Piedmont Healthcare's CEO Applauds Pickiness, Knocks Clipboards

The health system's top executive wants to relieve patients of unnecessary paperwork. But don't mistake him for a simple technophile.

Atlanta-based Piedmont Healthcare has more than twice as many hospitals today as it did when President and CEO Kevin Brown joined the organization six and a half years ago.

In expanding from five to 11 hospitals, the nonprofit health system has taken an aggressive but tactical approach, Brown said. That approach has taken stock not only of operational opportunities and cultural compatibility but also of the potential friction that tech tools can alleviate or cause.

With each growth spurt, Piedmont has prioritized moving to a unified electronic health record system because cultural and operational integration are really difficult to achieve without that common foundation, Brown said in Boston last month, during a panel discussion at the Kyruus Annual Thought Leadership on Access Symposium (ATLAS).

Having a common platform allows Piedmont to roll out a variety of patient access tools, such as online self-scheduling, to meet consumer expectations and improve the overall experience while still giving physicians the support they need, Brown said.

But there's still plenty of work to do, including some seemingly minor tweaks to the way a doctor's office has historically been run.

"I've got a personal goal this year to eliminate clipboards," Brown said during the ATLAS discussion.

It's not that there's anything inherently wrong with clipboards. It's just that they're often redundant in an organization that has invested so much into being completely electronic, Brown said.

"Patients come into our clinics, they get six pages of forms to fill out that duplicate everything that is already in the system," he said.

Pick Solutions, Not Pet Projects
 

Banishing the clipboard is a simple goal, and it's one Brown hopes will advance Piedmont's efforts to improve the patient experience through technology. But don't mistake him for some technophile who's easily wowed by the latest digital doodad. Under his leadership, Piedmont has sought to remain picky in selecting which tech to adopt—just as it has sought to remain choosy when vetting potential M&A partners.

Piedmont could have grown much faster, to include as many as 28 hospitals by now, but the system has turned away 17 individuals that sought to join the organization, Brown said.

"We said no because their culture didn't match, they weren't focused on the patient, they were looking for someone to be a bank and not a partner in health," he said, "so we've been very selective about our growth, yet we've grown very aggressively."

Similarly, health systems are bombarded with a glut of offers from firms peddling tech solutions. The challenge, Brown said, is picking only those options that work with Piedmont's core systems and make a difference for patients, not just some pet project.

"There's a million apps, there's a million devices, there's a million disruptors out there that are taking little pieces and parts," Brown said. "The trick is, how do we pick the right ones to make sure that it integrates into the systems that we have?"

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Every group within an organization will propose solutions that might work well for their individual teams or departments, but system-level leaders need to ensure that any technology the organization adopts ties back to the overall strategic vision, Brown said.

"We're trying to eliminate the number of systems we have, not add to it, because healthcare is way too complex," he said.

Expect Some Sputtering
 

When they launched a virtual app for primary care visits about four years ago, Piedmont's leaders thought they were ahead of the curve, Brown said. Now pretty much every health system has a platform for virtual primary care, and some of them are seeing lackluster results.

Piedmont's platform, powered by nurse practitioners, costs $49 and is available anywhere in Georgia, but it had few users last year, notching only about one visit per day, Brown said.

"It's available, we promote it, we push it. It really just has not taken off," he said.

"I've used it myself. My family has used it, my kids have used it. We're the one-a-day, I think," he added with a chuckle, suggesting that patients may simply prefer to see their doctor face-to-face.

"I think there's something about the personal interaction with the clinician that's never going to go away. There's always going to be that comfort and that compassion that our clinicians have and people want to have in their interaction," he said.

ChristianaCare Health System President and CEO Janice E. Nevin, MD, MPH, who participated in the ATLAS discussion with Brown, said her organization has had a more successful experience with its virtual primary care platform by treating it not just as a supplement but as the Patient-Centered Medical Home (PCMH) itself.

"Patients, our employees that have dependents, have the chance to sign up. They get their care virtually and are only directed to see someone or to a facility when there's a very specific need identified," Nevin said.

Secure text messaging accounts for two-thirds of the interactions through the virtual primary care platform, followed by secured video visits and very few in-person visits, she said.

Brown said his market differs from the one ChristianaCare serves but that he sees virtual care as an important long-term strategy.

"I do think it's going to explode at some point because I think the younger generation is more adept to use it," he said.

Piedmont has already found some virtual care success, Brown noted, through a virtual hospitalist program that serves rural hospital patients.

"That's really been a home run for us," he said.

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