Multiple factors are changing the business side of healthcare: the Affordable Care Act, an acceleration of mergers and acquisitions, increasing costs, and more discerning clients, to name a few. In response to so many moving parts, hospitals and other healthcare providers are looking for new ways to integrate delivery that achieves a high-performance continuum of care for patients and families. Enter the systemness approach.
What Is Systemness?
The simple explanation is that systemness refers to a coordinated care delivery model—coordinated being the key word. Donald Gallo and Patrick Kulesa of Towers Watson describe this approach in the article, “Five Ways Healthcare CHROs Can Drive Systemness" as having “effective alignment among the core characteristics of a healthcare provider's organizational design.” They go on to explain that systemness works toward integrating structure, culture, capabilities, processes, people, and rewards.
The ultimate goal, say Gallo and Kulesa, is to “produce measurable value in the patient experience, per capita cost of care, and population health.” In other words, systemness focuses on getting ALL the departments and functions within a healthcare provider organization to work together effectively and efficiently. Further, the idea is for organizations to become patient-centric, abandoning the traditional provider-centric attitude.
Obstacles to Integration
No doubt, these are lofty goals, and the path to achieving systemness isn't always clear. To better understand which elements of this approach are keeping providers up at night, The Advisory Board, a healthcare-focused think tank based in Washington, D.C., surveyed more than 150 of its members. According to the data, reducing clinical variation was the single most challenge to achieving integration, followed by physician alignment and efforts to optimize referral streams.
Not surprisingly, IT interoperability ranked as the third most-troubling issue. “IT interoperability is crucial not only for sharing information, but also for enabling internal benchmarking and allowing organizations to identify strengths and improvement opportunities,” write Advisory Board analysts Yulan Egan and Lisa Perlmutter in the February 2016 blog post, “The Top Four 'Systemness' Priorities for 2016 And Beyond.” Survey respondents also cited breakdowns in communication and the exchange of meaningful information as key barriers to achieving systemness goals.
Path to Successful Systemness
Pursuing systemness—or integration—can mean different things for different organizations. And while the route to systemness may vary, several steps toward progress remain constant.
On the technical side, the success factors are obvious, such as implementing an efficient electronic network and organizing shared services. “This isn't just about connecting clinical records and choosing a single EHR. The most successful systems bring together a vast array of information: financial performance, market analytics, consumer segmentation, even institutional knowledge like best practices or care protocols,” says Ben Umansky, a practice manager with the Health Care Advisory Board research team, in an interview with The Daily Briefing. The point with integrating technical elements is to generate actionable analytics that can be used to align financial systems and coordinate care—accurately and purposefully.
Matters become more complicated when providers try to apply a systemness approach to talent-related considerations, such as an organization’s ability to assume risk, adopt a team approach, and foster collaboration. Help with these elements must stem from active and engaged leadership from physicians, nurse practitioners, and physician assistants. In fact, systemness requires a new kind of leadership, contends Debra Walker, DDI vice president of healthcare, in “Systemness: A Context for Cultivating a New Caliber of Leadership.” The best way to prepare is to define what the new leadership profile will need to look like, identify individual strengths and gaps in this new meaning of leadership success, and teach individuals to lead in new ways.
For instance, Walker explains that some of the qualities required of systemness-focused leaders are: bifocal vision (they see the big picture), interpersonal diplomacy (they broker relationships with political savvy), and thirst for learning (they remove barriers so others can learn). Aside from these personal assets, leaders also need the business savvy to seize new markets, master networking, build strategic partnerships, and influence without authority.
Research from Deloitte concurs. In Toward Systemness, Jennier Radin and Tiffany McDowell explain that this approach “demands strong leaders capable of bringing together separate teams from individual facilities or entities, changing their mindset about sharing services and talent.”
Role of HR and Talent Development
HR and talent development needs to play a crucial role in adopting systemness. For example, one area in which they may add the greatest value is in the support of mergers and acquisitions. HR and talent leaders—who are likely schooled in change management—can help their organizations plan for these major efforts by conducting needs assessments and managing cultural audits, for example.
HR and talent leaders also will need to work diligently with organizational leaders to assess skills gaps impeding success of the new operating model. More importantly, the talent development function will need to lay the ground work for development opportunities based on the new leadership profile that emerges from systemness.
The talent function in hospitals and among other healthcare providers must then set a course to pinpoint strengths and gaps of those already in leadership positions, as well as high potentials who will likely hold leadership positions in the future. By doing so, organizations can select and promote leaders with the right inspirations, learning desires, and the predisposition to deal with the dynamic nature of business in healthcare.
