How health systems are working with startups, navigating 'pilotitis'

Sara Vaezy, chief digital strategy officer at Providence St. Joseph Health, talks to MobiHealthNews about the changing digital landscape and ways to enable positive partnerships.
By Laura Lovett
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Photo credit: Jason Kirk, Getty Images 

Increasingly, patients are looking for more digital tools and ease from their healthcare providers. Health systems are under pressure to keep up with the growing demands of patients and the needs of their system. 

At Providence St. Joseph Health in California, the digital team continues to prioritize tech when tackling the system's healthcare problems. Sara Vaezy, chief digital strategy officer for Providence St. Joseph Health, checked in with MobiHealthNews to talk about the changing landscape of digital health, patients' priorities and working with startups. 

“We are trying to get our patients and customers online with us and get them digitally enabled,” she said. “The second [goal] is to engage with them ... on an ongoing basis through digital.”

A number of trends in health are changing the way patients interact with the healthcare system. 

“With the increasing [popularity] of high-deductible health plans and more information out there … [we are seeing] Google shift the demand and drive consumers to specific services that are relevant to them,” she said. 

The team at Providence St. Joseph Health is addressing this growing pressure from the consumers with a multichannel approach, allowing patients to interact with the system through their preferred channel — whether that is a search tool, online visit or booking tool, she said. 

Patients are also seeking out price transparency in the future.

“Of course, over time we will not only be able to self-book and engage in specific services with health systems, but we will also know what we are paying for in advance and how much. Healthcare is one of the only industries where you buy a service without knowing the cost. That will increasingly change, in particular with services that are commodity services that are truly shoppable.”

She noted that patients may not be using a price transparency tool for emergency services or a liver transplant. 

“We are increasingly moving in that direction to give people the choice and the information, including the price and cost to them, so they will know what they have been on the hook for,” she said. 

While on the federal level there has been calls for healthcare organizations to provide cost transparency, that can be complicated for an individual consumer who may see a different bill due to insurance adjustments and other factors. 

“A lot of the price transparency work that has been done to date has been focused on showing folks list price to the actual out of pocket for them. So, we don’t have enough data to know when you show patients their actual out of pocket, how will that influence behavior,” she said. “We do believe it is the right thing to do to give patients the right information that they need to make the right choice for them.”

With consumers and health plans more on board with digital tools, provider organizations continue to look to tech to solve problems. Vaezy said that her department often works with the startup world to implement these tools. 

“We think the startup ecosystem and the entire market and third-party system around companies that are out there are extremely important to innovation,” she said. 

The digital team starts with a discussion of their major priorities that technology has the potential to solve. Then, they look and see if there are any digital tools already in play at the health system that could work. If not, they turn to the startup or third-party world 

“If we don’t find something then we look out into the market and engage with startups, engage with other technology companies that may be addressing it,” she said. “If we found something, then we will bring it into our ecosystem and test it out.”

The pilot process at Providence St. Joseph’s is set up with defined metrics and a clear problem that the technology is targeting, according to Vaezy. Recently there has been discussions over bloated or unnecessary pilots ("pilotitis," as many call it).   

“I think pilots unto themselves aren’t bad things,” she said. “We have to be able to test technology and make sure it works in our environment, and works with our patient populations, and does the thing it says it is going to do — ultimately, that these things work. Doing an experiment and a pilot is the right thing to do.”

The issue with pilots is that there is often not a defined next step once the pilot is finished, or there are no specific metrics that the pilot is judged on, she said. Having goals from the onset is key, she said. 

“If our pilots are successful we can scale those enterprise wide where appropriate,” she said. “If they are not successful or we didn’t find something in the market, that is when we will evaluate the possibility of building ourselves.”

Creating in-house digital tools has its pros and cons, often requiring a lot of resources. 

“If we build we then have a commercialization strategy around incubation and innovation efforts, meaning that we will then sell whatever we built to other health systems so they can deploy it across their patient populations and we can start the adoption of it that way,” she said. “We also create companies around anything we develop. That is why it is important to make sure that the market is sufficient, because development and actual innovation and incubation takes a lot of time and [is] resource intensive, and we want to make sure that it supports the effort.”

However, creating an in-house tool helps to side step some of the challenges startups often face.  

“I think startups have a tough job. They are on the outside and they are trying to solve what they think are major health systems problems that can be addressed through health technologies,” she said. 

Companies that are incubated in the system, on the other hand, are able to get a closer look at what a provider’s daily problems look like. 

“Xealth was a company we incubated and because they had access to our technology ecosystem and our clinicians and our care team, they were able to design Xealth with our end user in mind; around the provider’s clinical work flow and how they operated with the EHR. And they built a technology that physicians really wanted to use because they did it with the clinician’s workflow.”

Vaezy said that at Providence St. Joseph Health, the digital team is seeking to create more transparency for startups to work with them in the future. 

“What we’ve tried to do at Providence is say ‘Hey we have this rigorous process we are going to start publishing our priorities.’ So that we expose some of this information that they need to engage with us more readily and create an ecosystem.”