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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
• 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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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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