Marc Probst has been vice president and CIO at the Salt Lake City-based Intermountain Healthcare for nine years. In that time, he has continued and expanded on the work of his predecessors, leading a large team of IT experts and professionals in the integrated health system’s ongoing journey as a pioneer organization in leveraging IT for performance improvement and patient care quality optimization.
Probst will be speaking twice at the HIMSS Conference in New Orleans next week, including as the closing keynote speaker at the Meaningful Use Symposium. In that capacity, on Sunday, March 3, he will be speaking under the session title, “Update and Insights Regarding Meaningful Use,” from his standpoint as a member of the federal Health IT Policy Committee.
Probst spoke this week with HCI Editor-in-Chief Mark Hagland regarding his upcoming role as a HIMSS Conference presenter, and the broader issues around the meaningful use process and the current state of healthcare IT’s evolution more generally. Below are excerpts from that interview.
You’re speaking at HIMSS, including delivering the closing keynote address at the Meaningful Use Symposium, correct?
Yes. In the Meaningful Use Symposium, I’m closing out, with my perspective on some of the issues associated with meaningful use, because of my membership in the HIT Policy Committee. I continue to believe that we’ve been successful with meaningful use, but I think some things could be improved.
What things could be improved?
Standards, whether they’re around patient identification, or data transfer standards. I think the industry hasn’t achieved everything that the investment in EHRs [electronic health records] would allow it to achieve, because I think the government hasn’t been as focused on a host of standards, primarily around data, which is what I’ll be talking about on Sunday.
Within the patient identification and data transfer standards, areas, what issues would you like to point out?
Well, we can’t even reasonably move a lab result from one system to another and have the data be reliably transferred, because even with LOINC standards, you still can’t support physicians without a lot of extra work mapping data. In one system, they may define a nurse as a “1” and in another, as an “N.” Developing standards for data transfer is where you get value out of systems; and meaningful use is meant to help the country.
Is it providers or the government who need to focus more on standards?
This is a bit more controversial; I do believe that the government needs to, since the industry has not focused enough on it yet. And so if we’re going to do it more expeditiously, I think the government should get more detailed on this. And to be fair, Farzad [Farzad Mostashari, M.D., National Coordinator for Health IT] does get the concept, as does the HIT Policy Committee; but we’re doing it pretty incrementally. I have lobbied pretty hard up in Congress on this, but I have only one voice.
Certainly, I would think Dr. Mostashari would listen to you carefully.
And he is doing things, but the meaningful use process is getting ahead of standards development, and that’s going to be a problem. So I am bullish on ONC [the Office of the National Coordinator for Health IT]; given what meaningful use was asked to do, I think the Policy Committee is doing an excellent job; they’re an amazing group of people.
Is it your sense that we’re now reaching a critical mass industry-wide in the shift towards IT-leveraged clinical transformation?
Absolutely. I’m in awe of organizations like Sentara [the Norfolk, Virginia-based Sentara Healthcare, an integrated system with 10 hospitals and three medical groups]; and I’m in awe of Judy [Judith Faulkner, founder and CEO of the Verona, Wis.-based Epic Systems Corporation]. There have been so many investments in healthcare IT; and I think IT is absolutely critical to leveraging change. Ten years ago, you had to send a fax to share a patient’s information with another provider, and now you can virtually get someone’s key patient information electronically, even if that process is not necessarily seamless. And now we are focusing on how to making things more seamless and accessible, and improving the workflow.
What would you advise your colleagues about what’s been learned from pioneering organizations like yours so far?
The danger in my offering advice to others is that not everyone has the same level of resources. Intermountain has 60 people in the Homer Warner Center [the Homer Warner Center for Informatics Research, located at Intermountain Medical Center in Murray, Ut.] spending all their time on leading-edge innovations. The average community hospital organization doesn’t have that. And in terms of developing and implementing best-practice protocols for clinical practice, support and operations and in clinical information systems, and 90 percent of what we’re using, the concepts were actually developed elsewhere. We speak a lot about the 39-week induction protocol for inducing labor, for example. We didn’t come up with that; we just took it and implemented it, and were able to use our systems to support it.
What would your advice about using medical and clinical informaticists be? Obviously, Intermountain has created a culture of innovation and clinical transformation.
I was lucky; I inherited a culture that was already a part of Intermountain Healthcare. But it wasn’t without investment; even when I got here nine years ago, there were still lots of questions about things. But the proof’s in the pudding. And look financially at how we’re performing: on a per capita basis, we’re the most efficient provider of healthcare per capita in the United States. So it really is all about building, sustaining, and enhancing culture. And it didn’t just happen; it came from leaders like Brent James [Brent James, M.D., executive director at the Institute for Health Care Delivery Research at Intermountain Healthcare] and Homer Warner.
Yes, indeed. We’re honored to have Dr. James as our closing keynote speaker at the Healthcare Informatics Executive Summit in May.
Meanwhile, what do you see for Intermountain in the next few years?
Well, we’re definitely going to have to make some changes around our EMR. It’s older, and there are a lot of capabilities we don’t have.
But obviously, you’re going to keep your self-developed core?
Not necessarily; the analytics, certainly. But the CPOE [computerized physician order entry] system, and some of the apps out there, I’m not sure. We’ll buy pieces. I even look at the Google Glass out there. So EMR will be a focus; and security and privacy. And unfortunately, we’re going to have to invest in more. I would say we’re in the top five percent on data security, but we’re still going to have to invest a lot, because of the changes brought forward by the Omnibus Rule [for more information on some of the requirements in the new Omnibus Rule, please see this recent interview with Mac McMillan]. And we have a booth at HIMSS, with our IS Innovation Lab. And several of the products that are coming out of that, and several of the partnerships coming out of that, we’ll be displaying those at HIMSS. It’ll be one of the few booths at HIMSS where you won’t be sold anything. It will continue to let people know that we are focused on innovation, perhaps even in areas that they might not have been aware of.