Trends in Healthcare & Governance

From the Executive Director

HTNYS’ monthly Trends updates provide trustees with information about emerging developments in governance and healthcare. Published by HTNYS Executive Director Sue Ellen Wagner on the second Wednesday of each month, Trends’ timely statistics and insights help trustees fulfill their roles and responsibilities while adapting to the changing environment.

Generative governance: Transforming a board’s work
June 2019

Please note that Trends will not be published during the months of July and August. Trends will resume publication in September. Have a wonderful summer!

  • There are three types of governance: fiduciary, strategic and generative. Most trustees are familiar with and operate in the fiduciary and strategic modes of governance. However, a new model of governance – generative – is beginning to emerge and transform the way boards work.
  • Does your board appear to be disinterested during meetings? The generative model of governance looks at framing problems and asking “What is the key question?” Thinking and operating in the generative mode enables boards to shift their thinking. Generative insight requires that the board have a strong understanding of the organization’s identity to tailor their solutions to the organization’s goals and values.
  • To embrace a generative mode of governance, boards must be prepared to engage on a different level of analyzing and discussing issues from a macro lens. One major factor that will need to change to adapt to this mode is the way board meetings are structured by an agenda. More time needs to be built into the agenda for critical thinking and debate on bigger-picture issues.

HTNYS’ 2019 Annual Conference will include a breakout session on critical thinking for boards. The complete agenda is available online. Conference registration begins on June 26.
(Note: generative governance information source: BoardSource and the American Hospital Association)

New Technology to Track Our Health
May 2019

  • Cardiogram, maker of a smartwatch app that uses technology to detect various heart conditions, announced that a deal with Oscar Health to give members health detection technology. This new technology will enable consumers to be monitored for signs of diabetes and atrial fibrillation, and if someone is at a high risk for one of these conditions, they will be offered a confirmatory test such as a blood test or an ECG.
  • The FDA has cleared a new wearable device that uses machine learning to remotely track and analyze multiple vital signs, including respiration, pulse, oxygen saturation and temperature. The product can deliver continual updates on a patient so doctors can intervene quickly if the data signal an emerging problem. The device, called Current, is already used in hospitals and the clearance means it can monitor patients at home between visits with their doctors. It uses machine learning to analyze the data it collects and notifies doctors of problematic changes via mobile devices or in electronic health records.
  • Artificial intelligence (AI) and machine learning capabilities are being integrated into workflows for many clinicians and administrative staff at hospitals and healthcare systems. AI is being used as clinical support tools to improve diagnostic accuracy and to customize treatment plans for patients. AI will also be used to automate manual tasks and improve the accuracy, predictability, and speed of managing risk compliance, insurance claims, and the supply chain.

Challenges for healthcare boards – age, diversity and technological savvy
April 2019

  • Aging governing boards: As healthcare providers continue to face the challenges of serving an aging population, the average age of governing boards is also increasing. Many healthcare organizations are working to recruit younger board members such as millennials and Gen Xers to increase generational diversity on their boards. Thinking outside of the box for recruitment, some organizations are looking beyond their service areas to recruit younger board members while others are beginning to consider compensating board members beyond reimbursement of expenses. Other organizations are looking to change their traditional governance structures to attract and retain millennials.
  • It pays to have a digitally savvy board: Along with opportunities, the digital era brings many risks for organizations, such as cybersecurity breaches and business model disruptions. As a result, it's important for all business leaders to be digitally conversant. A recent study published in the MIT Sloan Management Review found that this characteristic is particularly critical for board members, as it is a new financial performance differentiator. This study showed that companies whose board members are digitally savvy outperform other companies in areas such as revenue growth, return on assets and market cap growth.

Recent disruptive activity that is impacting healthcare
March 2019

As the pace of technology continues to accelerate, trustees need to be aware of these changes and how your organization is planning for them.

  • Alexa at the bedside: Voice assistant devices manufactured by Amazon, Google, Apple, Microsoft and others are now making deeper inroads into patient care. Hospitals are exploring new uses in intensive care units and surgical recovery rooms, and contemplating a future in which voice avatars like Alexa become a virtual member of the medical team. For example, Northwell Health is preparing to put Alexa in private rooms to allow patients to tap into their electronic medical records. Meanwhile, others are testing voice assistants for clinicians to improve or even replace EMR interactions.
  • Walmart drops price of virtual visits from $40 to $4: Walmart is offering employees a 90% discount on telemedicine, dropping the price of a virtual visit from $40 to $4, according to The Denver Post. The retailer reduced the cost of telemedicine services to increase options for employees seeking care. Walmart's health benefits currently cover more than one million people enrolled it its Associates' Medical Plan. Through this plan, virtual visits through the Doctor on Demand app are covered like a normal physician’s office visit. However, just eight percent of Walmart’s employees at large and midsize companies used telemedicine benefits in 2017, according to the report.
  • CVS looks to make its drugstores a destination for healthcare: CVS believes that the healthcare industry is currently organized for the convenience of doctors, hospitals and other providers of care. They see an opportunity to organize around the consumer. CVS plans to transform some of its stores and its existing retail clinics into “minute clinics” that will offer more healthcare services and products. The company says this retail approach will make it easier and cheaper for people — particularly those with chronic illnesses like diabetes, heart disease or asthma — to manage their conditions.

How do social determinants of health impact your community?
February 2019

  • Non-medical factors such as housing, nutrition, income, education, transportation, social isolation, health literacy and access to care and healthy food can affect healthcare outcomes and health.
  • Societal trends and the social determinants of health greatly impact the health status of the people who live and work in our communities.

How can trustees help?

  • Understand what is happening in your communities, where the problems lie and how your community can begin to address and solve these problems.
  • Learn how your organization is looking at population, demographic and socioeconomic trends.
  • Obtain a high-level overview of key data that highlight obstacles to addressing social determinants of health.
  • Find out if your healthcare organization is already collaborating with community-based organizations, businesses and education to begin to address how these social determinants are impacting your communities.

Identifying and creating community-wide interventions with key community partners can be a first step to addressing these issues.

A Good Orientation is Key to Being a Successful Board Member
January 2019

  • Board Orientation: As new board members are elected to your boards, remember: It is very important that they have good orientation to assist them in becoming familiar with healthcare. HTNYS can help! We have great resources that can assist you with board orientation. Our Boardroom Basics publication provides a strong foundation on board roles and responsibilities. Our website contains helpful resources on key topics such as self- assessment, quality and strategic planning.
  • Single Payer Primer: An issue that will likely surface in 2019 is single payer. To begin to educate trustees about the single payer issue, HTNYS developed a Single Payer Primer. It is important for you to know about the single payer issue so you and your board colleagues can begin to help us shape state and national discussions on this issue. Fundamentally, the single payer debate is not about single payer vs. no single payer; the challenge has been and will continue to be how we make New York’s healthcare system sustainable, accessible to all, of the highest quality and affordable.
  • Save the dates for HTNYS’ Annual Conference, September 13-15, 2019 in Saratoga Springs: The “Power of Governance” theme was chosen to feature key topics that trustees need to fulfill their leadership roles as board members. The conference will feature exceptional speakers on key topics such as leadership, governance, the opioid crisis, behavioral and mental health issues, system-ness, and much more. More details will be coming your way soon.

2018 Trends