Three Strategies for Health System Success in 2023

Rich Miller, Chief Innovation Officer, QGenda

As healthcare puts 2022 in the rearview mirror and welcomes 2023, HIT Leaders & News has the pleasure of illuminating the insights of diverse industry leaders. In this Q&A, we speak with Rich Miller, Chief Innovation Officer at QGenda, to discuss his views on how health systems can mitigate common challenges and thrive in 2023.

Question: The past few years have been pretty hard on health systems’ balance sheets. What will they need to do in 2023 to get back on a solid footing and scale up as they’d like?

Answer:  Coping with the financial and operational implications of the pandemic has been challenging, without a doubt. But for health systems to thrive—not just survive—in the coming year, we need to go deeper and focus on a more foundational issue: How to consolidate successfully.

Health systems have spent years trying to scale their operations by engaging in mergers and acquisitions (M&A), consolidation, and service diversification. In theory, these activities should generate economies of scale that improve care cost, quality, and productivity. In reality? Not so much. In fact, we often see declines in all these areas. Why?

The answer is a matter of priorities. Efforts to coordinate provider operations are too far down the priority list.

Health systems in M&A situations typically tell me they don’t have time to worry about streamlining provider scheduling, on-call, etc., because they’re still struggling to integrate cultures, services, and care settings. I understand what they’re going through—but they have it all backward.

They’re overlooking a pivotal point: A health system’s core strength lies in its providers’ talents and time. By ensuring providers are delivering care as efficiently as possible and with minimal administrative distraction, health systems develop high-functioning operating units. The harmonization of provider workflows creates the desired integration and resulting efficiencies.

In 2023, health systems will have an opportunity to revisit how they prioritize provider workflows. By wrapping enterprise tools and processes around them, health systems can get back on a solid footing and scale successfully.

Question: What about the clinical side of the equation? Where should health systems focus to improve access to high-quality care?

Answer: It may seem counterintuitive, but let’s carry forward the idea that health systems gain efficiencies by optimizing provider workflows. It’s vitally important for health systems to understand that the very same processes they use to improve provider operations should also increase care quality.

I typically see this idea manifest in three ways:

  1. Clinical capacity. Why should patients be forced to wait days, weeks, or even months for an appointment? Think about what happens to a health system’s clinical capacity when providers’ schedules are harmonized with processes like credentialing, on-call, and room management. It expands! Providers don’t waste time running from the wrong exam room to the right one. There’s no lag time between credentialing and scheduling. Instead, the right providers are in the right places at the right times to see the patients they’re qualified to see. Process harmonization turns commonly wasted time in providers’ workflows into productive time—which in turn maximizes patients’ access to care. 
  2. Centers of Excellence. Variability is costly in terms of both clinical outcomes and costs. Centers of Excellence recognize and address variability by centralizing certain services (e.g., performing all hip replacement surgeries at one location). Thus, entire provider workflows can be standardized to best practices. Care teams become so experienced in a specialized service that they know how to maximize efficiency and effectiveness. The only way to build these centers of excellence is to establish an enterprise strategy that balances integration and autonomy, so providers have the tools and authority to do what they do best.
  3. Operationalized data and analysis. Evidence-based medicine is built on data. But provider data is a valuable resource that’s too often overlooked. Useful data is produced every time a provider gets credentialed, is scheduled, or sees patients. When operationalized, this treasure trove of insight can contribute to better efficiency and outcomes.

Question: So far, we’ve talked a lot about provider workflows. We haven’t discussed the providers themselves—in particular, provider burnout and labor shortages. What can health systems do to successfully mitigate burnout and satisfy providers?

Answer: Great question! There aren’t many quick fixes for the current wave of resignations, “quiet quitting,” and other labor woes pervading healthcare. But one thing has become crystal clear: It’s impossible to undervalue the power of work-life balance. And that’s excellent news for health systems.

It’s hard for cash-strapped health systems to compete for top talent based on salary alone—and it also misses the mark. Increasingly, what providers really want are equitable, flexible, and predictable schedules that give them more control over their work-life balance. A new study from Medical Group Management Association (MGMA) and Jackson Physician Search found that reducing administrative burden and providing more flexible work schedules were among the top five key areas to address burnout. Fortunately, that’s something health systems can deliver by leveraging advanced enterprise scheduling. The beauty is that advanced scheduling simultaneously accommodates individual providers’ preferences and optimal staffing for each team, facility, and organization. One doesn’t have to be sacrificed for the other. 

Staffing challenges will persist into the foreseeable future, and there will likely be clear winners and losers in the provider engagement arena. Health systems will need to take a more strategic view of provider operations. Those who genuinely support providers by lessening their administrative burdens and improving their work-life balance will come out ahead.   


business strategy, Health System, operational strategy, QGenda


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