlets to engage
the consumer/patient and
access the patient portal.
Care coordination
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Patient portals
Physician engagement platforms
Health information exchange
Enterprise file synchronization
and share
Clinical communication
and collaboration
The RTHS Is Mobile
• Contributes to optimized
workflows and timely access
to patient information.
• New face of consumer and
patient engagement.
• One of the HDO's biggest
privacy and security
challenges.
• Extends the reach of
the EHR.
• Clinicians remain the
vanguard of mobility.
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Mobile device management
Secure texting
Clinical communications
and collaboration
BYOD
Unified communications
The RTHS Is Demanding
• Requires superior service levels
and end-user/patient experience.
• An increasingly mobile and
remote workforce across multiple
care venues.
• Focus on high performance
and availability.
• New approach to service desk
and application support.
• New IT service delivery models.
Service-level management
Best practice frameworks
End-user experience monitoring
Business continuity management
Legacy decommissioning
Remote hosting
Cloud services
Service desk/application support
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Key Messages
CARE for the DIGITAL Dragon
onstruct your Vision
rchitect Solution
eassess your current state
xecute your decision
14
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The RTHS Provides Visibility to
Critical Events
Sensors
Alerts
&
Notifications
Administrative
Systems
Business
Processes
Event-Handling
Systems
Filtering
Correlation
Aggregation
Dissemination
Building
Systems
Business
Activity
Monitoring
Process &
Outcomes
Analysis
Point-of-Care
Systems
Communications
Systems
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BI/Data
Warehouse
The RTHS Will Change the Focus of IT
• Will cause the HDO to focus
more on the end-user
experience — application
performance and high availability.
• The RTHS will consume IT
resources at a faster rate, so
initiatives like information life cycle
management will gain more traction.
• Will drive use of alternative delivery models like remote
hosting and infrastructure cloud services.
• Will focus more resources on wireless and mobility, and,
in particular, smartphone management.
• Will drive adoption of operational best-practices.
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Changing Clinical Arena
• Greater pressure to control costs and improve quality
• Increased transparency of value
• Risk-sharing payment models distributed across the entire
delivery system and tied to value
• Reconfiguration of the delivery system to a patient-centric
model including prevention, wellness and disease
management
• Increased meaningful use of technology
• Demand for coordinated care across all venues
• Greater emphasis on personalized medicine
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And Introduce New Challenges
Surrounding…
• User support
• Security and privacy
• Remote access
• Data loss prevention
• Legacy decommissioning
• Medical device integration
• Mobile device management
• Disaster recovery
• Interoperability
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Key Messages
CARE for the DIGITAL Dragon
onstruct your Vision
rchitect Solution
eassess your current state
xecute your decision
19
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Using the Nexus of Forces
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20
Forces: Social
Clinicians/Patients
want to connect…
• To share
experiences
• To find answers
• To engage with the
community
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Forces: Cloud
Clinicians/Patients
want seamless
experience:
• To access anything
from anywhere
• To use multiple
devices (and apps),
sometimes
simultaneously
• To blend work and
non-work activities
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Forces: Mobile
Clinicians/Patients
want to be mobile…
• Using devices of
their choosing
• Staying connected
with co-workers &
patients
• Being able to
switch easily
between work and
non-work activities
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Forces: Information
Clinicians/Patients
consume and
generate information:
• They need access
to their information
and applications
• They want context
relevant information
to augment their
activities
• They don't care how
it works, only that it
does
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Migrating to Digital Health Business —
Two Paths, but a Winding Road
Longitudinal
Incentive-driven
E-Healthcare
Health
Management
(Accountability,
Finances,
Life Cycle,
Consumer)
Current
State
Digital
Business
Healthcare
Digital Care
Delivery
Knowledge-driven
Care Delivery (Diagnosis, Treatment, Outcome)
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Recommendations
For Executives of health delivery organizations:
 Adopt the real-time health system paradigm to
manage your foundation technologies.
 Position the organization for alternative care delivery.
For Executives of healthcare payer organizations:
 Take a leadership role in filling the white space of
healthcare coordination, shopping, engagement,
member motivation.
 Create a focal point in the organization for capturing
emerging digital moments.
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Action Plan for Healthcare Executives
(Payers and HDOs)
Monday Morning:
- Share what you have learned with your enterprise partners in clinical,
operations, patient/consumer-facing functions, etc.
Next 90 Days:
- Introduce concept of digital business in to your discussions with
business partners.
- Identify the most critical consumer engagement issues to create your
own business moments.
- Engage business partners in planning through the use of business
moments to develop your story on the potential of
digital business for healthcare.
Next 12 Months:
- CIO presents on digital business in an upcoming strategic
planning session.
- Pilot initiative to build experience with business moments.
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‘If you think you’re too
small to make a
difference, try sleeping
in a room with a
mosquito’.
African proverb
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28
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Recommended Gartner Research
 2014 Strategic Road Map for the Real-Time
Healthcare System
Barry Runyon (G00253192)
 Master the Six Essential Elements of a Digital Strategy
Stephen Prentice and Ken McGee (G00247641)
 Get Ready for Digital Business With the Digital Business
Development Path
Jorge Lopez, Patrick Meehan and others (G00263766)
 Six Key Steps to Build a Successful Digital Business
Ken McGee, Diane Morello and Lee Weldon (G00261624)
 Healthcare Payer Transformation Key Initiative Overview
Robert H. Booz (G00263114)
For more information, stop by Gartner Research Zone.
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