By Mike Miliard, Healthcare IT News | April 18, 2019
Hospitals and health systems are seeing their clinical and operational processes reshaped by the same forces as the rest of the economy, says Deloitte: AI and robotics, automation, virtualization, the ‘gig economy’ and more.
For its recent report on the future of work, Deloitte Center for Health Solutions checked in with more than 100 administrative C-suite and other operational leaders at health systems and health plans across the U.S. and asked how they’re preparing for the future.
With technology evolving at warp-speed, employee and consumer expectations shifting accordingly, generational shifts occurring across the workforce and new imperatives necessitating changes to longstanding ways of doing business, big changes are afoot, Deloitte found.
While the report was focused primarily on the business and administrative side of healthcare, its findings also echo similar changes happening on the clinical side – and indeed in the U.S. economy as a whole – such as major expansions of artificial intelligence capabilities, new growth in freelance and outsourced contractors and challenges posed by vast differences in experience and expectations for workers (and patients), ranging in age from Baby Boomers to Generation Z.
“The future of work involves reimagining the way work gets done to address generational changes, new technologies and talent models, and increasing consumer demands,” according to the report, and it “requires investing in emerging technologies that are just beginning to show their value.”
The report’s lead author, Jen Radin, principal at Deloitte and national leader for its Health Care Human Capital practice, spoke with Healthcare IT News recently about how hospitals can balance the “exponential” pace of technology’s evolution with the “linear” change that most healthcare organizations are used to.
Reconciling those two facts, she said, means that health systems need to be very proactive to position themselves for the future.
“As we think about technology increasing in capability and effectiveness, with more and more data to drive insights and foresight, and the ability to automate a lot of the work that is done, we really need to be able to prepare our workforces and workflow and operations,” said Radin.
In fact, “one can argue that the future is already here, it’s just evenly distributed,” she said. “Some organizations have already started to make a lot of these moves, while others are a little bit further behind the curve.”
As they grapple with these challenges, healthcare organizations need to be thinking in terms of three sides of the same triangle, according to Deloitte – what, who and where:
- What work can be done by (or with help from) AI, cognitive computing and robotic process automation?
- Who can do the work, whether contract workers, crowdsourcing or new employees with new skills?
- Where is the work done? Is it done onsite? Co-located? Virtual?
Whether those jobs are clinical, financial or operational, smart health systems are already looking at “new ways of working, across work, workforce and workplace,” said Radin.
The questions that need answering are not so much about technology itself as about the bigger picture: “How do we prepare leadership and different workforces for the changes that are coming?” she said. And that holds true, she explained, irrespective of department.
Revenue cycle management
Many healthcare organizations, “particularly in the areas of finance and revenue cycle, have already started to think about what other kinds of technologies they could be using, whether it’s RPA or other forms of artificial intelligence, to automate a number of the processes that we have in place today,” she said.
“Particularly in those areas of the business, technology is often more accurate – and it then allows the humans to be focused more on driving the insights that come out of what the technology is producing,” said Radin. “It also allows for more of a 24/7 business cycle, to accelerate processes. So even things like closing the books can be accelerated in significant ways. We’re seeing a lot of that.”
Human Resources
In HR, meanwhile, more and more healthcare organizations are making use of various workforce platforms for talent acquisition and even leadership development and succession, said Raidin. “This is not to say that AI is replacing all human decision-making in the talent space, of course, but there are certainly ways that we’re seeing today of accelerating things like resume review, or opening up and thinking about new types of sourcing for certain parts of hard to find talent.”
She added that, as health systems continue to prioritize diversity across their workforces, such AI-enabled technologies are opening up “a whole new way of thinking about inclusion and creating an inclusive environment.”
Nursing
In the next couple of years, more than 60 percent of nurses in the U.S. are going to reach nominal retirement age, Radin points out.
“These are clinicians who have tremendous experience and expertise,” she said. “And to lose them in the workforce, in many cases because the physical aspects of the work have maybe become too trying for them, or the hours are not the hours they’re willing to work during a shift or during a week, is really an awful reason to lose all that expertise.”
Many hospitals and health systems are looking to emerging tech to help with their retention strategies, to say, “‘How can we take a very experienced ICU senior nurse and allow him or her to use virtual health platforms to monitor across a number of ICUs?’ for instance,” she explained. “You increase access for patients, you increase the supervision of the nursing workforce and that allows a more senior group of folks to stay active as clinicians.”
Physicians and their EHRs
“Burnout is a significant issues for physicians and nurses and so we’re seeing a number of different technologies that are starting to be explored that either are helping a lot with clinical operations around intake and/or discharge, as well as scribing,” said Radin. Voice recognition technology is “certainly getting more efficient and effective in that space, and there’s no question in the next couple of years it probably will be really, really powerful – with clinicians just having to edit the note, perhaps, instead of spending the hours and hours they do today cleaning up or writing.
“But there’s another aspect to this,” she added, which is scribes who are also clinicians – but perhaps in different parts of the world, but who are participating virtually in a health encounter,” she said. “There’s another clinician who’s capturing the notes – a ‘live scribe,’ if you will. A number of healthcare systems are exploring that.”
Radiology and imaging
“Radiology is a really good example where the future is already here, to some degree,” said Radin. “One could see a model where more simple scans are being read by AI, and then reviewed by radiologists, or reviewed by the human physician. And then more complex ones, perhaps, are just flagged for review by the technology.”
Another trend is radiologists doing that work “from wherever they are,” she explained. “You could actually see where that kind of work might start to be thought of as ‘gig work,’ where you might be compensated or rewarded based on the output of your product. So it’s even moving beyond the freelancer or the contractor, and moving into this other type of workforce. Some folks may say that’s too crazy. But if you start to think about the technology, combined with the workforce doing this, combined with the location, I think that that is a really interesting example.”
Where to start?
Artificial intelligence “going to continue to get better and better,” said Radin, so health systems need to be thinking about not just how it should be deployed today, but in “three years, when the algorithms are really quite accurate. How are we preparing ourselves today, across clinical and non-clinical resources, to be the humans who are working side-by-side with the machines, so to speak, in order to produce the best clinical outcomes, enable the best patient and family experience and reduce clinician burnout?”
For those hospitals that might not yet be fully comfortable investing in clinical AI, “there are lots of different clinical-operational spaces to look at and to start to think about prototyping and rapid piloting,” she explained. “Length of stay is a really interesting one. I think ED-to-inpatient transitions is a really interesting one as well.”
One thing is for sure: These technology-enabled changes in work, workforce and workplace are “all around us and they’re happening,” said Radin. The question is “how we choose to change our strategies and prepare our workforces for what’s happening, in order to better serve patients and family and consumers. They’re important choices to make. But I do think it’s a time where organizations in this country really need to lean into this, and take ownership of it.”