What was assumed to be a transformation journey stretching over several years has now shrunk to a matter of months, and the pace of change is accelerating. Paddy Padmanabhan and Ed Marx, the authors of the first book published on healthcare digital transformation since the pandemic hit us, discuss 5 major themes in healthcare’s digital transformation, and what the next normal looks like. They will present findings from recent research on how mid-tier systems must approach transformation. 1. How COVID-19 accelerated the timelines for transformation 2. Why health systems must go beyond just telehealth 3. Why digital leaders must develop enterprise roadmaps 4. How CIO’s can transform IT to support digital health 5. How technology decisions must deliver enterprise-level impact

1. DIGITAL TRANSFORMATION IN THE NEXT NORMAL
How consumerism, technology and the pandemic are accelerating the future
CHIME
College Live Webinar
Sept 17, 2020

2. THE BOOK

3. Paddy Padmanabhan
Founder & CEO
Damo Consulting Inc
@paddypadmanabhan99
@paddypadmanabha
Meet the authors
Ed Marx
Chief Digital Officer
The HCI Group & Tech Mahindra HLS
@edwardmarx
@marxtango

4. Work stoppage and closure of services such
as suspension of non-emergent procedures in
March and April resulting significant number
of patients had to delay care, and reduced
emergency department services
Cost burden on hospitals due to increase in
need to purchase the hospital supplies
including personal protective equipment
(PPE) in preparation for a surge of COVID-19
Decline in returns from the investments due
to volatile U.S. and global financial markets
-600
-100
400
900
1,400
1,900
2,400
2,900
3,400
in$million
COMPARISON OF OPERATING INCOME/LOSS OF 17 LEADING
HEALTH SYSTEMS IN THE U.S.
(H1 2020 VS. H1 2019)*
Operating income/loss - H1 2020 Operating income/loss - H1 2019
“Volumes and operating
revenue (will) continue to be
impacted by the pandemic
and driven by many factors,
including but not limited to,
the duration and severity of
the pandemic”
* DamoIntelTM research

5. • COVID-19 has accelerated the timelines for digital
transformation
• Virtualization of care will penetrate deeper into healthcare
services
• Contactless/low-contact visits: “drive-through” experiences
• Digital leaders must develop and implement digital
roadmaps in line with strategic priorities for the enterprise
• CIO’s must transform IT to support digital transformation
• Technology decisions must deliver enterprise-level impact
instead of departmental or functional priorities
Telehealth and
digital: looking
beyond COVID-19
©2020 Damo Consulting Inc.

6. How healthcare CEOs are approaching
consumerism in a COVID-19 era*
* Modern Healthcare CEO Power Panel Survey 2020
©2020 Damo Consulting Inc.
“These types of programs are
part of a growing trend - the
“drive-through” experience”

7. Digital health is set to grow exponentially
©2020 Damo Consulting Inc. 7

8. Non-traditional
players are
moving
aggressively
into healthcare
8©2020 Damo Consulting Inc.

9. The current environment for
mid-tier health systems
CHIME Online Focus Group July 2020 - Highlights
Δ EHR systems are the primary platforms for digital health programs
IT leaders are exploring standalone platforms, beyond core EHR capabilities to
enhance virtual care capabilities
Δ Adoption rates for telehealth models are tied to reimbursements
 Drop in elective procedures leading to decreased profitability
 Lack of telehealth infrastructure in rural or elderly populations
 CMS telehealth waivers helpful but not adequate to cover revenue
shortfall
Δ Telehealth continues to rise. However, virtual visits dropping off as patients
start to return to hospitals
 Initial rise in telehealth visits
 Have fallen to a third as hospitals have reopened
 Uptick in in-person visits after businesses reopened
Δ Remote care models have created a new set of challenges
 Ensuring productivity of the workforce
 Increased IT security threats
 Lower levels of reimbursements than for in-person visits
Copyright 2020 Damo Consulting Inc. 9
We have definitely been hit
financially, which has now
caused some projects that we
had planned on doing over
the next few months, at least
the rest of this calendar year,
to be put off and into a kind of
wait and see mode.

10. Impact of COVID-
19
1. COVID-19 has been a financial challenge for
some, an opportunity to shift to virtual care
models for others
2. New opportunities in the virtualization of care,
with the recognition that some types of care
are easier with telehealth
3. Overall level of telehealth has risen significantly
from pre-pandemic levels, although recent
drops in volumes suggests a shift to an
equilibrium between telehealth and in-person
vists
4. Challenge: Reimbursement remains a big open
question
8
5 5
2
0
2
4
6
8
10
12
14
16
COVID-19 has
been an
opportunity to
shift to virtual care
models and save
costs
COVID-19 has
resulted in serious
financial hardship
that poses a long-
term threat for our
enterprise
COVID-19 has
resulted in short-
term slowdown in
digital investments
COVID-19 has
been a significant
opportunity for
market share
growth
No.ofrespondents
HOW HAS THE PANDEMIC IMPACTED YOUR
ENTERPRISE?
The plethora of
virtual visits just
really are nickel and
dime in terms of
revenue. Even though
you are doing a lot of
those, they won’t
compensate for a
quarter of the year
hit on mammography
fees and knee
surgeries and
colonoscopies and all
the things that
typically bring in the
revenue.
Copyright 2020 Damo Consulting Inc. 10

11. Definition of digital
health
1. Realtime virtual consults for ambulatory care is
the top priority for health systems
2. Virtual consult capabilities have become an
urgent need to continue to serve patients and
generate cash flow
3. Programs such as Tele-ICU, teleradiology, and
remote monitoring have continued to rise in
importance
4. Challenge: Improving the quality of telehealth
experiences
10
6
2 2
0
2
4
6
8
10
12
14
16
Real-time virtual
consults (routine,
urgent care)
Telehealth: tele-ICU,
tele-radiology,
remote monitoring
Online self-service
for improved access
(scheduling,
registration,
payments)
Something else
No.ofrespondents
WHAT DOES DIGITAL HEALTH MEAN TO YOUR
ORGANIZATION TODAY?
Copyright 2020 Damo Consulting Inc. 11
When I think of
digital health, I think
about a patient being
completely
independent and
interacting with the
health system
through digital tools.

12. Digital
transformation
strategy
1. EHR’s are seen as a landing point for digital
initiatives
2. Creating a seamless online patient relationship
is a priority in the digital transformation
journey
3. IT transformation is important to support new
care delivery models
4. Using best-in class tools to create seamless
online patient relationships
5. Challenge: IT organization’s focus on serving
internal customers as opposed to addressing
emerging consumer expectations
8
7
4
1
0
2
4
6
8
10
12
14
16
Use best-in class
tools to create
seamless online
patient relationships
Transform IT to
support new care
delivery models
Leverage our EHR
platform as a
primary tool to
expand virtual care
Something else
No.ofrespondents
HOW DO YOU DEFINE YOUR DIGITAL
TRANSFORMATION STRATEGY ?
Copyright 2020 Damo Consulting Inc. 12
Digital
transformation is
about offering some
sort of technology
support for patients
that are going to be
digitally engaging
with our system.

13. The digital
transformation
function
1. CIO’s are responsible for digital function in most
health systems
2. Digital transformation function is sometimes a
shared responsibility with other leaders
3. Challenge: Fragmented efforts to drive digital
initiatives at enterprise-level
15
3
1 1
0
0
2
4
6
8
10
12
14
16
CIO Other Chief Patient
Experience
officer
Clinical leader
with other
responsibilities
Chief Digital
Officer
No.ofrespondents
WHO OWNS THE DIGITAL TRANSFORMATION
FUNCTION IN YOUR ORGANIZATION?
Copyright 2020 Damo Consulting Inc. 13
CIOs need to multi-
task and get pulled
into security and
infrastructure issues
leading to a lack of
focus on longer-term
digital strategy.

14. Digital
transformation
budgets
72% of the mid-tier health systems do not have
a separate digital transformation budget
About 28% of the health systems have a budget
of 5 million of less
Digital transformation is part of the IT budget
with no separate allocations
Challenge: Prioritization of initiatives that have
an immediate top-line impact vs long-term
digital transformation
13
4
1
0
0
2
4
6
8
10
12
14
16
We don’t have a
separate digital
budget
5 M or less 5 – 10 M > 10 M
No.ofrespondents
WHAT IS THE ANNUAL DIGITAL TRANSFORMATION
BUDGET IN YOUR ENTERPRISE?
Copyright 2020 Damo Consulting Inc. 14
CIOs confirm that
digital initiatives are
funded out of the IT
budget (as would be
the case if digital
initiatives were
primarily seen as
EHR-related), or out
of departmental
budgets with IT
support for
technology
integration.

15. Digital maturity in health systems*
*Source: Damo Consulting maturity model framework
EHR as primary platform for
digital engagement
• “< EHR vendor name> is our
digital strategy”
• Focus on specific functionalities
e.g. access and scheduling, real-
time video consults
Model
Digital initiatives focused on
virtualization of care
• Telehealth, eVisits
• “Digital front doors”
• Remote monitoring
• Patient communications
Model
Stand-alone digital innovation
initiatives
• Enterprise-specific point solutions:
Homegrown and partner-developed
• Innovation programs for
commercialization of in-house
development
• Departmental initiatives: specialized
clinical needs
Model
Long term strategic bets on multi-
year investments
• Comprehensive, enterprise-level
transformation strategy
• 1-2 key strategic partnerships,
alongside EHR
• Robust governance model to
leverage startup ecosystem
Model
15
©2020 Damo Consulting Inc.

16. Technology Partnerships: Damo ICEA™ framework
Develop partnership strategy based on vendor attributes and digital roadmap needs
Innovators: We have a whole new way of doing it
• Stand alone solution or platform: digital health startups
• Cloud-first, mobile-first approach
• Small and agile teams, often VC-backed
Custodians: We have the data and the workflow
• Proprietary systems of record: Epic, Cerner
• Long-term strategic relationships with clients
• Deep knowledge of clinical workflows
Enablers: Rent it, build on it
• Telehealth, CRM, Cloud platforms: Microsoft, Google, SFDC
• Robust and scalable, leverage best practices across sectors
• Implementation partner ecosystem
Arbitrageurs: We can do it cheaper, faster, better
• Consulting firms: Accenture, IBM, Infosys
• Scale, expert knowledge
• Offshore-based development for low cost
Custodians
1
Enablers 2Innovators4
Arbitrageurs
3
Health
Systems
Confidential. Copyright 2020 Damo Consulting Inc.
16

17. Getting digital
transformation right
I. Develop a digital roadmap for the enterprise. Make strategic choices
quickly and efficiently to serve patient needs.
II. Invest in robust governance and processes for identifying and
managing technology vendors and maximizing the value of technology
investments.
III. Gain cross-functional buy-in and alignment for early and sustained
success with implementing digital roadmaps
IV. Consider setting up a digital transformation office that is removed from
day to day operational responsibility and can drive enterprise-wide
collaboration.
V. Continue to revisit the enterprise roadmap, involve stakeholders early
and often, and learn best practices from peers in the industry.
VI. Digital transformation success is predicated on new financial thinking
and analysis. Allocating investments in the digital age using old school
methods will lead to failure.
VII. IT will be challenged to significantly reduce costs while managing
increased investment in digital capabilities. This balancing act will
determine success or failure.
©2020 Damo Consulting Inc. 17

18. Research & insights on digital health and technology
landscape 18
Research and Thought Leadership White PapersNewsletter
Podcast
Speaking Engagements
Books

19. Digital transformation advisory focused on healthcare
Digital Diagnostics
• Digital maturity
assessment
• Discovery
workshops
• Competitive
benchmarking
• Future state
modeling
Telehealth and Digital
Roadmap
• Opportunity
assessment
• Stakeholder
surveys and
research
• Prioritization and
dependencies
• Roadmap
implementation
Technology Strategy
• Solution strategy
• Architecture
recommendations
• Vendor research &
evaluation
• RFI/RFP
management
Digital Transformation
Office
• Digital charter
• Budgeting and
planning
• Governance and
change
management
• Program
management
Digital Front Door
• Digital
engagement
• Journey maps &
experience design
• Digital health tool
evaluation
• Process design and
implementation
Digital Operations
• Operational
analytics
• Vendor
management
• Project charters
and TCO analysis
• Benefits capture
and reporting
19
Confidential. Copyright 2020 Damo Consulting Inc.

20. Thank You!
Paddy Padmanabhan
+1 630 649 8548
paddy@damoconsulting.net
www.damoconsulting.net
https://thebigunlock.com/
Damo Consulting provides digital transformation advisory services to
enable healthcare organizations navigate the technology-enabled
transition to telehealth and virtual care. We bring deep industry
knowledge, market insights and technology skills to help develop and
implement enterprise digital roadmaps. We work with healthcare IT
and digital health firms to develop and execute market growth
strategies.
©2020 Damo Consulting Inc. 20
Get a signed copy at
http://bit.ly/HDTBook