How a locally governed health system teamed up with Optum to drive change
ORLANDO, Fla. – As a nonprofit, locally governed system, Boulder Community Health has served the region for almost 100 years.
Since 1922, it has grown from a single facility to encompass a 173-bed hospital, a level 2 trauma center, 12 family internal medicine clinics, five imaging locations, five lab locations dozens of specialty care clinics.
The journey to becoming one of CHIME’s “Most Wired” hasn’t been without hurdles, explained BCH Chief Information Officer Michael Jeffries in a HIMSS22 “Views From the Top” session on Thursday alongside Optum Senior Vice President of Analytics Tushar Mehrotra.
Starting in 2009, said Jeffries, the system started playing “a little bit of catch-up with our technology.”
“We really had not been a technology-forward organization historically, so we started moving into some of the basics,” he explained.
Then, motivated by meaningful use – which Jeffries described as “the kick in the butt” needed by the executive team – the system hit the gas pedal.
It wasn’t all smooth sailing, though.
“We were deploying the technology faster than we could really stabilize it,” Jeffries said. “We were building up a lot of technical debt during that period of time.”
In 2013, the system experienced a ten-day downtime: a painful wakeup call.
“That spurred us to start investing in our infrastructure improvements,” he said. That, in turn, set the foundation to start looking toward the future.
Of course, the pandemic introduced yet another complication. The team was forced to reconfigure its 2019 strategic plan to account for ramped-up telehealth analytics needs, all while achieving EMRAM O-EMRAM Stage 7 validations.
Still, though, the system faced unique problems, particularly on the analytics side.
“We’d hire recruiters, we’d bring in talent, only to find them to be poached,” he said. The smaller bench forced the team to be generalists, their strategy relied heavily on requiring leaderships to stay up to date on what Jeffries called the “mega-trends.”
“The organizational demoutpaced our ability to transform,” he said. “Our people were asking for things we weren’t able to deliver.”
The team began investigating a partnership with UnitedHealth Group’s Optum, similar to its collaboration with John Muir Health in Walnut Creek.
“I don’t use the word ‘partner’ lightly here,” Jeffries said. “This was putting skin in the game together, mutually, with mutual goals that we’re gonna go after, then advancing beyond just the revenue cycle.”
In 2020, BCH officially teamed up with Optum, enabling growth acceleration.
“The premise of the partnership was really to explore innovative ways to drive efficiency help Boulder maintain independence,” said Mehrotra.
The three main pillars of the partnership, said Jeffries, were revenue cycle management, the clinical continuum enterprise strategic service – including analytics, strategic advising, portfolio management enterprise project management.
Eighteen months in, he shared some key analytics achievements: the partnership helped to support strategic initiatives, eliminate the accumulated backlog of analytics requests, implement an actuarial analysis of key programs connect the team with subject matter experts.
Regarding equity goals, he said, “with Optum’s support, our team was able to take the American Hospital Association framework for improving both care to our patients as well as our employees put that into analytics to help guide our strategy where we need to improve,” he said.
Jeffries talked through a few challenges of such a large-scale partnership as well, such as governance coordination, capacity compatibility, identity access management, contract incentives cultural alignment.
“This is really similar, if you’ve gone through an M&A, these are really similar challenges, just kind of on a micro scale,” he said.
Looking ahead, Jeffries gave a look at BCH’s new strategic plan from 2022 through 2024, buoyed by the power of the partnership.
Its goals include service line transformation, an integrated network, an extraordinary workforce consumer choice loyalty.
“We have given up no governance or ownership … of our organization,” he explained. “We have complete control of it, but we have this ability to scale in a way that we never had previously.”
“The explosion of data … has fundamentally transformed how we view the world,” said Optum’s Mehrotra. “The ability to link together disparate data assets to better understan individual’s risk profile or better understa population is truly transformative.”
“That’s where the power lies in my eyes: Taking these disparate data insights, driving insights importantly embedding those insights in workflow,” he said.