What are some of the main challenges facing CIOs right now, in the evolving operational landscape of U.S. healthcare? Tom Andriola, vice president and CIO for the University of California System and UC Health, shared his perspectives on the subject on Thursday morning, in his keynote presentation, “Managing the Changing Role of the Chief Information Officer: Clinical Transformation, Governance, Workforce Development,” at the Health IT Summit in San Francisco, sponsored by Healthcare Informatics, and being held Thursday and Friday at the Palace Hotel in downtown San Francisco.
Andriola directs IT strategy for the University of California System and UC Health; UC Health encompasses five University of California health systems—at San Francisco, Davis, Los Angeles, Irvine, and San Diego), accounting for $11.3 billion in annual patient revenues, and which trains 50 percent of California’s medical students and medical residents, and performs more than half of the organ transplants in the state every year. It is the fourth-largest health system in the state.
“There’s never been a better time to be in the business of technology, because IT is having more and more influence on the way we work,” Andriola told his audience. “And, as IT leaders, we have to start thinking more broadly, because there are more and more questions we have a role to play in.” An absolutely key element in CIO success, he emphasized, is that “We need to be in the right conversations at the right times, and to be ready to ask the right types of questions, to help our organizations engage in asking the questions about where we go next” in healthcare.
Andriola summarized some of the “dramatic changes taking place in U.S. healthcare,” focusing on some of the major challenges facing patient care organizations around “revenues, cost structure and payer mix”—where, he noted, “we have a huge challenge in cost structure around our academic setting”—as well as “care quality, patient mix and access,” and the increasing “consumerization” of healthcare. “It’s not just what’s going on in the Epic booth or the Cerner booth any longer,” he said, referring to disruptive entities coming into healthcare from all quarters. “The consumerization element and the broader recognition of who can actually help me with healthcare, that’s starting to change, and there are alternatives to getting care that will take revenues out of our pockets,” he said, referring to non-traditional providers of care that are emerging from outside established patient care organizations. “Now,” he said, “you’ve got disruption happening everywhere. There are disruptive outside forces around value-based care models, scientific advances, technological advances. The world has gotten more complex,” he added. “It used to be that competitors were well understood,” meaning traditional fellow providers. But incumbents are rapidly being gained on by new insurgents in the industry.
The impacts are multi-dimensional, and span the strategic to the practical, Andriola noted. Just to cite one very practical consequence of some of the disruptive changes affecting the healthcare CIO environment in California, he noted that “Very few people understand both the clinical science of healthcare and the data science around AI”—artificial intelligence—“and we have had a hard time keeping those people” within the UC Health system, he reported. “They get offered huge salaries to go work at technology companies across the Bay Area, with Silicon Valley ever-present in his hiring management calculations. The disproportionality of scale is a considerable issue, he noted, between what the public sector, including the state university system, and government, can offer skilled data scientists and other informatics experts, and what the private sector can offer them. “One of my colleagues,” he said, “recently pointed out to me that the entire budget of the National Science Foundation is $10 billion a year, whereas Amazon, Google, and Microsoft alone are investing $100 billion right now in cloud infrastructures”—and hiring data scientists, data engineers, and informaticists to help build out those architectures.
What should CIOs be doing right now?
“What should CIOs be doing today, and what should their contributions be to the organizations be?” Andriola asked his audience. “And what will advice to CIOs look like in 2025? One of the things I poke fun about is the fact that we CIOs now get way, way too much advice,” he said, “from Gartner, from CHIME”—the Ann Arbor, Mich.-based College of Healthcare Information Management executives—“and from everybody else. And some of what some of those organizations are saying is confusing.” He showed a slide from Gartner that he testified was very confusing. It was an unusual graphic showing a CIO’s “old job,” and then a cluster of bubbles showing “actions” the CIO should take, including “preempt disruption,” “define your new job,” “live your new job,” and then a final bubble labeled “new job.” “I’m not sure what this graphic even means!” he noted.
Importantly, Andriola said, “CIOs need to focus on the fundamentals.” First, “Can you be an effective leader? Understand what it means to be an effective leader.” Second,” In your environment, can you drive, coordinate, facilitate, effective collaboration, working outside boundaries?” It’s time, more than ever before, is to break down silos.
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