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Delivering Care Anytime, AnywhereThe Digital Transformation Journey

Edward Marx

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Cleveland Clinic

digital journey

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Cleveland Clinic Overview

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Founders

Dr. William E. Lower Dr. John PhillipsDr. Frank E. Bunts Dr. George W. Crile

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Organization Structure

• Not for Profit

• Group Practice

• Physician Leadership

• Salaried

• Annual Professional Review

• 1 Year Contract

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Care for the Sick

Investigate their Problems

Educate those who Serve

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Global Integration

Cleveland Clinic

USACleveland Clinic

Abu Dhabi

Cleveland Clinic

London

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myhometeam

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Cleveland Clinic

Digital Defined

digital journey

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Digital Defined

Digital refers to technologies that promise

to automate and accelerate how business runs

Digitalization is the integration of digital technologies

to change a business model and provide new revenue

and value producing opportunities

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Digitalization Maturity Model

Ad Hoc

Opportunistic

Repeatable

Managed

Optimized

• Digital health initiatives

are disconnected and

poorly aligned with

enterprise strategy, and

not focused on patient

experience.

• Enterprise has identified a

need to develop a digitally

enhanced, patient centric

strategy, but execution is

on a project basis.

• Progress is not predictable

nor repeatable.

• Digitalization goals are

aligned at enterprise

level around the creation

of digital products and

experiences, but not yet

focused on the disruptive

potential of digital

initiatives.

• Enterprise has an

integrated, synergistic

approach to

digitalization, delivering

digitally enabled product

and service experiences

on a continuous basis.

• Constantly seeking

opportunities to disrupt

own value chain.

• Enterprise is

aggressively disrupting

in the use of new digital

technologies and

business models to

affect markets.

• Ecosystem awareness

and feedback is a

constant input to

enterprise innovation.

Digital Resister

Digital Explorer

Digital Player

Digital Transformer

Digital Disrupter

Business outcomesBusiness outcomes

Business outcomes

Business outcomes

Business outcomes

Enterprise is a laggard

providing weak patient

experiences and using

digital technologies only to

counter threats.

Enterprise provides

digitally enabled patient

experiences and products,

but they are inconsistently

and poorly integrated.

Enterprise provides

consistent but not truly

integrated products,

services, and

experiences.

Enterprise is a leader in

its market, providing

world-class digital

products, services, and

experiences.

Enterprise remakes

existing markets and

creates new ones to its

own advantage.

Today

Target

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Digital

Marketing

Distance

Health

eHospital

Solutions

Patient and

Caregiver

Apps

• Apps

• Blogs

• Social Media

• Email

• SEO / SEM

• Virtual Visits

• Online 2nd Opinions

• eVisits

• Remote Health

Monitoring

• Remote Imaging

Uploads

• Outpatient Virtual

Consults

• Inpatient Virtual

Consults

• eICU

• Patient Apps

• Provider Apps

Provider - Patients Provider - Patients Provider - Provider Provider - Provider

Provider - Patients

Our Journey

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Vision & Strategy• Need for a clear and coherent vision and strategy for digital patient

journey, business model, and operating model transformation

opportunities

• Multiple disparate digital initiatives designed to address siloed

opportunities

• Limited integration across existing digital initiatives impede ability to

develop differentiated and maximally robust capabilities and experiences

• Inconsistent enterprise digitalization standards, technology platforms, and

development processes

Coordination

Integration

Standardization

Digital Innovation• Enterprise innovation capabilities yet to be fully engaged to drive digital

transformation and identify disruptive opportunities

Ex

ec

uti

on

How to…

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Cleveland Clinic

Digital Defined

Digital Transformation

digital journey

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Key Elements of Digital Transformation

Skills

Governance

Digitalization Engine

Focus Areas

Strategy

• What are the digital imperatives aligned with

your strategic direction?

• What are the digital focus areas aligned with

your strategy?

• What operating model is required to drive

digitalization as an enterprise?

• What are the key

capabilities needed to

execute digitalization?

• What is the governance and resource plan for

digitalization initiatives?

Partnerships

• What external partnerships

are needed for the

digitalization initiatives?

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Digitalization Transformation Vision

Engage

Patients

Enable

Caregiver

s

Optimize

Value Chain

Transform

Services and

Products

Systems of Intelligence

Trust

Integrated ExperienceS

ca

lab

le P

latf

orm

sIn

no

va

tion

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Digital

Capabilities

Critical Digitalization Enablers

Systems of

Intelligence

Integrated

Experience

Scalable Platforms

Innovation Engine

Trust

Description Ability to integrate info and generate insights across enterprise functions from care

delivery to business operations to create value propositions & differentiated

experiences for patients & partners, e.g., using machine learning to develop optimal

methods for distribution of clinical services.

Standardized technology infrastructure, systems, data, policies, processes and

support structures that can be leveraged to support digitalization across the

enterprise, e.g., Terradata data warehouse for data storage across the enterprise.

Consistent and rationalized standards, policies and methods for interfacing with

external stakeholders such as patients, caregivers and business partners, e.g.,

standards for communicating with patients across channels.

Capability to identify, prototype, pilot and systematize digitalization opportunities

using in-house development, start-up partnerships, JVs & collaborations, and

hackathons etc.

Ensuring confidence in data and information used to drive digitalization by ensuring

appropriate security and compliance measure are consistently implemented across

the information life-cycle.

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Capabilities of a Digitalization Engine

Market Sensing

• Proactive view of ongoing and emerging

digital trends and market players.

Digital Enablement and Planning

• Facilitate identification, definition,

prioritization and program management

of digitalization opportunities across the

business.

Agile Development Teams

• Model for collaboration between

business and IT to execute on

digitalization opportunities using an

iterative solution development approach

Experience Standards

• Standards for maintaining consistent

patient / user experience across various

digital and non-digital touch points.

Digitalization platform

• Flexible, interoperable, cost effective

and accessible infrastructure

components that can be leveraged by

various digitalization initiatives.

Ecosystem Partnerships

• Strategic partnerships that can be used

to source skills and capabilities required

by digitalization initiatives.

A set of

enterprise

capabilities

required to

initiate and

sustain digital

transformation

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Digitalization Engine Structure ExampleDigital Strategy Development Operations

Digitalization Platform

Experience

Architecture

Interface –

Device

Architecture

Information

and

Knowledge

Architecture

Commerce /

Finance

Transactions

Architecture

Business

Process

Architecture

Channel

Architecture

Technical

Infrastructure

Communicati

on

Infrastructure

Security, Privacy, and Trust Architecture

Operating Model and Support

Market Sensing

Enablement and

Planning

Ecosystem

Partnerships

Agile Development

Digital Experience

Design

Digital Architecture

Support Operations

Platform Operation

Security Operation

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Digital Governance Example

Component

s of Digital

Governance

Program

SponsorshipProgram

Funding

Roadmap and

Business Case

Approval

Benefits

Realization

Drive participation

across the institutes

and shared services

Establish funding

sources for

digitalization

initiatives

Define prioritization

and business case

review process for

digitalization

initiatives

Monitor ongoing

benefits realization

and value creation

from digitalization

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Cleveland Clinic

Digital Defined

Digital Transformation

Culture Considerations

digital journey

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https://www.ted.com/topics/innovation

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https://belimitless.com/focus-focus-focus-a-key-element-for-success/

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Cleveland Clinic

Digital Defined

Digital Transformation

Cultural Considerations

Early Success

digital journey

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eHOSPITALE M E R G I N G C L I N I C A L S O L U T I O N S

Remote “bunker” providing an additional clinical tier of monitoring for ICU patients

2-way audio and video capabilities between bunker and unit

More than 200 total beds monitored from 7pm to 7am

Bunker has access to Epic, can place orders, review labs and view imaging studies

Bunker (think “clinical air traffic control”)

Risk Classified Patient List

Video/Audio Camera and Patient TV “Highjack”

Utilizes existing screen in the patient’s ICU room to display on demand:

Remote clinician video and audio

Images, etc as directed by remote clinician in support of local staff

Can power-on TV and remotely adjust audio levels from eHospital bunker

Bunker “Doorbell”

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VITAL SCOUT SCREENSAVERE M E R G I N G C L I N I C A L S O L U T I O N S

Provide high volume, floor based clinical data as a screensaver via a web based application. Display statuses of key vitals with

PHI removed for use throughout the hospital system.

‘Always On’* HIPAA de-identified information outside of Epic (location only) with the screen saver facilitates rapid recognition of

patient changes; full workflow remains within Epic

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MULTIPLE SCLEROSIS APP INTEGRATION

E M E R G I N G C L I N I C A L S O L U T I O N S

The Mellen Center for Multiple Sclerosis has a custom iPad app that collects patients answers and performance on physical

tasks. The app gathers valuable data but is not integrated with Epic clinical documentation tools.

The MS App will now integrate directly with Epic, allowing clinicians to view its data in Epic-native tools and automatically

pull the data directly into their Progress Notes.

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IRIS MOBILEE M E R G I N G C L I N I C A L S O L U T I O N S

iOS mobile application, designed by Cleveland Clinic physicians, providing valuable insight into real time data contained within the EMR (MyPractice) securely on their

Cleveland Clinic issued iPhones.

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APPOINTMENT PASSE M E R G I N G C L I N I C A L S O L U T I O N S

AppointmentPass gives Cleveland Clinic patients a way to quickly, easily and privately check in for their

appointments using a self-service electronic kiosk.

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PATIENT GENERATED DATA

E M E R G I N G C L I N I C A L S O L U T I O N S

Empower patients to be active

participants in their care

Increased patient engagement

Allow providers to track and monitor

patients remotely

Ability to quickly identify specific and

actionable patient trends

Utilize patient outreach to effectively

manage patient conditions

Monitor specific health populations

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Sidekick – Care Coordination AppE M E R G I N G C L I N I C A L S O L U T I O N S

Enter and save patient data on the go

Real time documentation

Epic always the source of truth

Color/Time stratification fr patient

lists

Bidirectional EMR/Mobile device

integration

Utilize ANY Epic flowsheet

Customizable as adjunct to any

workflow

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PATIENT WAIT TIMESE M E R G I N G C L I N I C A L S O L U T I O N S

Helps patients proactively identify which Express Care location

may be less busy

Helps staff re-route patients that may come to a busy location

Covers All Express Care Clinics

Available on CCF.ORG

Adding Mammography for FHC’s

Employee Clinic Wait times added to Intranet (Sept 2017)

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eCONSULTE M E R G I N G C L I N I C A L S O L U T I O N S

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MyConsult Online 2nd Opinions

1,400+ medical/surgical diagnoses

Access to 425+ specialists across Cleveland Clinic

Patient report within 14 days

Delivered in 50 States, and over 115 Nations to date

Most-requested diagnoses:

1. Coronary artery disease

2. Atrial fibrillation

3. Prostate cancer

4. Kidney / renal tumor

5. Mitral regurgitation

6. Breast cancer

7. Aortic stenosis

8. Epilepsy

9. Lumbar disc herniation

10.Spinal stenosis with

degenerative spondylolisthesis

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eVisits• Common acute problems

– Back Pain, Sinus Symptoms, UTI, Cough, Vaginal Yeast Infections

• Chronic Care

– Dermatology, POTS, Hypertension

• More under development

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