Sentara Healtha healthcare system serving Virginia and Northeastern North Carolina has undergone a transformation into what it calls One Sentara – a strategic alignment of its provider and payer organizations to create a seamless and affordable experience for its customers.
THE PROBLEM
Before the One Sentara realignment, the healthcare delivery side and the healthcare plan side operated as virtually two independent businesses. This often led to abrasions for patients and members, with duplication of services, such as care management.
It also contributed to patients’ and members’ perceptions that the health care system did not “know” them.
“The One Sentara transformation allows us to create shared services that deliver a high-quality, consumer-centric and consistent experience,” said Tim Skeen, executive vice president and CIO at Sentara Health. “It’s about making healthcare interactions easier, more seamless, more personalized and more affordable, from start to finish.”
PROPOSAL
It’s important to understand that One Sentara’s strategic alignment has the consumer at the center, Skeen explains.
“They are at the center of everything we do,” he said. “As an integrated healthcare network, we knew we needed to more closely align and streamline our care delivery, along with our healthcare coverage processes.
“To this end, Sentara is migrating from fragmented patient interactions to a holistic view of our patients and members,” he continued. “Patients are not acute or outpatient, they are simply people who need care. Often the language of healthcare is confusing at a time when people need clarity most.”
To solve this problem, Sentara is implementing a clinical access center where it has centralized scheduling, answering calls, and connecting a patient to the right clinical resource and referrals.
“In conjunction with the clinical access center, we are implementing omnichannel experience and preference management, allowing patients to receive the information they need through their preferred channel,” Skeen said. “We are seeing extremely positive results in surveys after meetings with our members and patients as a result of the changes we are making.
“Patients are no longer on hold or left a voicemail, they are speaking to and receiving people the digital feedback interactions they expect,” he continued. “Additionally, as we implement these improvements, we are discovering numerous opportunities for optimization and key processes in our delivery system.”
MEETING THE CHALLENGE
The One Sentara transformation creates a need for a consistent healthcare management platform while enabling value-based contract performance for the integrated healthcare system, Skeen said.
“It’s important to remember that we’re never done when it comes to improving the customer experience,” he explains. “As needs change, so will technology, and we must keep our finger on the pulse to ensure we are effective.
“Two key strategic initiatives we have launched on our enterprise data platform are the Consumer Data Hub and the Enterprise Data Fabric,” he continued. “The Consumer Data Hub will provide a secure 360-degree view of consumers – including members, patients or potential customers – to enrich our understanding and interactions with them.”
Similarly, the Enterprise Data Fabric will unify diverse data sources, provide instant access and enable advanced analytics AI and machine learning.
“These efforts are intended to improve data management and governance, ensure smooth integration and access across the organization and with partners; and drive data-driven decision making and highly personalized consumer experiences, setting a new benchmark in service -excellence,” said Skeen.
Key points to consider include:
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Managing consumer data and creating detailed profiles for better engagement
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Management of healthcare provider data, so that healthcare professionals’ data is carefully managed
The goal is to transcend operational efficiency, promote more insightful decision-making and a customized approach to capturing consumer interactions.
“In addition, we are investing in a real-time Customer Experience Dashboard, which provides feedback loops to resolve issues and connect operational leaders to pain points,” Skeen explains. “Our team is focused on finding the pain points, implementing changes and providing a continuous feedback loop for improvements.
“As part of Sentara’s company-wide focus on consumer experience, we have replatformed our entire customer experience platform with the latest technology,” he added. “This includes digitizing all pre-arrival paperwork, registration and questionnaires to make the initial interaction process seamless and streamlined.”
A few key examples of other changes include implementation new major language model platforms to direct patient questions to the appropriate queues and reduce provider burnout. Employees are revamping the entire digital access experience for more flexibility when making and rescheduling appointments.
“We are also redesigning our communications to support the queuing of patient requests with the appropriate resources,” he noted. “For example, pharmacy refills go to a specialist team and rescheduling is handled in our new Clinical Access Center, allowing doctors to focus on patient care.
“Using external data to complement our clinical data to provide a more complete picture of our patients and members is essential to our mission,” he continued. “We incorporate social determinants of health data into a variety of our initiatives, both in the community and within the system.”
Sentara Health uses publicly available data such as census data and applies it to geocoded analytics to explore the characteristics of its patients, members and communities. It also includes data from third-party aggregators that use broader SDOH information to add specific risk predictors for a variety of conditions, such as diabetes and congestive heart failure, as well as for specific events such as emergency room visits and hospitalizations.
RESULTS
“2023 was an exciting year for all of us here at Sentara, and we are equally excited about what 2024 has in store for us,” said Skeen. “We have released our new strategic plan, ‘One Sentara: Our Way Forward,’ with the goal of creating a simple, seamless, personalized and more affordable experience for those we serve.
“A key part of this effort was the creation of a new department, the Transformation Office,” he noted. “This office serves as a hub for driving change, promoting innovation and ensuring efforts are aligned with strategic priorities. We believe this office will play an important role in creating a healthcare system that is even more consumer-centric and is a leader in the industry.”
Areas where Sentara Health has already achieved success, according to Skeen, include:
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Structure. Established capabilities across the organization have resulted in greater transparency and accountability with the implementation of uniform tools and processes across all projects. This includes creating infrastructures that purposefully bring together patient and member experiences.
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Involvement. Leaders from across the organization have come together to create, plan and implement initiatives, including the launch of a system-wide ideation tool. Also launching new cultural features that align with the new strategic plan.
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To invest. A fundamental ability to serve patients and members. From these foundations, the healthcare system enables new models of care and more seamless interactions, and reduces administrative concerns in areas such as bill paying, lab scheduling, reducing paperwork, and setting up an engagement center.
ADVICE FOR OTHERS
“Engage your team members broadly and deeply to identify opportunities to deliver on the strategy,” Skeen advised. “The strategy cannot be executed in a silo with a small group of leaders, given the critical dependency on organizational change management and culture change.
“Create a prioritized portfolio of initiatives, ranked by business and financial value,” he added. “Create a sense of urgency to execute on the highest-value initiatives, focusing on early wins, while taking a multi-year approach to achieve comprehensive transformation.”
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