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Cleveland Clinic CIO Ed Marx Urges the HIT Summit Audience to Take Risks and Lead Proactively

March 27, 2018
by Mark Hagland
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Cleveland Clinic CIO Ed Marx urges his HIT Summit audience to lead boldly, creatively, and proactively

The success of healthcare IT leadership in the coming years is going to be based very strongly on the degree to which CIOs and other senior healthcare IT leaders show leadership in their organizations, Edward Marx told attendees Tuesday morning at the Health IT Summit in Cleveland, sponsored by Healthcare Informatics. Marx, the CIO of the integrated Cleveland Clinic organization, is one of the best-known CIOs in U.S. healthcare, and has served as CIO or senior leader of numerous nationally known patient care organizations.

Presenting the opening keynote address—entitled “Time to Lead: Identifying and Executing Business Strategies”—at the Summit on Tuesday morning, Marx told his audience, gathered at the Cleveland Downtown Hilton hotel, that CIOs and other senior healthcare IT leaders face a constellation of challenges in the coming years, as policy-, payment-, regulatory-, business-, and technology-related changes shift the landscape of healthcare IT executive management. And he challenged his audience to rethink how they’re leading their own organizations. “Somewhere in the last 10 years, we gave up our authority, and no longer took up our leadership positions—across a huge range of titles,” Marx said. “We’re all leaders in our organizations. And somewhere along the way, we gave up our leadership position. One result is that in some organizations, the shadow IT is as large as the regular IT,” he said. “Another issue is around the rise of the title of chief digital officer, which in some organizations is now as important as the CIO.”

A key element in all of this, Marx told his audience Tuesday morning, is that CIOs and other senior healthcare IT executives in hospitals, medical groups, and health systems, need to be proactive in their leadership, not passive. “Why aren’t we at the table?” he asked. “The message is, you just have to take the lead. You can’t sit back. I’m very much into mountain climbing. And I know that sometimes, it’s easier to sit back and let someone else take the lead. But that’s not we’re called to do. And in mountain climbing, the leader of a particular expedition may be tired and need someone else to take the lead. I’ve had that happen to me, and also have taken the lead from someone else who was tired.”

Seeking opportunities around leadership is essential, Marx said. “Maybe there’s a digital void in your organization? Are you just sitting back, waiting for someone else to take the lead? When you take the lead, you have success and reach summits. And I would argue that IT is one of the top two or three most strategic assets in a patient care organization.” And he showed the audience a slide that articulated the return on investment in IT, in healthcare organizations. “This slide shows 600 percent ROI on investment in IT—and it’s more than five years old,” he noted.

Considering future scenarios

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Urging his audience to consider diverse future scenarios in their operational landscapes, Marx told a bit about the story of what happened with a bridge in Choluteca, Honduras, several years ago. As the Wikipedia article on the subject notes, “The new Choluteca Bridge, also known as the Bridge of Rising Sun, was built by Hazama Ando Corporation between 1996 to 1998 and became the largest bridge constructed by a Japanese company in Latin America. In the same year that the bridge was commissioned for use, Honduras was hit by Hurricane Mitch, which caused considerable damage to the nation and its infrastructure. Many bridges were damaged (including the old bridge) while some were destroyed, but the new Choluteca Bridge survived with minor damage. While the bridge itself was in near perfect condition, the roads on either end of the bridge had completely vanished, leaving no visible trace of their prior existence. More impressively, the Choluteca River (which is several hundred feet wide) had carved itself a new channel during the massive flooding caused by the hurricane. It no longer flowed beneath the bridge, which now spanned dry ground. The bridge quickly became known as ‘The Bridge to Nowhere.’ In 2003, the bridge was reconnected to the highway.”

The key point about the story, Marx told his audience, is that, “They invested in this bridge that would connect the two parts of the country. And they hired Japanese architects to build this hurricane-tolerant bridge. And the bridge survived the next hurricane, but the river moved. So the lesson is, we have to move with the times and not be stuck in the past.”

Meanwhile, Marx asked his audience, “What does it mean to be a post-modern leader? How come IT didn’t take the lead on social media? How come you and I didn’t? So, at Texas Health, we actually led our social media efforts, and then handed that off to others. But we created a lead in the Dallas-Ft. Worth market.”

There are countless opportunities to help lead innovation forward in one’s organization, Marx noted. “Are you personally known for innovation in your organization?” he asked. “For being the digital expert? For some aspect of leadership that takes technology and applies it to healthcare? I would guess that the majority of people would say, no, I’m not known for that. But wherever you are in your organization, you can lead; you don’t have to be a CIO to lead.” Meanwhile, he said, “Here’s an area of opportunity: who’s leading artificial intelligence in your organization? Augmented reality? And are you the first place your CIO looks to when they ask, what are we doing in machine learning?”

Another element in all of this, Marx told his audience, is that “You are what you measure. The number one thing we measure” at the Cleveland Clinic organization, he said, “is quality and safety. And if there’s a never event, a serious safety event, everyone comes and reports. We find out what happened and why and what we’re going to do about it. We do the same thing in IT,” whenever a “never event” occurs. What’s more, he said, “If you report on an incident, you gain credibility.”

All of this also requires some level of humility, Marx told his audience. “At the end of the day,” he said, “none of this works if you’re not humble. At the same time,” he added, “Leaders bear the burden of visibility; you have to be seen.” In fact, he noted, “I’ve rarely had an office in the jobs I’ve been in. I was always out with my customers. That was true in both New York and Texas.” And real leadership requires creativity, and the willingness to take risks, to be a risk-taker.

And, he said, it’s important to think about a metaphor around plants. “Are you potted or planted?” he asked. “A potted plant is temporary; a planted plant is permanent, with deep roots.”

 

 


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Early Career Physicians, Pharmacists, Keen on Working in Tech, Survey Finds

December 18, 2018
by Rajiv Leventhal, Managing Editor
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A survey of 502 early career U.S. physicians and pharmacists revealed that 47 percent of these healthcare professionals are interested in working in the technology sector.

A LinkedIn survey, conducted in October, queried 502 physicians and pharmacists in the U.S. who completed their degrees within the last five years. The participants, all of whom have LinkedIn profiles, were chosen at random and reflect different specialties and years of experience.

Thirty percent of respondents said they were “somewhat interested” in working in tech, while 17 percent said they were “very interested.” Another 21 percent said they were “somewhat uninterested,” and 20 percent said they were neutral. Just 11 percent of respondents said they were “very uninterested.”

Participants were also asked to share their views on why they would or wouldn't consider working in the technology sector. Fifty-eight percent of respondents cited substance of the work, 57 percent said total compensation, 50 percent said working hours, and 49 percent said the impact of the work.

Notably, 85 percent of survey respondents said that having peers with their background represented at tech companies could lead to innovation for “traditional” industries.

Another 48 percent of respondents said the technology sector has an allure that makes it difficult for other industries to compete for top talent. Meanwhile, 47 percent said that those who move into tech from a different industry are more interested in “big impact.”

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The Modern Healthcare CIO, CMO, and CTO

December 10, 2018
by Lori Williams, Industry Voice, vice president of fulfillment, Gigster
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Disruption in the healthcare space comes primarily from the expansion of data’s role in the industry, and the healthcare C-suite’s familiarity with that expansion will help drive company and industry success

For the healthcare C-suite executive, the industry has never been more complex—nor has it ever contained so much potential. Emerging technologies mixed with political uncertainty has created an environment where incredible amounts of healthcare data are revolutionizing how patient care is handled, but patients remain uncertain about the future of their own health. With better data and the means to draw insights from it, healthcare CIOs, CMOs and CTOs are in a position to help address patients’ uncertainties and make hospitals and clinics more accessible and effective than ever before.

Here’s a look at how the role of the modern healthcare CIO, CMO and CTO is changing:

The Modern Healthcare CIO
The modern healthcare CIO’s role has evolved to become more innovative. No longer a title reserved strictly for engineers and IT professionals, today’s healthcare CIOs are focused on information science instead of simply setting up network infrastructure or providing back-end support. The trend towards a more data-centric role began as hospitals rolled out electronic health records, equipping individuals with better access to healthcare provider data. Through enterprise data warehousing, CIOs are becoming masters of data management, governance and predictive analytics, and passing along the many benefits of those knowledge bases to patients.

The Modern Healthcare CMO
The confusing healthcare landscape makes the role of a healthcare CMO more necessary than ever before. Thanks to ongoing regulatory changes, uncertainty surrounding the Affordable Care Act, and shifting consumer expectations for on-demand services, healthcare CMOs are responsible for helping patients navigate their way through a complex and opaque industry. As patients continue to assume the role of consumers, carrying out comparison shopping as they would for any other industry, CMOs must be adept in crafting a healthcare provider’s brand and messaging.

At the same time, CMOs must also ensure that healthcare providers offer a modern online experience, ensuring websites are mobile-optimized and social media accounts are generating engagement. This also means CMOs need to help move marketing efforts into the 21st century, transitioning away from direct mail or billboards towards digital marketing and CRM tools. Because if they don’t, there are plenty of med tech startups that will promptly eat into their market share.

The Modern Healthcare CTO
Unlike healthcare CTOs of the past who remained siloed off from the rest of the organization, today’s modern healthcare CTO is fully engaged with healthcare providers and their technology stacks, utilizing new software and hardware to improve daily workflows. The CTO is enabling the transition to patient-oriented self-service operations, enabling patients to carry out administrative tasks like scheduling appointments or refilling prescriptions over the internet. Because medical data is often stored in a variety of different sources, it’s critical for the CTO to be able to keep these systems interoperable with one another. For hospitals riddled with legacy software, CTOs should expect to continue employing middleware solutions to bridge the gap between old and new.

Members of the healthcare industry C-suite have the power to transform lives, and the CIO, CMO and CTO have roles that directly affect a provider’s ability to carry out positive change. With better data from the CTO’s tech stack, the CIO can use better analytics to help providers determine the best solutions for their patients, marketed to consumers by the CMO through modern platforms in clear, easy-to-understand language.

Lori Williams currently serves as Gigster’s vice president of fulfillment. Prior to joining Gigster, Lori was the general manager for Appririo.


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What Does Your Magnum Opus Look Like? A Few Operatic Thoughts

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I was given the privilege and pleasure recently of presenting, for the second year in a row, a lecture on Richard Wagner’s “Ring” cycle, as the leading opera company in my city, a world-class opera house, has been putting on, in yearly succession, the four operas of the “Ring of the Nibelung” cycle by German composer Richard Wagner (1813-1883). Last year, the second opera in the tetratology, “Die Walküre,” was performed; this year, the third opera, “Siegfried.” After the concluding opera, “Götterdämmerung,” is performed, the entire cycle will be presented in festival format, always a major cultural event. I spoke on “Siegfried.”

I’ve been fortunate to have seen six complete “Ring” cycles in live opera houses in different cities, and I can tell you, it’s a life-changing experience, as this four-opera work (16 hours of music altogether), sits at the absolute summit of western art. Richard Wagner was a hideous human being himself, but spent numerous years working on something that changed the course of classical music and redefined opera.

What’s more, from the summer of 1848, when Wagner wrote a first sketch of the libretti, or texts, of the operas, until their true compositional completion in 1871, more than 23 years were to pass; and it would be another five years before the tetralogy was fully presented, in a purpose-built new opera house in the Bavarian town of Bayreuth. It was a herculean feat to create the entire text of these four long operas, and compose 16 hours of music that would completely redefine the concept of opera. Indeed, when the crowned heads of Europe, the great living composers, and the 19th-century European intelligentsia and glitterati, gathered at the new Festspielhaus in Bayreuth in 1876, many were so overwhelmed by what they saw and heard, that they were rendered speechless. Even now, 142 years later, first time Ring-goers are overwhelmed by the breadth and sweep, the musical and dramatic audacity, and uniqueness of the “Ring” operas, with their story of gods, giants, dwarves, flying Valkyries, Rhinemaidens, one huge dragon, humans, gold mined from a river, magic swords and spears, and of course, a gold ring whose possessor can control the world and its fate.

Even just looking at the third opera, “Siegfried,” Wagner struggled mightily. For one thing, being essentially a grifter and a cad, Wagner borrowed/took money from everyone who would lend/give it, and often had affairs with the wives of the patrons bankrolling his compositional work, leaving his life in constant chaos, as he fled from one city to the next. One such wife, Mathilde Wesendonck, inspired the opera “Tristan und Isolde,” groundbreaking operas that Wagner wrote during a 12-year hiatus in his composition of “Siegfried.” And “Tristan” itself changed the entirety of classical music, its tonality-challenging chromaticism.

Well, no one is expecting anyone to match the unique creativity of Wagner’s “Ring” cycle. But the leaders of U.S. patient care organizations are doing a lot of important things these days, including using formal continuous improvement methodologies to rework core patient care delivery processes in order to transition into value-based healthcare. What’s more, as our Special Report on Leadership outlines, the entire role of the CIO is being rethought now, as the demands for leadership and strategic capabilities are catapulting that role forward; and patient care organizations are beginning to make real headway in advancing equality for women and people of color among the ranks of healthcare IT leaders and managers.

So while no one is expecting anyone to create an operatic tetralogy that will change the face of music, there are plenty of heroic endeavors open to anyone willing to envision the healthcare system of the future. The opportunities are as limitless as the imagination.

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