Health leaders share IT transformation stories

- [Heather] Hello everyone, and thank you for joining today's webinar, Modernizing Healthcare Operations Through IT Transformation. My name is Heather Vollmer with Optum, and I will be your host today. Before we begin, please note the following housekeeping items. At the bottom of your audience console are multiple application widgets you can use to customize your viewing experience. If you have any questions during the webcast, you can click on the Q&A widget at the bottom of your screen to submit a question. We do capture all questions and we'll be providing follow-up to questions as appropriate. If you experience any technical difficulty, please click on the Help widget. It covers common technical issues. You can expand your slide area by clicking on the maximize icon on the top right of the slide window or by dragging the bottom right corner of the slide window. There is a Survey widget, which you can use at the end of the webcast to provide us with feedback on today's presentation. Additionally, this presentation uses streaming audio. You may listen to the audio through your computer speakers or headphones. To ensure the best possible system performance, please be sure to shutdown any VPN connections and connect directly to the internet. And with that, I will hand it over to Scott Gaydos.

- [Scott] Great, Heather, thanks so much. And again, welcome everybody to today's discussion. We've got some great stories of transformation to share today. But before we do, let's start with some brief introductions. So I'm Scott Gaydos. I lead our IT services business here at Optum, which is focused on helping healthcare organizations get the most out of their foundational IT services to successfully power, if you will, the rest of their clinical and business and administrative services. So with us today, we've got Deedee Francisco and Chris Johnson. So let them say a quick hello as well. Deedee?

- [Deedee] Hello everyone, I'm Deedee Francisco, and I will be sharing later today the story of John Muir Health. I am the CIO of John Muir and Optum vice president for IT and also analytics. Chris?

- [Chris] Thanks everyone. Thanks, Deedee. Nice to meet everybody. Appreciate it being here. So I'm Chris Johnson. Like Deedee, I lead the account IT delivery for the Bassett Healthcare Network. Looking forward to sharing our story here in upstate New York.

- [Scott] Great, thanks, Chris. Thanks, Deedee. So what are we gonna cover today? So first, we'll spend just a few minutes sharing our thoughts on what transforming IT through Optum IT performance services looks like. This is just a brief intro on how Optum sees the opportunities and challenges that face this healthcare landscape that we all live in. And as it relates to the underlying IT services upon which providers, payers, life science, and government health organizations really rely. In this section, we'll also share a little bit about our point of view on the kinds of services needed to address these opportunities and then what kinds of value these services need to bring to organizations as they progress down their IT transformation journeys. Now, after that, we'll spend the bulk of the time together hearing from Deedee and Chris, and they'll tell the stories of IT transformation at both John Muir Health and then the Bassett Healthcare Network, noting that both of these organizations are at different stages of their transformation. So we'll get to see lessons learned over different perspectives and stages of transformation over different periods of time. And then we've left some time at the end for Q&A, and as Heather pointed out, the mics are muted. So any questions you think of along the way, please jot them in the Q&A chat feature and we will try to get them all answered. Great, so let's jump in. Okay, so at Optum, we look to support many clients in their digital healthcare transformation, but we continually see a few challenges that are typically preexisting in healthcare IT. And you can see these sort of across the top here. As organizations progress on their digital journeys, we often hear that current IT ecosystems move far too slowly to adjust to the rapid changing needs of say, digital business plans or if IT solutions have been chosen to help advance, then sometimes they're too generic. They're meant for a multi-industry world and they don't take the specific nuances of healthcare workflows into account. Manual processes in IT are always a common source of frustration. Cloud leverage, if it exists, is sometimes very limited. You'll get the, "Yes, we can use cloud, but we're not allowed to store any protected health information or personally identifiable information in the cloud." Well, that's incredibly limiting then in being able to leverage cloud to its fullest extent to actually accelerate digital healthcare transformation. Things like ever increasing IT costs, that's always a barrier for necessary digital investment. And finally, security keeps everybody up at night, but we sometimes find it can be lacking, or sometimes when better security is in place, it's either cost prohibitive or like stifling for business innovation. You can see here some of the things that we focus in in our services from making public cloud healthcare safe to streamlining IT services through automation to a focus on healthcare specific IT security. I don't want to turn this into a commercial for Optum. So suffice it to say that the kinds of services that we offer and the way that they're structured for only healthcare organizations are in direct relationship to these challenges that organizations face on their digital business journeys. So another major theme that we've found over time is that, even as we continually invest in very specific services and solutions that are a fit for say healthcare IT purposes, the packaging of them can't be a one size fits all as clients have quite different needs at varying points of their strategy. So that said, we found that these solutions need to bring some concrete, measurable value to organizations and that different configurations can bring different elements of that value. So sometimes the most value is in taking on say, the complete landscape of IT services for our client. Other times, the value comes from choosing a subset of services for hyper-specific needs. Either way, the key is different elements of value sort of light up depending on what the right partnership is for an organization. Now the two organizations that we're gonna hear from today, John Muir Health and Bassett Healthcare Network, are both what we call market performance partnerships, which you can see on here, where we're not only helping with their IT transformation, but also things like revenue cycle, clinical, analytics, and other interconnected enterprise-wide transformations. So when we connect the dots of specific IT services value across an appropriate partnership model that fits the needs of clients, then we find a great match, right? To help power those digital business transformations. So speaking of digital business transformation, this is one of the opportunities to engage early here. That's our first polling question. So where would you say your organization is in its own digital journey? So feel free to go ahead, we'll take a moment, let folks answer. And as you're thinking about that, you think about it, digital means different things to different organizations. It's useful to kind of talk about how do we define that here at Optum. When we think about a digital transformation, I think the most important thing to say there is that, digital strategies are business strategies supported by technology, right? Not the other way around. It's not technology looking for a business problem, but rather we are going to do something to our business. We're going to knock over barriers, kick doors open, turn a business 90 degrees to the right and do something wildly different. The way in which we wanna engage with our customers in a completely different manner, or we're going to completely revamp how we do some back office process and take out 75% of all of the administrivia that goes in there. Those are digital business changes. And so, these digital journeys then say, what technologies are there to actually help support this digital business that we've got? So hopefully, that's enough time for everybody to have given a thought. So here we go. Interesting, this is quite a mix, and we see this a lot too. I kinda chuckle at the what's that one. But that happens, right, in organizations where we're not sure yet, we don't really know what our digital journey is. And then pretty sort of even distribution here around we're started, we're a little bit of the ways, we're going, but we could use some help. And then actually a good amount, a quarter of all of you think saying that we're super confident. Like we got this, we know what we're doing in our digital strategy. So that's exciting. Okay, so let's move to our first use case then for the day. I'm gonna turn it over to Deedee Francisco, CIO at John Muir Health, to talk about the multi-year journey that they've been on to help modernize their IT ecosystem as part of that broader enterprise-wide digital strategy. Deedee?

- [Deedee] Hello. Greetings everyone. And as I mentioned earlier, I am currently responsible for IT and also analytics for John Muir Health. Just a little bit of background, John Muir Health is a not-for-profit tree hospital system in the San Francisco Bay area. We do have two big medical centers and a behavioral health center that provides both inpatient and outpatient care. The John Muir and Optum partnership is the first MPP and it started in 2019 and we are crossing the fourth year of this extremely wonderful relationship. And I say that with so much pride, because we have accomplished a lot during this period. I was personally part of this from day one. John Muir Health have rebadged internal IT together with other towers like analytics, PMO, revenue cycle, care coordination, and risk operations. With the rebadging of an extremely talented group of people and the many capabilities of Optum are shared by Scott, we had lots of work to do ahead of us, and that was very, very exciting. And that really was the purpose of the partnership. So we initially started with a steady state period, just like any engagement does have. But during startup and just as we were about to kick off all of the wonderful transformation initiatives that we wanted to do, guess what happened in March of 2021, COVID. And of course, we had to make some pivotal changes in the modernization plan, but that really did not stop us from transforming IT. In fact, just like many provider organizations, COVID drove unprecedented change in digital health, remote care, and decision support analytics. And I'll talk about that later. You'll see that timeline there and there's really a lot that happened. So while digital transformation was the main objective and again, Scott defined digital transformation as business enablement through technology, and I'll go there shortly, there were some foundational things that we needed to do to enable that digital journey. First is obviously modernizing the system infrastructure and improving our cybersecurity capability. Those are a must. And again, Scott mentioned, those are key capabilities that we have invested within Optum to enable our customers to have it. In John Muir, when this journey started, we had quite a number of legacy systems and we transformed a lot. And it's gonna take me the whole day to talk about everything. But I would highlight a few things that I think was worthy of sharing because it really was the highlight of the partnership. The first is obviously building the cloud capability for John Muir Health. I mean, as with any provider organization, as with any company, right? The move to the cloud is inevitable. JMH knew that they had to move to the cloud from a resiliency, efficiency, and cost perspective. But that would've been very difficult to build from scratch with an internal IT organization that we had, small sized, focus on patient care, and rightfully internal IT should be focused on patient care 'cause that's our core business. Investing on the cloud capability, the skills to do that, maintain the skills ongoing, it's just very difficult. John Muir is in the Bay area, thus less than an hour from Silicon Valley. We needed a partner to take us to the next level without having to invest on key capabilities that we know over time we couldn't sustain 'cause we're competing with the companies in the Silicon Valley. JMH was able to leverage on prebuilt capabilities and solutions that has built by our Optum tech partners with robust secure, and really a managed centralized organization. And that was pivotal for us, because we were able to spin up cloud environment that secure built specifically for healthcare, able to handle obviously data, and we didn't have to build that from scratch. And this same capability is now being leveraged by other accounts that we are venturing into. And again, a key success, something that would've been very, very challenging if John Muir had to do it on their own. The other thing that I wanted to highlight as a foundational capability for digital transformation is security. With all the heightened cyber threats in the environment, we needed to be diligent. The likes of threat vulnerability, certificate management, identity and privilege access management capabilities were all foundational capabilities that we had to put upfront as foundational systems and capabilities where all of our digital transformation will actually ride into. Again, something that our partners in Optum had helped John Muir bring to the table. The one thing that I also wanted to talk about is rationalizing the technology. We had a lot of systems, and simplification is a strategy that we held into. We took an approach of rationalizing all of our systems, updating our outdated software and hardware, and making sure that we're investing our effort in Epic, Workday, Kronos, Microsoft, the key systems that we have today. And the last thing that was very important in our digital transformation was the culture of automation. Change management is probably the biggest hurdle in digital transformation. We needed to make sure that the organization is ready for that kind of change. We needed to make sure that we communicate and everybody in the organization is actually willing to go through the journey. And after building all of those foundational capabilities, now I can share with you what we have gone through in terms of digital transformation. You can see here that the journey from now until 2023, and we have ways to go. Early in the journey, where we actually put in some basic capabilities like test results, medical library, refill requests, messaging of providers, direct scheduling, which is a big hit, web scheduling for those do not have Epic MyChart and e-signature. Just the refill request functionality, that one resulted in a 10 times increase in the use of that functionality. And really from a patient perspective, a huge win. It's a huge patient satisfier. Then we went on to further improve the patient experience through workflow improvements like eCheck-In, online bill payments, fast pass. All of these enhancements were driven by patient journey mapping, which is really identifying the pain points of our patients and making sure we have workflow improvements in technology to make things better for them. At the end of the day, we're doing all of this for our patients. So today, by enabling online billing alone, 45% of our copays are actually done by a self-pay online. That's huge. The amount of savings, productivity, revenue cycle recognition, that key technology made that happen. Of course, we had COVID, we had telehealth, everybody has that right now. I don't know how we can survive without telehealth, but telehealth was really a boom in 2020. We had further capabilities like ticket scheduling, campaigns. More recently we have Welcome Mobile, which is a significant improvement for patient throughput and handling of patient inflow. Hello Patient, which allows for geotracking. Again, another area to improve what patient throughput. We do have a lot of in-flight transformations as well. So we're working on CRM, customer relationship management, we're working on a lot of throughput improvements. The big pain point all providers have right now. We're working on making documentation for our nurses, for clinicians better and more optimized. Labor scheduling, with all of the labor shortage, we're working on how we can better manage scheduling, resource assignments through technologies that we have in Kronos, online scheduling, ship management, and of course, health equity. Very, very important. So for two consecutive years, we have achieved CHIME level. We actually achieved that for the first time last year and we got it again. And this is a recognition of our ability to implement modern digital tools to support high quality, safe care for our patients in at a very optimized cost. And I mean, there's a lot of results here that I put in and I believe you can just read through it. But I would just wrap up this journey by saying that, as we went through this journey, we have been very fortunate to also develop and maintain a very engaged team. Both our employee engagement and client engagement surveys, scores or affirmation that this partnership is a success. And personally, you can probably see how proud I am because this is the community where I really take my family. John Muir is where we go for patient care and the fact that I, from an IT perspective can help transform the level of care my own family will get is just a very humbling experience, I would say. So with that, thank you for listening. But before I turn you over to Chris to share his Bassett story, I do have a poll question. Next slide. So how do you plan to maintain competitive, innovative, and possibly independent in a current environment? Oh, that's a tough question. I don't know how I'm gonna answer that too. Options of, have no idea. We are working with a partner to figure this out and we have a plan in place and are making great strides in all areas. I'm a little bit biased, so I think I know what my answer would be. We have the results? We are working with a partner to figure things out. Best answer. Thank you so much. And I will hand it over to Chris.

- [Chris] Thanks, Deedee. Thanks for letting me join and share my story with everybody today. So as I kinda shared earlier, I'm Chris Johnson. I oversee and deliver the IT services to the Bassett Healthcare Network. I think what I'd like to do is give you a little bit of sense of who the Bassett Healthcare Network is, before I talk a little bit about our Optum journey. So Bassett Healthcare Network is a rural healthcare network in upstate New York. Our flagship hospital is located in Cooperstown, New York, as population of about 1,800 individuals. The organization is the largest employer in our region. They employ close to about 5,000, 5,500 people. Our geography, we have five hospitals in our network. We have about 45 or 50 out-clinics and school-based health centers, and we cover about 6,000 square miles. So if you're curious what that might look like, envision the state of Connecticut with the same size. So unlike Deedee in her story, you can imagine for an organization like Bassett resources, particularly staff are can be tough to come by, particularly in the IT space. And you know, I joined the Bassett Healthcare Network right around 2011, and at that time, I think we were about 65 employees. And I gotta watch this group morph and transition and advance to close to 200 employees, which I suspect is pretty similar for more IT shops in healthcare. And move from kinda some of the earlier EMRs and some of the smaller systems to some of the more monolithic enterprise class, Epics, the Kronos, InForce, right? And watch us kind of feed that machine and move into that space. Well, I think the other piece that I want to share is that, the Bass Healthcare Network over those 10 years moved from more of an affiliation to more of a formalized network, right? So you can imagine we had five hospitals, each kinda doing their own thing, their own IT, moving in their own directions. And over time, one of our goals was and challenges was to progress that and transition that to a common platform, which even for our EMR and our Epic, the rev cycle components, that didn't happen until recently as far with it just as looking back, it's 2017, 2018. And from an ERP perspective, we all just got on the same platform here this year across the network. So it gives you a little bit of sense of who the Bassett Healthcare Network is. Like Deedee, I'm gonna say it's a world class. They deliver phenomenal patient care to the region. I, like Deedee, use this group for my family. But I think what they were bumping up against is, when you grow that much and you invest in that, right, it becomes a big challenge. The complexities that we're faced now in IT space to support healthcare increased dramatically. It takes a lot of capital to keep that machine moving and forward advancing, so the Bassett Healthcare Network was really looking to get a partner that was gonna help them modernize and keep that progression moving, where they could focus more on the patient care and the services they deliver to the community. So when the Bassett Healthcare Network partnered with Optum, I kinda frame that as, we wanna modernize our performance, we wanna enable savings and growth so that they can remain competitive and independent in our region, but yet can get world-class IT services. So that's kind of the context of where we came from. So as Scott mentioned, we've been with an Optum partnership now for about 18 months. So we're just about a year and a half into our journey. So where we're at is a little bit different from what Deedee shared, right? So our first year was really kind of taking a look at, how do we get from point A to point B? What are those points that we really want to move through? There's a lot of activity on discovery on who we are, opportunities for transformation, identification where we can really push the needle on digital transformations to support the network and kind of the IT services that we deliver. So what we focused on in that first year was really more enablement for another domain and particularly the rev cycle space. So the Bassett Healthcare Network was looking to improve revenue capture, reduced denials, improve that situation. And it's not that they hadn't tried. I think that like all healthcare organizations, one of the challenges is, is that you've got so many different fires you've gotta feed that you can only give so much time to something. So from an Epic perspective, we didn't necessarily leverage the full capabilities of that solution. So one of the important pieces of a partnership like MPPs Scott was outlining, is IT oftentimes is the driver and at the center of what a lot of the other domains do. And when Bassett signed up for rev cycle patient access analytics in addition to IT, we wanted to look at how can we move the needle on the revenue space to start. And so we put a lot of energy into supporting and streamlining kind of our rev cycle processes and had a lot of traction because now it was managed and being owned by Optum. And so we really kind of revamped how our rev cycle teams operated. And we did that from an IT-centric approach. So we looked at their pain points of self-pay, their claims clearinghouses. Again, think about five hospitals and trying to streamline and standardize on something that's gonna be successful for the network. So I won't drain the slide and go through all the examples, but I think some important points came out of that, right? Is having an IT shop that knew the organization, partnered with somebody who knew best practices in rev cycle, we pushed, as an example, our point of sales collections, 50% in that first year, right? Cash in the door upfront, changing the culture, drastic improvements in what we can do for the organization, as well as a consistent patient experience across the network, because suddenly, it was all being managed under the same umbrella. So that's one of the key items that I think I wanted to highlight. The second piece that Deedee outlined is the workforce support. So we had an amazing team to start with and we have lots of capabilities, but where Optum has really kinda helped us out is, is when you need that gap coverage, when you need some specialization, somebody in a specialization space, particularly in a place like upstate New York where it's tough to come by those resources. I've got those people at my fingertips now who get to jump in and help us out and design and solution and self help us some of the lift to really advance where we're looking at, to going. So I highlighted here, we've got transformational initiatives on our docket. So after the first year, we developed a first year IT roadmap with 26 major in-flight initiatives to really advance how we do IT and how we deliver those services to our customer and how we can really take advantage of things like automation through ServiceNow and other technology to improve what we can provide and enhance our previous services. Again, like Deedee highlighted and I mentioned coming from five different organizations, we are in the process of doing app rationalization and standardizing our platforms, and I've got an amazing team behind me here at Optum who leads that work, partners with us to help kind of define our best path forward so we can say what is it we have, where do we want to go and how maybe we take a advantage of, for example, a cloud platform. We have four data centers right now. We don't need four. We don't wanna invest in four. So how can we centralize and standardize on one and then maybe leverage cloud is the secondary. So again, we thought internally, it would probably be about a seven-year journey. I've got a great team who's kinda put together a roadmap for me that we're now in embarking on. We're a few months in, and we're hoping to have most of that work done here over kind of the next 24 months. So great acceleration in what might have been a long heavy investment for Bassett with Optum kinda helping shoulder this work and streamlining it, some pretty impressive outcomes that we're looking forward to. The other item as Deedee mentioned, which is probably on everybody's minds these days, is due to all the incidents that are going on with malware and hacking and ransomware is, we did a very strong engagement in our first year around risk reduction in that space. And so like Deedee highlighted, we've done projects in vulnerability management, stood up formal TBM programs that are now actively monitoring, identifying risk, and immediately resolving those. We've moved to an immutable backup solution to ensure that, should we get a ransomware attack. We have a safe copy of things that we can leverage to move to. We have implemented new solutions like Censinet to do third party risk assessments, which is not something we had done formally before, which really more of kind of an offline conversation between our CISO in the third party vendor. And now we're leveraging a lot of the depth in the knowledge that Optum has collected to help drive kinda how we score risk and maybe look to alternate solutions or work with vendors to kind of overcome some of the challenges they might have. And there's several other things that are on our slide here, but in the end, I think what I'm gonna highlight is, from a security perspective for adoption of features, we're on Epic's latest polling, we're at the 90th percentile for feature adoption and risk reduction, which is a pretty impressive feat that Optum has helped bring forward for Bassett. And that actually was recently considered when Bassett just went up to renew their insurance. We saw a 25% reduction over what we anticipated the uplift in being. So from a Bassett perspective, that was great savings that they weren't anticipating and gave them more options to when they looked at the market and who they might wanna partner with. So let's just share some of those highlights for you, gives you a sense of who we are and a little bit about our journey. I hope that in future months or years, I can come back and maybe share some more as some of these things come to fruition. So appreciate your time in listening. Thank you.

- [Scott] Awesome. Chris and Deedee, thank you both so much for sharing those stories. It's really great insights to different stages of transformation. And interesting that, though I would say, many of the transformation initiatives themselves are similar, but the sequencing and prioritization of them are really different, right? Depending on what is your specific situation. Chris, you were talking about, what is your point A. You know what? Kind of know what point B is, but the point A, the starting point is different and therefore, the sequencing and prioritization is gonna be different. So really, really cool stuff. Before we move to Q&A, we had I think what I'll call a curiosity question, somewhat comical actually, but let's just call it curiosity. So I don't know how many of you follow Avasant Research, but they recently named Optum as a leader in healthcare provider digital services in their RadarView. That's their version of a Magic Quadrant or an Everest PEAK Matrix, et cetera. Anyway, we were just curious if that resonates in the community. So we thought we'd ask all of our new friends here today on the webinar if you've even heard of it. So just a yes, no. So let's kinda see where we are. Wow, I'm actually fairly surprised that 33% said, "Yeah, we have heard, but, thanks for telling us, Scott, so now we do know." But that's really, really interesting stuff. So thanks for indulging us. You know, I wanna say thanks again to Deedee and Chris for sharing these stories. Really about how Optum is helping our clients in their own digital transformation journeys. And these journeys are a combination of tech and process and capability and people. And in the end, it's about what Deedee and Chris were really mentioning regarding, it is exceptional and exceptionally different experiences for patients, for customers, and for employees, right alike. That's a huge part of a digital transformation, the internal transformation for an organization as well. So we've got some good time left here for Q&A, so I am gonna turn it back to Heather to take a look and see if we've got any questions that we can help answer for anybody. Heather?

- [Heather] Great. Thank you so much, Scott. Before we get started with the Q&A portion of today's webcast, we'd like to take a moment to remind you of the survey located beneath the slide deck area within your audience console. We'd love it if you'd take a moment to provide us with feedback on today's presentation. As a reminder, if you have a question, you can submit your question via the Q&A widget located on the left side of your audience console. And with that, we'll go ahead and get started with our Q&A.