By Erin Cristales, Vizient
The theme of this year's Vizient Health Care Executive Forum (VHEF) was "Repair, Refocus, Reimagine" but by the conclusion of the three-day event, a fourth verb joined the alliterative trifecta: "Resolve."
More specifically, participants resolved to think differently, with top healthcare leaders and Vizient leadership purging "business as usual" from their mindset.
That was especially clear during the discussions at VHEF — which took place Feb. 8-10 in Scottsdale, Arizona — that centered on imperatives like embracing innovative business models and consumer-focused strategies, improving public perception of the industry and transforming payer/provider dynamics.
Throughout the conversations, one thing became increasingly clear: Executives are not alone in facing complex, and often kindred, issues. Why not draw on each other's unique perspectives to clear healthcare's hurdles together?
"When you think about repair, refocus and reimagine, it really comes down to the idea that none of us in healthcare can rest on our laurels," said Dr. David Levine, Vizient chief medical officer. "We have to continue to evolve."
At the event, four topics in particular emerged as top of mind for healthcare leaders this year: artificial intelligence, workforce, health equity and culture. Here's a look at some key points surrounding those themes.
1. Artificial intelligence
If, to borrow a pop culture reference, you've situated yourself in the John Connor camp, it might be time to reconsider the (positive) ways AI can benefit humanity through augmentation. In fact, Levine said, "augment" was the AI buzzword at VHEF, especially during the keynote address, "Artificial Intelligence and the Transformation of Healthcare," delivered by Dr. John D. Halamka, president, Mayo Clinic Platform.
"It's a myth that AI will replace doctors," Levine said. "But doctors that don't embrace AI as part of their practice will become extinct."
So, what are a few ways healthcare organizations can effectively implement artificial intelligence?
- Ambient listening: This AI-powered voice recognition technology transcribes conversations in real time by analyzing and extracting medically relevant information from clinical interactions, meaning doctors can focus on the patient instead of the computer screen. The tool also automates routine tasks like uploading clinical notes into the electronic health record (EHR) and generating notes for medical coding and billing. That's an important benefit, since — according to Becker's Health — administrative burdens like EHR documentation cost the U.S. healthcare industry $1 trillion annually.
- Remote patient monitoring (RPM): Everything from smart scales to continuous glucose, blood pressure and remote electronic respiratory monitors allow physicians to keep a (virtual) eye on patients' vitals and determine when interventions are needed. RPM also enables a more comprehensive data set that can fuel predictive analytics and risk assessments for treatment approaches to determine individualized recommendations based on a patient's holistic medical history. RPM is especially helpful in serving patients who live in medical deserts; according to the National Rural Health Association, the patient-to-primary care physician ratio in rural areas is only 39.8 physicians per 100,000 people, compared to 53.3 physicians per 100,000 in urban areas.
- Diagnostics: AI has perhaps seen the greatest application in the imaging space — in fact, according to the American Hospital Association (AHA), there have been nearly 400 Food and Drug Administration approvals of AI algorithms for the radiology field. That's crucial, considering the World Health Organization estimates hospitals perform roughly 3.6 billion imaging procedures annually, with approximately 97% of the data generated unused. With AI allowing radiologists to prioritize and leverage the sheer volume and complexity of radiology exams, there's nowhere to go but up in terms of diagnostic accuracy. That also includes monitoring for issues such as early sepsis or deterioration, which can sometimes go undetected (and many pre-AI algorithms triggered false alarms).
What does this all add up to? In addition to better overall patient care, it also means a decrease in "pajama time" — a term coined to describe the post-workday tasks that doctors are expected to complete, particularly related to entering information into the EHR. Once you factor in the numerous benefits of AI implementation in the healthcare workstream, the dream of consistently operating at top of license moves closer to reality. Even better: It also represents an opportunity to reduce burnout, which the American Medical Association found more than half of physicians reported in 2023.
2. Workforce
No surprise here — labor remains a top operational concern across the board. At VHEF, one long-term (but less-discussed) strain on workforce took center stage: Declining birthrates are creating decades-long gaps that employers must figure out how to fill. According to the Centers for Disease Control, U.S. birth rates dropped from 14.3 per 1,000 people to 11.1 between 2007 and 2022 — a nearly 23% decline. Add to that a shrinking percentage of working-age people in the U.S. (down to 64.9%); a rising median age (up 3.4 years and growing); and an increasing share of people dependent on the working-age population, and the consequences for healthcare snap into focus.
The big question is: How can you recruit and retain workforce — and alleviate the pressures placed on them?
- Work assignments: The AHA predicts that by 2033, America will face a shortage of up to 124,000 physicians and will need to hire at least 200,000 nurses per year to meet increased demand and replace retiring nurses — making employee satisfaction and career growth essential strategies to recruit and retain. "If you want your specialists working at top of license, do they need to see patients for routine visits or could they see a nurse practitioner or physician assistant instead?" Levine said. "Nurse ratios are going to have to be rethought so that hospitals are still providing a safe-grade environment that also allows nurses to work at top of license while the employees who support them, such as nursing assistants, handle less specialized tasks."
- Technology advancements: We've already discussed the many workforce-related benefits offered by AI (see above), but here's a couple more:
- Chatbots: They help answer patient questions and enhance scheduling.
- Integration into the EHR: Generative AI is being used in EHR systems like EPIC to personalize responses to patient questions and refill or referral requests sent through MyChart or other similar applications.
- Revenue cycle coding: Some have argued that the strongest use cases for generative AI in healthcare are in revenue cycle management. For instance, ChatGPT can be used to generate appeal letters for claim denials, speed up the prior authorization process, and assist with data validation and scrubbing, relieving staff of those administrative burdens.
And don't forget that health equity (see below) also plays an important role in retaining workforce. Often, your employees — especially those in roles such as environmental services, food service and nurse assistants — are facing the same social drivers of health barriers as your patients. Hospitals should work to identify the SDOH that most impact their employees and deploy internal resources and community partnerships that will address the most prevalent factors.
3. Health equity
Health equity is, undoubtedly, a huge topic, but when it comes to narrowing your focus, the answer boils down to analytics, analytics, analytics.
"Health equity is huge right now — it's on everyone's mind," Levine said. "The key is to continue to advance analytics to create evidence-based interventions."
Tools like the patent pending Vizient Vulnerability Index™ help providers do just that. The multifaceted resource allows users to support SDOH at the neighborhood level, and unlike other indices that have a single index algorithm for the whole country, the Vizient Vulnerability Index™ adapts to the local relevance of each domain as it correlates to life expectancy. It also breaks down vulnerability into a number of domains such as food insecurity, transportation challenges and air quality.
Once vulnerabilities have been identified by geographic area down to the census track level, healthcare organizations can work to address issues such as food insecurities and lack of transportation, insurance or housing through solutions like:
- Partnering to host farmers markets or providing food vouchers for patients to visit local farmers markets. According to the U.S. Department of Agriculture, 44.2 million people live in households that have difficulty getting enough food.
- Creating mobile clinics to visit patients with mobility issues or no insurance (read about UCLA's Homeless Healthcare Collaborative in our high-performance report). While a recent U.S. Department of Health and Human Services report showed that the number of uninsured Americans reached an all-time low in 2023, 7.7% of the population still has no insurance.
- Investing in affordable housing through initiatives like the Flexible Housing Pool. Data from a report released by the Harvard Joint Center for Housing Studies in January showed that a record-high 22.4 million renter households (half of renters nationwide) were spending more than 30% of their income on rent in 2022. The number of units with rents under $600 also dropped to 7.2 million that year, 2.1 million fewer than a decade earlier.
- Teaming up with rideshare services to provide reliable transportation for patients (and, in many cases, healthcare workers). According to the AHA, 3.6 million people in the U.S. each year do not obtain medical care due to transportation issues.
- Working with community organizations to refer patients in need of food, transportation and/or housing to the appropriate resources.
"At VHEF, there was a definite emphasis on truly advancing partnerships between hospitals and the nonprofits in their communities," Levine said.
4. Culture
It might be listed here at No. 4, but culture is always priority No. 1 for hospitals looking to advance patient care and employee satisfaction. In fact, the closing keynote, "Culture is Key: The Courage to Lead," was presented by Dr. Marc L. Boom, president and CEO of Houston Methodist, a system renowned for a culture that has consistently landed it at the top of Vizient's Quality and Accountability rankings.
Of course, building top-notch culture can be a slow burn (all good things take time), but there are a few strategies leaders can implement in the short term to create the environment they want:
- Be mission- and results-driven: Every organization should communicate its "why," but it's also helpful to deepen employees' understanding of their roles through unit-level data. Essentially, make it clear the part they play in your organization's high-level goals and strategies, and the impact of their role.
- Be seen: Executives at every level should make it a point to be visible in their organization. For instance, some hospitals have mandated rounding for their leaders — but remember, Levine said, that the goal is not to go searching for problems. "It's about really listening and realizing that some of the best solutions come from your frontline workers," he said.
One of the prevailing ideas at VHEF was to [insert your best Ted Lasso impression here] "be a goldfish." After all, it's impossible for any creature with a nine-second attention span to get stuck in the past. Healthcare leaders likewise have to focus on the path ahead and … well … just keep swimming.
"It's not a novel concept," Levine said, "but you can't keep relying on the same old ways of doing things. It's the conversations about the future of healthcare, and how we get there, that matter."
Want to learn more about these topics? Look for our coverage in the Vizient Newsroom in the months ahead.