Enabling Digital Transformation in Healthcare on Health Innovation Matters Podcast

Michael Levin-Epstein | 05:03

So, you know, based on your experience, you’ve seen some dramatic changes, I would think, in the workflow situation, especially with digitization. You know, is it as dramatic as most people think it’s been in the last five or 10 years, this digital transformation that ServiceNow is addressing?

Yeah.

Elevsis Delgadillo | 05:29

One thing I think from the healthcare standpoint is that you’ve just seen a lot more data come into healthcare organizations over the last several years, and there’s a lot more activity between fulfilling or needing patient needs. You know, patients have higher or more robust expectations of their healthcare systems, of their payers, and how they kind of address their healthcare needs and how they take care of them, but how they’re going to be able to provide the services that they need. Providers have much more aggressive expectations of health systems and how they help them navigate through kind of the burdensome administrative work that they have. And so there’s really a lot of need for workflow in healthcare organizations, both payer and provider. And there’s a lot of things that IT organizations within healthcare are really starting to look at to help drive the inefficiency out of healthcare organizations to really allow patients to have frictionless experiences for how they go from I need care all the way to the point of I’ve booked an appointment, I’ve had the appointment, I’m making payments. For making a payment for the visit that I had or the service that I had to how they get kind of post care management.

So there’s just a lot to handle there. And even more for providers who are dealing with, you know, burnout. I think I read a metric recently that as of 2024, 48% of providers still kind of indicate that they’ve experienced some form of burnout. That’s a huge impact. It’s hugely impactful to, you know, how our providers are able to care for patients. Because again, with all of the other things they have crossing their path, how effective are they at taking care of the patients if they have a ton of administrative work, whether it’s, you know, documenting in the EHRs or other types of follow-ups they need to do, it can really impact outcomes for patients.

Michael Levin-Epstein | 07:27

So when you’re working with these healthcare providers, and systems, you’re you have a range of clients who run maybe from a small medical group to a healthcare system. Is that correct?

Elevsis Delgadillo | 07:45

The one thing unique about KeenStack is that we are a startup and that we’ve launched our organization just about four months ago. One of the things that was unique about it is that in launching about four months ago, we made a decision early on to verticalize really in the healthcare space because although the service now technology is pervasive in a lot of healthcare industries, Its adoption has been primarily within the IT space and really exclusively related to core IT workflows. Things like I have a broken computer, which would be considered like an incident or a request. I need a new piece. I need a new software installed on my computer or I need access to a certain system. Or even things around asset management and IT operations management. That’s really the block and tackle that ServiceNow has built itself around. But one of the things that’s really unique in the healthcare space and other industries as well, is that there’s a lot of business utility and a lot of business use cases that surround the digital transformation work that’s occurring. That a lot of organizations really don’t consider that same capabilities around workflow and the agentic AI within these workflows and how it can drive and really push their digital transformation endeavors forward. And again, that’s without having to bring net new technology into their operating, you know, into their environment. A lot of Health systems already operate this technology, but they really use it in an incomplete manner in the sense that they could take the same technology that they’ve used and operated in their IT organization for years and start to point it towards more business orientated issues and drive a lot of provider and patient value out of it.

Michael Levin-Epstein | 09:36

So when you have a new client, do you start with making an assessment about where they are from a digital and workflow point of view? Is that your kind of launch pad, so to speak?

Elevsis Delgadillo | 09:52

Absolutely. And it really depends on who we’re having a conversation with.

So, I mean, I can give you some examples. If we’re meeting with a human resources executive, you know, listening to what they say and what the challenges or the needs that they’re having within their space, one of the most common areas that we see issues is provider onboarding is an incredibly complicated and complex process. All the way from the recruitment side of things, to getting the provider onboarded, getting them credentialed, and getting them functioning and generating revenue for the organization. There’s a lot of workflow that happens behind the scenes in order to make that occur. If anyone’s familiar with credentialing processes, you know, it can be time consuming. And so depending on if we’re talking to, you know, an HR leader, or we’re talking to a cybersecurity leader, or even most recently talking to a lead that oversees patient access, you know, things like fax referrals. You could imagine that, you know, well, we don’t, you know, you don’t get fax referrals anymore, but health systems take a tremendous amount of fax referrals. The idea of having an agent, you know, take a referral, you know, store it into a system like a non-base, have to take the data, put it into the, you know, take the data out of it, put it into an EHR, like using, you know, visually transcribing it, And then having to figure out, does this referral meet the criteria to go, you know, be brought into the specialist?

And then you have a pre-authorization, maybe depending on what type of referral it is. And then you got to schedule the appointment.

I mean, you can think about all these steps you have to go through. But again, to your point is really listening to where.

You know, the different leaders are that we speak to within these enterprise, these organizations where they’re having problems and really trying to find or identify where a product like a service now can actually provide utility and value to the enterprise to help them kind of remove manual processes and manual workflows and honestly improve the friction that is kind of generated in the whole process as it stands today.

Michael Levin-Epstein | 11:58

So before we go to a break after you answer this question, if you could like kind of determine the three or four most, problematic areas. For IT and data, flow and workflow, what, you know, across the board, what would those three areas be? Is it in pre-authorization or I think you get where we’re coming from here. Just what, in your opinion, what are the three most, complicated or problematic areas.

Elevsis Delgadillo | 12:33

So I’ll start with the business side of it, because again, I, you know, they’re kind of a blended up with IT and I’ll address IT as well. But I see things like, again, I mentioned, you know, provider onboarding, you know, referral management tends to be an issue and care transition management.

So this is when a patient leaves the facility. There’s a lot of coordination that occurs getting whether it’s a, you know, a home care organization kind of onboarded, whether there’s durable medical equipment that has to be purchased. A lot of coordination for that. A lot of workflow around, like I mentioned, referral management.

And then again, the earlier one is the provider onboarding. I think those are three really big areas, but on the IT side, I think the biggest thing for IT organizations, I mean, I think that from like, From what I recall, IT organizations anywhere between represent was a three to 5% of the overall revenue that the health system generates. They’re an expensive area to operate within an enterprise. Their ability to actually drive efficiency and reduce costs. Really can help improve the ability of an enterprise, a healthcare organization to invest in more digital transformation activities that really benefit the patients and the provider populations as well.

I mean, this is around governance and keeping things out of the IT organization that shouldn’t be there. So many times you see new applications show up and you’re like, why do we have 10 of these?

You know, that’s a common issue. You know, outsourcing where it makes sense, but to outsource, you need to understand your operation and the work. And, you know, the tools like ServiceNow really provide a lot of value in that space. And I think the last one is rationalizing portfolios. You have so much. Procurement of a point solutions throughout health systems, the ability to understand your technology portfolio and understand, you know, where we have overlap or duplications and really ask tough questions through these governance processes around, is that 5% differentiation in a piece of software that you get really worth the investment? Those are the types of things that I think can really drive more efficiency in IT organizations and provide resources back to the business so that they can more readily transform themselves.

Michael Levin-Epstein | 14:55

Yeah, thank you for that answer. So we’re going to take a short break right now. Don’t go anywhere because we’ll be right back.

And we’re back and we’re talking to Elevsis Delgadillo. Of KeenStack. And, We’ve been talking about a number of different factors here going into making operations of healthcare entities go smoother in terms of IT, in terms of data management, in terms of workflow. And I wanted to begin the second half of this interview thinking asking you where you think healthcare IT is going to be going, how is it going to evolve over the next few years?

Elevsis Delgadillo | 15:53

No, that’s, it’s a good question. And I feel like I may have a bit of an unpopular opinion depending on how, how you perceive it. But I really believe that IT organizations are really focused on shrinking and optimizing the value they bring back into the enterprise. I think one of the things that you’ll see them changing is becoming more nimble and really reducing the amount of large capital investments that they make that really prevent them from adjusting and being more fluid. The speed of the business is really moving a lot faster.

You see them adopting new solutions or having new needs that arise as kind of our customers and patients shift as well. And when you make these really large capitalized investments in infrastructure and can’t get out of them because you’re waiting for a 10-year depreciation on an investment. That’s really not a healthy place to be. I really think you’re going to see an adjustment on how, IT organizations invest in technology and shifting away from capitalized investments. I think you’re going to see them start to standardize on more platforms or enterprise platforms, trying to shrink the portfolio of technologies that they have, which would reduce honestly the best part, not just cost, but the skill sets that they have to invest in. One of the most challenging things for an IT organization in healthcare to contend with the volume of skill set that they have to bring in to operate each distinct technology and platform. The fewer of those you have, the more effective you can be managing through a small universe of things like your EHR, your HR systems like Workday, your IT operations platforms like ServiceNow, and obviously expanding that out into other use cases.

So those are some of the things that I really see shifting or changing in the IT landscape that maybe Be more of a focused on managed services for areas that make sense where there isn’t a need to have a an in-house kind of a large FTE presence. But, you know, again, that’ll really be dictated by the business as it continues to shift over the coming years.

Michael Levin-Epstein | 18:10

– So do you see more integration among, The platforms, not having necessarily separate platforms for HR, and for, other kinds of departments, if you will, is that a possibility?

Elevsis Delgadillo | 18:30

I don’t know that you’ll have a product like, let’s just take a Workday, for example, become an all-encompassing solution or platform. But I think you’ll see… Fewer technologies in this space, especially in the patient access side. I just, when you look out in the marketplace today, you see all sorts of solutions intended to, you know, provider directories, pre-appointment documentation forms and collection, you know, all sorts of, you know, like I said, tools that do that. I think what you’re going to find is that healthcare organizations will find ways to look at the core platforms that they want to operate on and really, you know, Dig into those platforms and extend capabilities off of those solutions rather than investing in, like I said, 10 or 20 different technologies that all kind of provide some very bespoke one-off use case.

Michael Levin-Epstein | 19:22

So, are there adequate means of assessing the return on investment? Do you feel like, as somebody who’s so knowledgeable in this industry, that there are ways of making that assessment? In terms of the investment in new technology.

Elevsis Delgadillo | 19:46

You know, there’s always this, so that’s a, it’s good in the sense that you’re thinking about it that way. There’s always been this like nomenclature on soft dollar and hard dollar savings. And I’ve always wondered, you know, when you have value propositions come back that say, well, you know, we’re going to save resources, you know, 10,000 hours of time. But when you, we’re not, when you’re not able to translate that 10,000 hours of time into exactly, is that a Does that translate to a reduction in force to generate savings? Are there other value-added activities that you’ll be able to move those resources into? The things that I haven’t seen really adopted well within… Large enterprises holistically is resource tracking and resource management, time card management. That’s an area where there’s really a lot of opportunity within IT organizations, specifically within healthcare, is better utilization of time cards to understand where people are spending their times, how much time is being invested in project delivery versus lights on activities, Being able to track that and then as you implement various transformation endeavors and services, you should start to see the data show up and how the time cards are being represented and where the time is being spent. These are things where there’s definitely some foundational work to be done within organizations that are going through digital transformation endeavors to ensure they can quantify data.

You know, the work after they do it. Otherwise, it’s just a fancy slide with a bunch of numbers, but there’s no way to actually go back through it and, you know, justify or prove out that the value is actually being generated.

Michael Levin-Epstein | 21:28

That’s a really good point. So in the organizations that you’re familiar with, do they expect people that they hire to have the skill set to operate in this environment or do they figure that they’re going to have to train them on the job?

Elevsis Delgadillo | 21:48

You know, you asked the question a little bit earlier around, you know, how healthcare IT organizations are changing. And I think this kind of lends itself to maybe an expansion on that. I really think you see a lot of IT leadership and executives going out into the marketplace and hiring IT leaders that have a better understanding of business and business operations so that they can do a better job of translating the goals and objective from the business into the delivery on the IT side of the house.

Sometimes, again, if you’re not careful, you get IT for the sake of IT. Because it’s innovative or cool, but the point is, How does that How does the value or the thing that you’re doing in IT map back to a specific goal or objective for the enterprise?

And then how do you ensure that it stays connected? So I think you’re bringing in a different type of skillset from a leadership standpoint. And I think what you’re seeing to answer your question I think you’re starting to see again, The reduction in the And the number of platforms that are being operated helps simplify the skill set that you’re bringing in so you don’t have to do as much upskilling. I think one of the more challenging areas, think of infrastructure.

So much infrastructure is moving to cloud, but you have a lot of resources within healthcare IT organizations to support all of the switches and routers and networking gear. Within facilities themselves. And you have to ask yourself how much of that administration can get taken from on-prem systems. You’re not moving the boxes, the physical hardware, but how much of that we know gets shifted into, you know, a cloud operating system like a Cisco Meraki where you don’t have as much need for resource to handle all of the ins and outs of managing that network gear. I think it’s a huge paradigm shift and it’s going to change the skill sets that come in. You just have to have an organization that’s willing to kind of embrace the change and really drive that culturally through the enterprise and help put people into new roles and new types of positions where there’s more value or, again, help them find opportunities in other areas where they can kind of take their skill set and have success with it.

Michael Levin-Epstein | 24:06

And you mentioned embracing the change. And I have to say that you only mentioned AI once. And that has to be a record because I think in the last couple of months, the norm is to mention it at least a dozen times by now. But, of course, I have to ask you about it because, as I say in this podcast and other podcasts, you know, there’s not an industry today where you – Don’t ask the question about AI. And the question that I have for you is, in terms of the business operation of these kinds of healthcare entities, where do you see AI making the greatest impact?

Elevsis Delgadillo | 24:50

Well, I mean, I want to say, and just our ability to save lives in the healthcare side, I saw a lot of really fantastic, you know, AI solutions come into the way you can, you know, imaging reads to identify, you know, cancers or other types of conditions through medical imaging, really improving the ability of the radiologist and what they’re doing. You know, the ability for physicians to make quick decisions in emergent scenarios and using AI to help with that. I really think that’s beautiful as well as I think of the, you know, what doctors have to do with kind of all of the dictation and the notes, a lot of the AI capabilities for their charting and documentation efforts, I think takes a lot of lift off providers in that particular space. I’m super bullish on AI, but I’m a little bit hesitant.

You know, if you saw how fast it’s moved, we went from generative AI to agentic AI, literally, like, I don’t know, within the heartbeat. You think about all the investment in the generative AI, and now you’re figuring out how to do all the agentic stuff. I think you have to be really thoughtful about how you do it. We talked about the business moving faster. These investments are going to degrade so much quicker now as these things continue to flush out and being thoughtful about where you put your dollar is really important. I’ll give you an example on the agentic AI solution that I think would resonate with people. Let’s just say you have a big ticketing system where you have tickets coming in. And you have tickets that go from, let’s just say a doctor, doctors in a certain hospital need to have something changed. They need to have some software updated on their computer. And it’s pretty common.

So what they might do is they might call your field services staff in the facility, say, “Hey, can you pick up this ticket or how can you help me get this done?” So you’ll have a field services team member who really shouldn’t be taking on that ticket, pick up that ticket from the doctor as a favor, And what it does is it trains the agentic AI that those types of tickets should go to your field services team. You really need to be thoughtful about how you implement the agentic AI stuff and what it’s going to learn from your data, because you really bear the risk of just exacerbating bad workflows and bad processes. You need to put some make some investment, ensuring that you have the right workflows that the agentic AI tools are going to learn from so that you’re not just like making a inefficient. An inefficient process or system, even more inefficient. And I think that’s a scenario where I’ve kind of picked up on and heard a little bit more about. And I think it’s definitely a concern for this people rushing into the agentic AI, you know, rushing into agentic AI without doing Process mining or workflow architecture and stuff like that before just jumping in.

Michael Levin-Epstein | 27:48

Yeah, thank you for that answer. And I want to thank you for being on the podcast today. And I think when our loyal subscribers listen to this, they are going to see someone who is. Whether you might like it or not, a thought leader in this area, because your answers to these questions show, I think, our subscribers that you’ve given these kinds of situations, which are so important right now in health care, you’ve given them a lot of thought. And it really comes through.

So thank you for being such a great guest on Health Innovation Matters. I’d like to thank our assistant producer, Sam Hoffmeister. And thanks to all of you who tuned in again to Health Innovation Matters. If you’d like to be a guest. A sponsor, a marketing partner, and you have ideas for upcoming episodes, or you have a question about an episode, you just want to chat, you can email me at Michael Levin-Epstein at gmail.com, or just ping me on LinkedIn. And this is Michael Levin Epstein, and we’ll see you next time on Health Innovation Matters.

This podcast originally appeared on Health Innovation Matters.