How to Make IT the Underpinning
of the Enterprise Strategy
Session #146
February 22, 2017
John Ward, CIO
TriHealth
Bob Schwyn, Director
The Chartis Group
1
Speaker Introductions
John Ward, CIO
Bob Schwyn
Chief Information Officer
Director
TriHealth
The Chartis Group
2
Conflict of Interest
John Ward and Bob Schwyn:
Have no real or apparent conflicts of interest to report.
3
Agenda
A Case for Change: Making IT an Instrumental
Underpinning of the Enterprise Strategy
From Theory to Action – A Case Study
Lessons Learned and Key Considerations
4
Learning Objectives
• Describe how and why IT can and should become a leading component in
setting an organization's business strategy.
• Explain why the process matters and describe the specific steps to take.
• Describe IT's role and key steps the CIO can take in guiding and steering
strategy conversations.
• Use this case study example in one's own organization.
5
An Introduction of How Benefits Were
Realized for the Value of Health IT
Satisfaction: The experience and satisfaction of the patients, employees and physicians of the
provider organization were addressed to ensure a level of preeminent satisfaction in TriHealth’s
market arena
Treatment: Significant investment in EHR technology and the opportunity to build a high-performing
informatics capability drove improvements in care delivery outcomes and reduced clinical variation
Electronic Secure Data: TriHealth’s positioning for a best practice security structure and environment was
critical in developing the objectives of the plan
Patient Engagement: Recognized the importance of analytics, technology-enabled patient engagement
and EHR capabilities to support an aggressive movement into a value-based environment
Savings: Ensured a strong value proposition to offset increased investments in technology to
make certain the organization was making the right decisions at the right time, and at the lowest
cost
6
Agenda
A Case for Change: Making IT an Instrumental
Underpinning of the Enterprise Strategy
From Theory to Action – A Case Study
Lessons Learned and Key Considerations
7
Industry Point of View
The healthcare industry
is in the midst of a
multi-faceted shift that
is fundamentally changing
the context in which
providers deliver care.
Rise
of the
Consumer
The role of the provider is
being transformed and
will continue to evolve
over the next 10 years.
Strategic
Implications
Migration
to Value
Business strategy and
information and technology
strategy are increasingly
merging into one.
Technology
Advancements
8
Industry Point of View
Expanding Role of the Healthcare Provider
Care Needs
Access to Care
Wellness Care
Education
Intervention
Chronic Care
Informatics &
Technology
Driven
Acute Care
Informatics &
Technology
Enabled
Direct Care
9
Expanded
Provider Role:
Proactive, health
management
oriented delivery
of services and
information
Historic
Provider Role:
Reactive, illnessdriven delivery of
services
An Illustrative Roadmap: Understanding where are we and where are we
headed based on industry perspectives
By investing in new initiatives to transform care delivery, provider organizations can build upon its core
technologies to provide just-in-time, personalized care in any location.
What are the strategic functions
to the new business model?
Just-In-time
Personalized Care
Patient
Engagement
EHR
Touch
Points
Pop
Care
Clinical
Decision
Support
Telehealth
Efficient
Operations
Analytics
Circle
of Support
Strengthen core technologies
Transform care delivery
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* Roadmap reflects full scale production deployments
and — in many cases, pilots are underway pending
development of enterprise strategies
Real-time, personalized
care wherever the location
The Role of Health IT in Southwest OH
Provider 1
Undeveloped
Provider 2
Provider 3
Growing Competency
Foundational IT and Core
Clinical Technologies
Innovative Care Model
Technologies
Population Health
Capabilities
Consumer Engagement
Tools
IT Innovation
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Provider 4
Provider 5
Key Business Driver
Agenda
A Case for Change: Making IT an Instrumental
Underpinning of the Enterprise Strategy
From Theory to Action – A Case Study
Lessons Learned and Key Considerations
12
How We Did It
The Process is Important
System Strategic Plan
IS Strategic Plan
• Establish a shared understanding of the external
environment, emerging healthcare trends and consumer
dynamics, and TriHealth’s current strategic positioning.
• Assess the current state of TriHealth’s IS environment –
including external market trends, future IS scenarios, and
internal capabilities.
• Define a realistic set of future scenarios for the region over
the next 5-10 years – to identify and assess TriHealth’s
strategic options.
• Develop a long-range vision for IS that supports
TriHealth’s overarching strategic direction – including IS
mission, guiding principles, and priorities.
• Refine and clarify TriHealth’s strategic vision, priorities
and underlying business models to continue to advance
our strategic position and effectively serve our communities
in a rapidly-evolving healthcare landscape.
• Conduct a detailed review of IS organizational structure,
governance structure, and management structure.
• Develop a multi-year IS strategic roadmap with prioritized
initiatives to support the vision and identified investments,
capabilities and timelines for each initiative.
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Timeline
June
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Current State & Env. Assessment
Future Scenarios & Strategic Options
Engagement Phase
System Strategic Plan
Strategy Formulation & Plan Design
Major Activities
•
•
•
•
System Strategy
Steering Committee
Board of Trustees
Physician Strategy
Advisory Council
#1
Update
7/16
#3
#4
#1
x
x
x
x
x
Mar. Plan
Approval
Update
#2
x
#5
Nov. Bd
Retreat
Update
WG A/B
WG C/D
• TriHealth preferred “future state”
• Strategic vision, enterprise goals and initiatives
• Financial model
Key questions for strategy development
Future market scenarios and TH roles
Case studies
Options assessment and prioritization
#2
Work Groups
Interviews
•
•
•
•
Stakeholder interviews (combined)
Macro-trends assessment
Regional / competitive landscape
Internal SWOT analysis
#3
#4
#1
#2
#3
#4
#1
#2
#3
#4
Mid-July through Mid-August
IT Assessment
IS Strategic Plan
Engagement Phase
Support IT Scenarios & Provide Education
IT Strategy & Plan Development
Major Activities
IS Steering
Committee
Work Groups
• IT current state assessment, including
structure, governance, architecture,
vendors and processes
Initial ISSC
• Support enterprise work groups
• Education / workshops
ISSC #1
ISSC #2
WG E/F
•
•
•
•
ISSC #3
#1
IT vision, direction and principles
Optimal IT Governance
IT sourcing options and cost models
Staffing, timeline and implications
ISSC #4
#2
Mar
The Evolving Market
National Trends
Growing consumer role in managing health, healthcare services and
information
Growing commoditization of healthcare
Shift from defined benefit to defined contribution model – and increased
individual financial risk
Evolution from volume-based to value-based/risk-based reimbursement models
Payor-provider convergence
Downward reimbursement and utilization trend
Accelerating technological advances in diagnostics
and therapeutics
15
The Evolving Market
 Highly fragmented market
 Slow to move from volume-based
to value-based care
 Favorable overall business environment
 Competitive arms race
 Push the market increasingly toward value
16
Why Is
This
Important
Implications of the Evolving Market
Implications for TriHealth
Likely Market Evolution
Payor market consolidation and downward
reimbursement pressure
High historical rate increases will not continue
Shift towards value-based payments
Accelerating downward trend in hospital utilization, shift in
site of service towards lower-cost settings
Movement from a highly-fragmented to consolidated
provider landscape
Fewer remaining accretive opportunities outside of largescale system-to-system partnerships or mergers
Dramatic slowdown in physician consolidation activity
Future growth of physician network will be more
challenging
Growing demand for consumer and digital capabilities
Recognize IT is no longer just a business enabler but has
significant potential to accelerate business strategy and
differentiate services in the market
17
Key Areas of Focus
Enterprise
Strategic Plan
Network Strategy
Clinical Program
Differentiation
IS
Strategic Plan
Consumer
Engagement
Care Model
Innovation
IS Infrastructure
Population
Health and Payor
Strategy
IS Structure and
Governance
Telehealth
Value
Realization
18
Service Management
and Processes
Preparing for the Future
How Will Our Future Strategy Be Different Than the Past?
Strategy the Next
5 Years
The Future for IS
Population-based and cross-continuum care
• Insightful, prescriptive business intelligence
• Care collaboration tools
Risk-based payment environment
• Increased data volume and complexity
• More dynamic information sharing agreements
• Predictive analytics
Consumer-facing and patient-centric strategy
• Virtual care delivery via smartphones, Apple CareKit, Fitbits
• Robust security, performance
Market relevance = high-value, efficient, and
effective system of care
• Market relevance = quality of the Digital Health experience.
Healthcare services via online and mobile (i.e., Yelp, Uber)
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Integrated
System of Care
Securing Our
Strength in
the Current
Environment
ConsumerFocused
System
Population
Health
Management
TriHealth
Aligned &
Engaged
Physician
Community
Regional
Market
Strength
While Transforming to
Position For the Future
Innovation
High-Performing Patient-Centric Culture
Operational Excellence
Enabling IT Platform
20
Tactics
Services
Strategic
Initiatives
Vision
Aligning IS Services
Physicians, hospitals and communities working together to help you live better.
Integrated System
of Care
Regional Market
Strength
Aligned & Engaged
Physician Community
Population Health
Management
Innovation
Consumer-Focused
System
PMO
Services
Analytics/Data
Integration
Clinical Informatics
Clinical Solutions
Business/Finance
Solutions
Security
Infrastructure
Core Projects
Foundation Projects
Discretionary Projects
Directly support TriHealth’s strategic
initiatives and pillars
Required to maintain
existing IS service levels
All other projects not defined as
“Core” or “Foundation”
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Assessment Findings
What We've Done Well
Where the Opportunities Are
Value
Meaningful
Use
Project Management
Clinical Informatics
our IS strategic
imperatives for the last
Governance
Consumerism
22
Supporting the Strategy: The IS Work Group Charge
IS Roadmap
(Project and service definitions; timing, budget, FTEs, etc.)
Focus Area
Proposed Objective
Clinical
Informatics
Develop plan and build CI program framework, including required capabilities and resources, and clarify CI processes and
project prioritization.
Project
Management
Develop plan and build project and portfolio management framework, including required capabilities and resources, and
standardize IS project approach oriented around value achievement.
Service
Management
Develop and implement a plan to improve service delivery within IS with focus on Incident and Problem Management,
Continuity Management and Service Requests.
BI &
Analytics
Define approach to address gaps in enterprise analytics and information needs (e.g., full-patient view, cost-of-care
analytics, claims, etc.) in collaboration with BI functions across the organization.
Governance
Redesign
Revise guiding principles with orientation toward value realization and review and refine work group charters, roles, and
responsibilities to streamline IS governance.
Building a High-Performing IS Leadership Team
23
Focus on
Realizing Value
• Strengthen IS foundation
• IS project portfolio alignment with strategic
initiatives and pillars
• New IS projects now evaluated
by business value
• The continued focus on business value is
transitioned from project to operations
• Implementing robust IT Service Management program
1. Integrated
System of Care
2. Aligned &
Engaged
Physician
1.1 Operating model re-design 2.1 Development of a
– regional, care continuum
TriHealth system physician
structure
leadership council and
expanded large-scale
1.2 Ambulatory care
2.2 TriHealth Physician
partnership and alignment
Partners (TPP) structure,
strategy
governance and operating
model, with supporting
1.3 Create network of
2.3 Service line development
preferred post-acute care
strategy – including
partners
development of multispecialty care models and
1.4 Next-stage ambulatory
2.4. Use the TriHealth PHO to
development – deploying a
advance physician alignment
scalable multi-specialty
strategy with key remaining
ambulatory model (e.g.,
independent physician groups
1.5 Service excellence and
patient experience initiative
• Build culture of excellence and innovation
• Create a robust planning process
1.6 Retain and grow patients
within TriHealth's Integrated
Delivery System through
referral management
1.7 Develop comprehensive
foundation of behavioral
health services
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3. Regional
Market Strength
3.1 Streamlined referral
processes/transfer center to
our tertiary hospitals
4. Population
Health
Management
4.1 Set in motion a multi-year
payor contract transition
strategy from fee-for-service
to value-based reimbursement
3.2 Differentiated site-specific 4.2. Develop incentive based
tertiary programs (e.g.,
compensation design that
Perinatal Services at Good
meets current and future
Samaritan and Multispecialty practice needs and aligns with
3.3 Deploy primary care and 4.3. Develop and implement a
selected specialists at our
bridge strategy for population
community hospitals,
health data analytics and IT
ambulatory centers, and
capabilities until (and if)
3.4 Accelerate recruitment of 4.4. Organize all population
primary care physicians and
health management functions
hard-to-find, high-demand
into a re-designed Office of
specialists
Population Health
3.5 Enhance primary care
4.5. Align the Employee Health
capacity through care model Program directly with
and operations redesign
Corporate Health and
(including use of advance
population health programs
3.6 Evaluate partnerships with 4.6 Align the Employee Health
local health systems and
Program directly with
providers looking for
Corporate Health and
opportunities to expand or
population health programs
3.7 Gain access to new
4.7 Create and implement
markets through
direct-to-employer strategy
regional/statewide
targeted at regional employers
relationships (e.g., CHI,
3.8 Effectively utilize
4.8 Redefine local market
ambulatory surgery,
joint contracting strategy
procedural, and diagnostic
articulating the role of HSN
assets to provide accessible, and other potential system
3.9 Re-design specialist access 4.9 Continued evaluation of
to accelerate growth and
MHC relationship
retain specialty care within the
system
4.10 Develop Medicaid
strategy
5. Innovation
6. ConsumerFocused System
5.1 Develop the organizational
structure and operating model
for the TriHealth Innovation
Center
5.2 Elevate TriHealth’s
research and education
capabilities, including the
Hatton Research Institute,
5.3 Implement Director-Led
Action Councils to engage our
workforce to drive innovation
and improvement from the
5.4 Prioritize and implement a
select set of care model redesign initiatives for 20162017
5.5 Activate a system-wide
leadership development
program
6.1 Prioritize key consumer
segments and conduct
research to understand
motivations, needs and
6.2 Enhance consumers'
access to care, information
and education, tailored to
meet their unique health
6.3 Develop and adopt virtual
and on-demand care options
6.4 Provide transparent and
accurate cost, patient
satisfaction, and key
outcomes measures at the
6.5 Expand wellness and
preventative care resources
An Evolving Illustrative IS Roadmap: Guiding the Organization Towards the Critical
Technology Underpinnings of the Enterprise Strategy
By investing in new initiatives to transform care delivery, provider organizations can build upon its core
technologies to provide just-in-time, personalized care in any location.
EHR, Ancillary Applications
& Clinical Decision Support
 Standardized physician
documentation
 Enterprise imaging strategy
 Surescripts Med
Benefits coverage
Analytics
 Patient 360, Operational
360 & Member 360
 Pop Health 2.0
 Data Governance
 NLP predictive analytics
 Physician briefing book
 Standardized leadership
tools
Telehealth
 Video visits
 EICU
 Virtual consults/
care expansion
 eVisit expansion
 Mobility
 Rural telemedicine
plan
Patient Engagement
 Consumer
Efficient operations
engagement mobile
 Big data
development
 Clinical Informatics
 Patient portal IoT and
 Care model redesign
device integration
 Centralized contact
 Family billing
center
 Expanded care
 Clinical informatics
access
program
 Telemedicine
 Epic credit card billing
 Physician finder and
 Operational improvement
online scheduling
Foundational
Technology
Services
Enhanced Business Operating Model, Processes and Organization




Expanded interoperability

Data center plan

Enterprise master patient index (EMPI)

Voice and network infrastructure upgrades; contact center support 
and ACD

System refresh; zero client implementation
IT service management
Storage as a service
IT governance and prioritization
Cloud
Just-In-time
Personalized Care
 Predictive and
prescriptive
analytics
 Care model
redesigned
 Clinical trials
Agenda
A Case for Change: Making IT an Instrumental
Underpinning of the Enterprise Strategy
From Theory to Action – A Case Study
Lessons Learned and Key Considerations
26
Summary of
Benefits
 IT incorporated as part of the enterprise plan
 Increased CIO role recognition at the leadership level
 Executive recognition of importance of IT planning
 Set a precedent and integrated framework for
planning
 Enhanced education, innovation, industry
perspectives
 Increased level of IT maturity
27
Capability Maturity Progression
• A comprehensive IS roadmap that was well vetted and aligned to the enterprise
strategy
• A new clinical informatics structure with targeted objectives to improve care delivery
• Increased definition and measures for value achievement for each project
• An aligned analytics roadmap to support the evolving enterprise strategy
• Restructured the governance design to ensure the IS portfolio was focused on the
right things at the right time, achieving the desired value
• Restructured the IS leadership team positioned to support the future demands and
requirements of the organization
28
Capability Maturity
= Start of the planning process
= Today
SIGNIFICANT PROGRESS made in each area:
Focus Area
Low Maturity - Opportunity
High Maturity - Industry Leader
IS Roadmap
Clinical
Informatics
Project Management
Service Management
BI & Analytics
Governance
Redesign
Building a High
Performance
IS Team
29
A Summary of How Benefits Were
Realized for the Value of Health IT
Satisfaction: The experience and satisfaction of the patients, employees and physicians of the
provider organization were addressed to ensure a level of preeminent satisfaction in TriHealth’s
market arena
Treatment: Significant investment in EHR technology and the opportunity to build a high-performing
informatics capability drove improvements in care delivery outcomes and reduced clinical variation
Electronic Secure Data: TriHealth’s positioning for a best practice security structure and environment was
critical in developing the objectives of the plan
Patient Engagement: Recognized the importance of analytics, technology-enabled patient engagement
and EHR capabilities to support an aggressive movement into a value-based environment
Savings: Ensured a strong value proposition to offset increased investments in technology to
make certain the organization was making the right decisions at the right time, and at the lowest
cost
30
Questions
John Ward, CIO
TriHealth
[email protected]
www.trihealth.com
Bob Schwyn, Director
The Chartis Group
[email protected]
www.chartis.com
Thanks for your participation.
Please complete the online session evaluation.
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