Wen Dombrowski, MD, and Fard JohnmarWen Dombrowski, MD, and Fard Johnmar share the newly released results of the State of Digital Health Innovation survey and what they mean for providers. Only 5% of health systems are operating at a peak level of digital health innovation, and even when they are working on value-based initiatives as an organization, the C-suite is often still focused on legacy sources of revenue. How can health IT be a part of the transformation to convenient, personalized health services, and move from the “shock and awe” of digital health to the “nuts and bolts?” Wen and Fard dig into the implications of today’s transformation in care and how marketers can take advantage.

Show notes

Air Date: May 25, 2016
Guest: Wen Dombrowski, MD, and Fard Johnmar

About the State of Digital Health Innovation Study

Visit digitalhealthmaven.com to learn more about the newly launched Wave II of the study.

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Full transcript

Jared Johnson: Hello, my friends and welcome to the Health IT Marketer Podcast, the podcast that tells the story of innovation in health IT. I’m your host, Jared Johnson of Ultera Digital, health care influencer and content marketing. This is the first and only podcast dedicated to the health IT marketing community.

Welcome aboard once again. If you want to keep up with the trends, voices and marketing tools involved in health IT and health care technology, you’re in the right place. This program is on iTunes. So you can leave us a review there. We are also on Stitcher Radio and Podbean.

Do you want a few reasons to go back and check out previous episodes? Listen to some of the guests we’ve had on in just the last few weeks. Mandy Bishop, Dr. Rasu Shrestha, e-Patient Dave DeBronkart, Dr. Danny Sands, Seattle Mama Doc, Dr. Wendy Sue Swanson, The Doc Smitty, Dr. Justin Smith, and many, many more. We’ve really had rock stars all along as guests on this show. Check out all of those previous episodes at HealthITMarketer.com plus full transcripts. And as always, tweet me and let me know what you thought about this episode @JaredPiano.

All right, listeners, well, I’ve got a double treat for you this week. I have two guests with us. The first is Fard Johnmar and I also have Wen Dombrowski with us this week. Fard and Wen, how are you both doing this week?

Wen Dombrowski: Doing well.

Fard Johnmar: Great.

Wen Dombrowski: Thanks for having us.

Fard Johnmar: And it’s a pleasure to be on the program once again. I appreciate you having me as a repeat guest.

Jared Johnson: Yeah, Fard. You happen to be our very first return guest on the program. So that speaks highly of the things you’re doing. Wen, likewise. I’m thrilled to be able to finally connect with you here and be able to bring you on the program and talk about some of the very cool things that you’re involved in as well. Yeah, welcome to both of you.

Wen Dombrowski: Thank you.

Jared Johnson: So Wen, I’m going to start with you and let you get a chance to talk a little bit about your background and where you are now and what you’re doing in your current role.

Wen Dombrowski: Sure. Thanks. I’m a physician informaticist and a digital innovation strategist. My clinical expertise is in the care of medically complex and socially complex patients, including older adults, people with disabilities and patients with multiple chronic disease. My work has focused on really helping health care organizations develop new care models that serve the needs of medically complex and socially complex patients. So what this has entailed is helping them set up new business models and the technologies needed to support innovative care.

I’ve worked with a number of health care organizations as a CMIO, Chief Medical Information Officer working with hospitals, post-acute care providers, community health clinics and value-based care initiatives. Currently I consult to CEOs and C-suite executives and health care organizations and technology companies to advise them on the new ways to deliver services and products and meeting the evolving needs of consumers and market trends.

Jared Johnson: So there are a couple of events you attended recently. One was Health Datapalooza and the other one was a reception for the Most Powerful Women in Healthcare IT. Tell us about where you’ve been lately.

Wen Dombrowski: Yeah. So earlier this week, Health Datapalooza is a national health IT conference that’s organized by ONC, HHS and Academy Health and really focuses on health policy and health services researchers and the use of open data to improve the delivery of care and payments.

And then yesterday I was in Boston with an event that was sponsored by Health Data Management to honor the Most Powerful Women in Health IT and really looking at what are some of the accomplishments that female leaders have had within healthcare IT and also what are some of the barriers and challenges to women excelling in healthcare IT.

Jared Johnson: Pretty fun week, it sounds like.

Wen Dombrowski: It’s been busy. Yes.

Jared Johnson: Very nice. All right. Fard, give us a chance to . . . I want to make sure we’re caught up with you again. You have been busy as well here. Tell our listeners about what you’ve been doing lately.

Fard Johnmar: Sure. So the big thing has been the release of the results of the State of Digital Health Innovation study that I came on the program and spoke about back in December when we just launched the study. So the initial results from that study were launched about two and a half weeks or so ago. I’m happy to say that there’s been a lot of conversation about that study.

So for those on the podcast listening to this podcast who really do not know who I am, I describe myself as a digital health futurist, strategist and researcher. I’m also an inventor of a digital health technology, which makes me very aware of the issues related to driving innovation through organizations in terms of that particular type of work. I’ve been in the global health arena for more than 20 years. I’ve spent more than 10 years in digital health. I like to say I was doing a lot of work in this space before it was called digital health.

So in terms of my work, I focus in on educating folks about the future of health and wellbeing from a digital perspective, specifically as it relates to how to understand how these trends will impact people in very practical ways, also provide strategy consulting to everything from governments, like the Canadian government to even individual startups in terms of helping them to understand how to navigate the space.

And of course another area of focus is research. So I regularly and have regularly conducted research, much of it released free of charge, focusing on how consumers and also the global health industry are impacted by health and medical technology.

So if anybody is interested in learning more about me, you can go to my website, my personal website at www.FardJohnmar.com, like my name, and you can learn a bit more about me. But it’s great to be here on the program and I’m excited for the conversation.

Jared Johnson: Yeah. You mentioned some of the free resources that you’ve been putting out there lately. There’s this portal that you’ve created and I signed up for it because I’m very interested in bringing these resources, making them available for folks that I work with and teams that I work with and it’s very interesting to me. I thought it was a really cool concept. Tell us a little bit more about the portal itself, what led you to kind of create that as a place and what type of resources do you have there?

Fard Johnmar: Yeah. So it was very clear from the research, from the State of Digital Health Innovation study research that there were specific issues and weaknesses that many people were kind of articulating through the study results. A lot of it has to do with really kind of understanding how these digital technologies will be playing a role, how to navigate issues related to driving leadership support for innovation, how to overcome obstacles and all those kinds of things.

So over the last three years, especially since 2013, although I’ve been publishing kind of open research, I like to call it, open research and open insights, meaning I publish it free of charge for anyone to access that have reached, I estimate, more than 20,000 people over the last three years. That number is sharply increased because of the fact that the study has been out.

So I decided to create what I call the Digital Health Innovation Acceleration Resources Portal, basically bringing together the best of the best content. I’ve got webinars. I’ve got courses. I have reports, like the State of Digital Health Innovation Study. And so I’ve brought it all together under my Digital Health Maven project, which this study is part of, to help people kind of give people one-stop shopping for those resources.

So basically I’m taking the best of the best resources and including it in that portal and that portal is free of charge. Anyone can access it and they can access a wealth of content as well as regular updates on what’s happening in the digital health space because I have a newsletter that I publish twice a week that has some major headlines in terms of what’s happening in the digital health space.

The final thing I’ll mention about the portal as well as this study that we’ll be talking about is that it is part of an initiative that I launched in 2014 called the Digital Health Maven Project. The Digital Health Maven Project is designed to provide people like you, meaning those of you who are listening to this call, with resources and insights and information that will help you accelerate your efforts to innovate with digital technologies.

So I launched the Digital Health Maven Project kind of as a trial balloon back in 2014 and I got a really great response to it, which is why it has expanded in the way that it has over the last few years. So thanks so much for giving me an opportunity to talk about that resource, Jared. And we were talking before the call, Jared, about your reaction to the portal and I’m very happy to hear that you feel that it’s useful and that you’re going to be sharing it with the people in your circle because that’s really what it’s all about, getting these insights into as many hands as possible. So thank you for that.

Jared Johnson: Yeah. One reason for that is definitely the insights that are part of it. The other part of it is I like seeing those like yourself who are able to show that this whole content marketing model quite frankly that it works and that it’s just as valuable in health care and health IT as it is in other places, in retail and places. So I love being able to do the research, pull the insights out, create some content, a great deal of it, in fact, for those who are paying attention that really can be valuable to them. A lot of positives there, so that’s why I loved letting our listeners know what’s available to them.

Maybe it’s a good place to really start and to dig in right now is to talk about the results of the survey itself. Fard, I’ll let you go first and then Wen, if you want to comment after that, maybe we can answer two questions. What are the top takeaways and what was the most surprising thing.

Fard Johnmar: Sure. So the top takeaway from the State of Digital Health Innovation Study is that only 5% of health organizations globally are operating at peak digital health innovation efficiency. So basically what that means is that there are a lot of organizations that are trying to sustain their innovations, trying to make sure they’re funded appropriately, trying to measure them appropriately.

So in this particular study, we looked at some very important forces that are impacting digital health innovation. So through that process of assessment, the respondents to the study and the respondents to this data were people that were working within health organizations, government agencies, pharmaceutical companies, payers, hospitals, as well as their partners, people who were coming into these organizations and helping the people from the health organizations execute.

So by bringing together insights from both those points of view, we’re basically finding that not just in the United States, but also around the world. The results were consistent around the world that many organizations are having a difficult time scaling and diffusing their innovations internally and externally.

So why is this idea of scaling and diffusing innovation really, really important and why is it that I decided to focus on that 5% statistic. Really, we have a challenge currently in health care in the US as well as globally. The challenge is how do we take and use these digital innovations that people are talking about a great deal and are very excited about and have the potential to really transform health and use them in ways that are going to be appropriate for physicians for patients and really solve some of the deepest and most pressing issues that we face in health care today.

So if we’re going to be able to do that successfully using these technologies, we really do need to do a better job of implementing around digital health. So this study is designed to provide some specific data about how health care organizations were doing globally as well as a roadmap that people within organizations or their partners can use to actually assess their own innovation progress and take action to address specific weaknesses or take advantage of strengths that they have in the innovation process.

So I really view this study as a very actionable one in terms of providing people with specific insights that will help them to say, “Okay, now I know how to really talk about my innovation activity in a much more productive way and I have some tools and resources that I can use immediately in order to execute effectively around digital health.”

So I was so pleased that my friend Wen, when I spoke with her about providing commentary around the issues related to this study really did focus in on this topic of execution and the fact that unwavering focus on execution is absolutely essential to succeed from a digital health innovation perspective. So that’s really what we’ve found in the results and more importantly, what I’d like people to think about doing as they consume this study and as they start to execute around improving their digital health innovation implementation activities.

Jared Johnson: So Wen, what would you say there about top takeaways and/or just anything that surprised you?

Wen Dombrowski: In my experience, I’ve spoken to a number of innovation leaders across health systems across the country and also I’ve worked with a number of different health systems. One of the barriers to executing digital health successfully is the lack of alignment at the C-suite level and that includes commitment to a financial investment, commitment to changing the operational workflow processes and then also changing the organizational culture. That is fundamentally needed in order to change the way things have always been done.

Jared Johnson: Wen, one piece I remember you wrote in your commentary because you provided the forward to this survey results, and this is what really struck me. I was mentioning to both of you before we got on the air here that this sentence, as soon as I read it, I thought, “I’ve got to have these guys back on the podcast and talk more about this.”

It was the part you said in the foreword, specifically when you’re talking about what the state is with providers and you said, “Some changes may temporarily cannibalize legacy sources of revenue, but there are significant first mover advantages.” And you went on to talk about what some of those are. I’d love it if you could elaborate on what that advantage is and address that pain point with providers. What are the keys to helping them move forward at this stage?

Wen Dombrowski: Yeah. That’s a great question. So first I’d like to start with some background related to the legacy sources of revenue that are preventing the alignment towards the new digital health innovations. So for many decades, most hospitals and other healthcare provider organizations have focused their business models on maximizing the number of patients that physically go to their hospital, ER or doctor’s offices.

When I speak with my colleagues in other health systems, most of the health systems, even the ones that have announced that they’re working on innovation or value based care initiatives, often times their C-suite is very focused on the fee for service mentality of maximizing the physical visits and therefore, they’re not necessarily willing to invest financially and do the operational changes and culture changes needed.

So one of the things that I’ve noticed is that a lot of times it’s easy for leaders of any organization, even outside of healthcare, but certainly we see this in health care. It’s easy for leaders to get caught in the trap of thinking that, “We’ve been successful for the past ten years, so of course we will be successful the next ten years.” This resting on the laurels of past success is very dangerous, but very common and prevalent in health care organizations.

What we’re seeing in recent years is there are actually more and more, especially on the small and medium-sized organizations, they’re starting to go through financial distress or be acquired because of their reliance on past successes. I know there are large organizations that will say they’re too big to fail. But even large organizations are susceptible to the market forces and consumer forces that are changing the nature of the game.

Basically, what I’m seeing is that a lot of health care organizations, whether it’s providers or some payers or pharmaceutical and device companies, depending on the companies. It’s not necessarily all organizations, but a large number of them are failing to recognize the rapidly evolving market forces, consumer demands and technology enablers.

So one analogy, one sports analogy I would like to bring up is that the game is changing and the rules of the game are different. So if you think about if there is an all-star football player that they became famous for their ability to play football but they may not know how to play soccer or how to successfully compete in a soccer match.

So bringing this analogy back to health care, when we see health care executives resting on their laurels of past success, they’re focusing on maximizing hospitalizations, surgeries and office visits. Yet, that is what the old and current reimbursement system rewards but not necessarily what’s going to be successful in the coming year and upcoming years.

So going back to your original question about first mover advantage, what I’m seeing is that patients increasingly want more convenience and personalized services. Also, outside of the consumer space, just in general there are increasingly more and more technologies that enable any competitor of health care or of any industry to really deliver what their consumers want in a new way.

So for example, if someone isn’t feeling well in the middle of the night or if they’re at work and they’re not feeling well, they don’t necessarily have the time or the energy to drive across town to see a doctor. So something like a telemedicine urgent care service would be helpful not only to these patients, but this can also drive new sources of revenue and customer acquisition to the health care providers.

So in this scenario, when the person is not feeling well, often times they might search on Google to ask what should they do or where should they go to get help. I believe the telemedicine services that are proactively available in the market will appear in the search results in the ads. Whichever one that the consumer clicks first, not only does that telemedicine company benefit from that one customer interaction, but that telemedicine company has the potential to determine all the subsequent referrals and utilization.

So for example, if a patient sees a telemedicine provider online, that telemedicine provider determines the patient needs further follow up, that telemedicine provider has the ability to refer the patient to a specific provider network of ambulances, ER, surgeons, dermatologists, laboratories and other services. So they’re really affecting not just that one time point of care interaction, but the customer lifetime value and their entire subsequent network utilization.

So I think that organizations that can think about this immediate and future competitive advantage are already investing in the technical human and marketing capabilities to launch these types of services locally. What’s interesting is that unlike old forms of health care where launching health care services was very much only a local play, it’s “I’m going to build a clinic on this corner, I’m going to build a hospital on that corner and I’m going to serve the people within this geographic driving distance or walking distance.”

What’s very interesting now is that companies that an build a technology-enabled electronic or digital service, not only are they able to reach their local markets, but then they have the ability to scale to wider geographies and become competitive entrants into new markets.

Jared Johnson: Fard, did you have any comments on that in terms of how to help clinicians move forward and just embrace digital health?

Fard Johnmar: Yeah. I think the type of comments that Wen has been making I think are really critical in terms of moving away from kind of the shock and awe of digital health to the nuts and bolts of digital health. I think I spoke about this in the last time I was on the podcast in terms of how overall digital health is moving into what I call the age of implementation. In the study report, I talk a bit about how we kind of know that we’re moving into the age of implementation.

Since 2015, one of the things that I’ve been doing is kind of looking at, on a regular basis, data related to what the conversation looks like on social media related to digital health. There’s an analysis in the study report which really looks at the tone and tenor of the conversation, specifically on Twitter, related to digital health.

One of the things that we saw over the last year is that the types of topics that the people were referring to in terms of implementation related topics including conducting research and testing digital health tools and things like that are kind of becoming more and more part of the conversation as we move on. That was just looking at about 630,000 social media data points.

So what that speaks to is the fact that a lot of people are thinking about the issues that Wen has been discussing. How do we change from a kind of older revenue model that focused on volume to a newer revenue model that’s focused on value? How do we take advantage of the ways that consumers in particular are utilizing these technologies in order to access things like entertainment and food and really having an expectation that health care is going to operate in the same way.

But at the same time that they’re kind of thinking through these challenges, the big questions are, how can we as an organization really try to figure out how to overcome or deal with kind of the barriers to doing that?

So one example that I like to use in terms of why this kind of thing in terms of the transformations that Wen has been talking about are so difficult is because in some cases, some payer organizations in order to do anything . . . and we’re talking specifically here in the US in terms of bringing on certain types of initiatives that may have an impact on their regulatory posture or their exposure to certain compliance regulations or the timing for when they need to get in reporting around their various activities can really have a big impact on the speed to innovation.

So people often talk about why does it take a major payer or a hospital or another type of organization sometimes a year and a half to go from learning about an innovation to actually executing? It’s because of the fact that people within the organization really need to be thinking through these policy and regulatory-related issues or dealing with what I call the human issues in terms of leadership support or also dealing with the economic issues, right? How do you engage in activities that are going to save money for the institution or actually make money?

And then finally as Wen as alluding to, how do you deal with those technological issues in terms of what it actually takes to deploy? So when you think about the impact of what I call those forces shaping digital health innovation, and again, that information is in the research report, it becomes very clear that even though people are moving toward focusing on this implementation issue, that it’s not the sexiest conversation to have.

But it’s the one that we need to be having in order to move from this posture of kind of hoping that somehow digital will be transformative to actually doing the things that we need to do to make sure that is. So I think the perspective of people like Wen is really important to focus in on these really executional issues.

Finally, I’ll talk about what this means for clinicians because I know that clinicians are part of your audience. One of the things that I hear in speaking with clinicians is they’re often times blindsided in some respects by all of these new technologies, all of these new workflows that are being imposed on how they work as a physician. I think physicians really should, physicians like Wen, really should have a voice in how these technologies are being deployed and the ways they’re going to be touching patients and others.

So these are really complex issues. So one of the things that I am trying to do in terms of this research report is to make those complex issues a bit more clear and a bit more easier to communicate and also having kind of a benchmark that people can look toward to say if we want to get better at all this stuff, here are the specific things that we need to do in these key areas that I’ve discussed. Let’s get down to the business of actually executing around that.

So I think we just had Health Datapalooza. We have events all the time where people are talking about the work they’re doing. Those events are really important. But there’s also a lot of stuff happening within organizations as we speak related to the deployment of these innovations and I’m hopeful that this particular study and some of the approaches outlined in the report can be helpful to those folks as they try to address those issues.

Jared Johnson: Yeah, there are. There are so many implications to the types of actions that you’re talking about, whether an institution decides to implement them or not. As we wind up here as we start to wrap up our discussion here, if you can stick around for a couple more minutes, Fard, you have already answered our bonus question. So I’m going to give Wen a chance to address my last question and then the bonus for us.

The last question I had before that bonus question, it’s simply just knowing these results of the survey, where should health IT marketing teams focus their efforts right now?

Wen Dombrowski: Yeah. Thank you. So I would definitely echo Fard’s comments. I really think that health IT marketers, one thing they can concretely do is to involve clinicians and patients in not just the product launch and sales part of their product lifecycle, but actually involve them on the product design. Because what I’ve been hearing over and over again from clinicians and from patients, is that there are a lot of products out there that are well intended but do not necessarily meet the needs of physicians or patients, especially patients who have multiple medical conditions.

I think that if you can involve patients and clinicians early on in that design process, not only is the product going to be more suited to the needs of the potential user base, but then you also have some natural champions to help you spread through word of mouth what is the value of these products.

The other suggestion I would have is that when trying to market to health care organizations, don’t just spam them and say, “Hey, buy our stuff, buy our stuff,” but actually educate your potential customers about what is the value that your product brings in terms of financial ROI, in terms of operational inefficiency, in terms of clinical outcome. And really be sharing in the thought leadership of what are the industry practices that you know of and how have you captured some of those best practices in your technology product to enable the customers to really executer on the digital health innovation.

Jared Johnson: Well, I appreciate those insights. I think they’re very meaningful and it really is a start of a roadmap for institutions to be involved and use this in their strategy day to day. So I thank you for sharing that. Like I said, at the end of every episode, I have this bonus question that has nothing to do with marketing or health care or anything. Fard addressed it last time he was on the program. So Wen, I’m going throw this one to you too, which is if you could join any rock band or music group for a day, who would that be?

Wen Dombrowski: That’s an interesting question. So I would say probably Zakir Hussain. He’s one of the great Indian tabla drum masters. I’ve seen him in concert. He’s got an incredible, it’s really hard to explain how incredible his musical talent is and I think it would be very interesting to see him up close for a day.

Jared Johnson: Very cool. This doesn’t happen to be the same drumming that was at SXSW that you were doing earlier this year or is that related at all?

Wen Dombrowski: That’s a different type of drumming. That’s a dhol drum. It’s a different type of drum from a different part of India and the Indo-Pak continent. The drummers that I saw during SXSW were . . . well, I saw a number of drummers, but the one you’re probably referring to is there was a Pakistani group that are the Legends of Dhol. They play a Sufi-inspired style of drumming.

Jared Johnson: Very cool. Okay. My mind is a little blown right now. That’s really cool. Well, both of you, I just want to extend one more time my thanks for being on the program and for doing all the work that you’re doing and just getting out there, about how to ultimately move digital health forward and providing all these practical tips and resources for everyone listening. Fard, thanks so much for coming back on. Wen, I’m so grateful to have you on and be able to connect with you.


Wen Dombrowski: Thank you.

Jared Johnson: Wen, if folks want to be able to connect with you, if they have a question for you, is it easiest to reach you on Twitter and if so, how do they do that?

Wen Dombrowski: They can find me on Twitter @HealthcareWen and also LinkedIn. They can connect me on LinkedIn and get my email through there.

Jared Johnson: Okay. Then Fard, do you want to remind everyone how to reach you as well?

Fard Johnmar: Sure. So if folks want to reach me, they can visit my website, FardJohnmar.com, like my name. There’s a contact form on the website that you can use to contact me. In addition, in order to access the study and other digital health innovation resources, I encourage everyone listening to visit the Digital Health Maven Project website at www.DigitalHealthMaven.com.

And once you hit that webpage, you’ll see links to research and the resources portal that I was speaking about earlier and other materials and insights that will hopefully help you with your innovation efforts, whether you’re a marketer, a clinician, an executive, there’s something on the website there for you and many of the resources are absolutely free of charge. I would encourage folks to visit the website and learn more.

Jared Johnson: Well, thank you both for being friends of the program and for being our guests today.

Fard Johnmar: Thank you.

Wen Dombrowski: Thank you.

Jared Johnson: Well, that wraps up the program this week. Let me know what you thought by tweeting me @JaredPiano. Let me know what you thought of this week’s episode. Please feel free to leave a review on iTunes or on Stitcher Radio, where you can find this program.

Thanks again for tuning in. Ladies and gentlemen, it is up to us to tell the story of innovation in health IT. Remember to build your audience one gig at a time. For a full archive of previous episodes which I encourage you to go to, go find those at HealthITMarketer.com. That’s HealthITMarketer.com. Thanks again for tuning in and I’ll talk to you next time.