Welcome to the Healthcare CEO podcast. Join us as Daniel Fernandez, healthcare leader and patient experience advocate leads dynamic one-on-one discussions with healthcare executives, consultants, and other industry experts. Listen in as they share actionable insights and unique perspectives into the day in the life of a healthcare CEO.
*The following has been adapted from our full-length interview, which can also be found on our YouTube channel.
Meet Chris Jenkins
Chris Jenkins is Symphony’s Chief Digital Officer. He has spent the past 15 years working in healthcare technology at companies including WebMD, CareMedic, and with rural healthcare providers at CHCA. He specialized in helping medical practices navigate EDI transactions to accelerate their ability to receive insurance payments. As CDO at Symphony, he is responsible for digital transformation strategies and process engineering across the organization.
A Year Into the Covid Pandemic
Daniel Fernandez (DF): It’s early 2021. We’re coming out of an extraordinary year, faced with unfamiliar and abrupt changes. We now face Q1 with a new focus on strategy and growth. And if you follow our podcast, you’ve heard that same message echoed by many of our guests.
With the release of the COVID vaccines, executive teams can once move forward with some confidence. Yet, healthcare executives still don’t have a proven path to success and still face levels of uncertainty in choosing the right course of action that will lead to measurable growth in 2021. Because we understand those challenges, we’re speaking with Symphony Agency’s very own Chief Digital Officer, Chris Jenkins. He recently published an article in Group Practice Journal, on Practice Intelligence.
Chris, before we get started, please tell us a little bit about your background in healthcare.
Chris Jenkins (CJ): I’ve been working in healthcare technology — mostly in the analysis space — for about 20 or 21 years. I started off back in the late ‘90s with an ambulatory transportation company and spent three and a half years at WebMD practices services. And then spent a couple of years working with rural healthcare providers in Florida’s Community Health Centers Alliance (CHCA) program. So mostly, technology side, but lots of analysis and getting down and dirty with the data.
DF: When I think of analysis, I always think about the first task I was ever given to strategize for a center. I had a boss come to me telling me to analyze all the information they collected, and from that, come up with a strategy. This was my first job in admin. I asked, “Where should I start?” He goes, “a pencil and piece of paper, and then carve out an analysis”. And legitimately, it was the only tool I had in my toolbox. I must have created about 40 SWOT analysis slides for a presentation because it was all I knew how to do.
What is Practice Intelligence?
DF: Today, we’re so empowered with so much more information, which is why I’m especially excited to talk to you about this article you published about practice intelligence. What is practice intelligence?
CJ: Practice intelligence is the idea of really treating your practice as though it’s a business more so than a healthcare practice, and creating the same sort of business analysis and operation information that you would if you were a factory operating widgets. One of the things that I like to focus on is metrics like profitability by procedure line. In the same way you might have a byproduct line analysis. So in practice intelligence, you should be able to see how your practice is performing from a financial perspective and build a strategy that helps your practice grow, based on that.
DF: When it comes to collecting that data — just from a call — we can extract metrics like never before: meeting minutes, participants, IM messages, device types. It seems almost endless. What are some of those key performance indicators (KPIs) that practices should be focused on?
CJ: Every practice is going to have a different take on what the most important key performance indicators are for them. But I think some common ones that everyone measures are things like costs per encounter, daily and monthly revenue, outstanding AR. Above and beyond that, there are a lot of other KPIs you should be paying attention to, because they drive so much of your outward reaching strategy. What’s your cost of patient acquisition? What’s the cost of patient communications? Are you factoring those costs into your net margin when you’re looking at your financials? And what percentage of your revenue does any specific procedure line constitute? That’s where I come up with profitability by procedure line — or cost per procedure, cost of patient acquisition line. When it comes to your marketing, how you’re delivering those communications, and the efficiency of those strategies, without that data, you really don’t have anything to operate on.
DF: I agree. There’s always the focus on your P&L. But there are so many other metrics that are often overlooked. And for a lot of practices, it can be almost intimidating. It’s too much. They have a hard time figuring out where to get started. A lot of people are given all these reports, but they don’t know how to make heads or tails out of that information. So what are some ways in which we can take some of that information and help them take actionable next steps?
CJ: The idea is that you want to have some business intelligence dashboards. Applying those concepts to practice intelligence, you’re probably going to have at least three to four major applications that all host different sets of data for your business. You’re probably going to have some sort of accounting tool, like Quickbooks, you’re going to have a practice management system, you may have a separate patient communications platform. The most important thing that you can do when picking those applications is to look to see if they provide an API. Some sort of ability to let that software talk to other software through a dedicated connection. If they have that, and those entry points for data are supported, you can build practice intelligence dashboards using third-party software, which helps tie that data together.
A lot of practices tend to start getting a little shy when you talk about some of these things because they involve costs. Generally, you’re going to need some sort of third-party consultant or developer of some sort to help put these things together. But the ROI on that investment is huge and quickly recognized when you put the time and effort into it.
Making Practice Intelligence Easier
DF: Information is so siloed. Are there certain APIs that are more open than others in the healthcare space?
CJ: That’s a hard question because there are so many products out there. But one of the things I think has been a big benefit to people trying to solve some of these problems is that we’re starting to have MWaaS (middleware as a service) software solutions. Those include products like NextHealth, Redox, and they do the heavy lifting. If you have an application and you can’t figure out how to get it to connect to other applications, they create integrations to allow these things to talk to each other. So if you’re trying to build a dashboard, but you can’t get the data somewhere meaningful so you can start to visualize it, you can look at some of those middleware services to help facilitate those conversations.
DF: Once you’ve extracted all this information and poured it all into one place, are there any tools that can help the visualization a little easier?
CJ: Yes. I think the two most commonly known are Google Data Studio — which is fantastic. If you’re already in the Google universe, that’s a tool that works well with both their back-end cloud services and any number of API-driven software platforms. For business analysis, Tableau is probably one of the most common tools we’d use for BI (or business intelligence). That is another tool that allows you to grab different data sources and start making meaningful connections out of it.
DF: Do you think there’s a one-size-fits-all dashboard? Or is there an art to creating a custom dashboard to solve a problem?
CJ: I’ve seen some actual administrators and/or healthcare professionals in private practice create some pretty darn good dashboards before. So I’m certainly not going to say that it’s impossible for a provider to create their own dashboards. But I do know that sometimes, things like UX and UI in design, everyone has their own personal take on. But a good business analyst, a good consultant who is really trained with this and who is focused on that end goal of creating the most actionable data possible to drive a strategy, they’re just gonna know so many things about how to cluster that data and how to put it into buckets, and how to nicely present them.
And generally, they’re going to work upfront with you anyway to have a conversation about how you do business and how you provide healthcare — your whole patient experience. So they’re already going to know the important things for you. And to me, that’s where you get a whole lot of expertise trade-off for what you end up spending for that consultant.
DF: That makes perfect sense. Ok. So you have this newly-created dashboard. You put in all the information from all of your sources, you can all see it. But now what? What do you do next?
CJ: That’s such an important question, because so many people so often take the time to create some kind of business intelligence, and then promptly ignore it. That’s a sad reality. And as someone who’s spent almost 20 years in business analysis, believe me, I’ve seen that countless times. Giving this advice to private healthcare practices — whoever the senior practice administrator is, the person who’s in charge of gathering this — you should be looking at this data basically daily. It needs to be part of your morning routine while you’re drinking coffee. Start things by reviewing how things were looking for the previous day, the previous week, the previous month, etc. You should just always have that data top of mind.
The Role of Your Leadership Team in Practice Intelligence
CJ: In addition, all of practice leadership — your Chief Medical Officer, the rest of the organization, whoever’s structuring marketing — should be meeting weekly and reviewing some of these key metrics within this data. You’re just creating a whole new high-tech data silo if you’re not communicating this well to the rest of your leadership team. And finally, I really recommend doing a monthly all-hands meeting with everyone in your practice, because you can take some of these key highlights and celebrate them. Review some of your positive reviews on Google and call out the people who are mentioned positively. It’s great for morale. It’s also an opportunity to let your practice staff know what you’re targeting and what’s the strategy for the next month, so that they’re all aligned as a team, supporting that strategy. Without those stages of review, you’re not really using this intelligence as well as you can within the organization.
DF: That is so true. I think about five or so years ago, when we were designing really amazing custom dashboard solutions that we were so excited to roll out for our customer base, and then we realized that none of them were logging in to look at any of it. It broke our hearts. And we’d go back and tell them that there was all this information they could leverage for their practice, yet nobody was using it. Obviously, things are starting to change. People are starting to pay more attention to that intelligence. If you don’t ever use it, then it’s not going to help you.
Maximizing Practice Intelligence Efficiency
DF: Historically speaking, data and healthcare has been very compartmentalized. There hasn’t really been a lot of sharing. People are starting to understand that it’s ok to share your information. It creates interoperability. Do you think that’s going to continue into the future and create more opportunities for practices?
CJ: The platforms themselves don’t have a vested interest in interoperability. Fortunately, this is one of those places where government interaction is starting to make that better. We’ve had multiple directives from CMS and other regulatory bodies that have made strong requirements for improvising the state of interoperability. But even as little as a year or two ago, when I was looking at the state of data in healthcare at large, about 85% of organizations had failed to achieve some meaningful interoperability among all the systems that they used, and that’s just mindblowing.
When we look at how agile we can be in the digital services world — when we can make all of our tools play nicely together — and then realizing that so many healthcare practices are still struggling so much with this, I think there’s a huge opportunity there to revolutionize how that works in the future. In a nutshell, without CMS pushing those changes, they just won’t happen. Most of these major providers don’t have a strong incentive to do so.
DF: When you talk about interoperability, one of the things that come to mind are all of the potential touchpoints the patient could have with the practice, online. You’re talking about review sites, Facebook, do you think there’s a lot of opportunities there to pull it all together and create one solution that can solve all of the communications problems?
CJ: Solutions like that are certainly possible. They’re starting to tie some of these things together. You mentioned social media, and the public side of what we call pre-care communications — especially during patient acquisition. That’s a big part of costs that a lot of providers aren’t measuring well. When I talked earlier about creating metrics, if you know what your patient acquisition cost is, by procedure, for your business — and that includes the sort of front-end marketing and public outreach stuff that you do — and then you’re measuring how effective that outreach is per product line, that gives you so much more data to act on.
If you’re driving scheduled vaccinations for your patients (which is a big topic right now), then you’ve got multiple opportunities of creating communications around that for the audience at large. You can structure your strategy based on how well that works in each platform. If you’re finding that your communication on Facebook is just turning into one big, long, anti-vaxxers thread and isn’t really driving in any real business, then adjust communications strategy and find other more effective ways to deliver this message. That’s just one of those places where, unless there’s a dedicated communications person within a practice, it’s very easy for providers to miss that sort of analysis.
Looking Into the Future
DF: Now a fun question. We’re hopping to the future. 2031. What do you think the space looks like ten years from now?
CJ: First of all, individual consumer data has been an ongoing conversation for the last 20 years. Especially with the bigger platforms, like the social media giants treating that data, shall we say, less than carefully. I fully expect that projects like Tim Berner Lee’s Pods project, which are driving the idea of every individual having their own portable data store — as opposed to these platforms having separate data stacks depending on our accounts with them — that’s probably the future of that. To me, your medical records tie into that as well. It all becomes part of your portable consumer data stack. And so whenever you’re moving from provider to provider, instead of having to go through the records retrieval process, you bring your USB drive or whatever the portable data format of the day is — or perhaps it’s even cloud-based. Who knows? That allows for instant transfer of records and sharing of data from one provider to the other.
And we’ve already seen the impact on the healthcare space from shared data initiatives over the last 10, 15 years. It’s been extraordinary. When you really use algorithms to look for places where you have negative patient encounters or harmful patient encounters — when it comes to interactions of medications, missed steps in procedural care, things along that line — the ability of AI systems to catch that and cross-reference that, it really has the potential to revolutionize the quality of healthcare in general. Given how much time we spend on quality of service surveys, that’s something where we could make some leaps forward that we’ve been trying to accomplish for years and haven’t hit the mark on.
Words of Wisdom to Live By
DF: There’s a lot to look forward to. Improving quality of care is definitely going to be one of those things. I have a few closing questions. It is said that leaders are readers. What is your favorite book?
CJ: I’m not sure it’s a book with a broad audience. My literature tastes are diverse. Mark Z. Danielewski’s House of Leaves. It’s probably one of the most extraordinary works of literary art that I’ve seen in the last 15, 20 years. It’s a really multidimensional book that kind of shakes up the concept of what it means to read a book. It breaks the fourth and fifth walls. It really goes to some interesting places. That’s very high on my reading list.
DF: What’s your favorite quote?
CJ: I’m not much of an inspirational quote person, but I do read a lot. And among the things that I like to read are the Stoics. So Marcus Aurelius, in particular. His quote about how it serves no purpose to wake up in the morning and think I’ve gotta work today. You should wake up in the morning and celebrate that you have the purpose to work today. I’ve always tried to use that, especially on hard days, when it’s a lot of work. It changes the perspective to hey, I’m privileged to be here. I’m glad I get to do the work that I do in a space that I love. Always take that for the privilege that it is, every morning.
DF: That perfectly segues into my next question. What has 2020 taught you?
CJ: It’s taught me that agility and resilience are probably the two single most important aspects of any business. Your ability to pivot and to take quick, decisive action in the face of an uncertain market landscape is definitely critical. And then building up the kind of resilience that comes from having a strong sense of how your business works — having a deep understanding of your financials, having the reservoirs of required assets and resources to be able to survive through the hard times.
DF: Final closing thoughts. What information or advice would you like to share?
CJ: I give this advice a lot in the technology space, but I think it’s applicable to anybody who is in a career growth phase: We take our knowledge for granted all the time. I sincerely recommend for anyone who’s trying to grow their career and achieve more in whatever particular direction — write a lot. Every time you solve a problem, write up a tutorial, a description, a white paper, a bug fix. Document what you do and publish it. The more you put your work out there, the easier it is to find you and see you, and see your potential. And that leads to career growth better than anything else — as long as you’re good at what you do.
DF: That is excellent advice. And with that, we’ll bring the show to a close.
Learn More about How Chris Jenkins and Other Leaders Are Shaping the Future of Healthcare
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