Dale Sanders is a leader in the area of applying data to improve outcomes across healthcare, however, he sees a potential to do this in a manner that may become a burden on healthcare practitioners. I always learn from Dale, hope you enjoy.
Jeff Johnson the VP of Innovation and Digital Health at Banner Health shares some very practical ways they established their digital blueprint and found quick wins for the organization. Great conversation for anyone who is looking for substance from their innovation program.
Bill Russell: 00:00 Welcome to this week in health it influence where we discuss the influence of technology on health with people who are making it happen. We are the fastest growing podcasts in the health it space. My name is Bill Russell. Recovering healthcare CIO and creator of this week in health it, a set of podcasts and videos dedicated to developing the next generation of health it leaders. This podcast is brought to you by health lyrics, health it. Do you need to do more with less? We’ve been in your shoes. We know where to look. Let’s talk visiting health lyrics.com to schedule your free consultation. If you’re enjoying the show and want to support our mission. As some of you have asked me, there are five easy ways you can do it. You can share it with the peer. Second is, you can share it on social media. A third as you can follow our social accounts, linkedin, Twitter, Youtube, uh, send me feedback, questions and recommendations, [email protected] I love the news story, recommendations and other things that’s very helpful and especially guests recommendations. Very helpful and you can subscribe to the newsletter on the website. So let’s get to the show today. We’re joined by Jeff Johnson, VP of innovation and digital business at banner health. Uh, Good Morning Jeff, and thanks for joining us on the show.
Jeff Johnson: 01:20 Good Morning Bill. Thanks for having me. Great to be here
Bill Russell: 01:23 man. So that’s that as you know, as I’ve said before, that’s a, that’s a great title. Sounds like you get to work with, uh, you know, really cool stuff, really cool people. Um, but not too long ago you were the VP of digital health, so there’s, there’s a lot of, a lot of change including a new office for you, uh, there in the background. So give us some idea on the role and, uh, and what, what it entails to be the VP of innovation and digital business.
Jeff Johnson: 01:47 Yeah, well thanks for noticing the nice office. I’ve got it here with absolutely no atmosphere whatsoever. Um, but it’s, you know, that’s actually part of the change here, the growth. Uh, I’m on my third job title in two years at banner. Um, this is my third location as well. So we continue to grow this innovation and in this digital segment, but I’m, yeah, you’re correct. I started, yeah. With banner, with this notion of it digital garage where we thought, you know, we need to start really making some headway into a digital strategy. And we realized really quickly, well that’s, you know, we can’t toy around in this stuff. This has gotta be a core competency and really have leadership at a higher level in the organization. So it’s evolved into this role of digital business and innovation. Um, our approach to this is that it’s not traditional It is not traditional marketing. It’s a, it’s a new competency. It’s a new area of focus with dedicated leadership and accountability. And, uh, I’m in the middle of, of all of those other areas, but that’s the way we’ve set ourselves up.
Bill Russell: 02:52 Yeah. So let’s, so this whole episode is going to be about, uh, about digital health and digital consumer and all those things. Um, and then, so we have some history. I, uh, I at the Scottsdale Institute you were on a panel discussion with, for similar types of roles. But I think one of the things that was interesting from that, uh, you know, from that a panel discussion was it very similar, but every health system seems to be doing something a little different. Was that, was that your feeling as well?
Jeff Johnson: 03:24 It is. And I get that sense with every health system and I talk to that everybody’s kind of cracking this nut a little bit differently. I’m careful not to say that the way we’re doing it is the right way. I think each organization needs to figure out the way, uh, approach it for themselves. Uh, and you know, based on their legacy and their skills and their leaders and who they have. But, uh, so far this is an approach that’s working for us.
Bill Russell: 03:49 So, so prior to that we had, we had some conversations leading up to the panel discussion and you, you sort of mapped out if my notes are correct, I think five areas, you have a, uh, a digital consumer, digital health engagement, digital workforce, digital experience, and digital garage. Are those, is that still accurate or have you morph that a little bit? Okay.
Jeff Johnson: 04:10 Well, first of all, a nice note taking that’s impressive. I didn’t think anyone listened when I talk, I thought for sure, but that’s, that’s nice. That’s pretty close to digital garage with sort of hold back and just the whole, it’s just part of digital business. So we really are focusing on those three fronts, that consumer, that more deeply engaged patient and the workforce. And then that digital experience team, which is really consumer centric design ties to all of those. And that, what was the digital garage? It’s really our interface into it where we connect with them. That role is morphed into how do we take these products and these product designs and work really closely with our it teams to enable them. So basically that same, but it’s kind of the way we divide and conquer such a big space.
Bill Russell: 04:57 Well, yeah. And so it makes sense. So you have, you have sort of an outward facing group that’s looking at the digital consumer. You have a, uh, for lack of a better term, sort of a pop health group that’s saying, Hey, look, we need to, we need to engage these people where they’re actually making health decisions, which is 98% of the time, not within our four walls. You have to look at the internal user, and this is one of the things we, we, uh, sort of gloss over when we’re talking about digital, but, uh, everything that’s happening within healthcare has a digital flavor to it now and it’s changing obviously the Ehr and the digital record. Um, the, the one, I’m not overly familiar with this digital experience, but how would you, how would you elaborate on digital experience? What do you, what exactly is, is that,
Jeff Johnson: 05:45 yeah, these are interactive, uh, designers. So the team are, uh, folks that come out of the agency world out of a web design, mobile design. Um, there, there, they put the work in and they do the consumer research as well. So it’s very much a, um, start first with what does our customer want, what does our customer telling us that they want? And then we begin translating that into a product or a solution or a service that meets that need. And the digital experience team is very involved in all of that research and that feedback and that information gathering to help us drive those solutions. Uh, something that our customer is actually asking for rather than starting on the tech side of it and saying, hey, we have, we have a bunch of technology and solutions. What should we give to the customer of what we’ve got is kind of, they help really flip that coin over if you will.
Bill Russell: 06:38 So you have a digital agency embedded in your group that that is, uh, getting the voice of the customer, uh, putting together a communication plans, helping to design I guess, or, or our craft, the features and those kinds of things. Is that, is that essentially what that is?
Jeff Johnson: 06:55 It’s a lot like that and pretty leveraged teams. So we outside of my area, we do have a whole consumer insights team and our marketing area is doing research. Um, so we leverage all the data that we get from that. We measure nps just, you know, constantly at every touch point of our organization. Um, lots of verbatim things from h caps and other things. It’s, that’s part of it. And they, that will oftentimes be a starting point, but the design team will actually, as they start building digital experiences and products, they are constantly on a daily basis testing what the concept is with the customer. We do that through sort of a crowdsourcing platform. So every single thing that we’re thinking about putting into that digital experience, we run it by, uh, you know, our customers and get feedback.
Bill Russell: 07:40 Oh, that’s great. So, so you mentioned nps. Let’s, um, you know, that’s one of the things I heard from the panel was that, uh, more and more nps is being used as the, the net promoter score is being used as the, uh, as, as a, at least a metric to augment the other metrics. Um, so is that, is that something you guys are moving? What metrics are you using to sort of measure your engagement with your consumers and your internal consumers?
Jeff Johnson: 08:10 Yeah, we’re starting to use more and more. And I think the old metrics of just, uh, some kind of a traditional Roi, like are you getting the patient to come in and use a service or are, you know, they don’t work anymore. So we’re looking at lifetime value of a customer and these engagements, um, for example, we’re doing a lot of work right now to rethink the entire emergency care experience or part of rethinking the emergency care experience to the benefit of the customer is they shouldn’t be in the emergency room. A lot of times they’re showing up there and then that health system does that and moves them out of there. Well, that that has an impact on traditional revenue streams right in the catchment that we use emergency rooms for what is the right thing to do? So we’ve got to figure out how do we capture the value that we’re giving to the for doing that. So sometimes we’ll look at the lifetime value of that customer and say, okay, we did the right thing for her. She didn’t come in at three in the morning with their two toddlers and spend six hours in the emergency room because she didn’t need to be there. But now we’ve earned some loyalty with her because we gave her the right service that she needed by, by sending her somewhere else. Time value, net promoter score, all new metrics that we’re using.
Bill Russell: 09:19 Well that’s, you know, that’s an interesting example that you give because it’s, it’s one of the conversations. This is why it needs to be digital business I guess. Because at, at, at to some extent you’re changing the business model, um, because when that person doesn’t come into the emergency room, there’s a certain amount of money that doesn’t flow the way it used to flow into flows in a new, uh, in a new way within the organization. So how do you, how do you engage the entire business? How do you engage the CFO, the operations people, the clinicians, to sort of rethink how we’ve done things in the past?
Jeff Johnson: 09:55 Yeah, and I just noticed I lost my light in this new office. So am I in the dark? Can you see me? Okay?
Bill Russell: 10:01 Uh, you know, I can see you fine. There’s sort of a glow around you, which sort of works.
Jeff Johnson: 10:05 Oh, that’s, that’s even better. So, yeah. You know, it’s a good question. Um, and you’re right, that’s, that’s where digital business really is. The way we’re approaching it. It’s different than those traditional areas. It’s really how do we change the business digitally or we use digital to change the business. So I have to start, you know, at a really high level, what, why does my group exist? Why are we here? And at banner, you know, we’re such a unique system. We’ve got everything we have. We have academic medicine, we have community medicine, we have quantiary care, we have urgent care. We have critical access hospitals and rural regions. We’ve got special departments, you name it, we have it. It’s just such a broad platform of care. Our charge in digital is how do we take all of that value and extend it and expand it further and further away from the original four walls? So it’s influencing our customers’ lives, um, much more comprehensively than it is today. Whether that’s helping them get into those four walls at the right place, right time, right cost, or keeping them out of them and still giving the care and the health that they need. So we start fundamentally with that kind of a concept and tie that right into our mission and our purpose statement as a company.
Bill Russell: 11:18 Yeah. So how do you, how do you prioritize those? So clearly you can, you can pick any one of hundreds of workflows and say, all right, we’re gonna, we’re gonna rethink this one. I mean, how do you, how do you sit down as a group and say, we’re going to focus on labor and delivery. We’re going to focus on orthopedics. What, how do, because you can’t do it all. I mean, there’s talk about budget in a, in a little bit, but how do you prioritize?
Jeff Johnson: 11:45 Yeah, so we’ve, we look at those insights, again, we’re always looking at what the opportunities are to improve the experience for the customer and by experience, I include cost and quality as well. And so again, having those channels in my area, we have priorities in each one of those things. I’ll give you an example. In the digital consumer, we realized that access was a huge opportunity for us. Our customer needed a better way to access the system. So we put a big priority on just simply accessing banner. And I’m not talking about so much, you know, the marketing outreach of how you reach somebody and um, uh, you know, through social media or through a Google ad buyer, those kinds of things. But how do you really make the system accessible? So we’ve, we, we’ve focused in on that as one example and we’ve built a blueprint. We, um, we did some really interesting work with our customers rather than an in, I, I don’t, I kind of have this fatigue about journey maps.
Jeff Johnson: 12:41 I don’t know if you do as well, but I don’t ever want another consultant come in and tell me that we need to map the customer journey. Like, I, I think we’ve mapped it enough. What we lack is a solution that the customer really wants. Um, not just digitizing the one they have, but we did a really interesting, uh, some really interesting work that we’re in the middle of where we brought in about 25 of our customers and we just sat down and we had them tell me what the, tell us what the journey really is and what it should be. And we did that, um, using a proxy methodology where we showed them here’s all these other digital experiences in your life. Here’s how you’re using rent the runway to get a gown for this big event. Here’s how you’re using Pat Quinn. Tell us how you’re using pack point to prepare for a trip.
Jeff Johnson: 13:28 Tell us how you’re using LG to buy a refrigerator. And then each one of those, we said none. If that was a health care service, what would that mean? And so you can imagine like, okay, LG is really cool. I can stand three refrigerators up to each other side by side and I can kind of compare costs and quality and availability and said, why can’t I do that with your services? How come I can’t compare three doctors side by side? And compare emergency room, this stock in urgent care side by side. And so anyway, we took all of that learning and we built what we call the blueprint, which is an actually of a visual representation of what it could be like to interact with this, um, digitally, both in, both through voice assistant, through native mobile, through Web, through Chat Bot, and uh, painted this really compelling story.
Jeff Johnson: 14:17 And then to answer your earlier question, we take that out to all those stakeholders and say, this is what Sophia wants, this what she’s asking for? How we all need to fit into this? So that revenue cycle is in building one experience over here on the bill pay scheduling is building another experience over here and patient edge is building. They all need to come together. So those blueprints become helpful in bringing us all together around that customer.
Bill Russell: 14:45 So Sophia is your, your digital consumer persona?
Jeff Johnson: 14:51 Yeah. Did I say Sophia? Because I, it’s such a habit here that if I say it, I apologize for saying it without telling you who she is. Uh, yeah, you did say it. So it, so elaborate at the library on your persona. Yeah. So this, this is really, uh, I think something that’s worked really well and this is, this is the, you know, all credit to our chief marketing officer, Alex Morehouse, he created this persona, named Sophia.
Jeff Johnson: 15:16 And we have, you know, we have multiples personas that we might use in product development to represent different, um, you know, segmentation. But what Sophia is as a way to take this, you know, this, this idea, this is value that we have, that we’re customer obsessed and this mission statement that we have that we’re going to make life easier and make healthcare easier. So life can be better to really start to translate that into something tangible that every employee in this organization can rally around. So Sophia became the face of that. And she’s a real person. Um, she shows up at a leadership events. We have videos with her. Uh, we have cardboard cutouts of Sophia that people take selfies with in our hospitals. So every employee rallies around this persona of Sophia and they think about what they’re doing in terms of, how does this impact Sophia, it’s kind of cool.
Jeff Johnson: 16:09 It’s, it’s, it’s really helped in digital and all of the spaces,
Bill Russell: 16:12 I’m sorry, she’s actually a real life person who shoes, who received care at your facility.
Jeff Johnson: 16:20 No, I mean she’s a, she’s a, an actress, I should say for purposes of pictures of her and those kinds of things. But you know, she needs the real face. a human being that people, people know, like if you saw her and people have seen, or if you see her in the grocery store, you would say, oh, that’s Banners Sophia, even though that’s not her real name.
Bill Russell: 16:41 Right. And that, but what that ends up doing is, uh, personifying the people. We already know, the people we work with, the people in our community, people who stop us at dinner parties and say, Oh, you work for banner. You know, what would be great if you guys did this. So she sort of personifies that voice of the consumer saying, Hey, this is how I want to sort of interact with health care. Can you guys do this for us?
Jeff Johnson: 17:05 Exactly. And uh, you know, yesterday was interesting. I did a walk through almost all day with a big consumer tech company. I won’t mention the name, I don’t know if they want me to, but you’d know who they are. Um, and w they came out to explore some things that we could do together and health. And so we walked through our cancer center, we walk through an emergency room, we to the urgent care center. At the end of the day they said, wow, never been in a hospital system where everybody’s cohesively talked about either Sophia specifically or knowing, talked about the customer as the very first part of the interaction. It would. So, and so it’s worked really well to help, you know, do that translation of the, of the mission to do something tangible.
Bill Russell: 17:48 So you have you internal customers to though, so you have, uh, people whose lives have been a really dramatically changed by the introduction of the EHR. And you know, they’re ending up adding an hour ot two to their day. They’re doing a lot of documentation and those kinds of things. Are those areas you’re looking at, are those areas you’re trying to address?
Jeff Johnson: 18:10 Well, we certainly are at Banner or I’m not as directly involved in some of the Emr optimizations on workflows and those kinds of things, things around the edges. Because what we found is that our clinicians are just like our Sophia’s in the sense that dealing with banner is big and complex and having the right kind of access to what you needed the right time at the right cost. So there’s a lot of things that we’re doing outside of that Emr to improve that experience digitally?
Bill Russell: 18:37 Yeah. So we’re, we’re doing things around, they had, so, um, talk to me about your partnerships. So strategic partnerships, you, uh, you’re bringing in vendors and, um, I don’t know it, another innovation partners, as we’ve talked about on the show before, and we’ve talked with others that the models are so varying. You have, you know, sort of, uh, uh, a model within health systems where they’re investors, they’re actually VC or even private equity you have. Um, and they’re, they’re really looking to almost create a new business model, but there are also others that are saying, you know what, we already have a multibillion dollar business. That’s our business and what we want to do is to optimize that. Um, talk to me a little bit about your model and how you think about partnerships and how you invite in the innovation community.
Jeff Johnson: 19:30 Yeah, I think our approach is kind of in the middle of what you said. We, we certainly are looking at investments in strategic partners. Um, I focus more on what I would consider a partnership relations than traditional vendor relationships. So certainly we leverage those. But first and foremost, when we are dealing with the partner, um, whether we’re going to look at investing in them or not, it’s can we show that there’s real value here at banner? Is there something that it’s really doing to enhance our business model? And then secondarily, if we believe that that is the case, we may choose to invest in them because we think we can enhance their service to the market and help them show that the, you know, the demonstrated value in our environment. Just a venture fund just to fast forward to build our own software companies just for a go to market approach.
Bill Russell: 20:19 So yeah, the uh, you know, you have to, you have to fund this group. It’s in, you know, people have, people have talked about this and have asked me questions about this. Uh, you know, the, the one that everybody likes to talk about is is providence because providence has like 200 people in downtown Seattle that are not a part of their it organization, but our former Amazon people and they’re doing all sorts of stuff. And I’ve had people ask me questions like, what are 200 people doing? I’ve had other people say, where’s the money coming from? And you know, at, at some point I’ll get Rod Hochman back on the show and I’ll ask him some of those direct questions. But, um, but you know, how do you fund this and what roles do you look to put in place?
Jeff Johnson: 21:05 Yeah, so funding, you know, it’s, it’s just part of our capital and operational budgets is what we’re doing right now. We do have this notion that especially on the innovation side, we’ll create this virtuous cycle where those investments will help bring money back in to drive further growth. But right now this is part of the way we see the doing business. It’s going to be done digitally. And so it’s an investment that we need to make to do this. A lot of it though, I mean some of it bill is like the Roi and some of this are so easy and it’s just such stuff on the top. Um, that it makes a lot of sense. And an example, we had an urgent care, a service that we provide and uh, we had, you know what a lot of organizations have, you could, the customer could come in and you could capture them digitally because they could make that urgent care appointment.
Jeff Johnson: 21:51 But it was bad. It was a bad experience. It was an out of the box vended solution. When we tested with our customers, they didn’t have a lot of competence. They didn’t really trust it. It wasn’t easy to use. So we get a front end redesign on that. Um, and you know, type in to the backend systems to the API APIs. But at the result was when you design that experience for the customer, we went from an 11% conversion rate online for people seeing that offer to checking online and actually showing up to a 42% on the day we launched it. So that’s an easy thing to say. Well that’s a good investment in designing for the customer and providing a digital product that matters because 300% increase in your, um, digital capture rate for urgent care. That’s just one. So there’s a lot of easy Roi is to do in digital still in health care.
Bill Russell: 22:37 So there’s a lot of them. I mean, it’s not hard to find those kinds of opportunities.
Jeff Johnson: 22:44 Yeah, there’s a lot. Um, give you another quick example. Um, we have a medicare advantage population and we’re trying to engage the seniors much more in their healthcare. And one of the ways is to do that is to get him in for their annual wellness visit. If that health risk assessment done, we had a bet at zero compliance on Health Risk Assessments for Medicare advantage folks. And it’s because we would ship them a piece of paper expecting to fill out the piece of paper and bring it to the docs. So we ask our Docs and go, how often do you see those and go, what are you talking about? I’ve never seen them? get a little chat Bot that actually that the member doesn’t even know they’re filling out the Hra really mean they know they’re giving this information, but it’s not like a form. They’re just answering questions in this chat Bot. And we went from about a 0% risk assessment completion prior to the visit to a 51% completion by putting it into a digital modality and had a, and that had an effect on no show rates. So there was a positive correlation if engaged with that digitally before the visit, their likelihood to show up and, and they said also went way up. So there is some, there is some easy pickings still.
Bill Russell: 23:55 So. So Jeff, it’s interesting you said, you know, if I have another journey map, journey map fatigue and those kinds of things, but, uh, you know, I, I am still going across the country, I’m still talking to a lot of different health systems and while some of them are starting to build out some journey maps and those kinds of things there, they’re not necessarily in tune with the experience that people are. I mean, they, they know that there’s areas to improve clearly. Um, they know that there’s frustrations with the consumer. They know that, uh, you know, people have trouble getting to where they need to get to. They know there’s, there’s some obvious low hanging fruit, but yeah, but they don’t, they don’t necessarily know where to start. Where should they start?
Jeff Johnson: 24:39 Um, for us, we started on big access points, like the emergency room and urgent care that I mentioned. That is, or just, and also primary care access as well. We’re just not quite as far down the road as we are on that.
Bill Russell: 24:54 But did, did you, did you start by saying, look, we’ve got to get a sort of a digital vision in place, we have to get people on board, we have to get marketing to work closely with this digital business team. I mean, was there, was there sort of work that went ahead of that?
Jeff Johnson: 25:09 Yeah. You know, I think just, I think part of the strategy for us is the creation of a digital team because then you’re putting a big stake in the ground that this matters, that there’s leadership in your organization, there’s accountability in the Organization for this to happen. So I always tell people, part of the strategy is how are you going? How are you going to form the structure to pull this off? That’s where I guess I would start as, who in your organization owns this?
Bill Russell: 25:34 Yeah. So how do you work with Iti? Have a lot of it listeners. So how do you, how do you work with it?
Jeff Johnson: 25:42 Well, hopefully very well. Um, you know, we have a fantastic IT team here. In fact, part of this new move that I’m involved in, we’re putting asked some of my digital teams, right, exactly. In the same floor is parts of the it teams that we work most closely with. So it’s a very, very collaborative joint effort in this space. Every organization’s different. My role could live inside of it in some organizations, uh, you know, at banner it made the most sense to put this into strategy. Um, but I, I think it kind of depends on the organization where it makes sense, but you do need someone that’s owning it. It’s setting the vision, um, that’s accountable for it.
Bill Russell: 26:19 Yeah. So you’re reporting into a Scott Nordlin and so that’s that strategy. Yeah. It reports up through what it does it report directly into the CEO or somewhere else into our chief clinical officer. Oh, interesting.
Jeff Johnson: 26:36 Yeah. And then, and then marketing in my role, both report into strategy and growth and the Scott,
Bill Russell: 26:42 that is a, that’s fascinating in and of itself. Um, you know, I mean there, there’s so many different areas and I’m actually going to, uh, I’m going to ask you a bunch more questions after, after we get on the line and I’ll share those on social media and things. Um, cause I, I think there is, you know, I, I’d love to hear, you know, how do you handle moonshot projects and um, you know, how do you handle failures? I mean, failures are a way of learning how to change that culture. So some of those questions I’m going to ask after, uh, you know, after, after I do the close here for our listeners, I know there, and this is like the third shot I’ve done this on. I’m trying to keep it to a half hour and it’s hard because so much to talk to in this topic, but I’m going to try to collect some more.
Bill Russell: 27:27 So Jeff, thanks for coming on the show. Great discussion. Uh, anything you want to leave with our listeners, we used to follow you ways to, uh, interact or anything like that.
Jeff Johnson: 27:36 Uh, you can find me on Linkedin is probably the easiest way of love collaboration. We’re trying to, you know, trying to really let the world know that we’re open for partnerships and relationships, uh, maybe better than we’ve done in the past. Uh, see a ton of value in that.
Bill Russell: 27:54 Absolutely. So please come back every Friday for more great interviews with influencers. And don’t forget, every Tuesday we take a look at the news that’s impacting health. It, this show is a production of this week in health it for more great content. You can check out our website at thisweekinhealthit.com or the youtube channel @thisweekinhealthit.com/videovideo. Thanks for listening. That’s all for now.
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