What does it take to get a digital tool used across an entire health system? That’s the question HealthLeaders asked three digital leaders on its panel The Winning Edge for Leading Digital Innovation at Scale.
Crystal Broj, chief digital transformation officer at the Medical University of South Carolina, answered by moving the question out of technology entirely. “It’s not a technology thing,” she said, “but really a change management problem.” She was joined by Lynnette Clinton, CIO at BayCare, and Kopal Seth, associate chief medical information officer at Phoenix Children’s, and over the course of the conversation, the three of them kept reaching the same conclusion from different vantage points. The tool is rarely the hard part.
“A successful pilot proves that something can work,” Broj said. “But when you start scaling it, then you’re seeing that the organization can work differently because of the technology that you’re putting into place.” The conclusion she came back to: “Don’t confuse deployment with adoption. We can put the tool out there, but if people aren’t using it, being told what they’re using it for, then we have not succeeded.”
Start with the problem and name who owns it
Broj’s intake process begins before any vendor conversation. “We don’t look at initiatives until we look at problems that we’re trying to solve,” she said. She asks a fixed sequence of questions: the organization’s key goals, who the tool is for, whether there is a real operational or clinical problem underneath, and, the question that decides most projects, whether an accountable business owner is attached to it.
“A lot of tools will promise you the moon and the stars,” Broj said, “but you have to know for your own organization what you’re trying to achieve.” Decrease calls into the call center. Increase check-ins at the front desk. The target gets measured before the pilot starts, not after.
Clinton practices the same discipline at BayCare through a standard business case, with every measure written as from, to, and by when. She’s also very conscious about the language she uses. When leadership has already committed to a rollout, calling the first site a pilot tells staff the decision is still open, so she reframes it as piloting the workflow rather than piloting the tool.
One consideration should be prioritized, according to Broj.
“It’s really important to make sure that we’re not just adding on to workflow or making another destination for a patient or a clinician,” she said, “but instead taking work out of the system.”
Design with Janet, not for Janet
MUSC brings everyone into the room on day one. Broj calls them big work sessions: call center staff and their managers, marketing, IT, and legal, all walking the workflow together before anything gets built.
Connecting one system to another, in Broj’s words, “affects Susie at the front desk, or it affects Janet that’s answering the phones.”
Getting the people affected into the room at the very beginning makes all the difference. Janet gets to say, “This is how I do it today, and I already have two screens up, and this is too much work if I have to open a third window.”
Those same staff then test the build, which doubles as their onboarding. At launch the team returns to the original problem statement and asks the users whether the thing in front of them solves it. “Sometimes you have to figure out what the biggest friction point is and just do that,” Broj said.
Broj summed up the reasoning. “Most people don’t resist technology as much as they resist the technology being done to them.”
Seth reached the same place from the clinical side. “Systemwide adoption really is way before the go live,” she said. “It starts with listening, understanding that workflow, making sure providers and staff feel heard.”
Clinton then turns those staff into adoption helpers, putting frontline team members into BayCare’s campaigns for new tools, because “they sell it to their peers better than anyone in IT can.”
Plan for the time you free up
It’s easy to get caught up in deployment and forget the bigger picture of why a solution was implemented.
“If we save somebody three to five minutes of a phone call, that might add up to a certain amount of time per day,” Broj said. “But then what is that person doing with the rest of that time that they’ve saved? If we don’t tell them what to do, if we aren’t doing something else with that time, then we really haven’t solved any problem at all.”
Managers can end up being more of a constraint than the frontline staff using the tool. “It isn’t just the frontline employee, but the managers have to be prepared for that new adoption model,” Broj said. Give supervisors a plan for the recovered hours and the savings become tangible.
MUSC’s own call center automation freed roughly 37 FTEs worth of time last year, and Broj’s point is that the figure means nothing standing alone. Staff were moved onto work that requires a person, including sequencing an MRI, a CT, and the follow-up visit onto a single day so the patient does not drive to campus twice. “That doesn’t mean that we eliminated 37 people,” she said. “It means that we took administrative work out from a workforce that was already stretched and allowed them to do higher-level tasks.”
Clinton said many of the benefits that look soft turn into hard dollars once a finance partner digs into them. An example of that is retention, Broj said.
“It’s hard to measure joy,” she said, “but if I actually need to go see my kid’s soccer game after work because I’m not charting all night long, then maybe I’ll stay in my job longer and you don’t have to replace me.”
Patients aren’t comparing you to the hospital across town
Broj’s ambition is a care journey with visible next steps, closer to a Domino’s pizza tracker than to what patients get now. “Most patients’ health systems are a black box and they have no idea what happens next,” she said. Primary care, then ortho, then an MRI, then a prior authorization nobody mentioned.
The benchmark is other consumer experiences outside of healthcare. “They don’t compare us to the health system down the street,” Broj said. “They compare us to the digital experiences they have with airlines, with Amazon.” Amazon reminds her the dog food is running low. No system reminds her to check a prior authorization so a biopsy can be scheduled.
Asked for one piece of advice on scaling, Broj said, “Start with a problem, start small, get it right with the front line, and then extend it accordingly.”
Across more than 150 conversations with health system decision-makers, DexCare heard the same pattern the panel described: capable digital tools bolted onto operational silos, each one launched on schedule, none of them changing where patients actually end up.
Watch the full panel: The Winning Edge: Leading Digital Innovation at Scale.
