• Systemness as a Lever for Greater Health System Resilience

    By Graham Gardner, MD Oct 16, 2018

    To strengthen their brands in a way that allows them to compete in a changing landscape, health systems should start by ensuring they have optimal insight into their provider networks.

    Business Resilience_Graham GardnerResilience has emerged as an increasingly popular word in recent years, popping up in everything from leadership development books to conversations about physician burnout. The ability to withstand pressures and keep pace with change is crucial in a variety of contexts. Only when there is a foundation of resilience can organizations develop the infrastructure they need to innovate in meaningful ways. 

    To flourish in today’s healthcare climate—characterized by an uncertain regulatory landscape, shifts in consumer expectations, and mounting pressure on the bottom line—how can healthcare delivery organizations build greater business resilience? While there are various initiatives that organizations can undertake, striving for systemness is the single most important business priority for any health system that seeks to survive over the long run.

    Systemness, or operating in a way that enables the system to create more value than the sum of its parts, can apply to many different areas of a health system’s performance. That said, the most important and visible manifestations of systemness are patient access and provider network management. As patients increasingly act more like consumers, health systems must meet the demand for convenient and timely care by providing a consistent experience across hospital and physician office locations as well as online and affiliated settings.

    Industry research has highlighted the weight that today’s healthcare consumers place on location and appointment availability in addition to clinical expertise. In a Kyruus survey of 1,000 consumers, 82 percent said appointment availability was extremely or very important in provider selection, while 77 percent said the same about location. This sentiment aligns with the recent growth of alternative sites of care, such as retail clinics and urgent care clinics. In the 10 years after their launch in 2000, the number of retail clinics grew to 1,200 and was on pace to more than double from there by the end of 2017.

    The good news is that health system brand matters. Health systems have an opportunity to meet and surpass their new sources of competition. In fact, almost three-quarters of the consumers in the Kyruus survey said it is extremely or very important for a healthcare provider to be affiliated with a hospital or health system, and 82 percent cited the reputation of the health system/hospital as an extremely or very important factor in provider selection. Health systems are thus well-positioned to differentiate themselves if they’re able to keep up with demand for more convenient access and sites of care—and link those sites into the broader health system. 

    Examples of Brand Strength Amid Growth

    Community Health Network (CHN) in Indianapolis and Piedmont Healthcare in Atlanta are examples of health systems that have expanded access to new settings while keeping their brand and the patient experience front and center. 

    CHN announced in early 2017 that it would operate and provide clinical services in 12 clinics located in Walgreens stores in Indiana. The organization named the initiative “Community Clinic at Walgreens” and branded the locations with the CHN logo. This strategy enabled the health system to provide walk-in appointments, same-day scheduling, and more-convenient access—giving new patients alternative inroads to the system while expanding follow-up care options for existing patients. The approach also fostered care coordination by facilitating access to patients’ medical records across care settings. 

    Piedmont Healthcare formed a similar agreement with Walgreens in 2017, announcing plans to take over 27 clinics in the Atlanta area. Piedmont called the clinic locations “Piedmont QuickCare at Walgreens,” building on the brand of the health system’s existing primary care and urgent care clinic network. Central to the launch and management of the clinics was integration of the Walgreens locations into the organization’s core provider directory and facilitation of online scheduling. In the year since the opening of the clinics, more than 100,000 patients have received care at them, and nearly half chose to schedule their appointments online.

    The opportunities for care coordination extend beyond the health system. Both CHN and Piedmont are among the 17 healthcare providers that Walgreens listed as participants in the recently launched “Find Care Now” digital marketplace. By demonstrating their ability to act as open and coordinated systems, these organizations became attractive partners for other companies looking to serve the healthcare consumer. Systemness thus has benefits even beyond the system. 

    Importance of Provider Directories

    So where do health systems begin as they strive for systemness? From an operational perspective, the first step is to build a directory of which providers do what, when, where, and for what insurance.  A comprehensive view of the “inventory” is a prerequisite for understanding network capacity and paving a path to optimal provider utilization. 

    In a recent article, Aaron Martin, a former Amazon executive and now Providence St. Joseph Health’s chief digital officer, explained the importance of having a digital “catalog” of providers as the foundation for digital innovation, much like the type of asset that proved foundational to successful e-commerce endeavors. Only when health systems understand their clinical “catalog” can they best position themselves to meet consumer demand and match patients with providers most effectively.

    When health systems have visibility into that catalog, they can not only facilitate better patient-provider matching but also begin to marry provider “supply” with demand. Which providers or groups have long wait times? Conversely, which practices and network designs seem to correlate with shorter wait times? Are certain specialties and/or geographic areas underserved while others have excess capacity? 

    Ultimately, understanding care settings, provider capacity and expertise, and patient demand will enable health systems to determine whether they need to make adjustments to free up, add, or redistribute capacity. This approach might involve making a host of data-driven decisions, such as where to open or acquire practices, whether to start or expand retail clinic offerings, where to focus recruiting efforts, or how to utilize nurse practitioners more effectively. 

    Ultimately, the complete view of the provider network informs how health systems can optimize their overall network schedule density—a key indicator of systemness and an important driver of sustainability. 

    A Strong Foundation

    Systemness fosters the business resilience that health systems need to weather the rising pressure on their financial and operational performance. A sound systemness strategy positions these organizations to capitalize on their investments in patient access and harness their brand equity to enhance their resilience against both industry pressures and competitor moves. 

    A system that truly operates as a system can attract and capture more demand while retaining its existing patients/consumers in a way that drives long-term stability, supports patient care goals, and provides valuable space to drive innovation in an industry sorely in need of it.


    Graham Gardner, MD, MBA, is CEO, Kyruus

ADVERTISEMENTS