The senior vice president of care transformation and innovation for the multi-state health system says successful change begins with a focus on processes and workflow.
Editor's note:This article appears in the March 2023 edition of HealthLeaders magazine.
For Michael Schlosser, MD, MBA, the key to innovation and transformation lies in workflows. Figure out how care is delivered first, then improve that process through new technology or strategies.
"We focus a lot on workflows because that's where the changes are going to occur," says the senior vice president of care transformation and innovation at HCA Healthcare. "You'll get better outcomes when you focus on the process first."
Schlosser is at the helm of a pretty big ship. Nashville-based HCA Healthcare comprises 186 hospitals and roughly 2,000 sites of care in 21 states and the UK. The organization set its sights on the health system of the future in 2021, when it created the Department of Care Transformation and Innovation (CT&I) and put Schlosser, then its chief medical officer, in charge.
"Looking down the road is what our office should be doing," he says. "Healthcare moves slowly and changes slowly, so we have to [plan carefully] to make that happen."
Michael Schlosser, MD, MBA, senior vice president of care transformation and innovation at HCA Healthcare. Photo courtesy HCA Healthcare.
To Schlosser, innovation has always been part of the healthcare landscape, even if it does take a while for unconventional ideas to be accepted. But transformation is a new concept, fueled in large part by the challenges created by the pandemic. Health systems and hospitals jumped on the digital health and telehealth bandwagon in droves as COVID-19 took over, and while the technology itself worked well, many organizations had trouble making it interoperable. Workflows and processes weren't well thought out, and care teams struggled to adjust.
"We need to focus on operational transformation," he says.
"Wd caught lightning in a bottle," Schlosser adds, looking back over the past few years. "The pandemic had created an environment interested in … change, which was different than the way things generally happen in healthcare. Adjusting wasn't easy."
As the pandemic fades (hopefully) into the rear-view mirror, he says, healthcare organizations have to adjust their strategies to look forward rather than just keeping up. New technologies and ideas that have proven their value need to be stitched into the fabric of the organization, not bolted onto the side like a new room added to a house. And that means pulling all of the different departments together, from IT to nursing to marketing and PR, to ensure that buy-in is complete and workflows are designed that benefit both provider and patient.
That could be a challenge for a health system as big as HCA Healthcare, but Schlosser says the size and breadth of the organization also offer unique opportunities. The health system has designated two Innovation Hub hospitals, UCF Lake Nona Hospital in Orlando and TriStar Hendersonville Medical Center in Hendersonville, Tennessee, which serve as two unique and individual sites for designing and testing innovative concepts.
"They have the bedside experience to serve as labs," says Schlosser.
But that doesn't mean those two hospitals are the only testing grounds. Schlosser says inspiration is "both structured and unstructured." It's discussed in advisory groups, eyed in other sources outside healthcare, and given the chance to grow in CT&I.
"We've become the funnel for innovation all over the organizations," he says.
As an example, HCA Healthcare identified a particular pain point in the managing of staff and scheduling and the assignment of care teams.
Schlosser says CT&I studied how patients were assigned care teams, built data science tools to create a patient-by-patient grid of care needs, then developed AI software to predict traffic and, in essence, "fill in the blanks" where care gaps surfaced. Working with Google, they created an automated scheduling platform that identifies and matches staff and their capabilities with patient care needs and procedures that need certain competencies.
"It's an iterative design format: Input from stakeholders was crucial at every stage of the process, and this process had several stages," he says. "We decided to test this in the labor & delivery space first because it's bit like a hospital within a hospital, with a lot of opportunities for improvement."
Schlosser says the platform is now in use in three hospitals and has shown improvements in staff satisfaction and time savings. As they measure how the platform optimizes each hospital's staffing and improves patient care, he says, they'll look to expand to L&D units in other hospitals and, eventually, other departments.
Beyond automated scheduling, Schlosser says he wants to tackle documentation, a key pain point and contributing cause to ongoing national epidemic of staff stress and burnout. This will be done not only through automation, but with technology that can capture patient-provider interactions and insert that data into the medical record. A pilot project at UCF Lake Nona Hospital is using smartglasses to record those interactions, allowing providers more quickly and conveniently review and edit their notes in between patient visits.
Schlosser says it's vital now to map out care transformation and innovation over the next five to 10 years, in particular because of the fluid nature of healthcare innovation. With the end of the COVID-19 public health emergency most likely taking place in 2023, it will be important to keep track of expiring waivers and incentives designed to improve telehealth and digital health adoption, and to adjust plans accordingly to continue supporting those programs.
"We're not focused just on technology, but a strategic understanding of how to redesign and enhance care delivery, and all that goes into it," he says. "Now we have a dedicated, focused, multidisciplinary team who wakes up every day thinking about this."
“We focus a lot on workflows because that's where the changes are going to occur. You'll get better outcomes when you focus on the process first.”
— Michael Schlosser, MD, MBA, senior vice president of care transformation and innovation, HCA Healthcare.
Eric Wicklund is the associate content manager and senior editor for Innovation, Technology, Telehealth, Supply Chain and Pharma for HealthLeaders.
HCA Healthcare, which comprises 186 hospitals and roughly 2,000 sites of care in 21 states and the UK, launched the Department of Care Transformation and Innovation (CT&I) in 2021.
Michael Schlosser, MD, MBA, who leads that department, sees innovation as a component of care transformation, and both will only work if processes and workflows are addressed first.
The health system is currently testing out an automated staff scheduling platform in labor & delivery units, as well as technology designed to capture patient-provider interactions and transfer that data into the medical record.