Knowledge Center

Research Paper

Telehealth and
virtual care priorities: a roadmap for mid-tier health systems


Leading health systems in the United States have been on a multi-year digital transformation journey and have used their scale and the resources to invest in accelerating digital transformation. IT leaders in mid-tier health systems now have a unique opportunity to help their enterprises catch up.

Damo Consulting’s ongoing research of the digital initiatives in the top health systems highlights a set of common themes playing out in the top tier of health systems today.

Telehealth and digital front doors are top priorities among top health systems.

What does the picture look like for mid-tier health systems that may not have the resources and the organizational support that the leading health systems enjoy? Our research team recently conducted a focus group discussion with 20 CIOs and technology leaders from mid-tier health systems and all CHIME members, to find out what is happening with their digital transformation journeys.

The current state of digital maturity among health systems

Digital transformation efforts in healthcare correspond with one of the four models described in the visual below:

Digital maturity models in healthcare by Damo Consulting Figure 1: Digital health maturity models

Digital maturity in healthcare today falls mostly in one of the models described in Figure 1 above. Mid-tier health systems (broadly defined as institutions with under $4 billion in revenues) are in models 1 and 2, and a small number are maturing towards an enterprise approach and roadmap for healthcare digital transformation in model 4. Model 3 typically sits alongside one of the other models in large enterprises with dedicated innovation groups that focus on commercializing internal innovation and making strategic investments in startups. It is important to note that model 1 is foundational. In other words, health systems looking to implement digital roadmaps must necessarily have a robust EHR system in place. Read more…

The current state of healthcare digital transformation

Most are at Model 1 or Model 2 right now. It is hard to imagine somebody further along that spectrum.

The current environment for Tier 2 health systems

Tier 2 health systems tend to have certain unique challenges relative to larger integrated health systems. Our focus group discussion highlighted a few key factors:
  1. EHR systems are the primary platforms for digital health programs: Given their financial and resource constraints, Tier 2 health systems in our focus group were mostly dependent on their EHR systems for digital functionalities. However, IT leaders acknowledge the need to look beyond core EHR systems and are beginning to explore standalone platforms (especially telehealth) to enhance their virtual care capabilities, considering the pandemic. In our maturity model, they tend to fall in models 1 and 2 mostly.
  2. Adoption rates for telehealth models are tied to reimbursements: Many of the health systems in our study were financially impacted by the drop in elective procedures, which were primary contributors to the profitability of the system. An interesting aspect of many of the firms was that they served rural and elderly populations that were not fast adopters of telehealth. Reasons included lack of broadband internet access, population without video-enabled smartphones, and in some cases, a preference for phone visits as opposed to video visits. In all cases, the reimbursement model for telehealth, especially the CMS waivers in the wake of the pandemic, was seen to be helpful but not adequate to cover the revenue shortfall from the drop in in-patient visits.
Read more…

Organization Models and Best Practices for Healthcare Digital Transformation in A Post-COVID 19 Era

Digital transformation strategy


What health systems must do to accelerate digital transformation

CIOs see EHR systems as a “landing point” for digital initiatives and recognize the need to implement best-in-class tools with string integration features to create seamless online patient relationships. They also recognize the need to support transformation in IT infrastructure to support digital transformation. CIOs insist that a strong EHR foundation is essential for advancing a digital strategy. Many CIOs expressed concern about a lack of willingness in the clinical community to support a transformation of IT to adopt new care delivery models. In the remote monitoring space, the clinician community’s lack of confidence in the quality of data, especially self-monitored and patient reported data, was seen as a challenge despite the obvious benefits of being able to manage large chronic populations through connected devices. Read more…

The IT organization thinks of itself as offering services to caregivers and to those that work and are employed within the health system. Digital transformation is about offering some sort of technology support for patients that are going to be digitally engaging with our system.

What mid-tier health systems CIOs must do

CIOs in mid-tier health systems have a unique opportunity to drive digital transformation in their enterprises.
The shift to telehealth and virtual care models is already underway. Large health systems have been investing
heavily in digital health for the past few years. New market entrants are moving into the primary care space. For
mid-tier health systems, financial constraints and lack of resources may seem like a challenge against these
odds. However, healthcare CIOs can turn this to their advantage.

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