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[00:00:00] This episode is brought to you by Pixel Health. Pixel Health provides strategic planning, clinical workflow optimization, and patient access optimization services to improve patient engagement and operational efficiencies.

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Today on Town Hall

(INTRO) experience is really the great equalizer in healthcare facility planning. By focusing on the desired experiences that we want, we can align our perspectives and create a shared vision.

My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health.

Where we are dedicated to transforming healthcare, one connection at a time. Our town hall show is designed to bring insights from practitioners and leaders. on the front lines of healthcare. .

Alright, let's jump [00:01:00] right into today's episode.

Welcome to this episode of TownHall. We're diving into the future of healthcare facility planning and technology integration with Jill McCormick, who's a principal at Pixel Health. Pixel Health is a strategic advisory firm helping healthcare organizations design human-centered technology

driven environments that are enhancing both patient and clinician experiences. Jill specializes in facility planning, patient journey mapping, and digital infrastructure strategy using the sprint process to tackle complex healthcare challenges. Today we're gonna talk about how health systems can better integrate technology into facility design to improve efficiency, care, delivery, and the overall experience.

Jill, welcome to the show. Hi. Happy to be here. Thanks for having me. so Jill, I would love for you to share with us really the intersection of facility planning and technology because most people don't understand how or why technology integration has become such a critical component of healthcare [00:02:00] facility planning today.

Yeah. And so as I was thinking about this, I'm thinking about experience is really the great equalizer in healthcare facility planning. By focusing on the desired experiences that we want, we can align our perspectives and create a shared vision. So this is incredibly important for facilities planning because the experience components actually need to be decided years before the building even opens.

And so without having a clear vision for the future state experience that you're trying to enable with a built space, with a technology. Then it becomes challenging to really understand or imagine the future or budget for future tech. And as we work towards the space actually opening, we might not have the optimal workflows and just end up repeating the past instead of taking an innovative and future proof approach.

What happens with clients where it's almost like a remediation effort because heck, I worked in some buildings that were [00:03:00] really old and to try to design what the patient flow or the patient experience should be based on the technology that was coming. Some of it was massive retrofitting or really try to be as creative as possible with the environments that we were in.

When you have to rehab an existing space, what are some of the protocols that work that allow you to still achieve. The desired end goal.

Yeah. And even just highlighting that most of the buildings that are out there were built in, or at least, one of the clients that I'm working with I think their buildings were built in 1940,

and so they were not as future proof as you can imagine . And so when you think about how do you retrofit something to fit a new experience, there's a lot of work that goes into reimagining the space, working with the walls you already have, working with the cabling that you already have.

Thinking about the wifi and the endpoints, like will they support the technology? Will they support the new ways that you're using the technology, and it can be really challenging [00:04:00] to do all of that work. And so part of what my approach is really about going back to that experience layer again is like, what is the experience you want your patients to have in your space?

And usually that experience actually starts at home or before they even get there and nailing the intake and arrival process, for example. A lot of times in human-centered design, what we do is we look for areas of the patient journey that matter the most to the patient. Like, where is the most problem, where is there cognitive burden, what are the moments that matter the most and really starting to think how are we gonna nail those moments to create that sort of continuous experience within the environment.

And so oftentimes when I think about it, I think about the building last or the technology last, and I say, what is the experience that we want to have? We study the current state and when you put it all together from, prior to arrival, intake, and arrival, how I find my [00:05:00] way throughout your building, where I receive the care, how I get discharged, or transition into, my next step or my next clinical action is this the optimal experience.

If you stick with a clinical perspective or a technology perspective,

it's almost like that elephant story of the blind men and the elephant. If everybody's touching a different part of the elephant and describing the problem. That what experience does is it gets everybody on the same page and then you say what are the set of interventions to the building, to the technology, to the operational workflow that need to change in order to create or unlock that experience that you need?

And so from there you start to say, okay. I know what the experience is. I know what's gonna have to change operationally, what needs to happen to the building, what needs to happen to the technology?

Oftentimes what areas that I run into problems with is that I'll find, hey, we're thinking [00:06:00] about, Expanding our front desk. the problem that we have is that when patients come in, we have two offices that are serviced by the same window, and the lines get long and people get into the wrong line. And so our solution is we need a new front desk. And what I found in my, work in this area specifically, this one example that I'm sharing with you is you didn't need a new front desk. You needed a new workflow. You needed a new digital experience, where now all of a sudden the size of the front desk actually goes by the wayside, and so you start to save some of the dollars and don't need a remodel that you may have thought that you needed.

Throughout all of this, you use the sprint process to solve some of the challenges that you've just shared with us. Walk us through either a recent client engagement where the process helped to solve a significant challenge. It could have been not having to use all those dollars on redesigning the front desk, but when you really think about a sprint process being in [00:07:00] place to decide.

That human-centered design principle to meet the patient needs, the clinician needs, and to have the best possible outcome, that to an extent is future-proofed. What does that actually look like in practice?

Yeah,

that's a

great question. So yes, we do a sprint process that is the Google Ventures sprint process for being able to rapidly make decision making or rapidly make decisions, include all of the right stakeholders in the decision making, and also really push you into thinking differently, thinking innovatively in the process.

And so the way that we do this work isn't exactly how Google Ventures does the work. We do research ahead of time. So we will meet with key stakeholders that are going to be in, let's just say the future built space. So meet with the stakeholders who will be in the future build and just get a sense for what their challenges are or what do they imagine for this space?

Why are we even embarking on this new space altogether? And what, [00:08:00] problems and challenges are there for patients. What problems and challenges are there for staff? If you could wave a magic wand, what are the kinds of things that you would want to see improved? Then we also do like rounding and visiting and observing the pain points.

And what this allows us to do is to get all the stakeholders on the same page for what the highest level current state is. , we take this all into a facilitated workshop where and we did this one most recently in two days where we. Put the patient at the center of the change process. So we said, what journey are we gonna try to solve for? What's the most important journey for this built space

that we decided based on what the strategic reasons were and what the problems that needed to be solved was the planned patient visit. So a patient knows they're coming to the hospital. Hospital and they are going to have a procedure, they're probably gonna visit multiple departments or multiple areas of the hospital when they're there for their visit.

[00:09:00] And then they're going to be discharged to the community, ideally home. And then they're gonna talk about with their friends. Family members, what a great experience they had. So that's the highest level experience that we want to design for our patients. And so we bring in the people whose attributes are known for being able to imagine a brighter future for the patients have. Surfaced, opportunities for enhancement that are known within their colleagues for their problem solving capabilities and their ability to bring others along in the process.

So you select the right people to come into the room. And so then. Together you use a process where you translate all of the challenges in the current state into opportunities. What if or how might we actually enhance the arrival process? What's going on in the arrival process today? What would it look like in a future state to be able to do that?

As part of the process, we bring in [00:10:00] the art of the possible. What other health systems that they might look up to or doing what's happening in other industries that's exciting and compelling. Maybe the client that you're working with is actually wanting to be the most digital or the most people centric, or the most preferred, most advanced, like most something in that work.

And so you have to bring. Solutions and inspiration to that art of the possible and the art of the future into those conversations. And then you literally, you just co-design the future state experience. People are sketching and drawing and they thought they could never draw or never sketch, and they're telling a story.

About what does this experience look like and what happens when I get dropped off and how do I navigate the hospital and what happens when I get to my room?

So many emerging technologies like you discussed. You've got AI, IoT, smart systems, sensors. How do you help the client balance innovation with the practical realities of budgeting, the actual [00:11:00] workflow, and even some of the regulatory requirements that we're seeing today?

Yeah, I mean, I think it's really a matter of understanding what their risk tolerance is and what their own environment is that they're working in, and what the relationships are within the leadership of the organization to be in alignment about what they're going to do next. Forget facilities for a second, but any project that you're working on that has these new technologies involved in it, you have to ask yourself, what is the strategic reason for doing this? And in that strategic reason for doing this, you should have an understanding of like at what cost compared to what other areas that you want to enhance and.

I have to say, you really have to get, I'm gonna be a little provocative here, but you have to get really serious about think about how many dollars are going into buildings. Like these are billion dollar projects, $2 billion projects, [00:12:00] $3 billion projects. And yet from an IT perspective, a lot of the challenges aren't really about where the cables are gonna go or what's the cost per square foot.

Of the floor itself, it's the digital enablement of being able to use all of, like that AI isn't in the walls. Those are just sensors. That's the easy part, right? How are you going to build an organization that can try these new technologies that has a, a. Pathway for strategic learning and evaluation that can judge the results of any of these tests of change in order to be able to receive those benefits.

And what's the infrastructure underneath it? I always talk about connectivity as a core component, in a future state vision that I was working on with some clients. And they were really imagining a very connected. Workflow for I hate to use the word workflow, A patient journey where the journey starts at home.

I collect all this [00:13:00] information. I show up at the hospital and they already know who I am and they are expecting my arrival and then they know certain things about me and they're navigating me the way that I want to be navigated. They are putting me into a room where I have all of the comfort at my fingertips, where I can, adjust my lights and my blinds and, I can manage my own comfort.

All of that you're talking about is a very seamless journey and experience that requires infrastructure beyond just whatever's going into the walls, navigating that and being really serious about what the investments are and understanding that in order to deliver an experience at that level requires significant. Considerations and budget around all of that,

and you're likely still gonna have a little bit of resistance to change in that equation.

So when you consider some of the challenges that you've encountered, when you introduce new facility planning, the human-centered [00:14:00] approach, the technology solutions that need to be in the future X amount of years, how are you navigating some of that resistance to change?

I think again, it's using the experience as the great equalizer.

It's saying, Is this the experience that we want to deliver? And then. Getting agreement on that with the stakeholders that have been selected because they know where the bodies are buried and because their department is the one that's gonna be occupying the space. And because they know what advanced care needs to happen in those procedure rooms, et cetera, getting their buy-in as the first, piece to this.

And so by following this process that they co-designed the future state agreement and they were selected for this process. The ones that did the co-design based on their ability to be the change agents for this process. And then of course, testing it with the front lines and with patients as well to say, is this journey what we want?

Then it becomes the magic of. This is what we intend, and then this is the reality. Like you [00:15:00] still have to balance those two components, but at least directionally you're headed somewhere where everybody wants to go.

And you mentioned

this can be expensive. These are not short-term engagements.

These are not insignificant changes that are occurring in an organization. How are you measuring the success of a facility's design? And so let's also see the technology integration. What are some of the key metrics or even the feedback you're looking for post-implementation to help understand. How much of the pre-planning was successful and how much tweaking or modifying the initial workflows and the patient experience looks like after it goes live?

It depends on what it is that you're trying to implement. What is the core reason or strategic reason that you're trying to do this?

If you're trying to have an advanced health system that is a place for retention and attraction of new talent, maybe you're in an area that is hard to recruit in. Maybe you're an area that is super saturated with competitors and you wanna be [00:16:00] able to show that you are the premier preferred place for doing these types of procedures in your area.

So depending on what the goal is of the space, is how you construct the measurement. But if I'm thinking just purely on experience, if I could only pick one measurement factor or one KPI or one measurement. Is the customer effort score, how easy or hard did you make each step of this journey for me?

How easy did you make it for me to, be a patient X, Y, and Z? Yeah, typically when you're going to the hospital, it's for a procedure of some sort. Sometimes you're going for a mammo or another test that's pretty routine. The same time you don't know what the outcome of that test is going to be until you get your results.

So it's rare that you go to the hospital without some level of basic anxiety built in. That's right. It needs to help calm any of the concerns, even when you're doing some routine activities as a patient, as an example. So [00:17:00] that perspective is huge and it gets exacerbated by the illness or by the people that may be there to be seen as an example.

So I'm glad that is a guiding principle for you and for the organizations that you serve. So I have to ask you this last question. This is all about the future of where some of this is headed. If you had to predict the biggest shift in healthcare facility planning over the next five years, what would it be and how should systems be preparing for it?

If you're building a new building, then you don't necessarily wanna pave old cow paths or create a environment that's not future proof. But if you use your existing workflows, your existing point of view and bring it into that process, then you're just going to be keeping the work in the workflow and not necessarily improving or innovating on top of it.

And so one of the challenges that you'll face is that you're going to have a lot of legacy system. Legacy operational [00:18:00] processes, legacy technology in the other parts of the organization. And so when you're building new, how are you using that new space to create the standard for how you want your experience within your enterprise to look and feel like for patients?

And then how are you going to deliver that in the various different areas of the enterprise. And so I think that's gonna be a challenge in top of mind. And I hope that it doesn't hold people back from leapfrog technologies or leapfrog opportunity because they're thinking about the whole system at the same time.

So I think threading the needle on that is going to be an interesting area of focus of how do I create the most future proof. New in all of my new investments should be as future proof as

[Mic bleed]

and which means flexible because the technology is changing so fast that we need to be able to be nimble and to move quickly [00:19:00] and to be good at innovation, and to be good at tests of change and good at new intervention.

If I was interviewing for a CIO job today, I would wanna go on a facility tour to really understand what I'm inheriting and also what my capabilities are for going towards some of the newer technologies and opportunities.

Because to your point, I've worked at buildings where. Hey, you're over an aquifer. Hey, IT is in a basement. Hey, it's next to rooms with leaded walls, and it's next to places where it's subterranean two or three stories down. Like it's hard to do some of these activities when you have partners like Pixel Health.

Then to your point, the art of the possible is really about what we can do and we can best have that impact. We appreciate you so much as a partner and for all the work that you're doing with a lot of the systems that we also serve and have friendlies in our 2, 2 9 community. So thank you, Jill and thank you to Pixel Health for really bringing new ideas forward and the future of healthcare facility planning, technology [00:20:00] integration, the human-centered approach, all of the things that allow an organization to truly improve efficiency, drive the best care, delivery, and overall experience.

We appreciate you and your time today. Thank you so much. I appreciated it.

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