Most Healthcare Systems Don't Have Digital Strategy Beyond EHR, Focus Group Finds

Seth Augenstein
AUGUST 20, 2019


Healthcare systems are generally not looking far into a future with a digital strategy in mind, according to research by an Illinois-based consulting firm.

About half of systems are looking primarily to their EHR system as their main driver of digital engagement, according to a series of focus-group discussions with 40 chief information officers (CIOs) and other senior health IT leaders.

Out of four progressively complex models of digital integration, only the nation’s largest health systems are operating on a level of planned-out strategic investments in long-term digital platforms, according to the Damo Consulting findings. 

The lack of an integrated overall strategy means some health systems are not benefitting the way they should from the ongoing “digital transformation,” because of piecemeal changes in their infrastructure.

“Before you know it, you’ve got technology sprawl, you’ve got all these other challenges, you’ve got to support so many different vendors… it just adds to overall inefficiencies,” said Paddy Padmanabhan, MBA, the CEO of Damo Consulting. “Plus, you don’t even know whether they align with the overall strategic vision of the enterprise.

“Digital transformation is a multi-year journey, so we make decisions today which will result in commitments over a multi-year term which we can’t just keep changing on the fly,” Padamanabhan added, in a phone interview with Inside Digital Health™.

The four models of digital integration are: Model 1, describing a reliance on the EHR system; Model 2, in which digital strategy is focused on care virtualization; Model 3, in which stand-alone initiatives in the digital space are driven by internal demand; and Model 4, the strategic planned investments in long-term digital platforms.

All the CIOs in the focus group discussions agreed Model 4 needs to be achieved. But Models 1 and 2 were predominant, with roughly half in Model 1 alone. Fewer than a tenth of the respondents are implementing a platform with the help of a major technology firm, as described in Model 4.

Model 3 can be just an accumulation of specialists asking for specific apps which would not have a place in the overall digital development of a hospital chain, said Padamanabhan.

“It can be a bunch of standalone initiatives driven by internal demand, evaluated on a case by case by case basis,” he explained. “It’s not aligned to some grand strategy. That’s where we are.”

One major takeaway is that CIOs are also functioning in the role of the chief digital officer (CDO) in their organizations currently. The CIO assuming this digital leadership role in healthcare is not found in other industries, like in banking, said Padamanabhan, who authored the 2017 book The Big Unlock: Harnessing Data and Growing Digital Gealth Businesses in a Value-Based Care Era.

Overall, smart strategic questioning of digital moves needs to be consistent, the consultant said.

“Lots of things are going on. People are being reactive, more than seizing the initiative, for the most part,” said Padamanabhan. “Many health systems, especially the smaller, regional community hospitals are going to be blindsided by this, if they don’t step up and meet the market’s expectations.”

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