How Johns Hopkins is Preparing for the Future

Healthcare organizations continue to face constrained resources, shifting volumes, rising expenses, and market challenges with third-party disruptors. Despite these macro headwinds, recharging enterprise growth in today’s disruptive environment is possible by applying innovative strategies to familiar growth levers.

During an American Hospital Association (AHA) Advancing Health Podcast, Kevin W. Sowers, president of Johns Hopkins Health System and executive vice president of Johns Hopkins Medicine, and David Burik, partner and Center for Health Insights leader at Guidehouse, discussed how health systems should be thinking about and preparing for the future to ensure long-term financial stability while managing day-to-day complexities.

Listen to the Podcast

Highlights from their conversation are below.

Innovation Gaps

When the pandemic hit, healthcare providers were focused on addressing immediate operational issues. Meanwhile, payers and other disruptors have been able to use this time to build out their strategic goals.

“We were forced to use technology in a way that we’ve never used it before,” said Sowers. “Prior to COVID-19, we were only doing two to three telehealth visits a day.” That number quickly shifted to more than 5,000 a day in the first month. Sowers noted that Johns Hopkins was “also forced to use big datasets very quickly to try to understand the virus and the variables impacting patients."

Now, these disruptive market changes have become an added challenge for providers that are still managing day-to-day issues due to the pandemic. “Many health systems have tried to go back to normal, realizing it’s not here anymore,” said Burik.

Adjusting Operating Models

“As we looked at telehealth, many visits are those that used to go to urgent care. Over time, as we take one transformation in healthcare, like telehealth, we’re asking how it will impact existing strategies,” said Sowers. “It’s time to stand back and understand unintended consequences as we transform our care delivery models.”

For example, Johns Hopkins is developing a precision medicine product that takes big datasets and looks at different disease groups, such as multiple sclerosis, to understand potential outcomes of new medications and treatments. The goal is to accelerate predictive models around which treatments will provide the best outcomes. These precision medicine initiatives are also investigating how to create actionable insights from new data sources, such as wearables and other home data. Without these insights, more data risks overwhelming an already strained workforce without clear patient benefit.

This is just one example of how Johns Hopkins is capitalizing on the digital innovations to care delivery.

“In thinking about the implications of these innovations, we’re considering the concept of the risk benefit balance,” said Sowers. In doing so, Johns Hopkins is asking the right questions, including:

• Do they improve the way we deliver care or is it too much of a burden on the provider?
• Do we need to change the primary care model?
• How can we prioritize the most important initiatives?
• Do we have enough access to capital and resources?
• Which sites will we use as beta testers?

“Lots of leaders don’t think these questions through, because the culture wasn’t right within the setting to embrace the change and transformation,” Sowers said.

Sustaining Innovation

While the goal is to drive better care overall, some more disruptive innovations may be happening too fast for communities and providers to adjust to new services. For example, Sowers said that certain markets have moved to concierge medicine, which can lead to access issues for others.

“Seeing what venture capital companies are doing in the market, it is starting to create access issues that will lead to further health equity issues,” said Sowers.

Additionally, Burik noted the economic model to support embracing digital health, concierge medicine, and other innovations hasn’t kept up, adding to its complexity. “Out of my 40 years, it’s the most challenging time I’ve ever seen from a workforce perspective, and managing financial implications from the pandemic,” said Sowers.

Many health systems are in survival mode. Decreases in specialty services at the community level and hospital closures are contributing to increases in admissions at academic medical centers and large health systems – which is increasing the cost of care.

“It’s going to take partnerships with state and federal government,” said Sowers.

There is a need for state and federal legislatures to come together with the industry to create sustainable innovations. Unfortunately, it is becoming increasingly difficult for healthcare providers to consider what they should be doing in the next five years because they are so focused on what they need to address day to day.

However, Sowers said leaders need to be thinking about the future now. “If we don’t do this now, we aren’t going to have enough providers for the future. We’ll be facing an existential crisis in healthcare. The current way we deliver services and get paid for them isn’t sustainable,” Sowers continued. “There will be a forced transformation.”

Burik agreed, saying, “We are in a period where there is a lot of innovation and innovation doesn’t happen in a centrally planned ‘certificate of need’ kind of world. It happens case by case. I see a rethinking of what we want our health system to look like. Understanding what you’re going to be five years from now and investing to ensure that future really is relevant.”