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How HonorHealth Balances Quality, Cost, and Access

Featuring James Whitfill, Chief Transformation Officer at HonorHealth

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On The Agenda:

Dr. Whitfill, HonorHealth's Chief Transformation Officer and named one of Becker's 32 inspiring chief transformation officers in healthcare 2022, shares his mission to use digital technologies to assist not only patients, but also caregivers, practitioners and employees the like. We discuss the specific milestones he uses to measure the success of HonorHealth's digital endeavors, as well as how to balance quality, cost, and access.

Topics

00:00 - 02:48

HonorHealth and the connection to community

02:48 - 04:08

Digital Innovation initiatives

04:08 - 05:22

Challenges in change management, and solutions

05:22 - 13:26

Workforce transformation and online scheduling

13:26 - 19:06

Bullish/Bearish: Jim Whitfill places his digital bets on emerging tech

19:06 - 26:34

Let’s get personal: career advice and lessons learned

Topics

00:00 - 02:48

HonorHealth and the connection to community

02:48 - 04:08

Digital Innovation initiatives

04:08 - 05:22

Challenges in change management, and solutions

05:22 - 13:26

Workforce transformation and online scheduling

13:26 - 19:06

Bullish/Bearish: Jim Whitfill places his digital bets on emerging tech

19:06 - 26:34

Let’s get personal: career advice and lessons learned

Full Transcript:

[00:00:00] Liat: Today we have a very special guest, Dr. Jim Whitfill, Chief Transformation Officer at HonorHealth who leads digital strategy. Dr. Whitfill, it's great to have you with us today, 

[00:00:12] Jim: Liat, it's great to be here. It’s really gonna be a lot of fun today.

[00:00:16] Liat: Very excited. And first of all, congrats on your most recent award from Millennium Alliance as healthcare provider innovator of the year. Very honored to have you on the show and hear your insights today. How is winning that prize? 

[00:00:28] Jim: I'm always moved and humbled when people give me a prize and, like a lot of people, I sometimes suffer from imposter syndrome.

I think if people only knew the real me, they would certainly never give me prizes, but after a couple of decades that doesn't seem to have sunk in. So I just, I smile and I'm, I've learned just to be grateful when those come. You're very modest, 

[00:00:48] Liat: but you really are making some waves in the industry.

We're gonna start with an interesting fact: HonorHealth traces back to 1927, where at the time they provided food and medical care for folks who recently moved to Phoenix. So Jim, tell us about your role at HonorHealth and how you got to where you are today.

[00:01:03] Jim: And before I do that you put that kind of fun teaser out there and it really highlights one of my favorite things about being here, and that is our connection to the community. And we see health as much more than just medicine and illness. And that, those roots of trying to help those who are less fortunate with some basic needs like food and shelter still are alive today.

Today though, we are a complex integrated delivery healthcare delivery system. We've got over 12,000 employees, six hospitals, and as chief transformation officer, I've been really focused on how we apply new digital technologies for our customers, our patients, our caregivers, our nurses, our physicians, our advanced practice providers and even all of our employees. How do we help with making people more efficient and supported after what's been a really tough couple of years.

[00:01:51] Liat: So that actually brings me right to my first question. We're all curious. What's the most important thing you're working on today at HonorHealth in your role when it comes to the digital patient experience?

[00:02:01] Jim: So many of these things are intertwined, but actually while we've made some really nice progress with our digital platform, we call it H2GO it's how we deliver healthcare for our patients. We're really now focusing on our caregivers because if we don't have a great experience for them, our patients won't get a good experience.

We've really doubled down this year in terms of mapping, where are we doing well with supporting our nurses and physicians with technology and where do we have gaps? So firmly, as a physician myself, I see patients in one of our offices. I know the impact that technology has on your day on the way you deliver care.

So we're really excited to focus on that piece. And we know, certainly we're not giving up on all the work that we've been doing for the last couple of years with our patients. But we think that'll be a nice compliment. 

[00:03:11] Liat:  Amazing. And also, for healthcare executives like yourself, when you're always leading digital strategy and trying to push these projects along, what are some challenges you're facing that aren't being talked about enough?

[00:03:21] Jim: I think everybody, and I'm a technology person, so I don't mean this to be insulting, but we always think, oh, if I just had the right software platform, the right tool set, everything would be fixed. But the reality is because we have PE there's people that are delivering care. And so doing all of the change management and doing it in a.

That is in concert with folks. So not imposing change on them, from a one sided perspective, but walking with people along through that change, I think is a really a critical part of. Doing it successfully. And that includes things like being able to deliver training with, with things, making people feel comfortable with that technology. So I'm a big bullet. I love technology. I love new, there's so much fun stuff that's out there, but the reality is if we don't understand the workflow and we don't support people through the changes in their workflow, we won't be very successful.

[00:03:55] Liat: For sure you gotta be the right bridge to bridge between all these factors. And sometimes it's missed along the way. So it's really a work of art to implement technologies into healthcare, specifically as a very slow moving industry. You spoke very passionately at Avia about workforce transformation and how online provider scheduling is gonna be a pivotal direction for Honor.

Can you share with us how you're leading that initiative and how providers are adapting to these changes? Absolutely. 

[00:04:21] Jim: So there's a couple of pieces we just spoke about a few seconds ago around with every technology innovation. You also have to have sort of a workflow Component that goes along with it and really walk people through those changes.

So at HonorHealth, one of the things we've worked on for the last couple of years is enabling our patients to be able to digitally schedule with our providers, with our physicians and. There's a technical component to that. We you can go through our chat bot. You can go through our EMR portal.

You can go actually just on HonorHealth.com. Pretty much we'll let you schedule any way you want. First, we certainly had to build those different channels, but the other piece we had to do is work with all of our physicians to have templates that would. That type of workflow. And we have to remember that our physicians and our advanced practice providers have been through just an incredible amount of difficulty the last several years.

So it's been working with them in parallel. And for example, While we have as a balance scorecard measure, what percentage of our appointments are being scheduled digitally? We put in a balancing measure and this is what Erin really liked. We put in a balancing measure and we surveyed the physicians each month and we said, how happy or unhappy are you with the way your schedule is working.

And the reason why we did that is we said, it's not gonna be a win. If we create the ability of our patients to schedule digitally. And yet all of our physicians are miserable, with what, the way we do that. And so we wanted it to be a win, both ways. That really helped. And I wanna just shout out to one of my colleagues, Dr. Melanie Patton, who really led those, that, that work. And what it did is it created a space where the physicians trusted us, that we weren't going to, I won't use the, the words that probably in their mind, but we're gonna put them at a bad place, that we would have metrics that were measuring their experience and the patient's experience at the same time.

That was really good. 

[00:06:13] Liat: I love that. I love that. That is such a nice point. Considering both ends of the stick. And not just enabling, schedule away. And then it makes them feel a bit bitter about the outcome. You seem like you're really good at measuring KPIs. What are some other KPIs you use to measure the success of digital transformation in general, that others maybe can use?

[00:06:31] Jim: 

Sure. One of the ones that we've, as I mentioned, you asked me earlier what I might focus on this year and it's really our experience, our caregiver's experience with technology. So we recently went through. An exercise, I'll keep everything generic, but we went through an exercise where we benchmarked our caregivers with their experience, with technology against other large health systems with the same EHR that we have.

And my goal is we're about at the 85th percentile. My goal is to be at the 90th percentile or higher. So that would be one. We talked about the we're trying to get, we have about 20 to 25% of our primary care appointments being scheduled online. We'd like to now extend that out to our specialty space.

So that would be another, KPI, another, a third one kind of related to that is we measure with a national. Patient satisfaction company that everybody would recognize patient satisfaction with scheduling, right? So that's a metric that we measure as well. So we want that experience to be high.

We we explode out a lot of other metrics in turn everything from the service levels and our call centers, both for it and for outward facing patients. That's a critical area. I. You shouldn't ask me that question, cuz I can actually SP out KPIs all day. I'm gonna stop there so that we can stay efficient.

[00:07:47] Liat: You're actually very efficient, even more than I thought. So we have time. If anything else comes to mind, really, we are here to soak in your wisdom. So feel free. 

[00:07:55] Jim: You're very kind. 

[00:07:58] Liat: All right. I'm gonna challenge you even more now. And I wanna know, I know this might catch you off guard, but if you had as Dr. Whitfield, a hundred million dollars to spend on health tech and no red. Yeah. How would you spend it? 

[00:08:10] Jim: That's a really good question. And I would actually try to do a hundred different $1 million projects. And by the way, I don't even know I'm assuming we have a bunch of magic here because of the way you set it up, the reason being that there is, there is so much hype, around digital health and we've seen the market really change.

In the last couple quarters, but over the last several years, I think there's been a lot of, there's a lot of hope that digital health can really address some of the fundamental challenges we have in healthcare. And I think the reason why there's hope is because the challenges in healthcare are so big, they are so overwhelming.

How do we balance quality cost and access? And some would say those three things are locked together. You can't win it all. And so we have hope that digital can move the needle, but it's not clear to me which digital effort is going to do it. And so rather than put a hundred million dollars into one effort, like for example, a lot of people are looking at predictive models in AI, but they're, and I won't name names, but there's been a lot of big Claim outs of spending hundreds of millions of dollars trying to do that.

It's really hard. And so I'd like the model of a lot of innovation, a lot of small innovations to see what works. And in the end we're only gonna advance care for our patients. If we can be evidence based. We need to be innovative. We need to try things. And then we need to figure out what works and then do more of that and stop doing the things that don't work.

[00:09:35] Liat: What do you think is the next trend in digital health today? Not in five years from now. Cause we'll get there but today. 

[00:09:42] Jim: So I think a lot of people are, there's some really interesting trends that I'm watching. The first would be how do you offer digital only care plants? Like how there, you're starting to see insurance companies and payers look at things Like a digital, only health plan.

I think that's intriguing to see again. I'd love to see if it’s gonna work? I don't know. It's probably gonna work for a very specific type of population. Maybe not the entire, so that's one area that I think is really interesting. I think continuing to figure it out - How do we integrate all of the data that we're creating? Whether it's from wearables, from well, patient monitoring, people being in the home. It's clear that for a lot of folks, they're gonna have to continue to have more consumerization of healthcare. And that means the patient being involved in her care. Being an active agent in that. I think of a lot of PE and I think that's a really good thing.

It does create so much information. We already have a problem with physicians. I'll sit down to see a patient and we've now been on our EMR for over a decade. So you can look at the there's a lot of information there. There's more information that I can't absorb all of it. And so right.

That's gonna get to your next question, I think, but looking at how we empower our patients to have more agency and control over what they're doing, I think is a lot of what you're seeing in digital health today.

[00:10:55] Liat: It's time to play a fun game where you're gonna be placing your digital bets.

Okay. I'm gonna be naming a technology in healthcare, and you're gonna tell me if it's bullish or bearish. Are you familiar with the terms? 

[00:11:05] Jim: Oh, yeah. I'm familiar with the terms and I'm trying to see how much I wanna go on record for these things. We'll have fun. 

[00:11:11] Liat: Oh, it'll be like a fast speed thing. All right.

You ready?.All right. Number one. Telehealth.

[00:11:17] Jim: We've settled in, we're gonna, we're gonna keep telehealth at around 15 to 18% of our visits. It's not gonna be 90%. It's not gonna go back to two. So I don't know. I'm neutral on that one. 

[00:11:28] Liat: Neutral. Okay. Interesting. Number two, Wearables.

[00:11:31] Jim: I'm bearish, I actually have two wearables or one at night, one of the day. So I love them personally, for me, it's just not gonna deliver what we want, it's great for consumers who want to do their own data. We don't yet know really how to make a meaningful impact on.

[00:11:50] Liat: Okay. Number three, conversational AI

[00:11:52] Jim: I'm hopeful for this obviously and I'm trying not to be biased by my host. But I think conversational AI has come a good way. Still has a ways to go a little bit, particularly when you get into really healthcare things.

But getting out of the tyranny of for example, IVRs, and being able to get into something that's an interactive voice response where people don't know which is the, press one for this pursuit for that. So I think conversational AI, I'm bullish on. 

[00:12:22] Liat: Okay. I didn't pay him to say that. Number four, remote patient monitoring, 

[00:12:29] Jim: remote patient monitoring. I am bullish on if you are, you need to be in the right payment model. You need to be managing a lot of patient lives at significant financial risk. And I think that we, again, at the beginning of a conversation, we talked about change management with technology. There is a ton of change management attached to remote patient monitoring. I think there is a lot that we can do. To help monitor our patients at home, keep them from coming back to the hospital. Because nobody wants, I don't want my patients to come to the hospital when I'm sick. I don't wanna go to the hospital. I wanna stay at home. However, change management is big and you need to have the financial incentives. I think that taking financial risk lines up with the clinical incentives and the change management. So only under certain circumstances. 

[00:13:15] Liat: Okay. Interesting. Lastly, augmented reality.

[00:13:19] Jim: I am, oh boy, I don't wanna be too much of a curmudgeon. But I am I think that there are, I'm gonna be something bearish, cuz you want me to go fast, but there are some really interesting things that people are doing with augmented reality.

For just one particular niche that I think is cool. Now I know it goes against the bearish, but for example, people with Phantom limb pain which is if you have an amputation, you can actually, your brain can interpret pain in a limb. That's not there anymore. It's a terrible condition, very hard to treat.

There are some really interesting things with augmented and virtual reality that actually can help rewire the brain to do that. So there are certain cognitive and psychological impacts that that definitely helps with. So is it gonna change everything? No. Is it gonna dramatically change a few things?

Yes. 

[00:14:07] Liat: Very interesting. Is there any other technology you would add that has a contemplation of it that has, people are talking about not yet.

[00:14:17] Jim: I don't. I think that we are okay. We are swallowing between consumerization predictive algorithms, you talked a little bit about robotic process automation, or how do we automate work?

What's interesting in healthcare is, and this is where I want to be both hopeful, but also skeptical if we look at other industries. Manufacturing would be a good example of banking or financing. We say, okay, what are technologies that have worked in those spaces? Can we adapt them to healthcare?

What we find is the combination of the regulatory models, at least in the United States. Israel, Y'all have a really impressive system going down there. But in the US, we have a complex intersection of the regulatory model, the financial model and the clinical model together. And maybe even the cultural models and you put those four things together and all of these things that work in other industries we bring them into healthcare and they often meet two of those.

And then they crash and burn with one or two of the others. And that's what is really hard. Somebody once said healthcare who knew it was so complex and it is amazing actually. The amazing thing is not that, that the healthcare system is as convoluted and as clunky as it is.

And it's terrible. Like I'm a patient and I really do not enjoy it. But if you look at every other industry, that's tried to come in and fix it. They actually are like, oh my gosh, this is, we can't even operate in this. I think we have to figure that out one of these days, but I have not yet seen anybody that has like the silver bullet.

So in the interim, it's trench warfare. How do we make it every day? A little bit better for our patients? A little bit better for our nurses, a little bit better for our physicians, for our employees. And that's where the victory. If 

[00:15:53] Liat: there's someone who's gonna do that, it's gonna be you. I'm sorry to break the news.

you are at the forefront. . And speaking of Jim you mentioned you love mentoring and watching leaders grow. What is your best piece of advice for digital innovation executives? 

[00:16:09] Jim: think a couple things. One is to be realistic. I think you wanna, there's so much. We talked about this before.

There's so much need, people want a solution to like, why are we have a lot of problems? People want a solution. It's understandable why people would want technology to provide that solution. And but at the same time you can't get caught up in the hype. So how do you provide hope without deluding people?

Is the first piece, the second piece that I don't, I'm gonna force into your, to your, into my answer is that as a leader, I think it's really important to build a team and let that team do what they do best. If you're gonna be a digital innovation executive or any executive I'm, I strongly believe in not micromanaging your team, that instead you should remove the barriers that they're running into.

You should. Guide them, where they need help, but let them, let them grow, let them feel passionate about what you feel passionate about. And then they go out and they accomplish what you want them to accomplish. And so that is, I think, one of the hardest things for people to learn that in a world where you feel out of control, which we, I think many of us do The paradoxical success.

The more you'll have much more control. If you let go of the, that your team around you and you let them do what they do best. I 

[00:17:30] Liat: love that Jim, I do wanna know what is a mistake that you've made in the past, in your professional career that you look back on and learn from 

[00:17:39] Jim: today. So two mistakes that I've made in my career.

One was in a couple of decades ago. I had a chance. To go to business school. And I was and it was right at the end of my training. I was so tired from my clinical and informatics training. I was just like I wanna just be done and , get out into the world. That, that, that was a mistake.

Because it really would've, enabled, I ended up, I've had a lovely career. I've really enjoyed it by the way I went back to visit school like last year. But that was one that really could have enabled me along the way. The, that, that's probably the biggest one that I look back on.

And and I made a decision about, like I said, about a year ago to say, all right, it's time to to patch that that. And the second one, the second one, I don't know if I'm gonna go on record talking about, but how about this? I actually shared this just for fun. I used to be the chair of a, of an informatics group called the society for imaging informatics in medicine.

And at our annual meeting this year, we had a session where two leaders shared their biggest mistakes. But in order to do that, I requested no recordings, no Twitter, not right. So that we could. Authentic, but I will tell you right back in 2012, I made a big career shift and I had I thought that I understood the partners that I was getting involved with and I didn't.

And that that, that led to a quick series of having to pivot to correct it actually. In the end. It was it was a bumpy experience, but it wasn't a mistake in the sense that I took a chance. I left and then it has created so many of the opportunities that I've had today.

That's why, when I, when you ask me, I don't know that it really is a big mistake. It was, a little bit bumpy, like I said, but I try to tell that to people because oftentimes what seems like a mistake in the short term, You can use to really transform your life. If you get, you can obviously get mired down in being yourself up around things, or you can fail to see how to turn it into an opportunity, but sometimes the biggest mistakes are when we get stuck doing the same thing over and over again, and we're afraid to change.

And that, I think. What I've tried to counsel, especially other physicians. We are trained, we go to high school to go to college, go to medical school to, we're just on this conveyor belt, so we never have to take a big risk. It, by the way, it's hard to do that, but it's not risky per se.

For many people, I know some people don't match. I don't wanna go under, I don't wanna take away from how hard it can be, but in terms of jumping into the unknown that, that can be that can be hard. And yet it's one of the most. Liberating and productive things that I've done is when I've been able to take those types of risks.

Even when it initially didn't seem to turn out. 

[00:20:22] Liat: It shows you have a strong character. It shows you have a strong backbone to take a leap of faith because you trust that, the ground you're on in order to take that leap and you learned to pivot. So even if it didn't go well, you took the pivot and that led to opening new doors.

So I definitely don't see that as a mistake. Maybe I should reword that question next time, because these aren't mistakes, these are just, Paths. Yeah. Unwanted that end up being lessons. Cool. Jim, my last question to you is where is Dr. Jim Whitfield in five years from now in the industry?

What is he doing? Who is he surrounded 

[00:20:53] Jim: by? I really do think that we in the United States are facing some almost existential challenges with healthcare. And I decided in this last year that I had two paths forward, one would be to pull back and say, somebody else is gonna have to be there at the table to to fix this and really be there as we face some of these existential issues.

Or I'm gonna lean in and I need to be at the, be one of the people, making those changes and I've decided it's the latter I'm. So I think in five years we're gonna be really, I don't know what it is. I think that, but there are gonna be some kind of black Swan events that are gonna force us, at least in the us to really look at how we're managing healthcare on a national level.

And I would love to be a part of that solution. I'm not gonna be the only part of it, but I would like to be a part of the group. It's figuring out a better way for us to deliver healthcare for our country. 

[00:21:44] Liat: Amazing. I definitely see you there on June 29th and five years from now. I hope to have you here telling us more amazing stories.

So Jim, with that, I wanna thank you so much for your time. I'm gonna let you go. I know you're busy. I do wanna know if there's someone that you look up to, or that you see as a trailblazer in the industry that you'd like to nominate to share their insights on the show as well? 

[00:22:02] Jim: Sure. My, one of my good friends rush Rasta, who's atrium down in North Carolina has been, he and I have worked together for years.

I look up to him. I often ask him for advice. So he's a phenomenal leader with many, many more followers than me on Twitter. Amazing. Thanks again, Jim. Great. Thanks for having me.

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About the host
Liat Kozuch
Liat Kozuch
Podcast Host, Hyro

Part production junkie, part people lover, Liat's passionate about making genuine connections and amplifying peoples’ life stories. With exposure to Hyro’s champions at leading health systems, she started Patient Journey Pioneers to expose strategies from healthcare’s most influential digital leaders and C-suite executives, who share insights that are inspiring the industry to move further and faster than ever. Join the journey as Liat continues to seek the next-best-disruptor in healthcare.

About the speaker
James Whitfill
James Whitfill
Chief Transformation Officer, HonorHealth

James Whitfill is the winner of this year’s Millenium Alliance Healthcare Provider Innovator of the Year Award winner. Currently, James is SVP & Chief Transformation Officer at HonorHealth. With over 20 years in the healthcare industry, he has achieved success through and beyond the pandemic. James Whitfill connects information technology, analytics, marketing, clinical informatics and project management resources in pursuit of the best possible experience for the patients and caregivers he serves.

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