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10 tips for startups partnering with integrated delivery networks (IDNs)

When technology startups and healthcare delivery systems manage risk effectively, good partnerships emerge and innovation thrives. Advantages are created for both sides by understanding the operational realities and context of a large health system.

I attended the Chicago-Israel Health Tech Innovation Summit, where Northwell VP and CMIO Michael I. Oppenheim, M.D., shared illuminating insights on doing business with integrated delivery networks (IDNs), including:

1. Think through the whole workflow

Due to IDNs’ complex, interrelated clinical processes and workflows, startups need to think through how the solution may affect everything else. They can’t afford to disrupt an entire process, even if an application solves one problem in the most ingenious way.

2. Don’t add to clinician burden

It’s important to minimize the impact the new tools may have on clinician users. “To complete required tasks within their daily routine, they may already be interacting with a multitude of apps; it’s not appealing to consider launching yet another solution to do yet another subset of work,” Oppenheim said.

3. Consider a variety of demands

IDNs must continuously improve to meet evolving organizational priorities and regulatory mandates. “We are always updating our technology tool box to meet a variety of demands and have dozens of active projects. We must do all of this without contributing to clinician burden,” Oppenheim said.

4. Expect complex requirements and longer timelines

Even with an open electronic health record (EHR), IDNs have a lot of front-line systems, layers of identification management and thousands of interfaces. “When a health IT startup pitches a new solution and is excited to tell us, “All we need is an ADT [HL7 Admission, Discharge, Transfer] interface to get started!” – we still have a long way to go before we can successfully integrate this application,” Oppenheim said.

5. Testing must address a wide range of scenarios

Innovators must think beyond the expected. “In one of our smaller hospitals, we need to test 23 separate scenarios representing how a patient might get registered just for an emergency room visit,” Oppenheim said.

6. Have intricate needs for project management

IDNs require a level or predictability and scheduling rigor that often can’t be achieved with adaptive (or agile) methodologies. There are multiple stakeholders that require a more complex approach to project management.

7. Address privacy and security concerns

According to the FBI Cyber Division, cyber threats against healthcare and medical devices are increasing. “Large health systems must conduct thorough vendor risk assessments, and entrepreneurs must demonstrate best practices to gain a seat at the table,” Oppenheim said. Health systems must protect data and ensure that every innovation – no matter how small – is not a gateway into its networks for threat actors.

8. Get excited about “dirty data”

Data within a large health system often comes from multiple source EHRs, and it can get messy when there are multiple people documenting or infrequent patient visits. Startups can’t presume streams of information coming into their applications are going to be completely accurate, but instead should be ready to embrace “dirty data.”

9. Solutions must have clinician involvement and advocacy

Clinicians want to hear about benefits of a new solution from their peers – not from IT, and not from the entrepreneur trying to sell it. “Engaging (clinical stakeholders) is critical in these early stages, and clinicians exhibit great passion and talent in a wide range of areas,” Oppenheim said.

10. Think creatively about clinicians’ toughest challenges

Northwell is making some significant advances in monitoring, following the rapid adoption of sensors and wearables. “We’ve also explored UV light disinfection techniques, using drones to deliver materials into trauma situations as well as voice-based systems for patients and clinicians,” Oppenheim said.

Each time a startup approaches an IDN, it’s an opportunity to improve healthcare. IDNs are looking for new pieces to layer on top of their EHRs to create something valuable. Dr. Oppenheim’s full article discusses this topic in detail for the innovator, IDNs and patients.

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