The Digital Health Guy Gets the Expert Opinion: Tom Martin, Senior Vice President and Chief Strategy and Information Officer, Evergreen Health

Tom Martin is responsible for information technology, strategic planning and business and relationship development for Evergreen Health in Kirkland, Washington. Evergreen Health, a two-hospital system with an annual revenue approaching $700 million, is one of the largest and most innovative care providers in the Pacific Northwest. Evergreen’s hospitals employ 300 healthcare professionals and are affiliated with almost 400 physicians in their integrated care network. Evergreen also operates one of the largest hospices in the region.

Tom came to Evergreen in 2006 from University of Washington Medicine, where he served as Chief Information Officer for the UW Medicine organizations, including the UW Medical Center, Harborview Medical Center, School of Medicine and all Practice Plans. “They were writing software in the early nineties, and I went there as director of system development,” Tom explains. Previously, he worked for Andersen Consulting in their state and local government practice. He earned Bachelor of Arts degrees in mathematics and business administration from the University of Portland. And in 2014, he was recognized with a Puget Sound Business Journal’s 2014 Chief Information Officer Award, in the category of “businesses with more than $1 billion in annual revenue.”

Towards a New Strategy for Business Development in the Health Care Field

How do Tom’s varied skills in technology and business development come into play in the evolving world of digital health? And what can he tell us about larger trends in health care?

“Health information is complicated,” he says, “and it has been challenging to get the same levels of scale and benefit that you’ve seen in other industries. It has also been a challenge to arrive at the level of investment and benefits that have existed in other industries.”

For such reasons, Tom says, investment and innovation in the health care industries have lagged somewhat behind those in other industries. He also has observed that government regulation has discouraged entrepreneurs from becoming as active as they have been in other industries. “Regulation has caused them to not be interested because of the steep learning curve and the fact that profitability and returns are just not there in the same way.”

“We’ve always had the vision to do pretty amazing things with technology,” Tom states. “We spent a long time, from the early 1990s until today, getting people to buy into the concept of building an electronic health record. Now people can begin to see value in that, and to derive value from it. We’re not where we need to be from an interactive perspective. But with the amount of data that is now available, we’re going to be able to engage consumers more. It is going to be exciting.”

The Changing Face of the Patient Experience

In the past, hospitals typically interacted with patients when they were inpatients, or outpatients who were using hospital facilities. Now the scope of those interactions is expanding. Patients tend to notice that change because they are turning to hospitals for a wider range of care options than they once did.

“The technology enables that,” Tom says, “one reason is that there is more accountability from a financial perspective. Hospitals are graded, if you will, based on patient experience and outcomes, and so financial incentives are starting to drive the move toward more services too.”

From “How Was Your Experience?” to “How Are You Feeling?”

Time was that hospitals asked patients about their level of satisfaction with specific hospital stays and hospital-provided services. Hospitals still communicate with patients about those experiences. But Tom points out the range and variety of communication between hospitals and patients is increasing. More information is flowing in.

“Digital tools allow us to have a more comprehensive interaction between visits, it you will.” Tom explains. “And we are able to get a better sense that people are feeling better. The level of interaction increased first with patients who had undergone orthopedic procedures. We were able to monitor how they were feeling, how quickly they were returning to normal activity, and how consistently they were going to physical therapy. And now, thanks to digital monitoring, we can intervene if they aren’t.”

And this increased level of monitoring and connectivity is expanding into nearly all areas of patient treatment and care.

“With orthopedics,” Tom explains, “it has been about providing prompts to get people to do their physical therapy, to be more involved and compliant patients, and to take an active role in reporting their progress. It’s more proactive than just monitoring.”

Now Evergreen Health is launching pilot programs to increase data-gathering and monitoring for patients who are losing weight and who are dealing with conditions that include COPD, chronic heart failure, diabetes, and high blood pressure. In addition, a program is in development for women who have developed high blood pressure during pregnancy. And nutritionists and other health care professionals are becoming affiliated with Evergreen and offering care.

“There will be other forms of home monitoring that we do,” Tom says. The result, he predicts, will be that patients will become more proactively involved in taking ownership of their own health care.

Incentives for Wider Sharing of Patient Data

Are we entering a new world where patient data will be more widely shared between physicians, hospitals, insurance companies and other entities on the health care landscape? Tom believes that a freer exchange of information will evolve. Yet from his perspective as a businessperson, he understands that there must be business reasons for those changes to take place.

“The government’s requirement under meaningful use to really push data-sharing has helped and driven the evolving standards of health,” he says. “And I think big consolidations within the industry and big partnerships have served as business reasons for sharing to happen, and have driven real business value.”

Trust and shared experience also play a role. Tom points out that insurers would like to have wider access to patient data, and that the level of trust between care providers and insurers has grown. “Yet as you might expect, we have to put protections in place where patient data is requested.”

And patient attitudes are changing about the privacy of their data.

“I think this is interesting,” Tom says. “People now expect care providers to know a lot about them. Yes, there are pockets of people that are really concerned about privacy, while others are starting to say that their data is just part of the digital world. Yes, some people worry that their data will get into the hands of the wrong people. But as you might recall, people had similar worries about their financial information about a decade ago.”

So attitudes are changing.

Bigger Trends that Tom Martin Sees

Where is the use of digital patient data going? How will it help patients experience better care? Here are some trends Tom points to:

• The predictive use of data. Care providers will be able to use data to engage in more predictive activities. “We will be able to monitor sets of populations for different problems and make smarter decisions about how we can help,” he says. “We will be in a position to say, `Hey, something is up here.’”
• Intervention. Care givers will not only know when patients are experiencing problems or have needs, they will be able to take proactive steps to contact those patients and deliver care, even when patients live far away. “The care can be less invasive than going to a clinic or a hospital,” Tom predicts. He also believes that thanks to emerging technologies, a wider range of actual care will be delivered remotely. “Sometimes, the intervention will be such that we will make adjustments to what patients are getting as part of their care, and those patients won’t even know we made them.”
• The use of data in research. When data is collected more widely, it will find wider application in research. “We will be able to tie in lots of different environmental data and make correlations we couldn’t before,” Tom predicts. Is pollution lowering the life expectancy of people in one part of the world or the country, for example? What affect is pollen having on public health? “We are going to be able to have more data to analyze questions like those and understand.”