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A Candid Conversation with CHIME’s Russ Branzell

November 2, 2017
by Rajiv Leventhal
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CHIME’s president and CEO discusses what CIOs and other healthcare leaders are most concerned with these days

With a membership base of more than 2,400 CIOs and over 150 healthcare IT vendors and professional services firms, the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME) plays a major role in health IT advancement efforts. At the head of the organization is Russell Branzell, CHIME’s president and CEO, who has been in his current role for almost five years.

Branzell, a former health system CIO himself, is well aware of the many challenges and pressures that CIOs and other healthcare C-suite leaders face today. Perhaps more than ever before, Branzell and his fellow CHIME senior leaders will be relied upon to help steer patient care organizations in the right direction as they enter into the new healthcare. At the CHIME 2017 Fall CIO Forum in San Antonio, Texas, Branzell spoke with Healthcare Informatics Managing Editor Rajiv Leventhal about the pressures CIOs are facing, where CHIME stands on certain policy issues, and more. Below are excerpts of that discussion.

What do you see as the core concerns right now for your members in this current healthcare landscape?

Cybersecurity has everyone focused, if not completely stressed out. Healthcare, as a general whole, has been late as an industry with this, and now with so much attention—whether it’s bad people trying to do the wrong things or just the general opinion of the public—we need to be doing more in this area. The larger organizations are doing fairly well, but even so, when you [look at] equivalent large industries to healthcare—meaning big banks and big manufacturers—they have far more resources dedicated toward cybersecurity and are actually [threatened] less.

Also, the industry as a whole is in significant transition, preparing for a future that’s often unknown. So whether it’s meaningful use, risk-based contracting, pay-for-performance, pick the buzz word, everyone knows we are moving in this direction, and they are preparing for it, but they are also still preparing for an unknown since many are operating in a fee-for-service environment. So there are cost restrictions, and organizations are trying to become lean and mean, and operate in this future world, but often it’s an unknown world.

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Russ Branzell

From a policy standpoint, CHIME has been at the forefront of providing insightful comments on government regulations. How do you see things progressing when it comes to MACRA/MIPS? Are you more confident or worried?

Well, no matter what the government puts out there, there will be a portion of the constituency who will not be happy about it. What I do believe we’re seeing, and this is truly bipartisan, is that they are willing to listen as things are moving through the process and being finalized, and adapt when things aren’t working as well. So I think we generally like the process we’re going through, but we do always have some form of comment or concern, or areas of focus.

One good example is that as you go through the process of realignment for physicians, the hospital side is not being fixed at the exact same time, as if these worlds are not an emerged environment. Most physicians, well over 50 percent, are working within a confined health system, meaning they are either employed or deeply contracted, so we change the rules and requirements for how physicians are paid, but we don’t change it for the hospitals to match that. It just doesn’t make much sense.

Why do you think there has been this lack of alignment?

Part of the reason is that you have lobbyists in Washington D.C. who did a very good job of representing the smaller portion of the industry—not smaller in size, but smaller meaning they might have represented more specialty-based physicians. So they get their voice out there, but sometimes due to the complexity, they don’t address the other [hospital] side of it.

But even in non-policy areas, there is still as much natural conflict. An example is that you get pushback that we need to be more interoperable and we need to be less difficult from a sharing data perspective, and we want to be empowering patients more with data flowing smoothly.  At the exact same time, we get pressure from OCR that you need to be super tight with security or there will be penalties. Those two things just come at odds with each other in today’s world. It’s not that we don’t try, but these things naturally have a conflict point.

Are CHIME’s members mostly prepared for MACRA or do you see the same concern that’s being expressed in many of these industry surveys that reveal a lack of readiness?

This is an overgeneralization, but it’s been a general truth that you can almost divide our industry at just about any given time into thirds. There are the proactive groups that are way ahead of the curve and ready at any given time; then the third that will come in near the finish line and do a good job; and then the third that doesn’t have the resources, skills, or staff in place—smaller, rural, or standalone places that will struggle to the very end. So our job is to help them and share best practices from the big guys, the ones that are proactive.

One of CHIME’s biggest initiatives is its National Patient ID Challenge. How are things progressing here?

This is taking longer than we thought, and part of that is the significant complexity, and also how the industry and technology keep moving. Phase one testing is being completed and we are in the process of evaluating that information. With this challenge, it’s a gatekeeping process and you do evaluations of levels of readiness to move forward. But the industry and technology continue to change since we started this initiative. So we need to pause and reevaluate, but we’re absolutely committed long-term to ensuring that some kind of solution will be in place. We are hopeful that the HeroX prize will be the methodology, but it has been much more difficult than we thought it would be.  But we will continue to support a solution long-term, and it may or may not be the HeroX prize [that is the solution].  

What advice can you give CIOs who are feeling as pressured as ever these days?

That is one of the primary areas that I get most concerned about—the overall health and wellbeing of our membership. It’s a very high-pressure point in time and this sounds simplistic, but we encourage our members to really take care of themselves. We are seeing a natural maturation of our members. We have had a maturity model for health IT and CIO leaders, which guided us to what we called the 2.0 leader. Now we are seeing this 3.0 leader, not just for CIOs, CMIOs and others, but for all leaders in organizations. These leaders are digital leaders of the future—the digital CEO, digital CMO, and digital CFO. And the person to move everyone along in that way is a great IT leader who can help the entire organization mature in its digital strategy.


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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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Using Performance Management to Scale

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Performance management is so much more than just a year-end performance review
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Performance management and goal setting have always been part of my DNA. It’s like a compass that tells us we are steering the ship in the right direction or gives us a chance to course correct if we wander off track. It’s hard for any organization to determine how they are doing unless there are clear measurable objectives. CIOs and their leaders need monthly, quarterly and annual goals to measure how you and your team are doing against the plan. I also firmly believe they should be S.M.A.R.T. goals: Specific, Measurable, Achievable, Relevant and Time-based.

Once the goals have been established, you need a written plan. I like three-year rolling plans so you can look into the future and describe your vision of what your organization will look like 36 months out. Then you can work back to the second year, and eventually the first year, to give you the framework for what you need to accomplish in the next 12 months. I suggest you do it with your managers. It makes them accountable to the organization since they are involved in the formation of the plan.

Your plan must be a living document to be used frequently during team meetings throughout the year to see how you are performing as a team and individually. This is not a process you invest in to review at year-end to see how you performed. By then it’s too late. It must be reviewed on a consistent basis to make sure everyone is on track. Performance management is so much more than just a year-end performance review. If there are individuals who are not performing against the plan, you can use the plan as a tool to performance manage them to re-engage as an important member of the team. 

I just returned from the Scale-up Conference in Denver and learned so much about taking goal setting and performance management to a whole new level by adopting the "Rockefeller Habits," as written by Verne Harnish. After reading the book, everything changed for me in the way we will be doing our planning, goal setting and performance management forever. It’s so brilliant and easy to understand. Here they are:

Rockefeller Habit #1: The executive team is healthy and aligned

Rockefeller Habit #2: Everyone is aligned with the #1 thing that needs to be accomplished this quarter to move the organization forward

Rockefeller Habit #3: Communication rhythm is established and information moves through the organization accurately and quickly

Rockefeller Habit #4: Every facet of the organization has a person assigned with accountability for ensuring goals are met

Rockefeller Habit #5: Ongoing employee input is collected to identify obstacles and opportunities

Rockefeller Habit #6: Reporting and analysis of customer feedback data is as frequent and accurate as financial data

Rockefeller Habit #7: Core values and purpose are “alive” in the organization

Rockefeller Habit #8: Employees can articulate the key components of the company’s strategy accurately

Rockefeller Habit #9: All employees can answer quantitatively whether they had a good day or week

Rockefeller Habit #10: The company’s plans and performance are visible to everyone

Accountability is no longer hard to measure since the entire plan is visible to everyone throughout the organization. Each part of your team should have key people accountable for every functional part of your organization. No more guessing is required. I’ve read countless books about leadership, performance management and goal setting, as I’ve been an avid student on the subject for decades.

These ten habits, once adopted and measured regularly, can change any organization that wants to grow and scale, and keep everyone accountable along the way.

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