Exciting things are happening these days in California healthcare, particularly in the integrated health systems connected to major University of California organizations—the University of California, San Francisco (UCSF), the University of California, Davis (UCD), the University of California, Los Angeles (UCLA), the University of California, Irvine (UCI), and the University of California, San Diego (UCSD).
As part of a broader initiative around strategic planning and strategic coordination among the CEOs and other senior executives at the University of California campuses, the CIOs of the five health systems connected to University of California organizations, have quietly been working together for nearly three years now, to harmonize health IT strategies, drive forward strategic organizational initiatives, and find operational savings where possible, across all five health systems, as they collaborate for the common good.
Recently, six CIOs involved in the initiative sat down for a videoconference interview with Healthcare Informatics Editor-in-Chief Mark Hagland. The six are: Tom Andriola, CIO of the University of California Office of the President, the group’s facilitator; Joe Bengfort, CIO at UCSF Health; Christopher Longhurst, M.D., CIO at UC San Diego Health; Mike Pfeffer, M.D., CIO at UCLA Health; Chuck Podesta, CIO at UC Irvine Health; and Will Showalter, CIO at UC Davis Health. The six healthcare IT leaders have been collaborating on a broad range of areas of effort, including sharing data centers, extending their instances of their common electronic health record solution (from the Verona, Wis.-based Epic Systems Corporation), and working to pool clinical data in a single warehouse, among others. Below are excerpts from the recent group interview.
Who would like to summarize some of the key elements of this important initiative?
Tom Andriola: in response to the challenges in the healthcare industry, we’ve created a coalition allowing five of us and myself to come together, to look at things both at a local level and an enterprise-wide level. We just had a very engaged discussion around data-driven use of analytics for strategy to help us compete at the local level and also at the enterprise level.
Was there a formal mechanism to begin to bring this together?
Andriola: It was our executive leadership that saw there was a lot of benefit to come together to deal with changes in the marketplace, and they launched the program in which we as CIOs could come together.
And what has the timeline been? When might you be able to say this began?
Andriola: We kicked this off in 2014.
Chuck Podesta: My second day here, I attended the first meeting around leveraging value.
Joe Bengfort: So we’re in our third year. Chuck was a new member when he started at UC-Irvine in 2014, Chris was new when he started at UCSD in the fall of 2015, and Will just came in, in the last four months. So we’ve had about 50-60 percent turnover of CIOs since then.
What can you do together, broadly speaking?
Bengfort: Very early on, we mapped opportunities on a two-by-two grid. What are the things that CIOs can do, versus major operational challenges? We mapped our opportunities against that, and said, let’s start on things in the easier, more-in-our-control category. So we started with major spend, and contract development, and consolidation of data centers. We can do that without changing things like formularies or clinical workflow. That’s where we started; now we’re doing things around clinical decision support and the VNA [vendor-neutral archive].
Chris Longhurst, can you share a few thoughts based on your experiences as a clinician leader and former CMIO?
Christopher Longhurst, M.D.: I just joined 18 months ago, and this is my first CIO role. Another tremendous value-add of this group is just sharing best practices. There are five health systems here, and most of these folks bring years of experience, so for me as a first-time CIO, that’s tremendously beneficial. We’re meeting face-to-face on a monthly basis. We’re meeting in Los Angeles right now. And that proximity and closeness generates opportunities. And that floats down; our CTOs are meeting today. Dr. Pfeffer sponsors our CMIO group,. I’m sponsoring our analytics team. So the best practices benefits are great. CISOs as well.
Bengfort: Also being able to trust each other. That’s probably the number-one thing here.
Dr. Pfeffer, could you also speak to your perspective on this with regard to your background as a former CMIO?
Mike Pfeffer, M.D.: Joe and Chris really said it well. And this kind of comes from teaching medical students and residents the importance of role-modeling. We all trust each other and hold each other in high regard. That role-modeling has really trickled down to all the people who work with us on our teams. As Chris has said, the CTOs are successfully meeting. You can’t force people to work together.
Bringing down the collective spend by working together, in other words?
Podesta: Initially, as Joe mentioned, some of the low-hanging fruit. We were able, from a hardware perspective to stratify things from highest to lowest, and we knew storage was a huge cost for us, so we got our CTOs together and our procurement people together, because we all had different contracts, for example with Cisco and IBM and HP, and we were able to move from five contracts to a single contract, and shifting the timing.
And that means working together to develop single contracts whenever possible, correct?
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