While both Edward W. McCallister and HCI Editor-in-Chief Mark Hagland were participating in HIMSS15 last week at the McCormick Place Convention Center in Chicago, they had the opportunity to sit down for a conversation on April 14. McCallister, who became chief information officer at the 21-hospital UPMC (University of Pittsburgh Medical Center) Health System in October, has spent nearly 17 years with the organization, most of those years with the organization’s 2.5-million-member health plan, of which he was CIO for several years prior to October 2014. He now oversees information systems for the entire system, including its 21 hospitals, 3,500 physicians in medical groups, and other outpatient services, and its 2.5 million-member health plan, and has over 1,400 professionals reporting to him across the vast UPMC organization. Below are excerpts from their interview.
There is a lot going on at UPMC these days. Now that you are CIO of the entire organization, what is your vision for the organization over the next few years?
Part of what’s going on right now is the whole restructuring of UPMC—it’s become a much flatter organization. I’m over the hospitals, medical groups, and insurance division, and am a customer/partner with the Technology Development Center, which has become our development arm, under the name UPMC Enterprises. But the vision is, with the alignment, with the move towards consumerism and population health, it’s putting the patient and consumer at the center. So the 50,000-foot strategy would be to recognize the opportunities to recognize the person.
When people come into the UPMC world as consumers of healthcare, we’re able to treat them in a way that is unique because of who we are. We address the consumer experience in three ways. First, we address it n terms of guidance: we provide the transparency tools, the cost comparison tools, and so on, to help them make decisions about their health. The second piece is supporting them in terms of motivation. For example, we actually have a platform that’s very device-agnostic, and gives them a place to capture data from their wearables and devices, through the insurance division, MyHealthOnline. And the third piece would be the convenience. You might be interested in all your information, and you might not necessarily want to have to pull up a portal, so you could get your information on a mobile device.
The pressures on CIOs in the new healthcare are intensifying. What must CIOs do in today’s evolving operating environment?
You bring up a good point. The role of the CIO—the changes have accelerated. Oftentimes, information technology is seen as an expense—a necessary expense, but an expense nonetheless.. I think the CIO has become a chief innovation officer and chief integration officer, and other things, all at once. So you need to start with the business leaders of your organization, and be at the table for the discussion from the beginning. Instead of CIOs being reactive, I think the role of the CIO involves being at the table in the first place, defining the future together with other senior leaders. And that makes the role of the CIO much more interesting, and much more valuable. That sets the stage, and then the CIO and his or her executive team, they’re able to figure things out together. It makes it more all-inclusive.
What are your biggest challenges at UPMC, going forward?
I think that the most difficult thing is to realize all of the opportunities and sequence them in a way that’s much more meaningful to the consumer, because at the end of the day, the patient has to be at the center of everything we do. That means sitting down with the business leaders of the organization and focusing on the consumer experience. And I think the excitement over the opportunity outweighs the fear of the challenge. I do see the challenges and opportunities. Think about telehealth and telemedicine: short five or ten years ago, the technology was the barrier in getting it done. The technology’s there now; it’s no longer the barrier to getting some of these things done. And partnering with the business is why you’re able to do this today. And I meet regularly with our telehealth director, Natasha Sokolovich. That’s a great example of what can be done together. The same goes for our ongoing collaboration with Dr. Shapiro [Steven Shapiro, M.D., UPMC’s chief medical and scientific officer since September 2010], in terms of the development of clinical pathways, as another example.
What are your top few strategic priorities as CIO?
We obviously want to do the business of IT. You start with the business of great care, and supporting 21 hospitals and 3,500 docs, and the health plan with 2.5 million members; and the international arm. So you want to drive efficiencies in our core business. Things like telehealth. The consumer always has to be at the forefront. So then, meeting the consumer where they expect to be met. And analytics. We continue to have a very focused approach to what we’re doing in analytics. The enterprise analytics initiative is an example of that. We spent the first few years building the foundation. It was more of a data warehouse initiative at first. Now, with the initiative with the University of Pittsburgh and Carnie-Mellon [in March, UPMC announced a new partnership with Carnegie Mellon University and the University of Pittsburgh called the Pittsburgh Health Data Alliance, to leverage big data for healthcare innovation], that provides the opportunity for more advanced analytics work as well.
Meanwhile, you continue to move forward on population health and accountable care as well, correct?
Yes, those ongoing initiatives are also focused on putting the consumer at the center. With regard to patient-centered medical home development, previously, we didn’t necessarily have the right model to address the patient in the right way. We were defining the PMCH and how the patient would be engaged, but in the move towards a more consumer-centric environment, it’s how the consumer can be engaged. It’s partly going to be about mobility, moving everything to the phone. And for the younger generation, their primary care doc is their phone. There’s so much self-diagnosis going on. My kids are in their early twenties, and the first thing they’ll do is to take a picture and do a web search. There’s so much self-diagnosis and education online, that the consumer’s more part of a care team. The PCMH was a great term at the time, but now it has to become a consumer-centric care team model.
Do you have any comments on the current policy and regulatory environment?
Any policy or regulatory activities that happen, in some fashion impact UPMC, so we have to be very aware, and we’re in a very good position to address them. We’ve attested to Stage 2. I think meaningful use was directionally a good thing. I think it moved people in terms of the direction of EMRs. So we’re moving in the right direction, and meaningful use is an example of a regulatory development that got the industry moving in the right direction, and it’s our responsibility to continue to move that forward to do what’s right for the patient.
You and your colleagues at UPMC have really helped to lead the way in so many areas when it comes to leveraging healthcare IT for innovation. What should your CIO peers be thinking and doing in the next few years?
I know I’m in an enviable position here. When you work for a company in which innovation is in the DNA of everything you do, that makes it great for a CIO. But for other CIOs, I would say, first, be at the table for the early discussions so you’re part of formulating the strategy with the business leaders in your organization. And not only is it more functionally efficient to do things that way; it’s much more proactive and cost-efficient. You need to be much more proactive than reactive. And my advice would be, be prepared around the consumer-facing applications that are out there. The traditional business platforms are becoming a commodity. And the investment should be on the consumer-facing side. And I would say, 10 years ago, HIMSS was much more about product. It was a shopping-cart technology. Now, you start with a strategic partnership with a vendor or the vendor community, and you need to start not with a product but with a problem. And I think the right product will evolve forward if you have the right discussion. And starting with vendor partners, that’s a much different prospect.
You seem very optimistic about the future.
I think the healthcare industry is at a tipping point in a very good direction. You hear a lot of talk about the unsustainable cost trajectory, but when you place the focus on the consumer, the conversation changes. It does come down to higher quality and lower cost, and a customer service wrapper that creates a good experience for the consumer. That’s where you start. And mobility will be an incredibly important element in all this. But I think we’re in a great industry today, we have tons of opportunity, and if we do things the right way, it will create an amazing experience for the consumers of healthcare. And analytics will drive action.