Q&A: Harmony Healthcare’s Randy Verdino on How People Power Data

HEALTHTECH: Why should hospital administrators embrace the agile approaches that IT companies regularly use when it comes to human capital?

VERDINO: It really gets down to two distinct areas: the speed at which you deliver and the expectations you place on the people who are doing the delivery. Anything we do in IT has to be laser-focused on leading with smaller teams in iterative results. In an agile IT environment, our delivery cycle is daily. The user isn’t always cooperating with agility, and that’s an opportunity.

Agility portends that the people involved are culturally aligned. They’re embracing change. They can move at a quicker pace. They’re good with self-organizing teams. They’re good with prototyping, piloting and learning as they deliver. They’re good with eliminating procedures or policies that have lost their way or become irrelevant over time. They embrace automation, and there’s what I call a constructive dissatisfaction among the team, knowing, “Hey, we can do better.” The old way might not be the right way. And let’s always look for better ways of improving things.

I view the impact of agile development methodologies, not only in its application to IT, but more as a business philosophy that we like to bring to some of our healthcare customers that are, perhaps, not moving at the pace that they need to in order to keep up with the demands of their industry.

HEALTHTECH: How can healthcare institutions embrace technology to bring innovation and cost reduction?

VERDINO: There is clearly some low-hanging fruit around applying technology within healthcare and the harnessing of data to get a better line of sight on root causes. But in healthcare, my opinion is the technology is only 25 percent of it. The other 75 percent is really having the right people who can use the data, once you have a good command of it, to inform decisions that lead to actionable improvement. To me, it’s not selling the virtues of what the power drill does. It’s more about teaching our customers how to put holes in the wall in an easier way. The bigger opportunity for me, though, isn’t necessarily on the cost savings side. It’s on the cost recovery side.

The research that we follow indicates that the denial rate on reimbursement continues to balloon on average across the top 1,500 health systems. It’s gotten worse, not better, over the past five years. It’s certainly been impacted by the public health emergency.

We’re advising some of the leading software firms out there on ways to attack business problems. I wouldn’t necessarily call those activities an effort to build a silver-bullet software solution that’s going to solve this. I don’t see that, but I do see this leading to having better power tools or accelerators that make the problem easier to contain and reduce over time.

At the end, with most of these projects in IT, it’s not as simple as pressing a button and it works and everybody is happy. It gets down to strong change management, discipline, building a guiding coalition among your leadership team, infusing a culture of accountability, having great leaders, a high degree of thoughtfulness and tenacity. There is a lot of work. It’s not just the technology that’s going to make it realize the wisdom of its functionality. It is going to take a lot of hard work on both the business and the IT side to realize the benefits of those things.

HEALTHTECH: How can healthcare institutions maximize reimbursements through accurate documentation and effective front-to-back-end revenue cycle operations?

VERDINO: It all gets down to the data. The applications themselves perform a function, and they perform a path. But the swapping of data interoperability across the application portfolio and healthcare can be quite complex. And many of the legacy applications were not built to share data. That’s changing over time, of course, with cloud and other stuff. But to me, the first thing you’ve got to have a handle on is what is your golden record? There are many applications that are capturing data.

The big ones are, of course, electronic health records. Some customers have multiple records that we deal with coming from consolidation. And there is a revenue cycle platform. Generally, there’s various bolt-on systems for different service areas of the hospital that consumers might use to pull reports from. And to me, the first thing to do is to clearly identify which of these systems are going to be your record of truth for the data, or to adopt strategies to attack that by putting everything into a data lake so you can get at the data and formulate your own opinion.

There also is a challenge with data stewardship. Who owns data quality? In some cases, the business thinks, well, this must be an IT thing because the data sits in our database. The IT folks clearly think it’s a business thing. A lot of industries have aligned cross-functional resources that maybe sit in the business, but they federate and are orchestrated by IT. So having an organization where you can value data, quickly get to data stewards, the data ownership — that is important.

The organizations in healthcare are still siloed. They’re protective of their statistics and their data. Some of that is righteous because of the health information. Some of it, maybe not so much. But having an open culture around data, the more that is pervasive, probably the better. I believe the question is, how do you get this to work better for the industry? Am I dealing with the record of truth? Do I have the right data stewardship?

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HEALTHTECH: How can these healthcare facilities harness better data management to deliver outcomes for population health and reimbursements?

VERDINO: Making sure you have a persistent method to drive change to mature the organization is important. It’s not easy. We’re trying to perform a service that is the highest mission and most critical service of all. We have regulation draped all over us. We have a complex morass of reimbursement. We have a challenge of applying technology to a moving vehicle. They can’t take time out to take a breath. So, the areas that I described earlier are really the big-ticket areas, but it comes down to the hard work and the people involved that really make the difference.

The question I ask my customers more often than I probably should is, “Is the pain of living with it less than the pain of fixing it?” Because I know how painful it is to fix it. And that’s a decision I think we’re faced with every day in healthcare, based on some of the other challenges we have and just delivering quality healthcare to the population we serve.