The Power of Collaborating in Digital Health

Soon after the inception of the Arch Collaborative, KLAS created a new role to better serve the provider organizations that are part of the Collaborative and contribute to our software, service and payer research. The position is essentially an account manager to help guide provider organizations through participation in the Collaborative as well as provide strategic resources for an organizations healthcare IT needs. KLAS deliberately gave the role a more distinctive name: Provider Success Manager. Why? Because KLAS is about helping provider organizations reach success with their healthcare IT investments.

KLAS has always tried to help our provider friends. In fact, the first of KLAS’ Ten Commandments is, “Everything we must do must benefit the provider.” However, one reason I got so excited when I heard about the Arch Collaborative was that I knew it would allow KLAS to provide feedback and insights from a large number of the organizations end users, who are using the system often, while also having data from a global benchmark to compare their results against. This has led to actionable learnings the Provider Organizations leadership can use to improve the clinicians experience immediately.

Over the years, KLAS has seen vendors make great strides through the “Measure, Collaborate, Improve” cycle. After considering numeric data and commentary about providers’ experiences with their HIT tools, many vendors have worked with their internal teams and their customers to improve their software and delivery. But what about providers? We wanted them to benefit from the same cycle. That’s why we started the Arch Collaborative and hosted the Arch Collaborative Summit in May: to get provider organizations started on the road to measuring, collaborating, and improving.

Measure

After doing several usability studies and thousands of conversations with provider organizations KLAS realized that less than 7% of organizations are formally measuring their end users’ satisfaction with the EMR. Why aren’t more organizations seeking this feedback? For one thing, most of them probably didn’t know of a way to benchmark themselves against other organizations. Perhaps some organizations felt that they were too busy to even investigate the idea.

Some provider organizations leaders may even have been afraid of what a satisfaction survey would uncover. After all, the EMR hasn’t received much good press over the past decade. And, as Michelle Lauria mentioned in her opening keynote at the Collaborative Summit, organizations and people are accustomed to promoting their successes and uncomfortable with discussing failures.  Michelle pointed out the following, the best of bad ideas are very well intentioned, the failure to discuss leads to a failure to learn and the failure to share leads to repetition. I am I’m grateful that Michelle Lauria kicked off the Summit by encouraging attendees to openly acknowledge and discuss their failures with each other, I think it helped everybody loosen up and be open to learn.

No organization can find lasting success unless we first recognize our current successes and failures. That’s why KLAS created a benchmarking survey for members of the Arch Collaborative.  There is a lot of power in having a benchmark to measure yourself against.

In a previous life I worked at a company that was interested in the customers experience with the products and services. I was tasked with a team to come up with a good way to measure our customers experience with our company.

We settled on using NPS or the Net Promoter Score. Our company had a score of 30, as we tried to explain to the company what that meant we ran into one problem, we had no idea if it was a good score or a bad score for our industry. If you compare against one of the top sectors, such as smartphones, 30 is a terrible score. However, if you compare against one of the lowest industries like internet service providers, 30 would put you ahead of the pack.

Having a context of where we compare makes a difference. One of the key insights we learned can be summed up as, “it’s important to measure your score against other companies in your industry, it's also important to measure your own score over time -- to see if it's improving, worsening, or remaining the same.”

Collaborate

The magic of finding your own failures is that it fosters the desire to improve. The magic of seeing others’ successes is that it fosters a desire to collaborate. Many participants in the Arch Collaborative proved this by asking KLAS immediately after receiving their survey results, “When can we talk with the organizations who outperform us?”

Eager to make that happen, KLAS organized the Arch Collaborative Summit. Once there, my KLAS colleagues and I were happy to see the enthusiasm and engagement between organization to engage in learning each other’s best practices that are backed by actual data. One of my coworker’s provider contacts said , “We never do this. I’ve never gathered with providers from outside organizations to share best practices, coach each other, or strategize about how to use the EMR.”

It was great to watch  organization find value in spending a day together to focus on EMR satisfaction improvement and collaboration. I felt great excitement in the learning sessions from the group. I listened to energetic dialogues between presenters and attendees. I smiled as I talked with organizations  who told me about things they had learned from their peers in even casual conversations. The Summit was the perfect beginning, for what I hope will be many collaborative relationships.

Improve

We have yet to see all of the changes and improvements resulting from the measurement and collaboration of the Arch Collaborative, but the Summit was absolutely saturated in the desire for positive change. I even heard about one example of how a health system plans to improve based on conversations they had at the Summit.

A leader from the health system spoke at length with someone from a children’s hospital. The leader mentioned that his health system had recently bought several new facilities and had been planning to replace the EMRs in those facilities with the EMR used throughout their health system. But after the conversations this leader had had at the Summit, he’d decided that his health system wouldn’t make the EMR replacement a simple extension of their EMR; they would use the implementation as an opportunity to fix the mistakes they had made when implementing their main EMR in the past. The representative from the children’s hospital loved this idea of how to approach the EMR replacement. The two organizations plan to connect after the Summit to exchange even more ideas.

At the beginning of the summit we were presented with a question that is asked of end users when they take the survey, “Does your EMR enable you to deliver high quality care?” The corresponding slide was disheartening, there is wide variation on how organizations answer this question:

There is even wide variation between organizations using the same EMR:

We are hoping the answer to this question in the future is just as obvious as these questions, “Does your phone help you? Does indoor plumbing help you?” Yes! Of course they do. Hopefully, eventually, so does the EMR.

I left the Arch Collaborative Summit feeling a positive energy around the future direction of the Collaborative. Where will it go from here? We are hoping to start a fire, where organizations are coming together and finding solutions to EMR frustrations.  

A quote attributed to Helen Keller sums up the purpose of the Arch Collaborative perfectly: “Alone we can do so little; together we can do so much.” Measuring successes and failures really does aid in collaboration, and collaboration really does lead to positive change and improvement. We are hoping organization will join us.