The Optimal Hospital Part II

Ochsner Medical Center in New Orleans has a very unique innovation model with a team that operates with the flexibility and autonomy of a start up, unlike the approach of most major healthcare organizations. In Part I of this series, I explained how they re-imagined patient care for a specific group of cardiology patients and shared the highlights of my tour of Ochsner’s Optimal Hospital.

This part is a deep dive into my interview with Jonathan Wilt, who was previously an engineer at Epic, and then ran his own consultancy firm, before joining Ochsner to lead the innovation team which currently consists of 18 people split between clinicians and engineers.

Omar Shaker: Thanks for having me Jonathan. Can you please explain when your innovation department was created and the purpose behind it?

Jonathan Wilt: If you want to be competitive in healthcare over the next five years, you need to think of what’s  to come. Value-based care will be the trend for entire industry, and so we must innovate to reduce cost and improve quality. The innovation department was built two years ago with the purpose of exploring new technologies and how we can use them to reinvent the clinical model.

OS: Experimentation of that sort doesn’t usually yield any return on investments in the short term though, how does your department resolve that with leadership?

JW: What we want is to reimagine how the patients are treated across the organization. The timeline on our projects’ returns are 3-5 years. Preventative care can’t show you outcomes or savings in a short time. We’re trying to prevent strokes and heart attacks. It’s not like you can say: If this patient’s blood pressure is under control then they won’t get a heart attack or vice versa.

Leadership understands that, and the department was created by Dr. Richard Milani with that vision. I don’t need results next month; I need results in a 2/3 year cycle. We can start 15 projects and they’d get narrowed down to one successful project.

To balance that, we sometimes need to work on smaller projects that are simply about optimizing existing business functions to make some revenue or cut some costs. We’d rather always be working on the cool stuff, but this is what is sometimes required to balance the budget and be able to pursue bigger things.

OS: What are some of those projects that you are working on?

JW: We have three major buckets of projects:

    • Digital Medicine Projects:

Our Digital Medicine Hypertension Program has 200 patients who had uncontrolled blood pressure and 70% of them have reached a controlled state within six months. We ask them to send a single measure per week and we get an average of six readings per patient per week!

We also have a wireless weight monitoring program for all cardiac patients, coupled with a medication adherence program done through our pharmacists who are part of our department.

The doctors absolutely love this program because it makes the follow up process much more effective and the patients are more engaged, because of the increased number of contact points that happens throughout their care plan.

    • Inpatient Care:

This is our Optimal Hospital Project which is an innovation wing in the cardiology department with 15 beds. This is where we test all our ideas and experiment with wireless monitoring, lab testing schedules, different lighting, sound monitoring and many more variables. We study how these changes help our patients’ recovery.

    • Patient Experience:

Text message appointment reminders are a good example for that bucket, where 140,000 people signed up in eight weeks. There was a huge demand that we weren’t fulfilling. The goal is to make patients more comfortable and giving them what they want.

OS: What are the biggest enablers you’ve had for your successes so far?

JW: Having agile leadership that supports and trusts us is vital for our success. We don’t need to go through approvals like other big organizations. This trustworthy atmosphere creates space for creativity.

Another thing that was instrumental for us was Apple’s Healthkit. It was a game changer, because it allowed us to push information from all these sensors straight into our medical records without having to worry about all the integration which would’ve taken immense amounts of work from us.

I’m a strong believer that things belong in their places and I’m very strict on maintenance. We can’t innovate in the future if we are constantly maintaining bad code or bad integrations. We have an electronic medical record, so we don’t build add-ons, everything lives inside of Epic. We do not want to invent a new universe or new web app, and that gives us a lot of data advantages.

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