- [Rajiv] Hello, and
welcome to today's webinar,
titled the Art of Innovation:
Digital and Clinical
Transformation at Jefferson Health,
presented by Healthcare Informatics.
My name is Rajiv Leventhal,
Managing Editor at Healthcare Informatics.
Today's program is sponsored by Appian.
Thank you to our sponsor
and to our audience
for giving us your time
and attention today.
At this time, I would like to introduce
the speakers for today's program.
Neil Gomes is the Senior Vice President
for Technology Innovation
and Consumer Experience,
and Chief Digital Officer at
Thomas Jefferson University
and Jefferson Health System.
At Jefferson, Neil drives
digital innovation in healthcare,
consumer experience and engagement,
training, and education.
He is joined today by Robert Neff.
Robert is the Director
for Innovative Technology
Solutions and Platforms at
Thomas Jefferson University
and Jefferson Health System.
In his role at Jefferson,
he leads teams that develop
applications and mobile
apps, digital properties,
and leverage new and innovative
technology to improve
the consumer experience cross
the university health system.
Thank you, Neil and Robert,
for taking the time to speak
with us today, and with
that, the audience is yours.
- [Neil] Hello, and welcome.
This is Neil Gomes.
I'm assuming everyone can hear me.
I'm the Chief Digital
Officer, as Rajiv said,
and I do thank you for the introduction,
at Thomas Jefferson University
and Jefferson Health,
and I'm joined with Rob,
one of my team members,
who is the Director for
Innovative Technology
Solutions and Platforms, and on my team.
I'm just verifying with
the rest of the presenters
that they can hear me.
- [Robert] Yes, we can.
- [Neil] Perfect, thank you, Rob.
Great, so I think we'll
start off very quickly
at the next slide.
I did notice that the fonts
are a little bit different
from our original presentation.
There are some aberrations,
I will explain them.
I always like starting with this slide.
You know, win-wins in
the real physical world
are many times very difficult to achieve,
but we believe firmly that
win-win-wins are not just
a two way kind of thing,
but are real and possible
in a digital universe,
especially where the consumer wins,
and Jefferson as a health system
and education system also wins,
and teams like ours who
help the organization
transform and move forward
also win in the process,
that we do meaningful work and we do it
for the benefit of patients and students.
Two of what I feel are the
most noblest causes, you know,
that you could associate with.
Learning and healthcare.
Before I go into explaining what we do
and how we bring about
digital transformation
in these two very challenging industries,
I just wanted to put some
context to the environment
which we work and also the
groups through which we work.
First, the environment.
We are primarily based
in the Philadelphia area,
and now in New Jersey also,
and surrounding areas.
Philadelphia, if you're
not familiar with Philly,
has a lot of saturation
in terms of universities
and health systems in the area.
There's also an innovation hub, you know?
There's lots of very large companies,
not just in healthcare and education,
but in other industries such
as telecom, and you name it,
you know, Philly has it.
We also are very, very
close to New York and DC,
so we have a lot of
influx of ideas, people,
companies and organizations
from those hubs too.
It's the fifth largest
city in the country,
and really, the second largest
city on the east coast.
All of this means that we
operate in a highly, highly
competitive environment and a
highly innovative environment,
and we live up to that.
Jefferson does pretty well in that space.
To give you some context
of who Jefferson is,
because not a lot of
people know about this,
and to understand it a little bit better,
the more near and close
environment that we work in.
Thomas Jefferson University
and Jefferson Health
is both a university and a health system.
Currently, we have 11
hospitals, and when I joined
three years ago, we had
about three hospitals,
so we are growing very, very rapidly.
We have over 20,000 employees.
We also recently announced the merger
with another university.
So, we are not just increasing in terms of
the healthcare side,
but also as a university
and increasing our portfolio.
The biggest metric, the most
impactful metric in here,
really, and what's more key
to this presentation today
is the third point, where we really impact
1.9 million outpatient visits,
and several patients in that mix.
We do about 350,000-plus
ED visits and about 96,000,
almost 100,000 admissions
in our hospitals a year.
That's a lot of impact, I feel,
at least in the health care state.
We do about $4.8 billion
in revenue a year.
We also are a research institution,
so we pull in some research dollars.
We have about 3,200
faculty, full and part time.
3,900 students, plus with
Philadelphia University coming in,
that would increase it
to almost 8,000 students.
Not many people know this,
but Jefferson is the second
medical school in the nation.
We've been around for nearly 200 years.
If you've heard of gross
anatomy, Samuel Gross,
who developed that concept,
was a Jefferson physician.
Jefferson also invented
the half lung machine.
So, there's lots of innovations
that we're known for.
We are the first and only
college of population health.
We have an institute for
emerging health professions
that creates curricula for
health care professions
that are of the future, you
know, that are not yet here,
but we kind of proactively
developed those jobs
and positions into the future,
careers into the future.
We're very much on the leading edge,
both in the healthcare space
and in the education space.
My teams have to live up
to that reputation too,
so that makes it, not
challenging, but exciting.
This is a little bit of
a construct of our teams.
We have four teams in
our technology innovation
and consumer experience group.
We're very, very particular about design,
and so we have a digital
consumer experience group,
and the ethos of that group is
that design is how it works,
and not just how it feels or looks like.
That's actually a quote by
Steve Jobs, so it drives us.
Design also determines what we work on.
A lot of times we get people coming to us
with a proposed solution and
want us to execute on it.
We want to be involved in that
process of decision making,
whether the solution that the
folks are coming to us with,
the proposed solution, is
really a true solution,
whether it addresses the problem,
whether they will realize the
outcome they wanna realize
if we fix that and work with them on it.
If so, then great, we do
it the way it came to us.
If not, we will reveal
to people using design,
using process design,
using some ethnographic,
embedded design principles that we have
where we go into those
environments and determine
if that problem really exists,
whether the solution that was proposed
is one that is really
gonna address that problem,
and if the problem itself is
solved, results in the outcome
that those groups were hoping to achieve.
We've developed a kind of
reputation within our community
that we can help in those areas,
and that helps us to ultimately
determine what we do.
The innovative technology
solutions and platforms team
of which Rob is the director,
and he's on this webinar,
the ethos of that group is
to work like a lean startup.
Develop solutions that matter,
and then do it really quickly
and do it in an agile way.
That group really is led by
lean startup and technology,
they're driven by that.
We produce solutions and develop solutions
very, very rapidly, we
test, iterate, we re-test,
and it can go on that way.
We also want to surround our solutions,
not just deliver them and then walk away.
We want to surround
them with good support,
good training, good
documentation, good education.
So, we develop online
support methodologies,
good documentation, online
training, and enable people
to really continue using
the solutions we use,
because so often in our
industry, we implement solutions
and then we walk away and
hope that the solution
keeps on living after we've stepped away,
and if you go back six months later,
even if you do bother to do that.
You'll find that people
have either gone back
to what they were doing before,
or they're doing something
completely different
and all the effort you put
in is probably not realizing
the outcome you hoped would be realized.
We don't like that to happen.
It's not a fault of the people, usually,
that are involved in the process,
but really of not having good support,
not having good training
and continued support,
documentation, where
people can continue doing
the things that you thought
would be good to do.
If you look at this the way
the group is constructed,
it's constructed in a way that, you know,
we are almost like a
company within a company.
The only functions that
we don't have in here
are sales and marketing and
that's something that Rob and I
and others do within the institution
as well as outside the institution.
- [Rob] This is Rob.
The one thing that I'd
love to add to that slide
is that no single tenant of our
group could stand by itself.
It's critical that they all work together,
and that's what we do as a team.
You can't have development
without critical design.
You can't have development
without training
and documentation and support.
You can't have support if you
have nothing you developed.
So, all four pillars of
our group work hand in hand
to ensure that the
solutions that we develop
meet the consumer's needs,
and then we support them
throughout the lifecycle of that solution.
- [Neil] Right, thanks Rob.
The other thing we like to do
is simplify complex problems,
bring them down to the core
and better understand them
before we make something.
That also goes into the
philosophy that we have
in terms of understanding our consumers.
We think that, you know,
consumers, really, it's not
a complex algorithm of figuring
out what exactly they want.
There are three things that they want.
Like everything else digital, right?
We think that healthcare and
education are so different
that we've got to have
a special model for it.
If you look at just the human aspect
and you consider yourself
also as a consumer sometimes
of these same services,
what you and I want
and what everyone else also wants,
it's not just as introspective,
really, is access,
you know, ease of access to services.
In healthcare, it's really
been a horrible situation
when you think about that.
We don't provide the access.
We don't allow our patients
to really interact with us
in as easy a way as possible.
We present restrictions.
It's not the consumer that
does, it's not the consumer
asking for something
untoward or unexpected.
It's just that we do it,
and we've gotta break
some of those barriers.
Then, convenience.
Consumers want these services
available where they reside.
If it's on the web, if
it's social networks,
if it's mobile in terms of
devices, even with wearables,
it's soon gonna get a
lot more sophisticated
that we can actually
engage people through them,
directly through them
using them as technologies.
We already do it with Apple Watch
and such other technologies,
and even in the Internet of Things.
As you've seen, a lot of
devices kind of involve
invading the home, making
their way into the home
and people wanna interact
with those devices.
Maybe they wanna speak to their physicians
through those types of devices.
There's no other intermediary,
there's no computers,
there's no phone even.
It's direct interaction.
So, we are thinking about all those things
and actually doing something about it too.
Finally, the consumer wants,
we think, a great experience.
A closed loop, digital experience.
The kind that you experience
when you purchase things,
let's say, with Amazon or Apple,
some of these great
companies that have figured
a lot of this out because
they focused on it
and they decided that that's going to be
primary to their existence.
They've developed these great experiences
when you buy something
on Amazon, for example.
You know, even when it ships to you,
it ships with a return label
in case you didn't like it.
Send it back, you don't
have to necessarily
get on a phone with somebody.
Even though the process
of purchasing Prime
and all of that is really delivering those
closed loop kind of digital experiences
and understanding that that's
of value to the consumer.
I think we need to do that more
in health care and in education.
Those are what we think,
that consumers in health care
and learning just want services,
like everything else physical
that they already experience.
It's not something new, you know?
How do we address each of these things?
We'll go through a few examples here,
but one example of access,
and other hospital systems are doing this,
but I'll talk about something
that's slightly different
than what you might experience
at other institutions.
We came out with an app
called myJeffHealth.
We went through two
iterations of the application
because we care a lot about
how consumers themselves
think about what we've developed for them,
and so we do primary research with them
as they come into our clinics or hospitals
and we expose them to
the tools we're making.
We develop them fast enough
so that we can do that
and then we develop them on platforms
and in ways that we can
change them very rapidly.
As you can see, if you go the Apple store
or the Google Play Store, so
you can download myJeffHealth.
It's an app that's available,
and you'll see the attention to aesthetic,
to ease of use, to the
ability to finding things,
to the understanding that
people are not just coming here
for health, you know, if
it's the healthcare side.
They're not just coming
here to go to a clinic.
When they come here,
especially to the city,
they want to know about parking.
They want to know about what
food is available in the area.
They wanna know about how to get here,
so we've developed this
concept called Journey to Jeff
where you can build such an
itinerary, save those journeys,
and share them with your caregiver, maybe,
that's going to actually
be getting you here,
or with someone who is
going to be doing it
for the first time.
We do all that.
You can even call an Uber from the app
to get to where we are.
All we have to do is step back
and take that 360 degree view
of what someone is trying
to do with your system,
not just, oh, they're
coming here to see a doctor.
No, there's a whole process around that
and you've got to take care of that.
So, that's one manifestation
of providing access.
Then, for experience, the
type of experience we provide,
the closed loop experience, right?
Most health systems
have these portal tools,
so patients download an
app or get on the computer
and go to a website,
they create an account,
and they can see their labs
and those types of things.
We have that too, but
adoption and statistics
across institutions show that
not a lot of patients actually
download these apps or go
to the websites very often,
because patients see
healthcare as being episodic,
but if you think about it
in an episodic kind of way,
they are not just episodes, but
many times they're journeys.
If you get pregnant, that's a journey.
If you get diagnosed with
cancer, that's a health journey.
If you have a heart related issue
or a heart health issue, that's a journey.
If you have diabetes, that's a journey.
So, all of these are
journeys, and you know,
the way that you interact
with a health system
and you get on the journey
needs to be completely different
from what a portal product can develop.
That's why one of focuses
is the journey area.
Our first foray into that space
is developing a pregnancy journey,
and we have an app out
called My Baby at Jeff,
which is used by our OBGYN groups.
Now, it's gonna be used
across our whole system
so we are putting in
additional information
based on that need, and
it's been very successful.
But again, what the patient sees is, okay,
Jefferson really cares about
how I interact with them,
and they're providing me with
this additional experience.
For us also, what it does,
apart from that goodwill aspect,
we can then engage more
deeply with our patients.
You know, if you had a cancer
app, a cancer journey app,
you can expose clinical trials,
because we are a research institution too.
We already have a
telemedicine application,
so now we can channel
the telemedicine aspect
into these journeys so that
someone can get on a call
while they're on this journey
app, or get on a video call
immediately if they wanted
to with their physicians,
already filtered by their care team.
All of these services create this
real nice closed loop experience.
The middle image that you're seeing there,
it's called At Your Service.
It's an application that we
developed, again, in house
that we built up really
rapidly, and what it does is
it enables the administrators
to round within our system
and we do this with immense discipline
in an agile kind of manner every week,
where a lot of hospital
administrators go around
and round not just with patients
but also with employees,
deliver honors to
employees for good service,
collect data from patients, and on the fly
within the app, triage those issues.
Let's say, a bed was broken,
or the air conditioning
is not functioning properly in that room.
Triage that directly to
the teams that are supposed
to do that work, and then
they solve those issues
while these patients are with us.
Most hospital systems, this
type of experience information
and this type of information is collected
after the patients are
discharged from the hospital
which really, you know,
a patient doesn't see
this engagement, right?
All they are doing is
collecting their information.
They don't see that you're
actually doing something about it
and this is our attempt at ensuring that
that is not the only type of experience
and engagement effort that we conduct.
You know, post factor.
This is while they are with us.
Many times, if you
revisit that same patient
while they're still with us,
you can report this information to them
and you'll see some of
the metrics behind that
and how it's really
affected our bottom line.
And then, myJeffEd is a
tool that we are using
with the company that makes the
student information systems,
and myJeffEd addresses the needs,
the journey aspects of a
student within the system.
That is slated for release at
the end of this fiscal year,
I think, in July, early July.
I just wanted to kind of
memorialize the fact that
these things that we do are
not just cool things, you know?
They're things that matter,
not just to the patients
but also to the organizations.
Many times, financial groups
within the organization
and even leadership
wants to see, okay, well,
I'm investing this money
into developing a tool
or a process or an application
and I have these teams
of people that do this.
What's the direct benefit
to the organization?
There really is great
benefit, we've found.
We always knew that, of course,
but as long as you ensure
you use design teams, for
example, or some kind of team
at the outset of developing
anything and you vet that
and you ensure that it's
something that ensures
those three wins, that
the team itself gains
and can grow so that
they can do more things,
'cause otherwise you get
encumbered by several things
that you've developed and then
you can't make anything new.
The team wins, the
patients and our consumers
and our students win, and
also the organization wins,
because if even one of
those constituents loses
in the process, many times
you can overall lose out
and the application
could get some (mumbling)
or something like that, or the
process could be developed.
We see real benefits, you know?
This is a quote from our
president of the hospital system.
The next quote is from the
CEO of another hospital
that is within our system,
and he directly credited this
application for moving us
from a two start to a three
star rating on the CMS,
something that they've been trying to do
for quite some time.
Increases in edge gaps scores,
which is our patient satisfaction scores,
credited directly to these applications.
And even increases in numbers of patients
and patient volume, we've
seen data to support that
directly from these types of applications
and these engagements.
JeffConnect, which is
our telemedicine tool,
is a tool that addresses
the convenience aspect.
I'm gonna speed up a little bit,
because we could be running out of time.
You may ask, those are some examples,
I wanna be sure that I made a point to get
the message across to you
that we need to understand
the consumers and we need to
understand what they want,
and then beyond that,
execute on things that matter
in a way that these
three groups really win.
Consumers win, people that
make these things win,
and the organizations win.
Those are some examples of that.
The question that might
be still in your mind is,
okay, how do we do that?
Yes, we focus on good
design and do all of that,
but again, to answer that question,
I am trying to simplify
it as much as possible.
I don't think it's huge and
complex and difficult to do.
Digital transformation
and the equations of that,
we feel, is very simple.
It's great teams, great
platforms, and great partners.
It may seem simple, right?
But to be able to execute
using that formula,
it takes a lot of investment of time,
because when you're trying
to build great teams,
you need to spend a lot of
time, and sometimes, you know,
take your own time about getting
the right people into that.
We have, for example, 12
principles that guide our teams.
We expose people even
at the interview level
to those 12 principles, so if they feel
like they don't seem to connect to that,
then we know it's probably not
the right place for them to work.
We get some of that
culture right out to people
before we even hire them.
Then, once you're in the group,
it enables you to make better
decisions because you know
there's some ethos, some
principle guiding this team
and the way that we do things.
The platforms, you know,
we take our time also
in picking the right types of platforms.
Progressive, future focused.
They may not be the biggest
platform that's out there
to solve the problem.
Many times, it's the reverse,
but it's one that is really,
again, focused on the
consumer, design focused,
and a platform that's
looking towards the future,
is open enough that we can
develop on it if needed,
that also is progressive
enough that it's allowing
or enabling you to then
extract data that's in it
and push data into it.
We're very particular about platforms
and we think that's important.
Innovation, as I've said, must
not really be the currency
(mumbling) but the combined
wealth of the many,
and platforms can make that a reality.
The third part of this
equation is great partners,
and I think we need to pick them
with the same kind of attention to detail
that we place in picking
people into our teams.
The same kind of attention
to a culture fit, you know,
as we have when picking
people to work on our teams,
because great partners
are not just focused
on their bottom line, they are
also focused on user creating
along with them, and that
really is a good partner.
They involve you in some
of their decision making.
They let you know what new
products they're coming out with
and new features that
they're coming out with.
And also, they engage
you in the enhancement
of their applications,
because as part of that,
your use cases can develop too.
Those are the kinds of partners
that we collaborate with.
Overall, we understand that
nothing really that we've done,
even the past examples
that I've shown you,
are not just us going out and
finding this real cool thing.
Most people think that, right?
I mean, when you see the startup world,
all these startups haven't
started because somebody had
this brilliant idea and then
executed on it on their own.
It's large teams working
together, small or large,
whatever, working together,
someone else finding a problem,
someone else executing on it,
so we are very, very
collaborative and open
with clinical teams, with
administrative teams,
with academic teams, with
research teams within our groups,
and ensure that credit
goes to the right people.
An example I'm gonna show you next,
it is one that we presented at Hinge,
where we developed this application
called Strength Through Insight
for a prostate cancer study.
This was a funded study.
Our researcher, he has
been able to collect data
using this tool and we did
it very rapidly for him.
It's on the Apple ResearchKit platform.
We used a great partner and
a company called CloudMine
that's an mBaaS solution provider,
built it on that platform and
did it in about three months.
Some of the larger companies
that do this kind of work
were gonna take about 18
months to do the same thing.
But the attention of Apple,
they represented there on this topic.
Ultimately, the biggest
benefit was to the patients,
you know, prostate cancer
patients that are now submitting
data on the longitudinal
study over multiple weeks,
and this is informing
research, this is informing
quality of care measures
and patient outcomes
over this extremely important study.
From the developer's
perspective, this is very, very
meaningful work that's going to generate
some great future
innovations in the space.
But again, a very
collaborative initiative.
We also work with IBM, for
example, in developing something
most people might think is
easy to do, because, you know,
you see a lot of consumer
devices coming out
that try to do these kinds of things,
but when you try to develop the
same use case in healthcare,
it gets very, very complex.
You need companies like IBM and Harman,
who we've been working with
on this, to work with you
and enable solution that's
an enterprise level solution
that can work within the
constraints of healthcare,
so that's what we've produced.
Again, something we've
talked about and put forward
at Watson, IBM InterConnect,
and a few other places,
it's gotten a lot of attention
in media, even at CES.
This was presented as a
big concept by Harman.
They've started building
what we've enabled
through this process into more commercial,
other industries, for
example, hospitality.
What this system does is
it's almost like having
a concierge in your room.
When you're with us, most
of the time these questions
that patients have are
answered by clinicians,
and we really want our
clinicians focused on
delivering great clinical
care to our patients,
and so if we have this
presence in the room,
which is really a Harman Kardon speaker
that connects through IBM Watson,
it takes unstructured questions, you know?
They don't have to be how
you interact with a skill
on the Echo where you say
a specific phrase, no.
IBM Watson doesn't need that.
In a healthcare environment,
we didn't think that
we needed to subject a patient
to remembering those types of things.
We just want them to
have a fluid conversation
with the room, and the room
will be able to, using IoT
and IBM's cognitive IoT
platform, be able to not just do
some of the things that you
see on the slide, you know,
telling them about times and
about their doctor, you know,
about visiting hours and things like that,
but also be able to interact
with the physical room,
change temperature, pull
the shades if you needed to,
play music, you know,
those types of things.
Things that, slowly, patients are already
getting used to in their homes,
so they want similar
experiences elsewhere.
But also, at the same time,
saving the organization
more time, resources.
About 10 to 20% of the time
that nurses and physicians
spend in the hospital
are spent on answering
some of the non-clinical questions
that a patient might have
and since those don't get prioritized,
the patients themselves don't
get responses immediately
to these questions and so the experience
is not that great for them too.
There's a win-win-win again
for everyone in this situation
and I think we've accessed that.
Another great example of this equation,
I'll just flip to the next slide here,
is the work that we've done with Google
on the Cloud Platform,
where we've moved a lot
of our web services
into the Cloud Platform,
providing much more responsiveness
and a lot more great
features, new features to come
into the future on the
web as a result of this.
We also used the Google Cloud Platform
and another mBaaS platform that we use
that uses GCP in the background
to develop applications
like our President's Dashboard,
which we then used for
other types of projects,
for example, our integration work,
that enabled our organization
to prioritize tasks,
inform themselves and
others that are on projects
about the status of the
projects, request help,
and do all those types of things.
So, a little bit of BTM in that.
Again, Google worked very closely with us
on doing these types of
things and hosting (mumbling)
developing spaces convey to in that case.
With Adobe, who has also
been a great partner,
we had about six content
management systems at Jefferson
for the web and we consolidated
all of them into one,
and we picked Adobe Experience Manager
as the platform that we would
use, and Abode worked with us
really, really closely
to enable that vision.
They see how healthcare and education
are getting consumerized to that level
and they wanna be in that space too,
and they wanna provide great experiences,
so they're learning from us,
we're learning from them,
and we're getting some
great synergies there.
These are some examples of the
web services we've developed
that are fully responsive
on mobile devices also
using this great platform with Adobe.
Into the future, we're also
working with Appian and may be
on the Appian platform for
low- and no-code BPM work,
because a lot of the work
that we get coming to us
and a lot of requests
that we get coming to us
are really business process
management related requests,
so instead of developing
these discrete solutions
that we then have to support
in a discrete manner,
we want to start consolidating
them on platforms like,
let's say, Appian, and do it
in a way that we don't need
extremely high level developers doing that
because that resource is
very difficult to find,
and also we have other
developers on our teams
that have not native
development skillsets,
but have web development and
platform development skillsets
that we could use towards
creating some of the applications
that we would otherwise
use native developers on.
(mumbling)
At the core of all of this,
we focus on three things.
One, we want to increase earnings,
definitely, for the organization,
we wanna build competitive advantage,
and we wanna accelerate processes.
We feel that in accelerating processes,
reducing latency, doing
those types of things,
focusing on the process itself.
Many times we do things
and we don't even focus on the process.
Just bringing that to the
fore helps tremendously
in building better consumer experiences,
and so the consumer benefits there.
In building competitive advantage
and increasing earnings,
the organization benefits, but
the core behind all of this,
at least to our team, is that consumer,
because if we create great
solutions for consumers,
the benefits are tremendous.
There's almost always a
win-win-win in that situation.
Some examples of other digital solutions,
we've built dashboards that reveal latency
and then accelerate processes.
These are some examples of
dashboards that we've built.
We also do this in the
clinical environment.
This is an ED dashboard that we've built
for one of our hospitals, Abington,
that enables them to really,
not just increase throughput
but also focus care to
specific teams within ERs
and utilize the ER in a
very, very efficient manner.
The same with the ER here at
Center City and Methodist,
we won the CIO 100 Award
for these applications,
which are now used widely
in our ERs in Center City,
which really enhanced
throughput within the ER
and there's some stats
here on how that happened.
This is another manifestation
of that same dashboard.
I'll quickly show you some testimonials.
When we implemented the Agile
ED processes and dashboards
in our ERs, we dropped our
Left Without Being Seen rate
from 4.6% to 1.2, and
this was within one month.
We reduced the average length of stay
for discharged patients by 42 minutes,
the average time to a
physician by 23.9 minutes.
This was the processes,
some construct of the ER,
as well as these dashboards that generated
this type of results.
It's tremendous, the
patient satisfaction there.
There's a reduction in time,
total time spent in the ER.
We see about 100,000 patients in just
those two ERs per year, and
that differential percentage
of Left Without Being Seen
where people were leaving
because either they couldn't
wait anymore or they just felt
like maybe, okay, well,
I don't need to have
this condition seen in the
ER, they were just leaving.
Now, at 0.8% from 4.6,
so that's thousands of
patients right there.
We also helped the medical oncology crew
reduce their time for
chemotherapy insurance
authorization from about 22 days.
Imagine being diagnosed with
cancer and then taking 22 days
to really start getting chemotherapy.
It's down to about five
days on average now,
and we did that in
collaboration with these groups,
these clinical groups,
revealing where that latency
was happening, dispelling common notions
of where the latency was happening.
Most people, oh, it's the insurance.
It wasn't, it was within
our own clinical system.
We revealed that, and
data speaks, you know?
We use a platform called Domo.
They did some features
on us on how we use them.
We use them for the ER
example that I just mentioned.
We use them for the chemo
insurance authorization example.
It's a great platform, but
what's really happening
in the background is what matters.
It's teams working together,
revealing a data story
and convincing the people that contribute
to a certain latency or
latency kind of situation
and convincing them that we
are all contributing to this.
If you say that to them without
data, nobody believes you,
so you have to have that focus on data.
This is an example of the
CMS project that we did.
I'll skip over that in
the interest of time.
(mumbling)
I just wanted to end with
some thoughts around,
you know, how we do some of these things
and what you might want to do if you think
this has been good, that
we've achieved something here.
What you need to realize
is that what got you here,
if you're experiencing a problem,
will not get you to a point
where you realize a solution.
You can't fool yourself by thinking that
everything is just gonna be
alright suddenly somehow.
You do need new ideas.
You need to look at other industries
and how they solve similar problems.
You need that outside thinking.
You need to engage in
immersive development,
because the reverse is
very easy, you know,
to just be outside the problem and say,
oh, I think I know what
the solution is gonna be
and here's what we should
do and let's try it out.
No, the difficult part is to actually go,
so when we did the ER
project, for example,
the difficult part was, we're
not just gonna, you know,
design a new interface for the ER EMR, no,
we're gonna go and see if the
solution you're bringing to us
is really addressing the problem
and is going to realize the outcome.
So, we're gonna come with you to the ER,
we're gonna live with you in the ER,
and not just administrators,
not just Rob and me,
but the developers too,
and we're gonna see if that
solution you're bringing to
us and you want us to execute
on is really gonna address that problem
and realize the outcome.
That's hard, that's difficult,
but you have to do it,
otherwise six months
later, three months later,
worse still, three years
later, you're gonna realize
you spent all that effort
and achieved nothing.
Use the lean startup methodology.
It's great because nowadays
you have technologies
that you can build and
solutions you can build.
Sometimes technology is not
even involved in the process.
When Abington came to us and said,
"We would like to use
your service at Abington,"
we said to them, well, first,
the technology is not the
solution in this case.
It's really being able to
stick to the discipline
of going out and talking to
these patients every week
and having people engaged in that process
and continue it over time.
We said, yeah, we'll give you that survey
type of tool in paper, and
try it out for a month,
two months, and see if people stick to it.
If they stick to it, they
show up, they come to these
weekly meetings and then go
out and meet with patients,
then we'll pull up the tool to Abington.
And they did it, they proved that us,
and so we went ahead and did this work.
Validate the problem or find a real one,
then devise a solution, and devising it,
build, test, iterate and rebuilt.
Always be asking these questions.
We're running out of time a little,
so I have just one more slide.
I know there's probably a lot
of tech people on this session
so I just want to say
to you that, you know,
IT is not just a cost center.
It's not even just a value center.
It's really a change agent,
and you can change different
types of industries.
You've seen it already
happening all around you.
It's not a mystery, it's not
something we have to prove,
but many times when it comes
down to being in these meetings
where people are discussing problems
and hoping for solutions,
IT can take a real lead role
because information, as I mentioned,
can be a catalyst for change.
Technology can be a driver for change,
and we really believe a
lot in scrum and agile
and lean startup
methodologies, and so we feel
they can really be a great
framework for change,
not just in software development
but also across the organization.
That, I think, wraps it up for me.
Rob, (laughs) I know I've
monopolized a lot of the time,
but if there's anything
that you wanna add to this
because you're really into the
practical aspects of things
and we're all in this together.
- [Rob] I appreciate that,
Neil, I appreciate that,
and I wanna give a
chance to hand it over to
our sponsor as well, but the
note that I've kind of thought,
and then I'll answer any
questions in the question aspect
if we have them, is that while
everything that Neil laid out
is a lot of the surface of
what makes what we do great
and really what makes Jefferson
a great place, there's a lot
of core foundational work
that's done behind the scenes
with the technologies
that we're laying out.
It's not just picking the right partners
and having the right team,
but it's also having a really
strong foundation and
architecture when we put together
solutions such that that
technology can be reused,
it can be adapted, and it can evolve
throughout time with the organization.
If you simply look at each
project or each problem
as a piece by itself,
you'll end up rebuilding
and rearchitecting, reengineering
over and over again.
But having a team that's
dedicated to overall improving
the consumer's experience throughout time
forces everyone to look at
every aspect of the experience
even when they're just
iterating on a small problem.
The technology behind all
of it is really critical
to get that right and
spend the time to do it
and not just rush to solve problems.
Anyway, more about that in
the Q and A if people have
questions specifically related
to how we do all of that.
- [Rajiv] Yes, thank you Neil and Robert
for taking the time to
speak with us today.
We do have some questions
already in the Q and A area,
and just a reminder, if
you'd like to use the program
to submit a question, you
can use the Q and A area
below the slides to submit
a question at any time.
I would like to introduce for
a minute here Fritz Haimberger
who is a healthcare, consulting, sales
and management executive
with more than 15 years
of health IT, clinical operations,
and revenue cycle experience,
with a strong background
in healthcare, administration
and operations,
business development
and IT systems design.
Fritz has extensive experience focusing on
provider solutions, both in
the US and internationally,
including Canada, Ireland and the UK.
So, Fritz, I'd like to bring
you into the discussion
for a minute or two and
just ask if you could share
your thoughts and perspectives
on what we heard today.
- [Fritz] Sure Rajiv,
can you hear me okay?
- [Rajiv] You sound great.
- [Fritz] Wonderful, thank you.
First off, I just wanted
to say thank you to you
and the team there, and certainly
to Neil and Rob as well.
This has been incredibly informative,
and I certainly do appreciate your time.
Just to certainly echo what
Rob and Neil have discussed,
the age of digital transformation
is certainly upon us
and I think being able to
work with those companies
that really, truly value
those partnerships,
as Neil mentioned, rather
than having just a vendor
client relationship, rather
taking it to that next level
and having folks who are
truly investing in your needs,
listening to your needs,
ensuring that you're on
the same team to the end,
that you are both looking
to achieve those same goals,
is incredibly important.
We here at Appian certainly have done that
in the healthcare sector and many others,
and are certainly looking
forward to working with
Neil and Rob and Jeff,
as well as anybody else.
I certainly look forward to
our Q and A session here,
so we'll send it back to you.
- [Rajiv] Great, Fritz, thanks so much
for a few minutes there,
and again, thank you to Neil
and Robert for a very
informative presentation.
As mentioned, we've already
had a number of questions
from the audience, but we'd
once again like to remind you
to use the Q and A area below the slides
to submit a question at any time.
The first question, we'll
direct this to Neil or Rob
for the app that you
mentioned that was developed.
How has it been shared with
the public or with employees
within your health system?
How did you announce its release
and what kind of response
has it received so far?
- [Neil] This is Neil.
The app, you're probably
referring to myJeffHealth.
I spoke about a few, but yeah,
myJeffHealth is really
a patient focused app,
if that's the one we're talking about,
so we do have some marketing behind it
but we haven't done broad marketing.
We've done a lot of broad
marketing around JeffConnect,
which is our telemedicine
app and solution,
and we've got extremely
positive response behind that
and lots of utilization too.
It has developed into a national brand.
The next goal is really to
start developing myJeffHealth
as this national brand and
it be the platform whereby
everyone accesses some of these solutions,
or all of these solutions.
JeffConnect, being available
within myJeffHealth,
our portal solutions being
available within myJeffHealth.
From the patient perspective,
they've received it,
it seems like, quite well.
We have people using these applications.
We have clinical units
using these applications
like the OBGYN folks.
We create collateral
and marketing for these
through our design group itself.
And even web presence as needed.
The response has been great.
Could we do more marketing?
Yes, certainly, we could and
we will in the near future.
And Rob, if you want to add to that--
- [Rob] The only other thing
that I'd add to that is that
Neil mentioned a bunch
of times that we have
a very agile approach to things,
so we try to put solutions
out there that are gonna
create value for our consumers,
but get them out there
as quickly as we can
and start collecting
feedback and analytics
on how well they perform.
So, in pretty much all the
solutions that we build,
apps included, we collect
data, not specific
to a particular user, but
just specific to trends
about how often certain features
in an app are being used,
how long they're being used,
similar to analytics that
you would use on the web, but
that allows us to figure out
what pieces are more important
and we wanna focus on more
and what pieces are less important,
and we do that in addition
to collecting data through
surveys and other ways
of seeing the population.
You'll see that more and
more features roll out
to these apps sooner and
sooner, and it is all based on,
in a lot of cases, real time
intelligence that we're getting
about how the apps are being used
across the different population.
- [Rajiv] Great, we do have time
for another question or two.
The next one is also about
apps for Neil and Rob.
Are the apps you have
developed EMR, EHR agnostic?
Do you have APIs for
these variety of EHRs?
- [Neil] Yes to all of these.
I know Rob might be
excited to respond to that.
(Rob laughs)
- [Rob] Actually, I can speak to that.
Neil mentioned that we've
grown over the past year
and gone from three hospitals to 11
and we're about to add some more,
so even within our own
environment we've had to manage
multiple different EMRs
at different locations.
While those will certainly
merge and migrate,
likely, over time, that
hasn't happened yet.
Even at a given location,
you'd see changes
in the EMR over time from,
you know, EMRs go end of life,
or you switch from one EMR to another.
That's exactly how we've managed
the solutions we've built,
which is building an
API layer that connects
the backend system, and then
having the front end system,
essentially, being fairly
agnostic of the backend.
Everyone on this call who's
been involved in healthcare IT
for some time knows that
you really can't have
a truly agnostic front end.
It would be great if you did.
We do have an API
management layer in place,
such that our front ends
look the same when we're on
one EMR to when they have
switched to another EMR,
and we've simply added new
services into the API management
platform that we have and
are calling similar data
from a new EMR when we
put that into place.
That just goes to the
overall note that I made
at the end of the presentation
that building out a proper
architecture for your solutions
across the organization is critical,
and that's what has allowed us to do that.
We've recently switched
EMRs on one of our campuses
and the dashboard, some of the
dashboards that Neil showed,
look exactly the same now
as they did previously.
Not only is that great from
a development standpoint
'cause you don't have to go
ahead and redevelop something,
but it's also great from
a process standpoint
and an employee satisfaction
and operation standpoint
in the hospital because those
processes that were relying
on that dashboard or that realtime data
didn't need to change, and
there was no reeducation
around those specific processes.
Again, going back to how
you architect solutions
across your organization are critical.
- [Rajiv] Great, thank you to Neil and Rob
for answering those questions.
Unfortunately, that is all
the time we have for today.
I would once again like to
thank Neil, Rob and Fritz
for today's fantastic webinar.
I would also like to
thank our sponsor, Appian,
for making today's program possible.
Finally, I wanna thank you in our audience
for joining us today.
With that, we hope you'll
join us in the future
for another Healthcare
Informatics webinar.
This concludes today's presentation.
