You learn a lot by watching.
Nectar’s Director of Client Services, Teresa DeLappe, did a lot of observing and learning during the 15 years she spent working across the healthcare continuum at Harborview Medical Center (HMC) in Seattle, Washington. She was fascinated by the growing technology dependence of healthcare organizations yet at the same time, observant to the gaps and impacts faced by Information Services (IS) during technology deployments. She noticed the challenges they faced in obtaining “buy in” from providers, care teams, and business operations and became convinced a fundamental failure to understand the intricacies of the workflows, engage and partner with workflow owners, and define the benefits of the technology in the voice of the customers, was at the heart of the problem. With those considerations in mind, she crafted an implementation approach she defined and trademarked, Beyond the Technology Management.
“Beyond the Technology Management™ (BTM) encompasses a philosophy that recognizes that while technology is often the catalyst for change, it is only one of the many tools and influences built into the human aspect of delivering healthcare. “To be successful in achieving full adoption and interoperability of technology into workflows, you must first recognize the relationship between the technology and the human factor,” says DeLappe. “With that knowledge, we can build a deployment strategy that optimizes the deployment, adoption and optimization of innovative technologies within the clinical workflow.”
Trained as a Registered Dietician, DeLappe speaks the language of care teams and has an appreciation for the workflow nuances within the delivery of care. Her subsequent years in hospital leadership and as the Directory of Process Improvement while at HMC were crucial building blocks as she transitioned into healthcare consulting.
“Within healthcare, we must recognize that no matter how fabulous the technology, if the care teams perceive the technology as a “tripping hazard” within their workflows, they will create workarounds, impeding full adoption. Those detours are costly and render the perception that the technology is obtrusive or broken,” says DeLappe. There are six principles for integrating technology into the model of care and they are the foundation for facilitating the engagement, assessment, and evaluation of current state workflows in preparation for future state technology, supporting interoperability of all elements of healthcare, prioritizing clinical workflow and health outcomes for patients.
A technology column on the Healthcare Financial Management Association website entitled, illustrates the BTM strategy in light of digital front door technologies that maximize patient engagement while creating financial value for the hospital from the moment a patient engages with the health system’s website or online portal. The authors conclude that there is often confusion between Digital and IT. “IT is about enabling technology systems, and digital is about making the experience of using those technologies more human and meaningful to each end user.”
DeLappe agrees the user experience must be carefully understood and defined before a technology is adopted. IT, clinical, and operations personnel must be engaged and see value in having shared ownership of the deployment journey from end to end. Full integration and adoption of the technology into the workflow will include proactively redesigning them in partnership with their owners and where possible, tweaking the technology to accommodate the delivery of care and create a collaborative partnership between IT and clinicians for continued optimization.
As we have all witnessed, COVID-19 has catapulted an explosion of Digital and Telehealth solutions. As Teresa points out, Telehealth is not necessarily new to healthcare, but its journey to being widely adopted has been a slow one. “Prior to the global pandemic, the approach and framework around Telehealth felt focused on the nuances of the technology and less about the nuances within the healthcare delivery system. It was a bit like trying to fit a square peg into a round hole. The technology was there, but the inner workings to care delivery models, scheduling templates and reimbursements weren’t aligned.” As a result she says, the workflows for providers associated with telehealth tended to be fractured and forced into a model that was designed for in-person, not remote care.
COVID changed that landscape and made the need for Telehealth a necessity, no longer a nice-to-have. “Healthcare providers are good at pivoting, adapting and making things happen when faced with a crisis. Telehealth was the tool that facilitated their ability to quickly respond to the COVID crisis but the true measure of the long-term success of Telehealth will be the industry’s ability to design the internal workflows, reimbursement models and resources necessary to not only facilitate the technology, but take into consideration the integration and adoption into new and/or redesigned workflows. Even before the pandemic, provider burnout was a crucial reality of the pressures and demands of an industry that increasingly added layers of documentation and technology into already complex workflows. As we navigate out of a pandemic and embrace the advances we’ve made, let’s just make sure that the technology decisions we make are done with consideration to the Human Factor.”
As she’s done for almost two decades, Teresa DeLappe will be watching. And learning. And making sure whatever technology is put in place is done in a manner that makes those delivering care feel “done with… and not done to.”