At Geisinger, Karen Murphy Maps Out Innovation Strategy With a Wide Lens

The executive vice president and chief innovation officer for the Pennsylvania-based health system is helping to create new programs and pathways, all while focusing on the path to value-based care.

Innovation in healthcare doesn't just mean finding a new way to do something. It's a "fundamentally different approach to solving a problem that has quantifiable outcomes."

That's the mantra for Karen Murphy, MD, executive vice president and chief innovation officer for Geisinger and founding director of the Pennsylvania-based healthcare organization's four-year-old Steele Institute for Health Innovation. As such, she's leading the way in one of the most competitive healthcare markets in the country to research and develop new technologies and strategies to take healthcare into the value-based care era.

She has her hands full. The pandemic may have propelled telehealth and digital health innovation forward by roughly a decade, but it has also exposed barriers in using technology to connect with underserved populations, as well as causing a surge in stress, depression and anxiety, and exacerbating the burnout rate and workforce shortages in healthcare. While giving Murphy and her colleagues good targets at which to direct innovation, these barriers can also be landmines, capable of derailing an innovative platform or concept if not addressed.

Karen Murphy, executive vice president and chief innovation officer at Geisinger. Photo courtesy Geisinger.

One more caveat: healthcare innovation isn't occurring in a vacuum. Healthcare organizations are expected to simultaneously evolve and continue to deliver healthcare.

"We are caring for patients each and every day, and it's very, very difficult to innovate and operate at the same time," Murphy says. "We are not a healthcare store. We need to integrate innovation" into the ongoing care platform.

That's why innovation needs to show value, and have measurable results that can be used to prove sustainability, especially on a timeline.

The idea that innovation is meaningful' "is really hard," she adds. "We constantly expect short-term results from long-term strategies."

One strong example is the Fresh Food Farmacy, a program developed out of the Steele Institute that addresses a key challenge to care management for people living with diabetes: diet. People living with diabetes need to carefully manage what foods they eat, including when and how much they eat. This is a social determinant of health, a factor not usually included in clinical care, but which affects a patient's health and wellness as dramatically as medication.

Through the program, patients are screened in a primary care setting for food insecurity, and if they have those concerns and an A1C level of greater than 8.0 (an indicator that the patient isn't managing his or her diabetes well), they're given a "prescription" or a referral for the Fresh Food Farmacy, which gives them and their household the ingredients for 10 nutritious meals a week.

To date, the program, which also operates in satellite locations in Kingston and on the Jersey Shore, has provided almost 2 million pounds of food, or roughly 1.5 million meals, to about 1,500 patients. Internal data suggests that has helped patients reduce their A1C levels as much as 2.4 points. Geisinger is now looking to expand the program and is partnering with digital health company Season Health to integrate the program later this year into the Geisinger Health Plan.

Murphy says the program demonstrates two key facets of innovation:

1. It rethinks how care providers collaborate with patients to improve clinical outcomes
2. It's not all about the technology.

"Digital allows us to communicate with patients more effectively," she says. "And it allows us to intervene for [preventive health and wellness] in a much more cost-effective way than in the past. It gives us the tools we need to engage with patients … but we still need to learn how to engage."

"I'm thrilled for the disruption that we're seeing in healthcare," Murphy adds. "It's forcing us to rethink how we engage with patients. It's not the same as 20 years ago."

In this case, Geisinger can use technology—e-mails, text messages, and virtual care—to connect with patients at the time and place of their choosing, and through these connections the health system can collaborate to improve not only care, but health and wellness. This shifts from the philosophy that delivers healthcare in episodes, to address immediate needs to a continuous model that manages care over the long term. With chronic care patients, such as those living with diabetes, that would include not only access to food but also meetings with dietitians to help manage diet and lifestyle.

"With value-based care, providers are reimbursed based on outcomes, rather than volume," Murphy says. "And we are gathering evidence, over the past 10 years, that we've [created] positive outcomes with quality measurements."

Murphy says those measurements and that data are also needed to attract payers and to reconfigure payment methodologies that, as of now, aren't in sync with value-based care. If innovation can be proven to transform care, payers and providers will need to agree on how these programs are covered and sustained, so that the incentives will be there to continue them.

That's where innovation is headed, into platforms and programs that enhance the connection between patient (or consumer) and care provider (or team), particularly outside the hospital, doctor's office or clinic, and in-between the scheduled appointments and treatments.

Murphy sees several areas in which innovation will play a part in the healthcare ecosystem. She sees AI and machine learning playing a part in the back end, automating processes, analyzing data, and reducing workflow stresses that plague today's doctors and nurses. Those concepts will also be brought to bear on the front end, helping to manage chronic care and other treatments while giving providers more face-to-face time with their patients.

She's also bullish on remote patient monitoring, a fast-growing and evolving strategy that took off during the pandemic. She sees traditional care pathways enhanced with RPM platforms that use sensors and AI to monitor and manage care at home through wearables, smart technology, and other tools.

"There will be other factors that we don't even know about today," she says. "That's what's exciting."