Bradley C. Leibovich, M.D., the medical director of the Center for Digital Health at Mayo Clinic, explains efforts to assure the unique in-person Mayo Clinic care experience is translated into the digital world.
In 2019, Mayo Clinic created the Center for Digital Health. Why? What has been achieved?
I’ll start with the fact that Mayo Clinic’s leadership recognized early that healthcare is increasingly driven by digital capabilities. The amount of data that is generated must be collected, curated, and analyzed to deliver high-quality health care is rapidly growing. Medical tests are getting more sophisticated; we are conducting more and more complex laboratory tests, data-intensive imaging studies, and genomic and other omics analyses are critical tools for modern medical practice. So the amount of data we need to harness is already massive now and will only become greater in the future.
The second major driver is changing consumer expectations. The simplicity known from ordering shaving cream on Amazon is also expected by consumers in other aspects of life. This implies the necessity to deliver health and well-being services in new, digitally enabled ways.
With that in mind, our leaders decided to enhance and accelerate Mayo Clinic’s capabilities by establishing the Center for Digital Health, allowing us to better coordinate digital development. We have created advanced analytics based on machine learning algorithms to turn data into actionable information easily.
For example, we have been able to use AI algorithms to find patterns in ECGs that predict disease before it is evident by other means or to determine the important regions on an imaging study, saving time and effort for our teams. Another example is the world’s best Patient Care and Health Information Library, available to the global population on the Mayo platform.
We are in the process of making significant improvements to all of our external digital properties, including mobile applications for patients, and improving the patient experience virtual health services, allowing us to broaden our reach and improve health equity. There are hundreds of ongoing projects with our current areas of focus being the expansion of virtual health, building patient-centered digital infrastructure, improving the ability of our teams to do their work with less effort while enhancing their ability to connect with and cure patients, and strengthening our analytical capabilities
Do you think all larger hospitals should have a department like that today?
I think most hospital systems already recognize the need for a digital infrastructure supporting healthcare. Those who have neglected this process are going to fall behind and will likely be disappointed in a few years.
One of the latest projects at the Center for Digital Health is the “digital front door.” What solutions exactly will the approach cover?
One of the problems with the digital front door is that everyone who uses the term imagines something different [laugh].
For me, this means that anyone around the world who is interested in health information, health and wellness services, or has a severe and complex medical problem should be able to find and understand the information that will help them and, when necessary, have care available digitally or in-person provided seamlessly with respect, compassion, and a personal touch.
If that digital front door is built correctly, the experience will not only be personalized but should be a frustration-free path to get the resources you need, whether know-how or advice, for subsequent stages of care.
In our case, that means providing patients with personalized content based on their needs, and that is their digital front door to Mayo Clinic.
The digital front door can also refer to other ways to interact with health care facilities, for example, an app that monitors patients’ vital signs and provides advice in a fully automated way or directs them to the appropriate point of care. The patient pathway becomes simple and transparent. A few clicks and you have an appointment, and your travel plans are set.
But to me, the digital front door is about far more than just the appointment process or explaining where the building is located – it’s really about taking care of all the needs of every consumer looking for information and assistance. When they open that digital door, the entire process from problem to solution becomes personalized, seamless, and frustration-free.
At least since the COVID-19 pandemic, many healthcare managers have faced the challenge of rethinking health delivery. What elements must be considered to ensure patient safety and the best quality of care when moving care from hospitals to homes?
The first rule is that if you can’t provide the same quality and safety at home as in the hospital, you simply don’t provide that care.
Much of the care provided in the hospital can be provided at home not only with the same quality and safety but also – and there is already evidence for this – with much greater patient, caregiver, and family satisfaction.
Patients who can be cared for at home enjoy the increased value of comfortable care in their home environment, together with their loved ones. Of course, this requires assuring the right conditions in the home to assure this. That is part of the process. There is another significant gain: Patients treated at home allow us to preserve the capacity to admit patients for in-hospital care to maximize that precious resource.
Care at home includes advanced tools to measure patient parameters, including vital signs provided by telemedicine devices and diagnostic results. In this approach, we need well-trained mobile caregivers who can administer more advanced medications, such as chemotherapy drugs, check how the patient is doing and react to emergencies. This process must be well-orchestrated and based on ongoing data monitoring, alerts, and the ability to mobilize local resources if needed.
Transferring care from the hospital to the home is a complicated process. But absolutely feasible thanks to the technology at our disposal. We just need to qualify patients for such a model very carefully.
Which healthcare shifts are most heavily influencing Mayo Clinic’s digitization strategy?
One of them is definitely data analytics and decision support for doctors so they can focus on the patient instead of the computer.
That includes developing relationships, understanding the patient’s needs, and smooth communication. If we do the digital transformation correctly, doctors and nurses will spend more time interacting with patients and less time interacting with technology because good innovations will allow them to do their job better. Data and analytic capabilities are going to be critical to allow our teams to predict and prevent disease or, when needed, cure disease even more reliably with even better outcomes.
Another challenge is changing consumer expectations for easy access to services. If we make it harder for people to access health care through inadequately designed processes, we’ll find they’ll go elsewhere to get help. So if we aim to provide the highest quality care at Mayo Clinic, our consumers will expect enhanced communication and high quality and easy access.
On top of that, you can’t forget about the large disparities in health care. Some communities have excellent health care and some have no access at all. This is often related to geography, socioeconomic status, and education. I believe that if we do the digital transformation correctly, it can help some of these disparities gradually disappear.
As a medical director for the Center for Digital Health, please share 2–3 key lessons you’ve learned in this role.
Building digital products and services is extremely difficult because they must be perfectly integrated with the existing system. For example, it requires asking “how do we ensure that solutions are not siloed.” So if we have a patient remotely monitored at home, are we getting complete information? How do we ensure that the transition between virtual and on-site care is seamless and integrated? That’s probably one of the hardest things to figure out.
Let me give you one more piece of advice: It’s teamwork! If we are to build e-registration, we need to work with those who sit behind the registration desk. What do they know about appointments at Mayo Clinic? What are the bottlenecks? What could be done better? What bothers them? What do patients complain about?
While building a telemedicine service, we have to ask doctors how to provide the most value from a video visit. What should we do to harmonize telehealth with seamless personal care? And how can we discharge people from the hospital faster and remotely monitor them after surgery?
We have built an amazing practice over many years and now we need to enhance and transform it by integrating digital services with the rest of the system while keeping things running smoothly and not disrupting everything we do so well already.
Could you please reveal your plans for the near future?
Some of the nearest initiatives will not be visible to the outside world. I’m talking about building a foundation for digitization, improving our data processing systems, and enhancing our analytical capabilities. One of the visible advances is our app that literally guides patients from visit to visit, coordinating care and helping them navigate the care system.
We also want to go beyond video visits, enhancing remote monitoring of the patient in the hospital and at home, to provide genuinely hybrid care much closer to what people get when they see a doctor in person. One of the things we hear from our patients is that they receive exceptional care full of empathy, compassion, and attention from the moment they go through Mayo Clinic’s door. Our doctors and other care providers take the time to understand the needs of their patients. This feeling of comfort is extremely difficult to translate into digital interaction. Nevertheless, we are doing our best to find a way to do it.
What would you advise managers who don’t know how to navigate a rapidly changing technological innovation ecosystem?
Start learning! There are many ways – like courses and conferences – to get information regarding digital transformation, artificial intelligence, data analysis, etc. Learn from others how to integrate digital solutions in healthcare delivery.
I also encourage people to look beyond healthcare. Many solutions from other industries can be integrated into the health sector or can at least inspire new ways to improve what we do in healthcare. Ask yourself how you can implement innovations from other industries to your advantage.
I don’t expect managers to become computer programmers. But they should gain the know-how to translate the needs of patients and staff into appropriate solutions that are implemented in the healthcare organization.
For example, I work incredibly closely with my partner Rita Khan, Chief Digital Officer at Mayo Clinic. She is not a doctor, but an expert in digitalization, data, analytics, and digital product mastermind who builds and manages the team to drive our digital transformation. My role is to explain the medical needs of the organization and the patients, so she knows how to translate this input into digital solutions. So every manager needs a close-knit team and collaboration across their organization.
Let me broaden the question then: How do you create a culture of innovation in a hospital?
You know, building a culture is extremely difficult. Thankfully, the Mayo Clinic culture was strong way before we began with this digital acceleration. There are innumerable sources explaining the importance of culture in large organizations. So I think, in practice, the better question for this topic is: how do you change the existing culture to implement the digital factor?
In healthcare, it’s pretty simple. If you just focus on what the patients’ needs and expectations are, while enabling our health care teams to work easier and better, then it will work.
On the other hand, if you work in healthcare and your culture is not digital, then your job is to explain that we need to become more digital because it will allow us to meet the needs of our patients and better maintain or restore their health. And then convince people that changing the culture to become more digital will make everyone’s job in the organization easier.
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