2023 Healthcare Provider IT Report

Erik Sunset: [00:00:00] Hey, this is the DocBuddy journal. I’m your host, Erik Sunset. We’re recording this episode number 37 on Wednesday, September 20th. Either welcome back or welcome for the first time. We’re glad you’re here. Thanks for spending a little bit of your podcast. Listening budget with us, your friends at DocBuddy. The topic of today’s episode is around a recent survey from Bain and company in collaboration with the good folks at KLAS research, the topic is 2023 healthcare provider. It reports. Doubling down on innovation. And as we’ve discussed at length in prior episodes, there is actually quite a bit of innovation happening in healthcare. You’ve largely HR vendors incorporating chat GBT. And products similar to Chad GPT, being large language models and generated text. AI softwares into their electronic health records. Folks are finding all kinds of [00:01:00] uses for these new products. Hopefully uses that cut down on physician and other clinical staff administrative tasks. In addition to optimizing the patient experience and their outcomes. So we wanted to highlight this reports and we’ll of course have a link to this report in the show notes and the description. Regardless of where you’re watching it, but there was a couple of items that caught my eye here at DocBuddy. Want to run through the report, give you some commentary, sort of give you our perspective on exactly what the the innovation that is being doubled down upon will mean and how that will translate across the industry. So to start. Health system, it leaders are using emerging tech to address their labor, shortages and financial pressures. This is nothing new leading up to COVID through COVID and then after COVID labor shortages are occurring theme, not just in healthcare, but kind of [00:02:00] across the board. And as I’ve said before, I can’t tell you exactly why I’m not going to go down. The path of people don’t want to work. I don’t think that’s true, but it is incredibly difficult to make good hires or really any hires at all. And obviously financial pressure. We see that not just in the us, but globally. Everybody’s being asked to do more with less. So in this survey from again, Bain and company and class research, nearly 80% of healthcare, executive respondents to the survey increase their spending materially over just the past year. Spurred by emerging technologies, labor, shortages, and cost pressures. Revenue cycle management, which is RCM. If you like the acronym, RCM and clinical workflow optimization remain top areas of investment while patient engagement has moved up the list of priorities, particularly among more advanced or digitally mature providers. And how I read that, you know, [00:03:00] particularly advanced or digitally mature. These are provider organizations that have any HR they’re bought into their EHR. They’re likely participating in quality reporting programs. And they’re likely very tuned into their patient’s outcomes and being able to report and dissect exactly what’s happening when a patient’s under their care. And that’s good. You would expect that we’re over a decade beyond the start of meaningful use we’re well into MACRA MIPS, you have commercial payers looking at quality reporting programs in addition to Medicare. So hopefully the bulk of the market is mature. There, there are certain provider organizations out there using maybe less technologically comprehensive softwares. Maybe they’re not utilizing all of the software that they have. But in any case those patient engagement solutions are kind of like the next block to fall. If you’ve already gotten the HR, if your clearing house is dialed away, if the billing [00:04:00] side of the house is, is squared away as well. You’re able to look then beyond sort of the basics and start engaging your patients where they are. And just to expand a little bit further on that, COVID really brought about a revolution in health that folks have wanted to be able to get care remotely via telehealth, via something like an electronic visit, like a FaceTime. Video call. But prior to coconut reimbursement just wasn’t there for the provider. So you were stuck kind of sending a message on the patient portal, getting basic Q and A’s answered. And we did a deep dive on the volume of patient messages and the impact on provider satisfaction in a prior episode. Really until COVID remote visits. Just weren’t a possibility because there wasn’t a reimbursement defined by Medicare and by the payers. But back on track here. Providers at these organizations continue to express a preference for fewer vendors, nearly two thirds of respondents [00:05:00] saying they look first to existing vendors for new solutions. Especially their EHR vendor for new functionality before evaluating other vendors with other offerings. And that’s understandable. The saying on the client side of this speaking from a health it perspective. The perspective on the client side of this is if you have one throat to choke, if anything goes wrong. That makes it easier to manage all of the software that’s in play at your practice or at your facility. And I get that. I think as consumers, we all would understand that. But when you look at that best in class leaderboard and that’s at KLAS research.com KLA. research.com. Sort of the The Yelp for health, it softwares to get a fair and unbiased review of them. You can see that as you, as you sort of scaled down from the acute care softwares, which are winning the best in class, but something like a B plus grade, or maybe an a [00:06:00] minus. So high eighties, low nineties. That’s very good. That doesn’t mean that they’re perfect. But as you, as you scale down from the hospital-based softwares, for things like epic, And move more into the practice space. That winner for the best in class is coming in with a B minus. You know, low eighties. So when you have an EHR, that’s already not. Ideal. You know, thinking about that best in class for being maybe a little bit lower than, than you would expect for the industry leader in a given category. What does that mean for the rest of their software offering? Now you’re asking a. Maybe sub optimal type of a vendor for the EHR as reviewed by its providers. So if the winner is a B minus everybody else falls. Low about threshold, right? You’re making them a. Not only a Jack of all trades and a master of none, [00:07:00] but like an okay vendor for its core functionality and then asking it to do more. So I’ve got a question that it makes sense that you want to have a single point of contact, a single vendor, a single bill for your AP department. But what are you really getting? Food for thought. And then continuing on with the the study, almost 6% of health system respondents had a generative artificial intelligence strategy today. So very few. About half. So about 50% are actively developing that generative AI strategy. And are planning to deploy one in the near future. And this highlights the transformative potential impact of AI.

That’s a tremendous acceleration. In utilization and in use and in planning, because really it was up until about June, July, where there were folks that were playing with this, but hadn’t deployed anything to production. We examined NYU Langone. NYU Tron. So, and [00:08:00] what you try and create name for their AI. A tool. Not necessarily generative AI either, but going back to hymns earlier in the year several vendors announced the integration of a generative AI product. Something like chat and GBT, where it’s able to generate a. Response based on a prompt or based on a data input. So this is moving really quickly. We’re turning the corner on this. And it’s a, it’s going to be an exciting space to watch going forward. So to get into sort of the, the meat and potatoes of the, of the article and of the survey. 56% of their pockets, fondants cited software. And technology is one of their top three strategic priorities compared with 34% in 2022. So health systems are looking to technology as a great way to leverage the ability to do more with less. Right. If you’re unable to make hires, if you’re unable to maintain a full head count. [00:09:00] You know, that’s tough to do. What can you do to streamline your own profit processes? It’s gotta be technology right. Around 75% of respondents expect growth in software and tech spending to continue over the next 12 months. And I would. Maybe you won’t see that type of acceleration and that type of growth in technology spend forever. But healthcare is much later to the table than the rest of industry with regard to leveraging technology, to be able to use software, to streamline and augment what are currently human based processes and sort of move them digital. Going further here, respondent’s side of the technological advances and the availability of new solutions, particularly around patient engagement and cybersecurity as a top drivers for new investments. The respondents also mentioned the more intense labor shortages and fash pressures have spurred spending. And this is the state of play. [00:10:00] What we opened the episode, this. There’s less people to do the work, but there’s no change in either growth or profit expectations. And due to financial challenges and margins. Investments in areas with clear near term ROI, such as revenue cycle management and clinical workflow optimization software are now high on the agenda. And the article astutely points out that RCM software is critical in the current environment, given its direct link to both revenue. So enhanced collections and cost streamlining and labor intensive processes. So essentially. RCM is a force multiplier for your collections, for your revenue. And you ultimately need less staff to collect what you’re owed from insurance and then putting myself back in. My revenue cycle. Days and my role doing that here in Miami. Even though on the insurance billing side revenue cycle enables less head count or enables the ability to maintain less [00:11:00] head count on the insurance side. Of your collections because that’s outsourced, you’re outsourcing to a team, not to your own team members. But it doesn’t mean you have to reduce your head count for it to work. Oftentimes it would be able to move existing past sets your existing personnel to the patient side of the house, patient collections. But it depends, you know, you’ll have to talk to your RCM vendor. There’s all types of service level agreements. Any really any arrangement that you’re interested in, they’ll likely be able to accommodate.

So moving over to the clinical side of the house you know, looking at the projected spend around RCM and, and patient engagement and being able to do more with less. As we shift gears to the more political side of things, survey, respondents expressed an interest and an equally strong desire for throughput force multiplier. So in the way that RCM enables you to do less with more on the insurance question side of things, respondents to the survey, I want to do less with more for patient throughput.

And [00:12:00] what that means is that respondents to the survey are interested in technologies that identify and mitigate potential barriers to discharge such as missing tests. And these solutions can help optimize provider productivity and asset utilization. While improving patient sat. Via a more seamless. Retail, like experience. Once. And going back to one of the first things we pointed out, looking to your EHR vendor for solutions beyond just the core electronic health record, maybe the core practice management system. If you’re using a single software, Shouldn’t your EHR be able to share potential barriers to discharge. I mean, that seems like a really straightforward workflow item. To me. And I would imagine that comes down to configuration of said, EHR, not eating the bolt-on exist. An additional solution to it. But this still, you know, the shoppers are talking about patient throughput, but this doesn’t address the route of provider productivity. And really through our lens burnout, because the two are [00:13:00] so closely intertwined. We’re still looking at data entry and data management and acting on that data. For providers here. No, that’s not to say that patient throughput solutions are a bad thing or not worthwhile just as a really addressing the root issue that all of healthcare is facing. And surely the survey respondents are aware. But we’re, we’re looking at patient throughput solutions as opposed to provider satisfaction solutions. Maybe it’s your one on the same. Same continuing deeper into the reports. With current it solutions and EHR vendors, healthcare providers, psych cost and software integration and interoperability is critical pain points. Provider organizations are addressing these issues by streamlining their tech stacks and buying from EHR vendors and other suite providers where possible we send the preferences for a single vendor to supply all of your software needs. And the survey and the report shows this trend has [00:14:00] intensified since 2022. Which on the acute care side ends up assisting epic in particular to grow its market share to more than cert 60% of total us hospital, net patient revenue. And epic does a great job at having a very broad. Solution portfolio, of course. And while respondents are open to look elsewhere. If existing vendors lack a solution or have a significant functionality gap tight, the HR integration remains a key purchasing criteria for all healthcare providers evaluating it solutions. Right. And to my eye, the acute care market seems a little better served here with a broader, stronger solutions. You know, we mentioned the class scores a little bit ago in contrast to the ambulatory or even the surgery center market. The EHR solutions they’re in those spaces are a little more narrowly focused. And often the vendors. Rely on partners to fill gaps in their solutions and obviously the best type of partner. Outside of that acute care [00:15:00] space, if it’s not needed, it’s when it’s integrated. The last thing you want to do is send providers and staff through a bunch of different software applications, even more windows, even more picklist, and having to go back and forth. That is not something that providers enjoy doing. So let’s change gears a little bit to the generative AI side of this. Article and this reports mean we’re talking about doubling down. On innovation. In this report. So despite the growing interest, the health system sentiment around generative AI remains fairly mixed today. Around 70% of health system, respondents indicate that they believe AI will have a greater impact on their organization than last year. And this moves AI strategies from the it department to the C-suite. So radical shift there. No, almost 6% of respondents have a generative AI strategy today. Like we already said, this number is expected to climb. Tenfold in the next year. The potential for greater [00:16:00] efficiency, improve patient outcomes and cost savings. Underlies this enthusiasm. But concerns around security, privacy, cost and ethics, as well as ongoing issues around accuracy and reliability are cited by the providers that are less positive. And security privacy. Those are big. I mean, the compliance department, your legal department, if you’re evaluating this type of solution is going to be very busy.

So continuing on use cases that improve quality care like clinical decision support diagnostics are cited as top priorities, and these are expected to become increasingly important. Additionally as is the case with overall it, investment providers prefer AI use cases. Have they strong bottom line impact such as predictive analytics and workflow optimization?

So. Coming off of the report here. That’s what we’ve been saying the whole time. In some cases, [00:17:00] these generative AI products are sort of a solution in search of a problem. And it’s that. That old proverb. If you’re a hammer, everything looks like a nail. And to date, that’s how it appears to my eye with generative AI, integrating with the EHR, making it a part of their provider workflow. You know, in the prior one of our prior episodes, we talked about the immense volume of messages that providers receive. Through their patient portal. Amounting to something like two to four hours of after hours work, simply replying to these messages. We need to do everything we can to. Either reduce that limit that the study we looked at on the last episode shows that some health systems are beginning to charge for patient messages were appropriate because two to four hours is unsustainable. But what does AI really do for you there? If you have to still review a chart, you still have to look through your patient’s records in the EHR. [00:18:00] Ensure that the auto-generated AI response is appropriate. That doesn’t get you into any hot water that helps the patient outcome. And isn’t simply neutral or confusing. I mean the amount of time saved typing is almost certainly going to be made up by the amount of time spent reviewing. Yeah. So at least at present with what we currently know, that ROI outcome that return on investment outcome for provider time appears to be neutral. Because it doesn’t really changing. Anything and hopefully that does change. I don’t want to come off as negative around the use of generative AI to help physicians give two to four hours of their night back every night. That’d be great. Well, I would love that for them. However we’re still at the very infancy of this type of a product assisting providers.

So Janie gears, one more time. Overall market outlook around accelerated it investment. As providers continue to face an array of structural challenges, including [00:19:00] secular provider shortages, an aging population and financial pressures. They are going to increasingly prioritize it. Solutions that produce a tangible ROI. And we’ll more frequently look to simplify their tech stacks. Vendors will need to offer best of breed solutions or compelling suites in order to differentiate themselves. And in closing, according to the authors, the best vendors law for AI and other tech that creates clear returns to providers and help to mitigate structural challenges facing the us healthcare. Care industry. So with all that said, you can, you can see that health system executives are looking to the right place. The title is doubling down on innovation really might need a better title. If you ask me. Doubling down on using software to actually streamline workflows and streamlined processes because you can’t hire anybody. And that’s okay. Like we said, healthcare sort of has lagged beyond the rest of industry with adopting technology and adopting software. [00:20:00] Not necessarily healthcare’s fault either, especially with the push for me, we used to get everybody to in EHR. And then making sure that everybody is participating in all of the quality programs that they should be at the risk of their reimbursement. But as we look to the end of 2023, as we look ahead to 2024, that’s been a recurring theme with our guests. You need data, you need to be tracking and without data you can’t be doing any tracking.

Not financially, not for clinical outcomes, you’re just dead in the water without data. And when you look to what software can do especially through the lens of this report where you’re talking about patient throughputs, being able to get more patients through your waiting room, into the exam room, and then on their way. Software helps with that. Are you going to be able to collect data? Around timestamping. When did the visit start? When the visit ends? Hopefully you use that data for good and not just to bury your providers [00:21:00] under a even longer list of patients. And you look at the RCM aspect of this, you know, it makes an awful lot of sense. If you’re unable to hire staff and retain staff in your billing department, outsourcing it to professionals certainly makes a ton of sense. And finally the generative AI part still really early in that. I think there’s a lot of A lot of hope that it can do the right thing for positions for patients. But again, you’re going to have to work through a quagmire of compliance of safety and ensuring that it doesn’t end up taking more time for your providers to review the AI generated material. Then if they just did it, the old fashioned way annually.

So with all that, let’s put a bow on this episode. Thank you for listening to the DocBuddy journal, to get more information about DocBuddy and our suite of solutions that gives providers, their teams and their facilities more time for life. Is it DocBuddy.com. On behalf of the entire DocBuddy team. I’m [00:22:00] Erik, thank you for listening and we’ll catch you again on the next one.