Partnering for healthcare success

As healthcare providers reimagine their role in a rapidly evolving ecosystem, they face new challenges.

With deep healthcare expertise, proprietary data and the latest technology, IBM® Watson Health® provider consultants can help hospitals and health systems succeed in this new era.

Meet your transformation partners.

Strategic planning

Get support examining the challenges and goals of your enterprise, and create a roadmap for digital transformation.

Likeness representing Susan who is a consultant for Watson Health Likeness representing Susan who is a consultant for Watson Health

With more than 25 years of experience, Susan helps healthcare organizations develop comprehensive strategic plans using trustworthy data and analytics to solve business challenges.

1. Use the best data

Healthcare organizations operate in a fast-changing and competitive marketplace. Having a comprehensive strategic plan for addressing patient care, staffing, financial planning and other priorities is critical to their success.

To build an effective strategic plan, healthcare providers need access to the best data available, as well as advanced analytics tools to help them uncover insights that can inform their future strategic priorities. Working with an experienced, trusted healthcare consultant can empower health organizations to develop a robust strategy that addresses their key business concerns and supports innovation.

“I love the work I do as a strategic planning consultant,” says Susan. “I’ve always been a natural born problem solver, and I love working with providers to understand their challenges and figure out what data we can collect and analyze to make an informed decision. At IBM, we have unique, trustworthy data that’s unmatched in the industry.”

IBM Watson Health strategic planning consultants work side by side with hospitals and healthcare systems to identify their goals, priorities, risks and challenges. Watson Health teams bring deep, hands-on experience in the healthcare industry and unique data that’s localized to county-specific use rates. Starting with trusted, market-specific data allows healthcare organizations to build their strategic plans on a solid data foundation.

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5 ways FHIR can help improve healthcare data and analytics

2. Comprehensive strategy

When developing a comprehensive strategic plan, healthcare organizations need to address several key questions about their market, such as:

What are the demographics of our population? Is it growing or shrinking?

What are the social determinants of health in the region?

What are the projected numbers of uninsured and underinsured?

What ailments will be most prevalent in the next 5 to 10 years?

Are we prepared for physician and nurse supply and demand?

Are our emergency departments and urgent care centers properly sized to meet projected demand?

To deliver strategic healthcare planning and advisory services, consultants like Susan start by providing a comprehensive data review of the client’s market. Next, they conduct interviews with key informants, such as the board, physicians and members of the community to identify gaps and priorities. Once all the information has been collected and analyzed, the consultant works with the client’s strategic planning committee to produce a report and a roadmap for implementing the strategic plan and measuring success.

Strategic planning can feel daunting, but consultants can help ensure the right level of focus. “A strategic plan can be comprehensive, covering all aspects of the hospital or health system’s work,” says Susan, “or it might explore specific areas of the business, such as population health, physician partnerships, brand, or medical services for specific specialties, such as cardiac health, neuroscience or oncology.”

Clients stay with us for years and return to us for help on new strategic priorities because they trust our data, and they trust us.”

3. Grounded in trust

Organizations should understand their market, the people they serve and the impacts of insurance coverage and legislative changes. To do so, they need to work with reliable data and trusted advisors who can support well-informed decision-making as they plan for the future.

“I believe that IBM Watson Health provides the most unique and trustworthy data in the marketplace to inform strategic planning for healthcare providers,” offers Susan. “Building trust isn’t just about the data; it’s also about the partnership between a healthcare organization and a consultant. Clients stay with us for years and return to us for help on new strategic priorities because they trust our data, and they trust us.”

Answer 5 questions to find out how Watson Health provider consulting can best support your organization

Susan Shamoun, MPH, is an associate partner with IBM Watson Health provider consulting and analytics with 25 years of healthcare industry experience in strategic planning, consulting, and business and financial analysis. She speaks four languages and is credentialed through the Society for Healthcare Strategy and Market Development. In her free time, Susan enjoys walking, bicycling, swimming, travel and exploring local trails with her family

Analytics and data insights

Unlock insights that can improve patient care by digging into data with a knowledgeable partner.

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Meet Sara Atwell, BSN, MHA. With decades of experience, Sara helps healthcare organizations use analytics to unlock clinical insights that improve outcomes for patients and providers.

1. Unlock your data

Analytics has the power to drive excellence in healthcare organizations, helping providers extract important data that can shape the clinical care they provide. But health organizations face multiple barriers to using their data in meaningful ways, such as:

A lack of access to crucial benchmarking data to compare themselves to others

A need for specialized support in analyzing their data and translating it into concrete actions

Knowledge of how to transform their business and sustain that transformation over time

With a background as an ICU nurse and chief quality officer, Sara cares deeply about patient safety, performance improvement and quality outcomes. Her work in IBM Watson Health provider consulting focuses on helping healthcare organizations gather insights from their data that, along with the application of industry best practices, propel clients forward in their mission to offer higher-quality patient care.

As an industry leader, IBM Watson Health brings technology, methodologies and healthcare expertise to provider consultations. “When we work with healthcare organizations on analytics and clinical insights, we start by evaluating their current state and identifying their strategic goals for clinical and operational outcomes,” says Sara.

“We take in the organization’s data and compare it to industry benchmarks to demonstrate its performance around key metrics, ranging from mortality and readmission rates to cost and length of stay. Then we provide a roadmap with step-by-step guidance on how it can close performance gaps and achieve its objectives. We also support its technology implementations and help it monitor performance so it can see and measure its success.”

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2. Analytics in action

Advanced analytics have enormous potential to help hospitals and healthcare systems harness the power of their data to improve clinical outcomes in several areas, including:

Quality-of-care metrics, such as reducing readmissions, complications, mortality rates and length of stay

Financial benefits, such as reducing reimbursement denials and increasing profit margins

Qualitative improvements in staff satisfaction and engagement

Partnerships with other health providers in their communities

Healthcare organizations that work with IBM Watson Health provider consulting want to position themselves in the top 25%—or even top 10%—of their industry, so knowing where they stand in comparison to the competition is essential. The annual “Fortune/IBM Watson Health 100 Top Hospitals” rankings and “Watson Health 15 Top Health Systems” report provide meaningful benchmarks.

Watson Health is an industry leader in providing databases that are broad and deep. Consultants use them to compare each client to national averages and help clients on their journey to becoming front-runners.

“We offer robust benchmarking data from millions of patients across hospitals of various sizes, as well as risk-adjusted predictive models,” says Sara. “And today, we’re working to deliver current data and analytics to give healthcare organizations even more timely insights to help them achieve their business priorities.”

I love what I do because I truly believe we can leverage analytics to benefit populations and improve individual and community health.”

See The 2021 Fortune/IBM Watson Health 100 Top Hospitals rankings

3. Higher-quality care

Analytics is foundational to providing necessary information to healthcare organizations that creates opportunities for change. But having the data isn’t sufficient on its own. Success is ultimately driven by how organizations use data to create and sustain transformation in their business.

By providing clarity on a hospital’s current state and helping to identify what clinical and operational processes it needs to refine to achieve its objectives, data and analytics can prompt real changes that drive higher-quality patient care. Healthcare providers are inundated with data, but they often need help from data science and expert consultants to really put it to use.

“Our work with healthcare organizations helps them bring their data to life and integrate it into their organization,” says Sara. “IBM Watson Health consultants have deep experience in the healthcare industry—from community hospitals to health plans to governments—and our trusted partnerships with our clients sets us apart. We look at their leadership, how they’re governed, their processes and procedures, how they respond to change, how they engage clinicians and staff—and all this factors into how they can use analytics and technology to deliver higher-quality care to their patients.”

That outcome—higher-quality patient care—is what drives this work. “I love what I do because I truly believe we can leverage analytics to benefit populations and improve individual and community health,” says Sara.

Answer 5 questions to find out how Watson Health provider consulting can best support your organization

Sara Atwell, BSN, MHA, is an associate partner with IBM Watson Health provider consulting services. She’s passionate about personal and community health, and in her spare time works as a yoga and Pilates instructor and serves as board president of a foundation that supports a local food bank, family and child services, and geriatric services in her community.

Value-based care

Address population health and drive new revenue through value-based care.

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Meet Jim Haulihan, MBA, FACHE. Jim specializes in value-based care and helps healthcare organizations assess risk to equitably deliver the right care to patients in their target population.

1. Population health

Healthcare organizations in the US are challenged to address access to care and patient outcomes—while simultaneously driving revenue and ensuring high-quality customer experiences. Revenue streams like value-based care contracts offer an opportunity to tackle financial realities while delivering high-quality, patient-centered care.

Value-based contracts are more complex than traditional fee-for-service contracts. A successful transition to value-based reimbursement requires management buy-in and commitment across all levels of the organization.1

When financial incentives shift in a business, organizational change management is often needed to ensure financial viability. Working with an experienced partner can give healthcare organizations confidence in understanding, evaluating and expanding into new payment models that challenge existing approaches to population health.

“I started my healthcare career as a physical therapist,” says Jim. “Helping people as a clinician is the reason I got into healthcare. My career eventually grew toward various leadership roles as my focus evolved towards helping organizations grow revenue while delivering better patient care.”

Population health consultants focus on the needs of the organization by helping it develop a population health strategy, implementing population health solutions or transitioning to value-based care contracts. IBM Watson Health uses proprietary data assets, methodologies and analytic models to support change and growth for health systems as their population health strategies mature.

In addition, Watson Health consultants like Jim can provide ongoing analytics and strategy guidance after implementation. They have a wealth of technical, analytic, clinical and healthcare operational expertise to help healthcare organizations address revenue challenges while improving access to and quality of care.

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Read about machine learning technology addressing population health challenges

2. Value-based care

Healthcare providers often need help deciding which value-based care opportunities make sense for them, how best to implement those programs and then how to optimally bring the data together for effective information management, informed decision-making and reporting.

“In IBM Watson Health provider consulting services, we work side by side with healthcare organizations to help them evaluate and execute value-based care strategies and contracts,” offers Jim. “We know the healthcare industry well, and we can meet each healthcare provider where they are, establishing a trusted partnership for implementing new care models, offerings and technologies.”

Value-based care programs require healthcare organizations to deliver equitable care to a population. Healthcare organizations need to thoroughly understand their population’s health risks and the social determinants of health in the population—such as food security and access to transportation—to serve them better. Effectively engaging people in their health and well-being is key because, in value-based care contracts, providers are responsible for the health outcomes of the people they serve.

“Collaboration with community health partners—such as providers that offer alternate levels of care or necessary social services—is very important, too, because hospitals can’t do everything themselves,” says Jim. “The first step for healthcare organizations is to understand their population. Once a clear picture of the population and its needs is obtained, they will likely need to establish partnerships for a number of services not typically provided by the organization, such as post-acute care, meal delivery, transportation and assistance in the home. These partnerships influence and inform what resources care managers have available to them to optimize access for the people they are serving.”

Value-based care also necessitates a good information management strategy. Hospitals need technology platforms that can pull in and synthesize disparate data sources about their population, including clinical information from electronic health record (EHR) and claims data. Clinicians need a centralized view with the most up-to-date information so they can provide real-time care management to ensure the best outcomes for their patients.

The IBM Cloud platform can help you get the best outcomes. It has the flexibility, security and performance to deploy SAP S/4HANA and provides a full portfolio of solutions to support enterprise-scale SAP workloads. Additionally, world-class services offerings from IBM Services or our robust global partner ecosystem can simplify your journey from planning and migration to transformation and optimization. Compete strategically in today’s business environment with a database that accelerates real-time, data-driven decisions.

We know the healthcare industry well, and we can meet each healthcare provider where they are, establishing a trusted partnership for implementing new care models, offerings and technologies.”

3. Staying competitive

The pandemic has exposed some the shortcomings of traditional fee-for-service arrangements while shining a light on the benefits of value-based contracts. One-third of Americans said they delayed or cancelled healthcare services because of COVID-19.2 This surge in cancellations resulted in major financial loss in healthcare. Primary care practices lost approximately USD 15 billion in 2019 because of volume dips when communities shut down to stop the spread of COVID-19.3 Hospital visits hit a record low in April 2020.4 But organizations with a larger concentration of value-based contracts in place were able to pivot operations quickly and stabilize revenue while volumes dropped.

Aside from COVID-19, bottom-line concerns are still prominent, and value-based care can provide an alternative revenue stream and a new model for serving people. To stay competitive in this healthcare landscape, organizations must continue to differentiate themselves. Patients and payers today want more pricing transparency, so price differentiation has become a big focal point. The movement away from fee-based service agreements toward more quality and value-based care agreements is now more important than ever.

According to Jim, Watson Health provider consultants can help clients implement and manage programs and technologies that support their revenue growth and improve population health. “From my point of view,” he says, “if you can help organizations improve their quality of care and population health while growing the healthcare organization’s revenue opportunity, that’s the ultimate win.”

Learn how to get ready for more value-based care

Jim Haulihan, MBA, is an associate partner with IBM Watson Health provider consulting and analytics, and a fellow in the American College of Healthcare Executives (FACHE). He started his career as a physical therapist and worked up to hospital administration roles, including CEO of a few specialty hospitals. In his free time, he enjoys running and basketball and is very involved in the activities of his 2 young boys.

2 COVID-19 – Delaying Services (PDF, 982 KB), IBM Watson Health PULSE Health Poll, December 2020.

Technology strategy

Plan for and implement new technology while managing change.

Likeness representing Jacqueline who is a consultant for Watson Health Likeness representing Jacqueline who is a consultant for Watson Health

Meet Jacqueline Matthews, RN, MS. Jacqueline works with healthcare organizations to help them strategize about implementing new technology, navigating change and improving quality of care.

1. Change management

Healthcare providers are eager to take advantage of technologies that improve patient care and deliver quality outcomes. But they aren’t always prepared for the governance and operational structures required to support new technology implementations.

To take full advantage of new technologies, healthcare organizations need both a technology strategy and support from experts who can help them navigate complex changes. “My job is to work side by side with hospitals, providing technology strategy and support services,” offers Jaqueline. “In Watson Health provider consulting services, we help healthcare organizations analyze their capabilities and identify their priorities for the next 3 to 5 years. Then we provide recommendations for how to implement them, garner support from organizational leadership and establish accountability protocols.”

Before healthcare organizations invest in new technology, IBM Watson Health provider consultants can help them assess opportunities, evaluate their preparedness and determine if they have leadership buy-in. “During an implementation, we help healthcare organizations understand their data and clientele, ensure quality outputs, and build governance and operational support into the implementation so they can take full advantage of the solution. All this strategy and support takes time, and having dedicated consultants can make a big difference,” Jaqueline notes.

For her, the reward is the creative challenge of working with diverse healthcare organizations, looking closely at their unique issues and priorities, and helping them bring about strategic transformation. “I love it when I can empower healthcare providers to deliver better patient care with the aid of technology.”

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Read why everyone loves progress but dislikes change

2. Technology strategy

Just as you can’t build a high-rise without blueprints, a technology strategy is critical, and it must connect back to the overall organizational strategy, culture and priorities. In fact, 87% of healthcare executives say their organization’s business and technology strategies are becoming inseparable.1

When developing a technology strategy for a new technology implementation, hospital leadership should ask:

Why are we implementing this platform? What questions will it answer?

Do we have the right skill sets in our organization to manage the new technology?

How can we support the implementation through careful change management?

What privacy, security, governance and accountability practices need to be in place?

How can we make sure everyone—from leadership to direct care staff—is on board?

What do we do if we encounter resistance?

How will we measure outcomes?

These questions are foundational and asking them up front helps hospitals and healthcare providers prepare for a seamless implementation.

As healthcare providers reimagine their role in a rapidly evolving healthcare ecosystem and seek to adopt technologies that use the electronic health record (EHR) and support their priorities, having a robust technology strategy is essential.

I love it when I can empower healthcare providers to deliver better patient care with the aid of technology.”

Read how AI-infused clinical decision support is changing medicine

3. Using the EHR

The electronic health record (EHR) has become a critical technology for healthcare organizations. It started as a repository of patient information but is transforming into a predictive, interactive platform that can help providers make clinical decisions. It’s this EHR technology that healthcare organizations are hoping will drive substantial change. The possibilities for applying analytics and predictive modeling to EHR data are rapidly increasing.

“Adding technological capabilities that help healthcare organizations take full advantage of their EHR data system is the next frontier in healthcare,” offers Jacqueline. “For instance, how can you use natural language processing to be more efficient in your preauthorization processes? Or how can you analyze the data in the EHR—lab results, imaging, physician notes—to understand a patient’s complexity and evaluate their risk in the continuum of care?”

Information management is critically important in healthcare, given the array of platforms, systems and vendors storing and communicating health data. Technology has the potential to help with information management by streamlining systems so providers can get answers and address business needs more quickly. In turn, this process could potentially drive better patient outcomes and help them spend more efficiently.

IBM Watson Health provider consultants bring deep healthcare experience and expertise, as well as robust data sets, assets and methodologies to provide valuable benchmarking to clients. “We understand how healthcare organizations work, and we can help clients evaluate risk and make smart decisions about delivering quality care in a competitive marketplace,” says Jaqueline. “The ability to leverage Watson Health assets differentiates us from many consulting organizations. At our fingertips is all of IBM; we have the ability to reach out to other resources like security, design thinking, artificial intelligence, cloud and garage capabilities in each approach to a project.”

Answer 5 questions to find out how Watson Health provider consulting can best support your organization

Jacqueline Matthews, RN, MS, is an associate partner in the IBM Watson Health provider consulting practice. As a registered nurse and former director of quality in major healthcare systems, Jaqueline brings more than 25 years of healthcare work to her consulting. In her free time, she teaches yoga and cycling, and enjoys open water swimming, walking, reading and traveling to visit her 3 grown children.