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Digital Fluency in Healthcare: “The New Normal”

Session #66, February 12, 2019

Scott Floyd, Executive Director, Kaiser Permanente

Rattan Singh, Director, PricewaterhouseCoopers

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• Scott D. Floyd, BS – Business Administration, Executive Director at Kaiser

• Rattan I. Singh, MBA – Finance & Info. Mgmt., Director at PwC

Have no real or apparent conflicts of interest to report.

Conflict of Interest

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Agenda

Objective

Industry Trends and Context Setting

Cloud enabled Business Transformation – A Perspective

Hybrid Agile Implementation Method

Robotics Process Automation

Healthcare Case Study

Lessons Learned and Recommendations

Q&A

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Learning Objectives

Describe how to become a leader within healthcare in terms of outlining and

adopting the future state technology enablers to create strategic advantage and

state-of-the-art business, HR, and analytic capabilities

Recognize the implementation approach to enable business transformation for

healthcare, get leadership alignment and review the methodologies and processes

to leverage to define the right future state for the organization

Identify key insights into business benefits, considerations, challenges, and

lessons learned for enabling digital capabilities for healthcare organizations

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Mega Trends Impacting Healthcare

Theme

• Emerging markets

➢ Rising middle

class

➢ Leap-frog tech

• Digital initiatives,

co-create, iterate,

accelerate

Demographic

shifts Theme

• Was supply, now

demand…

• Climbing into

service, innovation,

ecosystem

managers

• Business models

change

Shift in global

economic power Theme

• Truly xSector

• Tech at the heart of

infrastructure,

resource utilization,

smart cities, etc.

• Consumer

expectations in

urban setting

Accelerating

urbanization Theme

• Key outcome is

focus on innovation

• Opportunities to

use tech to drive

more efficiency

• Sustainable

business outcomes

Climate change and

resource scarcity Theme

• SOCIAL, MOBILE,

ANALYTICS,

CLOUD, ROBOTS,

& consumerization

driving industry and

company

disruptions

• Ecosystem view

Technological

breakthroughs

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Healthcare – Business & Technology Drivers

1 Strong need for cost reduction 6Making sense of the data available to make

informed decisions

2Strong need for operating efficiencies and

increased productivity7

Expand access to care and move towards

preventive care

3Need to automate care delivery processes

and systems8 Value or outcome based care

4Need to modernize legacy applications and

systems9

Need for business model innovation to

improve sustainability

5Regulatory compliance and security

mandates10 Talent crunch and talent engagement

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Achieving Transformation

Business and Technology transformation is achieved by realigning the way organizations structure their business services, how they organize the people that perform the work, and how technology is used

BUSINESS AND TECHNOLOGY SOLUTIONSTOP BUSINESS DRIVERS

• Business architecture

• Organizational design

• Target Operating

Model

• Business processes

• Controls

• Business applications

and technology

• Change, Training, and

communications

• Project management

Finance

Supply

chain

Human

capital

➢ Business Model

➢ Holding Co to Operating Co

➢ Cost Reduction

➢ Increased Business Rigor

➢ Cloud Disruption

➢ Technology Obsolescence

➢M&A / Post Merger Integr.

• Strategy and planning

• Technology selection

• Business case

Strategy &

Planning

Structure &

Organization

People, Processes,

Controls,

Technology

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ERP Market Evolution – A Perspective

Enterprise Resource Planning (ERP) software market is undergoing significant change. Business & IT need to change appropriately.

.

First Era Second Era Third Era

Timeline 1980s – early 90s Early 90s – 2013/14 2013/14 - ?

What we call it “Best of Breed” Monolithic ERP Cloud

Software orientation Single function Data Business service

The promise Automate! Integrate! Agility! Metered use!

The contract Perpetual license Perpetual license Term subscription

The reality Siloed, disconnected Unwieldy, unresponsive Loosely coupled, Agile

Business outcomes Complex,

triggered ERP

Customized, static,

triggered Cloud

Standardized,

harmonized,

high reward, high risk

Cost $$ - $$$ $$$ - $$$$ $ - $$$$$

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The Evolution of IT Architecture

The Stages of IT Maturity show we are at a major turning point

Private Cloud Self-service

Auto-scaling

Metering &

charge back

Public Cloud Specialized

Shared

Standardized

Hybrid Cloud Federation across

public & private

Interoperability

Cloudbursting

Traditional Silos Consolidated

Physical

Dedicated

Heterogeneous

Virtual

Shared

Standardized

App Silos; Fragmented

Data; Sprawl1

Standardized Processes

& Platform2

Rationalized Apps;

Consolidated3

Shared Services;

Multi-tenant4

IT Maturity Stages –

Developing a cloud

strategy

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Enduring Credit Question 1

What is important to be done first when embarking on a large

transformation effort leveraging digital and cloud technologies?

A. Requirements

B. Business Case

C. Program Governance

D. Implementing Technology

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Cloud Adoption – Deployment Strategy

4 Target operating model

and business process

remodeling

3 Data classification

(including privacy and

locality requirements)

2 Business model (value-

based vs. volume-based)

1 Security requirements

(confidentiality / privacy,

integrity, and availability) When deciding to

deploy a particular

workload to the cloud,

healthcare

organizations must

take into account a

number of factors to

determine the most

appropriate

deployment model

7 Performance, upgrades,

backup and recovery

6 Cost and financial

flexibility and scalability

5 Vendor viability and

offerings

8 Enterprise digital

strategy

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HR Transformation & Supporting Technology

Scalable and

sustainable

solutions

Simplified

everyday

interactions

Lower overall

operating

costs

Fully

integrated

system

New

capabilities to

support the

business

Digitally

enabled

workforce

Productivity

gains

Digital experience

InsightfulConnected Mobile Secure PurposefulPersonalized

Program Objectives and Benefits

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HR Program: Complete HCM Life Cycle

Journey to a modern HR System

Personalized, Social, Mobile, Simplified, Secure Complete Talent and HCM Cloud Foundation

Modern

HR System :

Attract Talent

Screen/ Select Talent

Hire/ Onboard Talent

Manage Org & Employees

Manage Benefits

Manage Compensation

Manage Pay

Manage Time

Manage Performance

Develop/Grow Talent

Review Talent

Optimize WorkforceExecutive

Global Insight and

Strategy

HR

Employees

HR IT

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Design Guiding PrinciplesStandardization and Harmonization of Capabilities

Adoption

Enable transactions to be self-service

Guiding

Principles

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Ways of working

Provide managers /

employees the information to

make decisions and act

Shared services

Bias towards shared

services enablement to

optimize operations

Costs & investments

Configure system to delivered standard

capabilities

Approvals

Processes require 1 approval or less

Anytime access

Anytime, Anywhere, Any Device,

and Role Appropriate Access

Accountability

Empower & hold Managers and

Employees accountable for

value added activities

Levels of standardization

High Level of standardization of all

policies and procedures

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Enduring Credit Question 2

What are the key considerations when trying to determine the right cloud

approach and strategy for a healthcare organization?

A. CapEx vs. OpEx cost

B. Security considerations

C. Integration considerations

D. All the above

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Lean / Hybrid Agile MethodologyAccelerating the delivery of value through modern software development practices

Roles

involved

Process

Step #

Output

1. Sprint planning 3. Sprint reviews 4. Build Review

Product prioritize sprint

content based on product

backlog

After Sprint completion, core

team demo to showcase work

and solicit feedback

• Product Owners

• Scrum Masters

• Development Teams

• Leadership Team

• Key Stakeholders• Core Teams

Key stakeholders

review completed

work

Sprint Backlog Understanding of Work

Completed in Each Sprint

Assessment of

Completed Work

2. Sprint execution

Product Owners and Scrum

Masters to execute the Builds

per Sprint Plan

• Product Owners

• Scrum Master

• Development Teams

Potentially Shippable

Product Increment

Sprint Backlog

(Includes BPIs from

Retrospective)

Product Backlog

*Includes Daily Scrum

Meetings

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Robotics Process Automation (RPA)

Computer coded software

• Non-invasive, zero change integration on target system and security

• Operate on top of other existing software

Mimic interactions of users

• Record and automate user interactions with one or more software applications

• Interact with the user interface (UI) of existing applications in the same way that an

everyday user would

Work cross-functional and cross-applications

• Are entirely technology agnostic and can be used with any application (e.g. ERP,

Database, Microsoft Suite, ASCII file, structured PDF, thin clients such as Citrix)

• Use a central repository for easy management of automation scripts and processes

Enable the automation of repetitive, rule-based processes

• Build workflows with dynamic decision/branch points and loops for scaling (up/down)

• Ability to granulize processes into smaller components to allow reusability

• Enable end-to-end business process planning and governance

Robots are…

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RPA Strategy – A Perspective

Co-existence

Benefits• Tested & automated digitized processes• Reduction in costs for upgrading

functionality of existing systems• Increased flexibility provided by easy to

manage, configurable robots• Reduced risks of affecting existing

solutions/systems and overall architecture

RPA Tool is implemented in an environment of multiple systems that are not planned to be upgraded/replaced

Underlying processing

Current State

Partly digital processing with high fallouts and manual workarounds

Underlying processing

Aspiration

Digital Straight Through Processing

Upgrade

Benefits• Reduced design effort during upgrade –

processes standardized and requirements already captured

• Ease of data migration due to digitized and standardized processes

• Capital available for deriving higher order benefits

RPA tool is implemented in an environment of legacy system(s) that are planned to be upgraded/replaced in the near future

RPA provides immediate value and can be implemented by all organizations

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RPA Benefits in Healthcare

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Staff Shortages &

High Turnover

• Faster screening of qualified candidates: RPA can speed up the

initial candidate selection by shortlisting well qualified candidates for

recruiters

• Operational Efficiencies in the hiring process: RPA can help

reduce the overall time it takes in the hiring process by automating

the repetitive operational tasks to save several hours per requisition

Compliance and

Regulation

Adherence

• Hub of real time integration: RPA can talk to ancillary and other

third party systems that surround Cloud system

• Drive automation: RPA is cost effective and help automate the

monitoring and alerting of upcoming expiries

Operational

Inefficiencies and

redundancies

• Enhance productivity: By integrating disparate systems, RPA can

reduce manual effort by automating data entry

• 24x7 availability: Many of today’s digitally-enabled processes can

be orchestrated to operate autonomously 24x7, driving efficiencies

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Enduring Credit Question 3

Cloud and Automation Technologies still face the challenge of having

security vulnerabilities and integration challenges when it comes to

health care industry?

A. True

B. False

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Lessons Learned - Opportunities

➢ Get leadership alignment on change in mind-set to “Transform” business services

➢ Enable faster decision making at every level of the organization

➢ Get alignment on the design guiding principles for transformation

➢ Pay special attention to change management considerations

➢ Timely onboard critical project resources

➢ Enable cross-functional operating model from project kick-off

➢ Complete end-to-end business process definition prior to application build

➢ Instill adherence to strong project governance (including strict entry & exit criteria)

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Key Considerations for Cloud Deployment

➢ Outline a strong business case for the Cloud and Automation enablement initiative

➢ Define project guiding principles, maturity model, and target operating model upfront

➢ Invest in key stakeholders assessment and alignment

➢ Have a strong project management governance structure

➢ Establish the right partner relationship with cloud vendor and the system integrator

➢ Make the right investments for the cloud technologies for the end-state ecosystem

➢ Invest in the right training to enable in-house cloud expertise and skills

➢ Optimize the application ecosystem and not just Cloud / RPA technology

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Contact Us!

• Scott Floyd, Kaiser Permanente, Executive Director• Scott.D.Floyd@kp.org

• https://www.linkedin.com/in/scott-floyd-1544b02/

• Rattan Singh, PwC, Healthcare Director• Rattan.I.Singh@pwc.com

• https://www.linkedin.com/in/rattansingh/

Attendees: Please complete the online session evaluation

Questions