Mercy, a massive health system based in St. Louis, has a special patient experience project coinciding with the opening of the Mercy Center for Performance Medicine and Specialty Care. The organization is bringing new capabilities to improve patient experience, lower cost and improve outcomes.

Mercy took an experience design approach and developed new capabilities using both its Epic EHR foundational capabilities along with custom-developed systems from its development teams and vendors.

"Choosing how to differentiate your organization when it comes to patient/consumer experience is an extremely important strategic consideration for CIOs and digital leaders," said Scott Richert, CIO of Mercy Technology Services at Mercy. "We must own the responsibility for excellent experience, but we also need to know when and how to use the broadly available EHR capabilities and products, and when to add to or replace capabilities of the EHR consumer experience portfolio with custom capability."

We interviewed Richert to discuss this project at length so he could share lessons learned.

Q. Please describe your project bringing new capabilities to improve patient experience, lower cost and improve outcomes.

A. The Mercy Center for Performance Medicine and Specialty Care is a high-tech, 272,000-square-foot outpatient center. It's designed and built with the patient experience top of mind at every turn, offering a seamless experience for patients, visitors, providers and coworkers.

The center expands our promise to treat all patients as performers who are seeking to produce at their highest level and establishes Mercy as a partner in pursuing a vibrant life through clinical excellence and compassionate care.

When an organization like Mercy lays out a bold vision like this one, it is an exciting time for healthcare’s digital and technology teams. We've been able to use the planning period for this new facility to re-imagine an optimal experience for those we care for and for our caregivers.

This created a great opportunity for us to partner with our experienced design team who explored every aspect of the patient and caregiver experience in the facility, challenged the status quo, and collaborated with clinical leaders to define the optimal experience.

It's easy for healthcare technology leaders to install new technology for a project and claim it is designed for optimal patient experience, but unless is it designed around the patient experience from the beginning, then it's really a false premise.

We created ways to make arrival and navigation easier, including digitized wayfinding and digitally enabled concierge service that will change the way patients and families are welcomed to our facility and guided through their care experience.

By blending features available in our EHR along with our custom, location-aware digital products, we can guide patients to their next steps in care before they leave their appointment. Patients and their families will receive a welcoming experience they haven’t expected from their healthcare providers in the past. In addition, their next steps in care can be arranged before they leave the building.

Q. You told me that choosing how to differentiate your organization when it comes to patient/consumer experience is an extremely important strategic consideration. Please elaborate.

A. One of the strategic themes in our technology organization is to pursue "digital differentiation" – the creation of digital care and relationship-management capabilities that go beyond out-of-the-box offerings from our EHR and CRM vendors.

It’s been easy in the past to rely on these vendor solutions to define our digital experience with our patients, but we realized that unique combination of assets that we have in our organization and the specific goals we have rooted in our ministry for engaging our communities obliges us to go further.

As a CIO or digital leader, you must be thoughtful about this. There are two extremes to avoid – a provider who wants to own the digital experience they offer their patients can't just rely on their EHR vendor (no differentiation), but it also is poor strategy to build or buy commodity-level capabilities that your EHR already does well.

You must be very aware of the EHR road map and select the areas of differentiation where you can bring enhanced digital capability that exceeds what the EHR will offer. If you avoid both of those mistakes, you can optimize your digital spend and still create differentiating services in a fabric of capabilities that includes EHR, custom-built and partnered third-party components.

Siloed design and knowledge can be the ruin of a blended architecture, so we must organize our teams in ways to prevent that. In our case, a product management approach counts on product managers who know what the optimized patient and clinician experience looks like, and who work with product owners and architects in the technology teams to craft a cohesive solution.

None of this means your EHR isn't part of your innovation road map. It absolutely must be, because it is the center of gravity for how the hospitals and clinics perform their workflow. Our EHR partner has a steady stream of improvements in their consumer-facing offerings, of which we will continue to take advantage.

Our EHR support teams also have deep knowledge of clinic and hospital operations and hold a large amount of expertise that we need to deliver solutions that will work for our caregivers and integrate well into the EHR workflow.

It's also important to consider the fact that the analytics capabilities we've developed infuses all our digital assets and channels with AI assistance and optimized recommendations for our patients using those channels.

This capability helps us guide the patient into the most appropriate and cost-effective channel for their care. It will recommend optimized choices for scheduling multiple services and informs automations to recommend next best actions for patients utilizing our contact centers. With 14 years of EHR data, our AI and machine learning models have a very healthy base of data from which to learn.

Q. Mercy took an experience design approach and developed new capabilities using both your Epic foundational capabilities and custom-developed systems from your own development teams and other companies. Please explain when, in your opinion, it's best to go to the big established vendor, versus in-house teams, versus specialty vendors.

A. If you start with what the desired experience is for the patients and coworkers, you then develop needed capabilities to enable that experience followed by identifying the blended technology approaches to create those capabilities.

When you decide to create digital experiences that go beyond what the EHR can offer, it requires somewhat of a commitment to build digital-solutions-engineering capabilities in-house, or to find a partner that can build them with you. In our case, we found a balance of both.

We're confident that creating custom digital assets is core to our intention to transform the healthcare experience, so we have invested in hiring those skills. It's important that you have the core skills to define the digital vision and roadmap, but you can then enlist help from others for speed and scale.

That’s where your ability to attract and retain talent is important, and having a network of partners from which you can enlist expertise or delegate portions of your digital development is critical as well.

The EHR vendors have stringent requirements around third-party access, so that's always a gauntlet to get past; however, we've engaged vendors who can help achieve the capabilities we're trying to build. The larger third-party vendors can be an option, but in our case, we've worked with smaller digital innovators to help build our experience fabric.

It's important to own our own digital vision, architecture and design. No matter the blend of solutions we use, we must maintain ownership of the overall solution. This means understanding all the strengths and weaknesses of each component (EHR, vendor-built and custom-built internal) and making sure the integration results in a cohesive fabric that supports a great customer experience.

Q. What is the most important lesson you have learned while working to improve the patient experience?

A. I would say the realization that CIOs and IT leaders must partner differently than we have in the past. We inherently want to serve our clinicians and our patients with the technology solutions we can deliver. We've done that very well for more than a decade of EHR delivery and achieved a great deal of success.

However, for our patients to have a personalized, predictive and proactive experience, we must go beyond offering a series of solutions that are great, individually, but not designed around an overall cohesive, intuitive patient experience. A cohesiveness between the episodic experiences our patients need won't happen without intentionally designing around the overall experience.

In our organization, we've worked closely with new teams outside of IT that are specialized in designing end-to-end experiences. Our product development team helps to identify what capabilities a successful solution designed around the patient experience would include.

We then engage our architects and technology product owners to turn those requirements into solutions, typically iterating with the product team to deliver an MVP, followed by continued improvement cycles.

This a very different approach than we’ve done in the past and requires the business to become engaged in framing the problem we're trying to solve. This approach avoids the "shiny object syndrome" of cobbling together individual technical solutions that look appealing individually, but when layered on without a patient experience core design, can further complicate the experience.

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