FEATURE · SPECIAL REPORT The reality on the ground is that


most of the senior leaders in most of the patient care organizations in the U.S. are extremely overwhelmed, and most are frankly panicked over their financial situ- ations. And that is not a good place from which to innovate. Indeed, one of the core strategic dilemmas is that, in the typical hospital-based health system, the think- ing remains deeply conventional, with C-suite leaders still focused on filling as many inpatient beds as possible, and are still primarily leveraging technology and process to maximize success under dis- counted fee-for-service payment models. To take just one example, while most


hospital-based organizations have attempted to create population health management and care management structures and processes, the vast bulk of their energy remains inpatient oper- ations-focused, meaning that the ability to truly innovate remains limited. What’s more, the need to fundamentally rethink how their patient care organizations interact with clinicians, with affiliated organizations, and most of all, with patients and families as healthcare con- sumers, remains unattended to, because the vast bulk of their operations remains focused on filling beds. Further, the information technology


implementations that many or most leaders at inpatient-based organizations are engaged in, again, remain inpatient- centric, with the inpatient hospital as the hub of the entire wheel of care delivery, and all the other elements simply acting as spokes on that wheel—even as care delivery is moving out further and further from inpatient hospitals, even as far as into patients’ homes. Put simply, most senior leaders of


inpatient hospital-based health systems are still not “skating to where the puck is headed,” as the hockey phrase goes. Or, as one health system CEO was heard


to say recently (and we paraphrase here), “We all know there are things we should have done 10 years ago, but it was too hard. And now we’re in a situation where we just don’t know what to do, because we’ve spent years and years building expensive systems, and at this moment lack the capital sufficient to invest in the future of healthcare delivery and operations.” Thinking—and planning—forward


into the reality of the future As the reader will see (figure 1), the


leaders of patient care organizations are facing a series of transformations that


must take place systemically, over time, in order to prepare for the future—and therefore the future professional leader- ship roles that will be needed. As shown in this figure, the 1.0 stage


of patient care organization development, what we call “bricks and mortar health- care,” is very enterprise- and provider- centric. The next phase of development involves systems of insights and building new capabilities to achieve some level of clinically integrated networks, and a genuine continuum of care. Once a continuum of care is developed,


the leaders of a patient care organization can move forward into digital health and connected care and create systems of engagement through which they can engage with patients/healthcare consum- ers anywhere, at any time—with a focus on servicing consumers rather than remain- ing provider- and institution-centric. Ultimately, the senior leaders of patient


care organizations that successfully pursue innovation will reach a “4.0” level, which will involve creating person-centric care delivery in the context of a connected health and care ecosystem; they will leverage artificial intelligence and machine learning and will develop the delivery of personal- ized medicine; they will pioneer new deliv- ery, operational, and business models; and they will self-disrupt in order to compel their organizations forward into value. A recent article published by the leaders of Johns Hopkins Healthcare predicts that, in the future, no more than five to 10 percent of care will be delivered inside the walls of inpatient hospitals. We’ve simply got to plan for care to be delivered farther and farther out into not only outpatient care settings, but in the home—both physically and virtually. And the leaders of patient care organizations need to develop truly integrated strategies for the integrated real- ity of the future; they cannot simply add new people and new titles to their existing operational structures and processes.


Part two: the “Who” of the future Now that we understand the context of change, we can begin to look at the prolif- eration of new titles, positions, and roles that are being discussed across U.S. healthcare. So: what are some of the new titles


that are emerging right now? Among the most popular emerging titles are Chief Digital Officer, Chief Data Officer, Chief Analytics Officer, Chief Innovation Officer, Chief Experience Officer, Chief Transformation Officer, and Chief Health


24 hcinnovationgroup.com | SEPTEMBER/OCTOBER 2023


Equity Officer. What does the emergence of these titles mean? First, it means that patient care orga-


nization leaders recognize the need to recruit (either externally or internally) individuals with new skill sets to design the business, operating, and care models of the future. Yet, creation of new titles and employment of new leaders does not guarantee transformation of


the


healthcare enterprise. Traditional cul- tures may resist the changes these new leaders represent, siloed behaviors and decision-making structures may hinder collaboration across organizational lines, and lack of integration with key strategies, external partners, budget plans, data sets, and technologies may limit impact. Rather than creating new titles and


recruiting people to fill those titles, patient care organizations leaders are realizing that traditional C-suite roles—and sometimes, the people currently in those roles—cannot take the U.S. healthcare system to where it needs to go in the next decade. So what’s the answer? This set of chal-


lenges—how to redesign care delivery to transition into full-blown risk-based and other value-based contracting; how to create patient/consumer, family, and community engagement; how to address the social determinants of health; how to respond to future healthcare workforce issues; how to shift the entire healthcare delivery system into becoming a wellness- driven system rather than a sickness- driven system; and, in that regard, how to move away from an inpatient-centric focus and to community and home-based care, all while leveraging data and analyt- ics to provide continuous intelligence to encourage whole-person care, improved outcomes, and other appropriate changes in care delivery and operations. Now, let’s look at two alternate strate-


gies that the leaders of different patient care organizations are pursuing, as they forge forward into this new world. Among the teams of senior leaders rede-


signing their leadership teams, some are combining emerging C-suite roles with existing executive positions. Examples include the Chief Information & Digital Officer and Chief Health Information Officer (often combines CMIO & Chief Data Analytics roles). Another approach results in the creation of distinct posi- tions with defined responsibilities versus combined roles. The decision, of combined versus distinct positions, depends on the unique strategies, context, and needs of the


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