John Glaser, Ph.D. has been a well-known leader in U.S. healthcare for decades, as a consultant (with Arthur D. Little, 1984-1988), a CIO (at Brigham and Women’s Hospital, Boston, 1988-1995, and then with the merged Partners HealthCare, 1995-2010), and more recently, as a vendor executive (with Siemens Health Services (2010-2015; and since February 2015, with the Cerner Corporation, after it had acquired Siemens). At the beginning of this month, he published a book, entitled Glaser on Health Care IT: Perspectives from the Decade that Defined Health Care Information Technology. The 312-page book, published by CRC Press, is a compendium of columns he wrote regularly for Hospitals & Health Networks. Just prior to HIMSS16, Dr. Glaser spoke with HCI Editor-in-Chief Mark Hagland regarding his perspectives on the current evolution of U.S. healthcare and healthcare IT. Below are excerpts from that interview.
So, you’ve written a book. Congratulations—and tell me about it?
Thank you, and yes. Going back a decade, I’ve written maybe five or six columns a year on various topics, for Hospitals & Health Networks, on various topics, from the Internet of things, to assessing the effectiveness of IT organizations, to meaningful use-related topics. So there have been over 50 columns, categorized into four broad categories. [The four categories are “HIT Applications and Analytics Challenges”; “Improving Organizational Performance through HIT”; “IT Management Challenges”; and “HIT Industry Observations.”] So these are some of the topics I’ve thought about. So we took all these things, cleaned them up a bit, and packaged them, and am sharing them.
John Glaser, Ph.D.
When will it be released?
Very soon; there will be a book-signing session at HIMSS.
You’ve been a presence in the industry for a very long time.
Yes, altogether, over 35 years now.
And now is a fascinating moment in healthcare and healthcare IT, wouldn’t you agree?
Yes, I think so. And there’s a lot still to be done. But if you look at the last ten years, with EHR [electronic health record] adoption, driven by meaningful use, and the forward evolution of a broader range of technologies, including for population health, revenue cycle, telehealth, and so on, the technology has obviously continued to be relentless in its innovation. The advent of the web, the emergence of wireless technologies, advances in analytics and in sensors, all those have moved us forward as an industry. And we’re better at implementation now. We’re still not flawless... But we are increasingly able to use this stuff strategically and competitively. And the IT department is more effective than it ever was.
And lastly, the role of the federal government has jumped dramatically. So I think you’re right, we’re in an extraordinary time. I’ve never seen anything like the level of change and of innovation, around helping people with chronic disease managing their health, helping healthy people stay healthy, and so on.
And one of the things happening is a very significant change in the business model; we’re going from reactive to proactive management of health; from niches like pediatric care, to broader care management models. And we’re going through a fundamental shift in payment.
So, I need to ask you the classic “half-full, half-empty glass” question. It would be easy for any of us to pronounce the proverbial glass to be “half-empty” or “half-full” right now in U.S. healthcare. Your thoughts?
You and I could take turns taking each side of that for hours. Interoperability’s still kludgey. Interoperability—that’s still a challenge for docs in practice. You still have implementations that go sideways. You still have security issues… and now with this ransomware, goodness gracious! So there are still a lot of issues. And you could argue, woe is us. But then look at the gains in people using CPOE [computerized physician order entry], and the much greater ability to manage analytics. And the results in managing chronic illness are still mixed. But then, people are using cellphones to do things never done before.
And the reality is that you could go back and forth; and you’re always going to have things that are worrisome. But at the same time, we’re really making progress here. And you and I have been in the industry for a long time. And look at what HIMSS was like 10 years ago. And it will still be the same question of balance 10 years from now.
At a minimum, there’s tremendous policy clarity right now, compared to years ago, would you agree?
Absolutely! We aren’t going back. The dominant mode of payment is becoming a minority—fee-for-service. It’s hard to know what the mature form will look like, but the direction is absolutely clear.
What should CIOs and CMIOs be doing right now, given everything that’s happening?