Impact Insights

Building The Digital Health Portfolio: Aligning Strategy & Execution

Ben Wolfe

Daniel Burnham, the legendary architect and urban planner, thought big. In a 1910 speech to fellow city planners in London, Burnham said, “Make no little plans; they have no magic to stir men’s blood and probably themselves will not be realized. Make big plans; aim high in hope and work, remembering that a noble, logical diagram once recorded will never die.” Burnham understood that tactical success followed from strategic forethought, and that the key link between the two is a logical master plan. Just one year before, he had unveiled his 1909 Plan of Chicago – a masterpiece of urban planning that aimed to guide the City of Chicago through a period of vast transformation – from the 19th Century era of industrialization and explosive, chaotic growth toward a more orderly and civilized vision for the 20th Century city.

Fast forward to 2019, and health systems are on the brink of another kind of transformation – from the era of health record digitization with its focus on provider-centric workflows, to a new era of consumer-centered, digital-first solutions for engaging patients, gaining new data-driven insights, and increasingly delivering care outside of the four walls of the health system. Patients are also porting their experiences and expectations from other service industries (e.g. travel, hospitality, banking, etc.) to their health and wellness providers. And as a result, health systems are responding with new portfolios of digitally-enabled products and services that aim to improve patient access (e.g. telehealth and virtual medicine), manage chronic conditions (e.g. e-prescribed health management apps), and deliver personalized care (e.g. analytics-driven digital engagement).

This digital transformation can be fraught with challenges, however. One of the most common early hurdles is determining how to structure a digital health program that aligns both the technological and operational capabilities necessary to deliver on healthcare consumers’ changing expectations for convenience and simplicity. Overcoming this challenge often begins with questions like: “Where do we begin today? Where do we want to be tomorrow? And how do we allocate resources and priorities to successfully get from here to there?” Impact Advisors believes that the answer lies in Daniel Burnham’s observation that big dreams are best achieved via an orderly plan.

As we work with our clients who are leading the digital health transformation, we are increasingly seeing the value of a “macro to micro” approach to planning and managing the digital portfolio:

Step Example Questions To Ask Yourself
Start with digitally confident leaders
  • Who is accountable for the digital transformation in our enterprise?
  • What are operational leaders’ roles?
  • How and where should IT leaders participate?
Begin with the end in mind
  • What are the digital interaction points that are most critical to health outcomes and the consumer experience?
  • How do those points link to and support each other, both inside and outside of our four walls?
Chart the course…but don’t boil the ocean
  • How does the digital consumer experience differ in Year 1, 3 and 5?
  • Should the digital patient access experience be a Year 1 priority, or should we begin with digital care coordination? Etc.
Define the portfolio
  • Which IT and operational capabilities need to be delivered in each phase/generation of your roadmap?
  • Will we build/buy/partner for these solutions?
  • What is the sequence and priority for each?
  • Who are the business owners responsible for operationalizing and scaling the use of these new tools?
Organize for execution
  • Which projects need to be chartered to implement the technological and operational changes identified above? In Year 1? In Year 2? Etc.
  • Which functions and roles need represented within the project teams?
  • Which methodology is appropriate (Agile, Waterfall, etc.)?
  • How will the consumer/patient be involved?

1. Start with digitally confident leaders – Those who will chart a cohesive vision for your health system’s digital transformation, inspire change around that vision, and ensure accountability for delivering upon it. Engaged operational leadership is critical, as they sponsor and shape the digital product and service portfolio with capacity, readiness, and adoption. IT leadership also plays a key partnership role in the visioning process, defining the new technology architecture and in fostering innovation along with other digital thought leaders (e.g. Chief Digital/Patient Experience Officers).

2. Begin with the end in mind – Avoid the temptation to jump to individual technologies or projects. Instead, start by defining the future continuum of digital consumer interactions that must be delivered. Sketch out a longitudinal digital experience map that illustrates the consumer’s journey across their many touch points with your organization, across time. This will later be decomposed into component journey maps, technological and operational requirements, project charters, and resource allocation plans.

3. Chart the course…but don’t boil the ocean – The next step is to divide this grand vision into time horizons. Think about how the consumer experience in Year 1 will evolve and improve in Year 3 and Year 5. How can that transformation be made in stages? Find your organization’s most impactful point of departure and begin planning and define a progression that balances early impact with achievability, evolves the experiences and underlying capabilities over time, and layers on new and expanded experiences as your program matures. This becomes the multi-year strategic roadmap that will guide resource allocation and digital product/project prioritization decisions into the future.

4. Define the portfolio – Decompose this strategic roadmap into a portfolio of prioritized digital products/tools/capabilities (both IT and operational) that need to be delivered together and evolved within each time horizon in order to deliver on the intended, cohesive consumer experience. Take inventory of your technological capabilities and ask where you may need to internally develop, or seek industry partnerships to obtain them (e.g. virtually via API-driven software partnerships and physically with traditional business partners).

5. Organize for execution – And finally, it is time to define the execution plans that are necessary to deliver on the near-term digital portfolio objectives laid out above. This step involves further decomposition of the digital portfolio into discrete projects that will be prioritized, resourced, and accountably managed in order to achieve the consumer-experience objectives set out in each phase of the multi-year roadmap. Organizations who are most successful in executing their plans employ focused, agile and customer-centered project teams, transparent and accountable work tracking, and highly engaged, innovation-minded IT and operational stakeholders to guide the program to success.

By adopting this macro-to-micro visioning and planning approach, organizations are better prepared to avoid the most common pitfalls along the pathway to digital transformation: diffusion of accountability, disjointed digital experiences, unclear priorities, mismatched IT and operational objectives, and challenges scaling new digital products and services. Digital health is a team sport, and with an intentional, multifunctional approach that starts with a cohesive vision, builds with a cohesive plan, and innovates with partnership-oriented team structures, health systems can better position themselves, like Daniel Burnham, to deliver on a grand and important vision for the future.

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