{"id":956,"date":"2024-04-26T19:37:00","date_gmt":"2024-04-26T19:37:00","guid":{"rendered":"https:\/\/www.3pillarglobal.com\/?post_type=blog&p=956"},"modified":"2024-11-29T19:00:05","modified_gmt":"2024-11-29T19:00:05","slug":"healthcare-innovation-requires-deliberate-action-not-more-strategy","status":"publish","type":"blog","link":"https:\/\/www.3pillarglobal.com\/insights\/blog\/healthcare-innovation-requires-deliberate-action-not-more-strategy\/","title":{"rendered":"Healthcare Innovation Requires Deliberate Action, Not More Strategy"},"content":{"rendered":"\n

Over the past 15 years I\u2019ve led strategy, product, and application development<\/a> work with leaders across health systems, payers, and pharmaceutical manufacturers. I\u2019ve launched new pharmacy businesses, built patient check-in flows, and planned how to revamp payer ASO offerings. My big takeaway: healthcare leaders already know what needs to be built.<\/p>\n\n\n\n

They know what needs to change to make life better for patients and drive the business forward. They lead teams with absolute expertise in their areas. They know pharmacy, population health, value-based care, revenue cycle<\/a>, etc.<\/p>\n\n\n\n

Yet no one \u2013 including them! \u2013 is happy with the pace of innovation in healthcare. So what gives?<\/p>\n\n\n

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New ideas, legacy systems<\/h2>\n<\/div>\n\n\n

Nearly every change in a healthcare process will now involve software. That\u2019s just the world we live in.<\/p>\n\n\n\n

Yet engineering talent was precious and expensive over the past 15 years. Start-ups and software focused companies held the edge recruiting that talent. As a result, healthcare systems employ a limited number of engineers. And saying these engineers are overstretched is an understatement. The backlog of tech debt, integration requests, and custom development requests would take years to get through if the requests stopped coming today.<\/p>\n\n\n\n

The reality, however, is that the demands and requests are never going to stop coming; instead they are accelerating as healthcare organizations struggle to keep up with consumer expectations and shifting business models.<\/p>\n\n\n

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\"Healthcare<\/figure><\/div>\n\n\n

This has led to a tech stack that cannot support VPs as they try to implement their strategies. Some of the challenges I\u2019ve seen again and again:<\/p>\n\n\n\n

A \u2013 Overlapping and Ossified systems.<\/strong> I\u2019ll never forget a colleague describing her time shadowing the client team at a national payer. There was no common operating system between all the different teams. So the poor call center representatives had to log into multiple teams\u2019 systems to try to answer members\u2019 queries.<\/p>\n\n\n\n

These systems were built years ago and customized for a particular use case. They cannot accommodate new workflows, use cases, or definitions. Each team within the org uses their own operating systems. It\u2019s difficult to build new workflows or customer experiences across them.<\/p>\n\n\n\n

B \u2013 Disjointed data.<\/strong> Another payer example: a colleague wanted to create a smooth transition for members on commercial plans to Medicare Advantage plans. Make it seamless for them to stay with this payer rather than shopping on the market. Yet identifying the right commercial members and then moving their data from the commercial plan data warehouse to the CRM and then into the MA systems proved impossible.<\/p>\n\n\n\n

At most healthcare organizations, not only is there no common data layer, but the data isn\u2019t standardized. This is true of data within the healthcare org and with its software vendors.<\/p>\n\n\n\n

C \u2013 Reliance on software vendors.<\/strong> VPs find the SaaS tool that best approximates the requirements they need and implement that solution. However, post-contract they don\u2019t have control of the roadmap and additionally must retool workflows for the SaaS vendor rather than having software that matches their workflows.<\/p>\n\n\n\n

All this has had a more pernicious impact, though. When the engineering team is able to focus on building new experiences, it\u2019s often time-bound. The VPs I\u2019ve worked with have one chance to build \/ upgrade the system. So rather than iterative design, you get waterfall approaches to requirements that result in a static product that may not deliver the expected value.<\/p>\n\n\n

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The tech paradigm is changing<\/h2>\n<\/div>\n\n\n

I joined 3Pillar because the tech paradigm is changing. The agonizing \u201cbuild or buy\u201d decision of the past is giving way to new \u201cbuy to build\u201d platforms. Tools that allow healthcare orgs to build their own solutions specific to the particular needs of the business are finally becoming readily available.<\/p>\n\n\n

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\"Codeless<\/figure><\/div>\n\n\n

Some examples:<\/p>\n\n\n\n

Codeless platforms for application building<\/strong>
Building a website a decade ago required a designer, a front-end engineer to build the website, and a back-end engineer for advanced functionality (like purchasing items off the website). Now you can use \u201cdrag and drop\u201d services like Squarespace that don\u2019t require you to write a line of code. Advanced capabilities like ecommerce are pre-built and can be added with a click if applicable.<\/p>\n\n\n\n

To be clear, I\u2019m not suggesting that mature healthcare companies use Squarespace as their CMS of choice. But what Squarespace has done for building lightweight websites\u2014make it so easy a caveman can do it\u2014is a trend that we\u2019re now seeing used with healthcare technology. Healthcare organizations are building live applications using codeless<\/a> platforms for application building like 3Pillar partner Unqork<\/a>.<\/p>\n\n\n\n

These cloud-based platforms reduce IT and DevOps overhead on the initial build and make it easier to iterate and maintain applications over time. A custom patient portal that would take 6 months to build now takes 3 sprints. See what Maimonides<\/a> did with their patient portal using a codeless platform for application building. More importantly, business owners and their team can iterate on the application, trying various approaches and adjusting the solution based on effectiveness without major involvement from engineering.<\/p>\n\n\n\n

Robotic Process Automation for internal workflows<\/strong>
There\u2019s no shortage of manual processes at health systems and payers. This is true even within fairly rules-based, non-clinical processes like claims submissions or eligibility checks.<\/p>\n\n\n\n

Robotic process automations tools like 3Pillar partner UiPath<\/a> allow you to automate routine decisions (and flag items that require manual review). Importantly, these automation rules are configured by internal teams and live within your workflows \u2013 you don\u2019t have to work within the confines of a pre-built SaaS company.<\/p>\n\n\n

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\"Healthcare<\/figure><\/div>\n\n\n

Gen AI, Vision AI, and ML for intelligence<\/strong>
GenAI is already being used extensively in health systems and payers today. Some of the top uses cases:<\/p>\n\n\n\n