Visiting Nurse Service of New York

Susan Northover

While people often associate healthcare technology with the state-of-the-art scanning, life-support and surgical equipment found in modern medical centers, some of the most interesting health-related innovations are now happening in the home care arena, as the healthcare industry focuses increasingly on helping people maintain their health and manage their chronic conditions in a community setting—thereby reducing the need for costly hospitalizations.

“As the United States’ largest not-for-profit home and community-based healthcare provider, VNSNY uses technological innovation to advance a number of important goals”

As the United States’ largest not-for-profit home and community-based healthcare provider, the Visiting Nurse Service of New York (VNSNY) uses technological innovation to advance a number of important goals. We rely on innovation to improve our care delivery while also reducing costs; to gain a competitive advantage in the home care marketplace; and to maintain our role as a healthcare leader and change agent. To support these efforts, we’re continually looking for ways we can leverage technology to help our staff perform their work more effectively, enhance the services we provide to our patients and members, and improve our ability to meet our customers’ and our own organization’s needs.

How We Select New Products or Services

While innovation has always been a big part of VNSNY, we recently redesigned our innovation strategy and approach and are now working to implement that redesign. To facilitate our implementation of innovative technologies, VNSNY employs a codified, step-by-step process for the selection and adoption of new products and services. This internal innovation process is overseen by our Executive VP for Strategy and, in the future, a VP of Innovation, and is supported by VNSNY’s Performance and Innovation Department.

The selection process begins with a “search” phase, which involves our innovation leadership casting a wide net to surface new technologies, drawing on academic resources such as journal databases and white papers, conferences and other technology events, online searches, and ideas generated through our leadership and employee networks, industry partners, and other subject matter experts. When a promising product or service has been identified, members of our team will meet with the vendor to gain a better understanding of the product, including how it’s used, its price parameters and overall value proposition, and the product’s prior results.

Following this step, if we are still interested in pursuing the product or service, we’ll meet with an Innovation Panel, made up of VNSNY leadership and subject matter experts from the relevant VNSNY business units, to review the technology and determine if we want to move ahead—and if so, then how and where the product could best be piloted within our organization. This review will include having the vendor conduct a demonstration for the Innovation Panel. The review process, which varies somewhat by product and vendor, is typically supplemented by additional input from other key decision makers. The aim of this broad outreach is to avoid a siloed approach by soliciting perspectives from across the organization, so that we understand all the cross-functional implications of the product.

How We Design Pilots

If the product is green-lighted, we’ll then take the next step, and design and implement a pilot project to test it in the field. VNSNY’s piloting process is central to our innovation strategy. This process begins with a careful delineation of the product’s intended benefits, including problems or challenges that need to be addressed as well as the pilot’s desired outcomes, such as improvements in clinical efficacy, operational efficiency, and cost reduction. Next, the pilot’s target test group is identified and the pilot itself is designed in accordance with a number of key parameters— ensuring, among other things, that the sample size is large enough to validate the pilot’s results, and that the right controls and metrics are in place.

After the pilot design is completed, we identify and train the staff who will be conducting the pilot. Following the pilot’s launch, we continue to work closely with the vendor to reassess and refine the pilot’s design as needed. Depending on the product, a pilot can last anywhere from one month to a year. Once the pilot is concluded, we carefully assess its outcomes and compare these against the project’s goals. This information is presented to a second expert Innovation Panel, which reviews the pilot results, including clinical and quality outcomes and cost savings. This panel will then decide whether to move forward with either an expanded pilot, an enterprise-wide rollout of the product or service—or, if the results merit, an investment opportunity.

Examples of Products and Services Being Piloted

In practice, we’ve applied or plan to apply this approach to a wide range of innovative products and services, including telehealth systems, risk stratification tools, in-home care management devices, recruitment tools, and clinical technologies aimed at enhancing the effectiveness of our nurses and therapists. While each product or service is unique, they share one important element: All of the innovations we select for piloting have the potential to improve how VNSNY serves our patients, clients and plan members, by enhancing our ability to provide quality, coordinated care management in a more consistent and cost-effective way. Even better, these multiple innovations often have a synergistic impact over time. Given today’s rapidly evolving world of home healthcare, technological innovation is more than a strategy at VNSNY: It’s our ticket to the future.