Getting More Value From Your Digital Transformation Investment

Brian Anderson: Hi everyone. Welcome to “Getting More Value From Your Digital Transformation Investment”. I want to welcome you all to this, um, uh, webinar. You know why we’re doing this? We believe in an open dialogue among thought leaders in our nation’s leading health systems. We’re trying to help improve digital transformation and patient experiences for all of us. I’m Brian Anderson. I’m the CEO and one of the founders of Augusto Digital. Augusto helps healthcare organizations and health tech companies realize their digital goals by offering outsourced services, fractional teams, technical solutions concerning software development, user experience design, project management, and managed services. Today I welcome Bill Gagnon, Digital Experience Leader at Boston Children’s Hospital. I’m gonna let Bill introduce himself. Hi Bill.       

Bill Gagnon: Hi Brian. Thanks for having me today. Excited to be here. Uh, yes. I’ve been working in digital since the mid nineties. Uh, so started off my days at Citibank. I went to GE International, then to Cigna, and then now most recently in healthcare at Boston Children’s Hospital.

Brian Anderson: Super. Bill, this webinar is focused on helping people get more value from their digital transformation investments. Um, we know many health systems are focused on improving digital journeys for patients and their internal staff. Why does Boston Children’s invest in digital transformation? 

Bill Gagnon: Well, and I think it stems down to one easy statement. People expect to have the same digital experience they have with online shopping venues, right? You know, it’s all about, you know, easy to find information and answers at their fingertips, easy to engage with, and then also instant confirmation. They know that their appointment’s been set. And then lastly, updates ’em in mind of making sure that the day of their appointment is coming up, and then you know, what happens after their appointment. These are things that. They receive on a regular basis, whether it’s a retail shopping site or a travel shopping site, that they actually get this information. So it’s expected. 

Brian Anderson: Right? Yeah. I mean, it’s pervasive in our lives. Right. And so, um, when you came to Boston Children’s Hospital, where was the hospital with the digital transformation process?

Bill Gagnon: Sure. So I, I started a little while back. I joined around 2015 and hospital is made up of about 26 or so service areas, um, which have different operating, um, processes in different places. Um, and so there’s a little bit of a challenge there, but you know, as in most businesses there’s, you know, a lot of different things, good things going on in different places, so there was some digitization projects already going, um, underway when I came in, but they weren’t laddering up to an enterprise strategy. That was the challenge. 

Brian Anderson: Interesting. So how did you approach the process of understanding the gaps in organizing these digital projects? Like what process did you use?

Bill Gagnon: Sure. So, um, earlier when one of the slides was going by, it showed the Lean Six Sigma icon, and that’s something that I was very fortunate about my time working at GE to learn and get under my belt. And so I’ve created a, what I call a streamlined process of that, which you’re looking at here. And it’s basically simply laid out that the usual value stream mapping tools that they have for Lean Six Sigma, it, it takes, you know, a good couple days to a week. And sometimes when I knew that a lot of times we don’t have that, um, capability. And the reality is I just said there’s 26 areas in the hospital that I have to work with. So I have to do 26 different working sessions and also all the people that comes into that play. So one of the things I developed, the streamline process. So here it’s like a four step method that you saw was one with basically, um, you know, getting all the key stakeholders together and the key stakeholders. There are people that touch the patient experience, uh, you know, anybody from marketing to the call center, to the front desk when they check in, things like that. Um, then what we do is we actually talk with them and we do a full value stream mapping, which basically is just listening to each other to find out what happens, how do you, you know, attract patients in the door? How do you acquire them? What happens with the flow? And we document it all together.. Um, and then lastly, uh, the third step is that we call fact finding. So, as you know, not everybody can always go to these, uh, um, appointments. And so we wanna make sure that we circle back with people that might have missed the session, find out, you know, show them, we document it and find out if that actually, you know, resonates with them or if they have anything on their charts that they wanna put on there. And then a lot of the fact finding is things that you want to do a deeper dive on. So, for instance, um, at Boston Children’s Hospital, one of the service areas we learned had some challenges. In the waiting time, in the waiting room. And so what we do is the team would sit in the waiting room and mirror the experience. We would shadow permissions, we would meet with patients, talk with them, find out what was going on in their experience. So that’s all part of the fact finding. And then also going back to not only, you know, the, the nice part, but the first session is you get a full understanding of the process overall. But that’s from the side of our, you know, internal, what is the external person seeing. So that’s like the patient family. The referring physician and also researchers that use the site, what’s their experience like? So we meet with all those types of people to actually get their findings, put it all together in one document. And then the last part of it is coming back together as a team and looking at, you know, the process that we found, what are the opportunities we identified, and really working on prioritizing those to become part of a, a roadmap and a strategy for, you know, signing roles and rigor. 

Brian Anderson: That’s interesting, like, and it’s interesting that you boiled it down to like these four specific steps and you’re working through this with, with, um, different, um, areas of the hospital and consolidating a lot of this together, right? So, um, it does seem like a quicker process. It’s more efficient, like at getting to the heart of the issues. Can you go a little deeper into how you represent, um, like the voice of the patient and other end users in your needs assessment? 

Bill Gagnon: Sure. So with the, with the mapping process, again, you know, it points out all the different things of the challenges and some of the, you know, opportunities that come on. And so what I end up doing, and this is a great example here, you see here that this is an example of our surgery team went through that and you know, found out, you know, basically, you know, What are happening, you know, when the patient, um, you know, how they find us, how do they actually come in? And then what happens when they’re experiencing in the, in the waiting room. And so, as I was mentioning before, in the fact finding process, we sit down with them and we kind of go over this on a high level and then get their point of view of, you know, what was their experience? Did they, you know, what happened when they, uh, you know, how did they first find us? Did they come across us on a paid search ad or was it by searching or by word of mouth? Did they, uh, when they called in, you know, when they got the appointment, did they get the confirmation that was sent out? And then, you know, the appointment reminder that comes up days in advance of their meeting. And then how was their experience when they were in the hospital? Everything from parking all the way through to when they were, you know, leaving the hospital. And then next steps after, you know, are they gonna have a procedure or, you know, All these different things. So we documented all of that. So when we talked with them, we get their feedback. So we had a clear picture of what they were looking to do. And you know, at a hospital.

Brian Anderson: Yeah. And, and so like, I really liked where you were going with the fact finding too. So you, you work these sessions and you’re able to pull this information together and visualize it in a way that makes sense. So there’s all these stakeholders, like do they understand this map when it’s done? And how do they, what’s the process like to get to this, to this level of a map? With a, with a broad spectrum of people.

Bill Gagnon: Exactly. So I, I do something a little bit different. Um, you know, when I started off the conversation saying, you know, the Lean Six Sigma, anybody that’s listening in today, you know, a lot of people have, you know, do this on a regular basis and their, um, you know, their process and they do process mapping. And a lot of it is done, you know, on the wall with paper and post-its and, you know, the old fashioned way. And then it works fantastic. But I knew that, you know, basically I’ve got limited time to work with, you know, clinicians and staffing. And also I had to do 26 different areas, um, of the hospital. And so what I did is I took the, a finished version of this. So basically if you’re looking at this screen here, all these, um, swim lanes, I would keep the same. So I talk about the online, the offline backend, and also about the timing and things like that. But I would take everything the component wise, in the middle portions, and I’d move them off to the side. So I really did this in PowerPoint with the team. And so when I sat down with the stakeholders, they were looking at almost a blank grid except for the swim lanes. And so I would start talking to them and say, okay, let’s start from the beginning. How do we attract patients and families? And the nice thing about that is, you know, when you’re working with a paper process, a lot of people are gonna be, you know, a little insecure about going up to a board and writing things and putting it down. Whereas here, I’d already had a lot of these solutions already pre-done. I had things like direct to site, I had seo, paid search, email, so I can easily move them over and that’s a big time saver as well. And then they could add on and say, but we also do billboards on the highway. Great. And that takes me two seconds to really add one over and move it in. 

Brian Anderson: Mm-hmm. 

Bill Gagnon: So the process while you’re going through it, it’s always entertaining because it’s, it’s not pretty. And, um, there’s a lot of boxes. They’re not symmetrical, but at the end of it, it’s so much easier. I can literally spend an hour after the session. Clean this up and have a real clear view of what the patient journey is, and also the points of opportunities to actually improve that patient journey by doing it this way.

Brian Anderson: Yeah, that, that makes sense. And then, uh, um, kind of going into the, uh, the next stage, like you’ve, you’ve mapped this stuff and then you’ve done, you know, work to, uh, Prioritize with the team too. Maybe you could go a little deeper into that prioritization and the kind of, the fact finding and, um, you know, how do you get the green light from the C-suite to actually move forward with some of these initiatives?

Bill Gagnon: Sure, sure. So the, the thing is, and this is a snapshot of just that one instance of working and, and it’s a good example. So here we had 12 different opportunities identified, and the nice thing is that when you come back with the team, and again, this is something like maybe one or two days. Later tops, cuz you want it fresh in mind when people are, you know, just did the processing. Mapping and things. And the good thing is that these opportunities, the way that I run the session is that I don’t come to the table expressing to them what they need to put on the paper. They’re coming up with the solution saying, what if we did this? Or what if we tried that? Right there. That’s the advocacy already starts because it’s part of their brainstorming process. It’s a solution they came up with, and there’s more buy-in at that point. So when we get to this stage here, I remind them of, first of all, we look through the process map, one more time. We do a quick review, and then we look at, okay, this is everything that everybody here came up with. Let’s start looking at this from a point of view as a return on the investment, and also timing. What’s important here is this lower quadrant of the area chart is where I kind of gravitate towards because I’m also thinking long term when I need to get this all, all these 26 sessions done. Because ultimately, yes, I’m working with all the different service areas on all of these, um, Solutions. But in my mind, I’m laddering this up to an overall enterprise strategy, and so I’m gonna be presenting this out to the csuite. So what’s great is if I have a few of these at quick wins ready to go when I already go to that presentation. So I look at things like, um, you know, paid search or, um, chat, which is a great one. Chat on there is something that, you know, you and I, that’s when we first started working together. 

Brian Anderson: Mm-hmm. 

Bill Gagnon: Is that we had a rudimentary tool in place, so it was something that we could leverage, which meant we could do it right away, but it wasn’t fully tweaked the way we wanted to, to meet the patient experience. And so we worked together on doing all of that. So for me that was a quick win and a good return because it helped out with, uh, patients and families, referring physicians. But interesting what we found out afterwards, it helped out with the internal, um, stakeholders as employees because the people answering the phones. Uh, instead of using all different types of like tutorials or paper that they had written down with phone numbers, this tool had it all anyways, it had all the fax numbers, had all the locations, uh, valet parking information, um, you know, directions of the hospital so they could just easily use a tool as well. So it really worked on all four, all of those areas there. So again, the quick wins were nice on there and it gives people an understanding too. That it’s not so daunting, right? I mean, it’s one thing to do a working session. You’re taking time away from your day, you know, your day job to do this. The last thing you wanna see is an opportunity chart that might go on for months because it’s not attainable. And so we wanna make sure that we have it all documented. Yes, you’ll have some things that are bigger projects, of course, but it’s nice to have some of these really quick wins and have it mapped out so you understand like what, what’s gonna be the turn on the investment on this time, and things like that.

Brian Anderson: Right, yeah, I think that your approach in terms of trying to figure out how to get these quick wins is interesting. Maybe you could go a little deeper into that. We could slide to the, the, the, the, the last slide of, uh, when you’re consolidating all this information together. Right. Um, I mean these are, these are interesting the way you kind of approach this. Um, and, uh, Maybe you could just talk a little bit more about how you get to the point where you’re able to get the quick wins and like how do you piece together teams? Cuz you’ve talked to all these cross-functional people .

Bill Gagnon: Mm-hmm.

Brian Anderson: How do you actually pull them together and, and get the momentum behind the quick wins?

Bill Gagnon: Right, right. So, so what’s interesting is as I’m doing this in real time, As you can see here, I’m already creating, in essence, the strategy review at the end of the day, and that’s why I kind of have everything all this out. So for instance, here what you’re looking at is the 12 opportunities we have, but it’s also what are these opportunities? So they’re fresh in mind, not only for the team working on it, but also when you’re meeting with people, let’s say in the C-Suite or people you need to gain advocacy to go along with this strategic approach on that. And so having all these, you know, and it makes it easier to talk through at the end of the day too. And as I mentioned, you know, the quick wins are things that, you know, I usually outline when I’m going through this full list on it. Um, and it’s, you know, it’s something that it’s easy to follow through. And what’s nice is they, you know, people while we’re going through this list, like can already start to, you know, remind people in the room that this is something that you had already put your hand up, you know, you brought this to the table. We’d love for you to be a spearhead and kind of, you know, own this and run with this, going through it. The nice thing about this, if you look at this, is just like I said, one part of 26 working sessions. But what’s interesting though is even that, you know, um, coming into it, my concern was that as I mentioned before, 26 service areas that had unique, sometimes, you know, operating procedures in the back end. Ironically, this kind of came into the 80 20 rule where 80% of what we’ve heard consistently over the different working sessions was actually applicable throughout all of them. They all had the similar pain points with, you know, maybe how they’re getting out there to attract patients, and then also how they’re engaging with patients, and then how they’re actually working with patients. And so ideally, this all, you know, I, I took all these, and this was 12 here, but I would take all them together and ultimately collapse them all into one, basically, um, ROI procedure, and I was able to show all the different, uh, let’s say there was 47 of if they were all unique and we could prioritize ’em. So that helps you build up the overall strategy. And then from there, once everybody agrees that these are all the things we’re working on, it really comes down into let’s like basically putting together like a rules and rigor chart. They’ll say, okay, now that we’ve signed up for that, this is right. What’s gonna be actually, you know, driving forward and this is what it’s gonna take for, you know, you and your area to help build these out and get them going. 

Brian Anderson: Let’s talk a little bit about roles and rigors. Maybe if we show that slide, um, you know, like how do you go through the roles and rigors process?

Bill Gagnon: So each, each session that I would do, each department or service area, I would actually have a, a basically a whole review of this, you know, process and also with the roles and rigor on there, because ideally when I, when I leave that team, We’re already gonna be working on things and so nobody’s waiting for this, you know? Cause if you think about it, 26 sessions, right? That’s gonna be, you know, a good like five, six months down the road. Yeah. But we’ve got time to wait for that and or will they have the energy to come back to it. If I say, okay, now we’re ready to go. Once we get everybody to buy into it. So ideally I run this like a two-lane highway. We basically have the working session, and at that day one we start doing projects together. Especially a lot of those things that are quick wins. You want online chat? Let’s get that going. We want the chat bot. Sure. Let’s implement that. We have all that there. And so what this does is just keeps like an understanding of a roadmap, kind of working. How are we gonna attach this? How are we gonna work on it? And I know this is very, you know, detailed slides, so it’s something that, you know, people here can look at, you know, and they get a copy of it. But if you, you know, when you zoom in on this, at the end of the day, you can actually have , it has multi purposes, it has not only the task at hand, but also the value add that it brings. Does it, you know, does it make a better customer or patient experience? Does it reduce the wait time? Does it, um, drive more people within the hospital? And then also, you know, what departments are needed because, you know, a lot of these sessions, even though it’s like a, you know, we’re looking at the digital roadmap. It brings in everybody. A lot of this work is operations that you need to get together with. It could be a finance question that you have to solve, and it could be maybe research you need to bring into that. So it’s like all those people are identified in there, but more importantly in the middle, that’s when you look at, okay, timeframe. What’s, that’s what the upper hits the road. Let’s start next week and then when is it gonna take two, three weeks to get this done? So we do that during the session. We’re able to get people to sign up, put the hands up in the air, say, I’ll take this. They build out a team to start working on it. And yes, some of these on the overall enterprise strategic approach will kind of come together as a larger project team. But for the most part, when we, you know, go onto another service area, we’re already helping getting this one going. And we’re onto data. 

Brian Anderson: Yeah. And what is, what does your team look like? You know, like how, how big is your team and how are they able to execute these types of projects, so effectively? 

Bill Gagnon: So, uh, I, I go back to my days at GE, we use the, uh, center of excellence terminology, and that’s what we develop. And so I’m doing that since the days of GE to Cigna, even to, um, Boston Children’s. And so basically, you know, we have our team that has key stakeholders in every one of those groups. Meaning that there’s people that do. Web work, web design, web production. We have coders, we also have, um, UX/UI, we have optimization people, so anything along this line of the solution area, they would actually be able to help out. And then, you know, at, at the hospital, the way it works is that most of the bench strength sits in our team. And so we take on all of that, and those, those people I just mentioned have teams of the role that actually do all of this heavy lifting. Sometimes there’s people in the different departments that actually have some bench strength that like to jump in and help, and we’re always, you know, happy to have extra hands on staff, so. 

Brian Anderson: Mm-hmm.

Bill Gagnon: The more the merrier. 

Brian Anderson: And, um, and then like, uh, Trying to figure out like, you know, what other things do you wanna highlight, um, for people that are, you know, looking to model off of what you’ve done here? Like what, what do you recommend? 

Bill Gagnon: Sure. I, I think, I think the one thing that always stands out, especially, you know, when you and I have been talking about different projects that we’ve got, you know, and how do they come up to play? When you look at some of these working sessions many times in the past, I think where, you know, where I maybe had some not successful sessions is when we started off and we started saying, okay, we identified issues and issues is a word that makes people uncomfortable. And so I think that that was like one of the challenges. So I immediately switched my process over to opportunities and people feel excited that they’re actually bringing something valuable to the table and they wanna be part of that. Nobody wants to be part of issues and that’s huge. The other thing is too, is a lot of people that work in the, you know, the digital environment, you know, your job isn’t always gonna be digital. Yes. And, and that’s something you just gotta know today. It’s like a lot of the conversations I have, a lot of things I’m fixing were operational. Um, you know, when I joined the hospital, we started setting up the CRM system right away. And, you know, there was something that, cuz there was just, it was a need for things, but people weren’t there to do it. So we just jumped in and lend a hand. So these are things that, you know, you just need to be cognizant of. And the biggest thing is you’re, you know, what you don’t see here, but um, you know, it kind of organically happens is all the relationships and partnerships you have to have throughout the hospital with your no support people in operations, people in finance, people in your right, legal compliance, because none of this stuff gets going. And just you get some open approvals on those end. 

Brian Anderson: Right. Well, this has been great, bill, and I think that, you know, this is a great introduction here. Um, just wanna summarize it a little bit more. You know, like you’ve got, you’ve used Six Sigma, you’ve been able to develop a process where you’re able to pull in all these different stakeholders. And then, you know, run through this four step process, um, and, uh, and really boil it down. And, and I think it really speaks to, you know, you’re, you’re willing to give back and help others. And, you know, Boston Children’s being, you know, well known across the country as a teaching hospital. And so this is just super that you’re willing to share all of this. And you’ve also said that you’re willing to share the presentation as well. So if anybody wants this presentation and wants to dig in deeper, you can just email me at [email protected]. And I also, um, want to let you know that if you need additional help in these areas, that Augusto is happy to, to help and facilitate, you know, conversations with Bill as needed. Um, if you, if that’s, uh, something that, uh, Is, uh, necessary, uh, but we’re definitely willing to help and, uh, be part of your digital transformation journey as well. And I also wanted to let people know that we’re gonna run another, um, uh, webinar on July 19th. Bill’s gonna come back, and this time we’re gonna go deeper into how health systems can get quick wins with chat bots, ai, and other new tools. So I wanted to, uh, uh, leave it to you. Bill, do you have any other things you wanted to, uh, say as we sign off here? 

Bill Gagnon: Uh, I think you said it all. I think that, you know, we are, you know, we do come from a teaching hospital background. You know, I think that anything that I can do to help share and, you know, alleviate some, you know, pain points out there, uh, love to help out.

Brian Anderson: Wonderful. Thank you Bill. Thank you for your time. Look forward to the next webinar with you. 

Bill Gagnon: Same to you guys. Thank you so much. Appreciate it.