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How a locally governed health system teamed up with Optum to drive change

How a locally governed health system teamed up with Optum to drive change
Boulder Community Health Chief Information Officer Michael Jefferies told HIMSS22 attendees about the challenges and triumphs of the partnership, which launched 18 months ago.

ORLANDO, Fla. – As a nonprofit, locally governed system, Boulder Community Health has served the region for almost 100 years.

Since 1922, it has grown from a single facility to encompass a 173-bed hospital, a level 2 trauma center, 12 family and internal medicine clinics, five imaging locations, five lab locations and dozens of specialty care clinics.

The journey to becoming one of CHIME’s “Most Wired” hasn’t been without hurdles, explained BCH Chief Information Officer Michael Jefferies in a HIMSS22 “Views From the Top” session on Thursday alongside Optum SVP of Analytics Tushar Mehrotra.

Starting in 2009, said Jefferies, the system started playing “a little bit of catch-up with our technology.”

“We really had not been a technology-forward organization historically, and so we started moving into some of the basics,” he explained.

Then, motivated by meaningful use – which Jefferies described as “the kick in the butt” needed by the executive team – the system hit the gas pedal. It wasn’t all smooth sailing, though.

“We were deploying the technology faster than we could really stabilize it,” Jefferies said. “We were building up a lot of technical debt during that period of time.”

In 2013, the system experienced a ten-day downtime, a painful wakeup call. “That spurred us to start investing in our infrastructure and improvements,” he said. That in turn set the foundation to start looking toward the future.

Of course, the pandemic introduced yet another complication. The team was forced to reconfigure its 2019 strategic plan to account for ramped-up telehealth and analytics needs, all while achieving EMRAM and O-EMRAM Stage 7 validations.

Still, though, the system faced unique problems, particularly on the analytics side.

“We’d hire recruiters, we’d bring in talent, only to find them to be poached,” he said. The smaller bench forced the team to be generalists, and their strategy relied heavily on requiring leaderships to stay up to date on what Jefferies called “mega-trends.”

“The organizational demand outpaced our ability to transform,” he said. “Our people were asking for things we weren’t able to deliver.”

The team began investigating a partnership with UnitedHealth Group’s Optum, one similar to its collaboration with John Muir Health in Walnut Creek.

“I don’t use the word ‘partner’ lightly here,” Jefferies said. “This was putting skin in the game together, mutually, with mutual goals that we’re going to go after, and then advancing beyond just the revenue cycle.”

In 2020, BCH officially teamed up with Optum, enabling growth acceleration.

“The premise of the partnership was really to explore innovative ways to drive efficiency and help Boulder maintain independence,” said Mehrotra.

The three main pillars of the partnership, said Jefferies, were revenue cycle management, the clinical continuum and enterprise-strategic service – including analytics, strategic advising, portfolio management and enterprise project management.

Eighteen months in, he shared some key analytics achievements. The partnership helped to support strategic initiatives, eliminate the accumulated backlog of analytics requests, implement an actuarial analysis of key programs and connect the team with subject matter experts.

Regarding equity goals, he said, “with Optum’s support, our team was able to take the American Hospital Association framework for improving both care to our patients as well as our employees and put that into analytics to help guide our strategy and where we need to improve.”

Jefferies talked through a few challenges of such a large-scale partnership as well, such as governance and coordination, capacity compatibility, identity and access management, contract incentives, and cultural alignment.

“This is really similar, if you’ve gone through an M&A, these are really similar challenges, just kind of on a micro scale,” he said.

Looking ahead, Jefferies gave a look at BCH’s new strategic plan from 2022 through 2024, buoyed by the power of the partnership.

Its goals include service line transformation, an integrated network, an extraordinary workforce and consumer choice and loyalty.

“We have given up no governance or ownership … of our organization,” he explained. “We have complete control of it, but we have this ability to scale in a way that we never had previously.”

“The explosion of data … has fundamentally transformed how we view the world,” said Optum’s Mehrotra. “The ability to link together disparate data assets to better understand an individual’s risk profile or better understand a population is truly transformative.”

“That’s where the power lies in my eyes: taking these disparate data insights, driving insights and, importantly, embedding those insights in workflow,” he said.