Digital Transformation in Healthcare: Dr Scott Wolf On How Medical Practices Can Use Digital Transformation To Provide Better Care

An Interview With David McNeil

Care should be TIMELY, with access to the most updated information, so that decisions can be made effectively.

As part of our series about “Medical Practices Can Use Digital Transformation to Provide Better Care,” I had the pleasure of interviewing Dr. Scott Wolf.

Dr. Scott Wolf is a highly-accomplished physician executive with extensive achievements in leading strategic growth and transformational change in healthcare service delivery initiatives, hospital operations, quality and patient safety, and community engagement. Drawing on over 25 years of experience in various leadership roles in hospitals and Fortune 100 pharmaceutical and insurance companies, he provides clinical and strategic guidance in developing contemporary models of care that allow organizations to thrive in the current environment. Dr. Wolf is also a certified executive coach working with clients on their journey to healthcare leadership.

Thank you so much for your time! I know that you are a very busy person. Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a story about what brought you to this specific career path?

The pleasure is all mine and I thank you for the opportunity to share this time with you. For as long as I can remember, I wanted to become a physician. I can honestly say that one of my favorite presents I received as a young child was the game of Operation. It was an electrified game that consisted of an “operating table” and a comical figure as the patient. The objective was to remove the various plastic body parts without touching the metal outline. If you failed the task, his big red nose would light up and it would buzz loudly alerting you to your failed attempt to save his life! That is where I can honestly say my medical career began.

Fast forward many years, I have had the extraordinary honor and privilege of caring for patients and their families during times of great exuberance and deep sorrow. The entire spectrum has been extraordinarily humbling. I am fortunate, indeed, to serve patients directly, as well as through leadership roles in big pharma, managed care, and hospital system operations. It’s been an incredible journey.

Can you share the most interesting or most exciting story that has happened to you since you began at your company?

I currently serve as a physician executive with Berkeley Research Group (BRG), a global consulting firm that helps leading organizations across multiple sectors of the industry. Specifically, I work in the Healthcare Performance Improvement practice where we help healthcare providers identify and implement measurable and sustainable financial, clinical, and operational performance improvements. The overarching goal to optimize service delivery to enhance patient and provider outcomes.

The most exciting aspects of my role at BRG is the opportunity to partner with exceptional healthcare leaders in helping transform delivery of care to achieve the quadruple aim to:

• enhance the experience of our patients,
• improve the health and wellbeing of the population,
• control skyrocketing costs, and.
• enhance the experience of our providers of care.

With that, I’d like to express my heartfelt thanks and gratitude to all of our healthcare providers for their unwavering dedication to the patients and communities they serve, not only during the COVID pandemic, but each and every day of their service. They are truly heroes!!

You are a successful leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

I have had the good fortune of working with some exceptional leaders, many of whom have served as true mentors. Of course, my finest mentor was my father whose character I have tried to emulate in everything I do.

First and foremost is my sense of team. I have always strived to surround myself with people who bring a diversity of experience and knowledge, whose skills complement others on the team such that the whole becomes greater than the sum of its parts.

One of my favorite leadership books is “Team of Teams” by General Stanley McChrystal, Commander of the Joint Special Ops Task Force. I firmly believe in the premise that Teams are based on trust, where people come together around a common purpose and shared mission. In all of the organizations of which I have been a part, I would lead off each and every meeting with a review of the mission, vision, and values of the organization, and ask one member to describe how they resonate and connect them to their “Y” (more on that later).

The second character trait I hold to is one of servant leadership. Two of my most impactful mentors were consummate servant leaders whose example I follow every day. They are Scott Kashman (Market President & CEO, St. Dominic Health Services & St. Dominic Hospital) and Dan Moen (President and CEO at St. Francis Medical Center at Trinity Health). Both are ambassadors of leadership and epitomize what a servant leader is in serving others, not only to help produce quality results for the organization, but to support the professional growth and development of their team. Both Scott and Dan embrace their communities and ensure that the doors of their respective organizations are open to all. Valuing people, remaining humble, and respectfully caring for and serving the community is what I aspire to be each and every day and hold these values sacred.

Lastly, I try to be authentic and humanistic, always careful to not let the elements of any situation change how I show up. It starts with holding myself accountable, looking at myself in the mirror and asking what role did I play and what can I do to have an impact on an individual or situation. Another great book on leadership is “Accountability Now” by Mark Sasscer. I read it at least once a year as his ten (10) principals of leadership are foundational to who I am as a leader.

What are some of the most interesting or exciting projects you are working on now? How do you think that might help people?

As I stated earlier in our discussion, some of my most exciting current projects involve working with organizations to achieve the quadruple aim. To me, this involves the cultivation of optimal healing environments where system integration and coordination of services across communities serves to boost operational efficiency. It includes optimizing flow and throughput from end to end along the entire continuum of care, providing the ability to support the seamless transitions of patients to the most appropriate level of care (home, home with home care or post-acute facilities), enhancing patient access, and thus reducing unnecessary and burdensome variation in service delivery. The objective is to provide both exceptional patient and provider experiences, while enhancing clinical, quality and financial outcomes. Improving the health and wellbeing of the communities we serve is the ultimate goal.

Thank you for all that. Let’s now shift to the main focus of our interview about Digital Transformation in Healthcare. I am particularly passionate about this topic because my work focuses on how practices can streamline processes to better serve their patients. For the benefit of our readers, can you help explain what exactly Digital Transformation means? On a practical level what does it look like for a medical practice to engage in a digital transformation?

Digital Transformation is one aspect of the transformational change that can have a profound impact on our medical practices. Digital transformation has been defined as the adoption of technologies to improve workflow efficiency and patient care.

What this looks like in a practical sense for medical practices today is empowering employees to work at the top of their license and leverage their skills to positively impact their team and patients. It means engaging patients via various digital platforms to meet them where they are in a timely and efficient manner. It also affords practices the opportunity to enhance communication with their patients, families and colleagues through better coordination and integration.

What are the specific pain points that digital transformation can help address in a medical practice?

There are several pain points in a medical practice that I believe digital transformation can help address. Front end operations involving access, scheduling and communication is certainly one of them. Today’s patients expect to have a seamless interaction with the healthcare system and, in the current state, this is far from what they experience. As one example, patients are often met with an impersonal, complex and inefficient telephonic system when they attempt to execute a simple task.

Digital technology can enhance front end operations such as scheduling appointments, determining eligibility, and completing the myriad of forms that are required (we all know the experience of arriving at the office and being handed the infamous clipboard and a pen with instructions to “fill out a few forms”.) All of these front-end operations can help avoid issues on the back end such as denials, which are quite distressing to patients and providers alike. Such technology can help guide patients seamlessly and painlessly through a complex system.

What are the obstacles that prevent a medical practice from engaging in a digital transformation?

Technology has certainly enabled the healthcare industry to advance at a frenetic pace in recent years. Examples of such advances can be found in biologics, gene therapy, robotic solutions in surgery, just to name a few. Despite investing billions of dollars in tech enabled platforms, there are still several factors that prevent the full embrace of digital transformation Medicine. As an industry steeped in tradition, we still rely on legacy systems and conservative approaches to healthcare delivery.

To fully adopt digital technologies requires a cultural transformation amongst those providing care. There is also a gap in the skills and expertise that hampers this transformation. Forward-looking leaders in this space, who possess the requisite skills, temperament and determination, need to emerge to guide us on this journey. We also need to be willing to adopt new business models of service delivery. We need to take notice of other industries and how they are providing traditional services in non-traditional ways.

For example, Uber is the largest provider of transportation service, however, they don’t own the vehicles that serve the public. Airbnb is one of the largest providers of hospitality services, yet they don’t own a single hotel. In like manner, healthcare needs to embrace new models of care delivery in order to continue to deliver on the quadruple aim.

Managing a healthcare facility is more challenging than it has ever been. Based on your experience or research, can you please share with our readers a few examples of how digital transformation can help a medical practice to provide better care? If you can, please share a story or example for each.

In my opinion, these technologies need to be built upon a foundation of comprehensive electronic connectivity and data sharing across the continuum of care. A system of electronic connectivity should include evidence-based medicine and clinical algorithms to help providers use the data to further improve care delivery. The objective is to transform action-oriented clinical insights in to best practices that are based on accurate attribution and peer-reviewed outcomes provided in a seamless, non-intrusive format. The ability to reference patient preference and clinically sound data allows for easier review, more effective collaboration, and new opportunities to create innovative treatment paradigms supporting individualized care.

Utilizing this infrastructure, communication is made more seamless, redundancy is eliminated, care innovations are made available, and learnings derived from such efforts become embedded in the system. This infrastructure supports a data-driven system grounded in evidence based medicine, longitudinal care management and case coordination support that demonstrably improves health and quality of life. It facilitates learning, innovation, and research via continuous analysis of process and outcomes data that results in continuous improvement of care. One such example is Agathos, a tech-enabled platform that delivers clinical logic messaging to providers regarding best practice.

Another application of digital transformation is in the realm of care coordination system integration. Our present-day health care system is a complex maze of options and requirements that takes many hours of manual research and coordination to navigate. A revised process of discharge planning and coordination of care, two of the most vital services within the healthcare community, can significantly improve the navigational challenges many patients and their families face. Proper resource allocation and integration of the discharge planning tasks are critical to ensure the most appropriate and efficient treatment and/or placement of the patient.

To enable this access, review and navigational support is situated in what is referred to as Patient Navigation Assistance Centers. Many of these exist in the current market as central command centers and have various degrees of functionality. They can exist as a freestanding call center staffed by benefit coordinators, information technologists, and care managers. Through tech-enabled platforms, patients have access to all of the acute care facilities, which are then coordinated with post-acute services in the surrounding community. These centers can also serve as the virtual front door for patients allowing access to appropriate resources such as primary care centers, sub-acute facilities, long term care, community health centers, home care and hospice entities. As such, this helps to remove any barriers to disposition, such as eligibility requirements, all in a one stop shop destination. The benefits of such an infrastructure are:

• Decreased administrative waste and unnecessary variation and redundancy of service delivery.
• Coordinated patient disposition leveraging a comprehensive health record and optimized case management/discharge planning resources of affiliated providers.
• Consistency of care and reduction of errors through access and benchmarking of evidence based clinical guidelines.
• Provide an accurate census of medically fragile individuals at all levels of the healthcare system that allows for faster and more effective coordination of services.
• Maintain a registry of risk assessed patients allowing for more efficient allocation of care management resources to facilitate and support a model of chronic care management.
• In the aftermath of the pandemic, the system could also enhance its auto reporting of bio-surveillance and outbreak detection to local, state and federal agencies. This would aid in more quickly recognizing communicable disease outbreaks, and disease clusters.

Can you share a few examples of how digital interactions or digital intake processes can help create a frictionless patient experience and increase access for patients?

There are several examples of how digital interactions can help create a frictionless patient experience and increase access for patients.

Automation, which has grown in industries worldwide, is now banging on the front door of the healthcare industry. Historically in health care, it was felt that every interaction with a patient needed to involve a human being…the human-to-human connection was how “brand was built”. Don’t get me wrong, that is still paramount in the provider-patient relationship that underpins the very profession we are privileged to serve. We have to embrace technology in such a way that it allows us to garner some of that personal touch back!

Unfortunately, with the consolidation of administrative functions, what was once highly personal relationships between a patient and a doctor or his/her staff have all too often become a depersonalized call center experience. A real-life example of this is what my dear friend and colleague, Dr. Adam Silverman, Chief Medical Officer for Syllable (a cutting-edge healthcare technology company) is doing to tackle this very issue.

By leveraging automation in the form of AI (Artificial Intelligence) and Natural Language Understanding (NLU), their tech-enabled platform can automate several front door processes such as connecting the patient to right point of service and scheduling appointments. These technologies provide better issue resolution and a more efficient and seamless patient experience. By understanding why patients are calling and how they are using a purpose-built AI, Syllable is able to answer 100% of incoming phone calls 24/7/365, automate over 50% of incoming calls, reduce abandonment rates and give the practice staff more time for that personal touch.

Here is another example of how tech enabled digital solutions can help patient experience and enhance communications, and have profound impacts on practice experience as well as financial performance. Following enactment of the Affordable Care Act of 2010, the Centers for Medicare & Medicaid Services constructed the Hospital Value Based Purchasing Program, creating for the first time a net neutral program that either rewards or withholds Medicare revenue from facilities on the basis of various measures. Embedded within that program are specific benchmarks to rate the patient experience. Now over a decade in performance, hospitals have either gained or lost millions of dollars in rewards or penalties based on patient experience.

For example, to empower healthcare facilities, my friend and colleague, Kevin Makati, M.D., created Fast Pathway Inc., a patented software tool to help improve the patient experience in both outpatient and inpatient sectors. Their communication tool helps facilities prioritize patient centered care by elevating the overall experience of healthcare delivery. This is done through secure messaging, which allows for enhanced communication between patients, family members and their providers of care. Fast Pathway’s solution represents a growing trend within the tech sector to help healthcare facilities prioritize the patient experience.

Based on your opinion and experience, what are your “5 Things You Need To Create A Highly Effective Medical Practice” and why.

The focus of our discussion today has been on how digital transformation can help spur our healthcare delivery system to deliver better care. The medical practice can serve as a foundational establishment, a “medical home,” to support our patients along their journey to health and wellness along the entire continuum.

To be successful in this role, the tenants set out by the Institute of Medicine (which outlines the six aims for our healthcare system, STEEEP) must be followed. I believe incorporating these foundational principles into your medical practice will create an effective and successful practice for all stakeholders, all of which can be enhanced by digital technology.

• The delivery of care should be SAFE and avoid harm. Apropos of our discussion on clinical logic and the use of AI and wearables, we can take steps to ensure that our clinical decision making is based on the most up to date evidence informing care for our patients.
• Care should be TIMELY, with access to the most updated information, so that decisions can be made effectively.
• Care should be EFFECTIVE. We have discussed how predictive analytics can identify those most in need of services and resources.
• Care should be EFFICIENT. This is achieved by reducing unnecessary variation and redundancy in care and services, and allowing everyone to practice at the top of their license.
• Care should be EQUITABLE. Removing the barriers to care (the social determinants of health) improves access, especially for our most vulnerable patients, such that everyone, regardless of race, gender, and geography, can be afforded the highest quality care and experience. Ensuring diversity, equity and inclusion should serve as the foundational principles of every practice.
• Care should be PATIENT-CENTERED. Affording patients the best opportunity to engage in their care through enhanced communication with the entire care team is critical.

Because of your role, you are a person of significant influence. If you could inspire a movement that would bring the most amount of good to the most people, what would that be? You never know what your ideas can trigger.

If I could inspire a movement that would bring the most good to the most people, it would be a sincere effort at true health system integration.

The devastation wrought by the COVID-19 pandemic revealed the need for enhanced health care system operations, thereby providing an ideal opportunity to begin anew. Taking the lessons of COVID, we can move beyond the legacy system of yesterday and, in its place, create a freshly transformed health system based on new principles and new services. This would benefit everyone who touches the health care experience, ranging from patients to providers, payers, employers, and community agencies.

The healthcare community can serve as the model for a vibrant, patient centered, and efficient operations if the process of transformation is guided by thoughtful leadership, courageous innovation and a long term strategic vision. Then and only then will the obstacles that have slowed transformation of our healthcare environment be overcome.

The COVID-19 pandemic also put a spotlight on the problems inherent in our healthcare system both locally and nationwide. Members of the health care community continue to wrestle with the rising costs of care, the increasing prevalence of chronic disease, the administrative waste in the system, significant and unaddressed variations in care delivery, and the increasing dissatisfaction with care.

New ideas continue to emerge in various healthcare systems and offer an array of best practices and lessons learned. If brought together into a package of services, integrating the medical, technical and systematic practices of today while embracing the expansive innovations of tomorrow, these challenges can be boldly addressed with visionary leadership and commitment.

Final Thoughts

The topics discussed in this forum could serve as a platform for how we become a nimbler, more agile and visionary health care system as we emerge from this pandemic. Healthcare system that allow for better coordination of care and services, improved incorporation of new information, enhanced measurements around interventions, and promotion of wellness and health for patients and their families in the community will become the leaders in our industry. Such systems will allow for more efficient and effective provision of services that have been difficult to provide in the current state of healthcare. In addition, the ability to use health outcomes data to inspire strategy will ensure better individualized care and enhanced operations. The same is true in reigning in cost, as financial decisions will be more informed if guided by data rather than assumptions undergirding legacy patterns of practice. In a very real sense, the silver lining of COVID is its spur to create a more effective and efficient model of care. If we take the challenge, we will become a global leader in health and wellness, thereby meeting the goal of the quadruple aim; better outcomes, reduced cost, improved patient and provider experience.

How can our readers further follow your work online?

Thank you for asking. Readers can connect with me on LinkedIn (https://www.linkedin.com/in/scottwolfdo/), visit my website (https://www.drscottwolf.com/) or email me at scott@drscottwolf.com.

Thank you so much for sharing these important insights. We wish you continued success and good health!

About The Interviewer: David McNeil is the President of PatientPop, a Tebra company, a market leader in practice growth technology. McNeil is highly committed to helping the company build a modern go-to-market organization that delivers great value to practices in a time of rapid change in healthcare. McNeil’s business insights have been featured in publications such as Medical Economics and Los Angeles Business Journal.