Want to understand how Geisinger Health System is trying to change the way it innovates?
Just consider the story of a congestive heart failure patient in one of Geisinger's emergency departments.
As a doctor treated the man, she heard his daughter indicate she'd known at least three days earlier that the urgent visit was likely imminent.
The doctor asked how she'd known.
"She said: 'Three days before my father has an exacerbation of his congestive heart failure, he tells us he’s getting tired and then each day, he keeps getting more tired,'” said Karen Murphy, Geisinger's chief innovation officer and founding director of the Steele Institute for Health Innovation. It's an example of the wealth of information providers could use to more proactively treat patients' health conditions—if only they had a way to harness that knowledge, Murphy said.
"We’ve been slow as an industry to take patient-reported outcomes and we want to take those and synthesize them in a way that allows us to have better insight into disease progression and the impact on requiring a higher level of care," she said.
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It's also a problem that sits in the sweet spot where Murphy says the Steele Institute is looking to make a measurable mark on changing the delivery of healthcare using advances, for instance, in artificial intelligence and machine learning.
Murphy—who started her career as an ICU nurse—is uniquely qualified to lead their efforts. She'd moved from being a clinician to the ranks of administration and became president and CEO of Moses Taylor Hospital. She later went on to work in the Centers for Medicare & Medicaid Services as the Pennsylvania director of the State Innovation Models initiative before she was named Pennsylvania's secretary of health. She was recruited by former Geisinger CEO David Feinberg to become the founding director of the institute in 2018.
Murphy chatted with FierceHealthcare about their latest projects and her advice for ensuring an organization's "innovation" efforts are truly innovative.
FierceHealthcare: What's your philosophy for innovation?
Karen Murphy: You have to take a problem, marry a fundamentally different approach and then measure your outcomes. How we do that is we look at the largest problems that we have, for example, chronic diseases as an industry, which are the largest costs and where, many times, the outcomes we desire are elusive. We really try to focus on what are we trying to solve for and how is it going to be meaningfully translated to the outcomes we are looking for.
I believe that it’s very easy to get distracted when you’re innovating. It’s very easy to do many small things that don’t accumulate to large impact. We have tried to apply discipline to our approach. We’re not going for quick wins. We’re going for meaningful wins. We often expect short-term results from long-term strategies. We have to temper everyone’s expectations with the reality that doing really meaningful work takes time.
FH: How do you select the kind of projects you take on?
KM: We define innovation as a fundamentally different approach to solving a problem that has quantifiable outcomes. For instance, Geisinger has what are called Fresh Food Farmacies. Heretofore, we'd identify the patients, they’d come to Fresh Food Farmacy which is set up very similar to a grocery store with the exception that the foods are mostly fresh foods and low fat, high protein meats. We have fruits and vegetables and provide recipes, cooking classes, clinical dietitian services. We’ve seen really good results. We’ve seen patients actually lower their hemoglobin A1C, which is a marker for diabetes, and in some cases the food has been more effective than medicine to do the same.
After seeing those results and expanding, we’re in the process of developing a digital application that is a provider- and patient-facing app that provides all the work of the Fresh Food Farmacy in a digital application. We will be completing that in early 2020 and look forward to developing strategies to scale Fresh Food Farmacies across the country.
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FH: What are some of the other projects in your pipeline?
KM: We’ve launched a chronic disease management command center. We are building a platform that transforms the way we take care of patients with chronic diseases. So instead of using the traditional care manager approach with periodic touches, we are leveraging technology with patient-reported outcomes, artificial intelligence, machine learning and also remote patient monitoring with the goal of improving clinical outcomes as well as identifying periods of the disease process that would lead to an exacerbation requiring a higher level of care so we can intervene sooner.
We also added an intelligent automation hub department where we’re using robotic process automation with artificial intelligence to improve business processes across the enterprise … that are very repetitive and really don’t require intellectual skill. Processes that we do a lot of—such as faxing. Instead of having a full-time equivalent employee doing that, we could have a robot do that and allocate the employee to do something that couldn’t be done by a robot. Looking across the enterprise to develop processes that can be done in a more cost-effective way, eliminating the need for repetitive action.
In 2020, we’re going to be launching our digital strategy, which is very exciting. Our goal there is to really enhance the consumer experience, number one, leveraging digital technology to allow patients to have access to our systems in an easier fashion and leverage digital technology in transforming healthcare delivery.