Russell P. Branzell, CEO of the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), spoke with HCI Editor-in-Chief Mark Hagland on Wednesday, Oct. 9, during the CHIME Fall CIO Forum, being held at the Westin Kierland Resort and Spa, in the Phoenix suburb of Scottsdale. After six months as CHIME’s CEO, Branzell shared his perspectives on the policy and process change challenges and opportunities facing CIOs and other healthcare leaders in the current, rapidly evolving, environment. Below are excerpts from that interview.
Congratulations on the record attendance level of about 750 people this year at the Fall CIO Forum. It seems that there’s never been a better time for CIOs to talk with one another, right?
Thank you. And yes, you’re absolutely right.
Russell P. Branzell
So what kinds of conversations have you been having lately with colleagues, both in general, and also specifically, so far this week?
The conversations have really been taking place on two or three levels: there’s the macro level of policy, which includes meaningful use, big-skill development, best practices, etc. Then you start look at the micro issues—making sure you have the resources, the staff development, etc. And you can almost speak of a super-macro level as well—how can we make sure the entire industry survives? And that’s where we’re trying to work across associations, etc., to solve all these problems together, in a smart way, with less variation; and that means working with other associations, including across the provider sector, as well as to big pharma, health insurers, etc.
In talking with other association leaders, are you seeing some commonality of purpose right now?
There’s a commonality in terms of a desire to work collaboratively. People have been working heads-down, to ensure the future of their individual fiefdoms. But to protect and serve their portion of the industry correctly, there’s a significant realization that we’ve got to work horizontally. And that doesn’t mean that we ignore our vertical—in our case, the CIO and HIT community; it just means that we also means work horizontally as well. And I really believe that there’s an 80/20 factor involved; that we see 80 percent of things in an identical way. But what you hear about in the press and on the Hill [Capitol Hill] is about the disagreements.
We as an industry and society are struggling with getting to the new healthcare together—the transformed healthcare system involving accountable care organizations, patient-centered medical homes, true population health, care management, etc.—correct?
Yes, and the struggle is because of a continuing lack of alignment of incentives, still. Why are some of the ACOs attempting to be successful? Because the payment model supports that. The reality of reimbursement systems is that you get the behavior that you pay for. And so I think everyone in the country knows we need to get to that. The question is, how to you get to the transition. And as I say, this is not about the technology. Lots of technology needs to be put in place; that’s the easy part. The process and financial transformations that need to take place are massive, on an aggregate level.
When you talk to CIOs right now, what are their biggest concerns about this?
Again, I’ll speak to the macro and micro levels. And on the macro level, their biggest concern is the magnitude, the amount and complexity of the work that needs to occur. The micro involves the specific tasks that need to get accomplished in a very short period of time—the ICD-10 transformation, meaningful use stage 2, cybersecurity, etc. And there’s more work than any CIO could dream of doing right now. And everything is important.
What will CHIME be able to do in the next year or two to be able to help with that?
I think there are multiple things: one, we’ll continue to do our traditional roles of education and advocacy. And now, with our partnerships in Washington, the relationships we have, and now bringing together a much bigger stakeholder group of associations, will bring together a greater unity of voices. And while that sounds fluffy, it really is significant. And having talked to a senior official in Congress, one of their comments was that our comments were very important, but that they get comments from a hundred people. If they got unified comments from 20 or 30 important collaboratives of organizations, it would really make a difference. We have not traditionally worked that way in this industry; but I think CHIME will help being a facilitator of that and a collaborator in that.
You started in your role April. So do you have any particular perspectives on how things have been developing, after six months?
I’m very pleased with what we’re going through as an organization. We’ve just gotten through our first planning cycle with me on board. There have been new initiatives announced every few months. And also, I’m pleased with our advocacy work in Washington. We didn’t go in to whine, to complain, we went into help, to fix, and to serve. And I think it’s been appreciated by ONC [the Office of the National Coordinator for Health IT], CMS [the Centers for Medicare & Medicaid Services], and others. And I’ll bring you back to one common point as an example. Several months ago, it was considered completely taboo to talk about patient matching. Now, with our work with ONC, now, not only are the conversations occurring, they’re funding the conversations about how to get to a robust standard on patient matching. That was done because of a lot of behind-the-scenes work and partnership with the right people.
Speaking of ONC, what kind of person would you like to see as the new National Coordinator?
I think we’re at a unique point. We’re going to continue to need to have a very sharp statesman who’s politically aware, understands how to work in a government structure, but is fighting for this next stage of adoption to be technically and quality-wise appropriate. We’re leaving the foundational phase, and it’s now the time to put the walls up for the house, and that takes a different kind of skill set. And we need someone skilled in putting up the framework, as we launch into stage 3. And I personally don’t want to give a specific judgment of any individual person. My limited interaction with Dr. Reider [Jacob Reider, M.D., Acting National Coordinator] has been that he’s been very similar with Farzad in his wanting to collaborate. I would like to see somebody who is a little bit more directive in driving very clear standards and very clear requirements coming from the federal government.
Could the current federal government shutdown, if it persists, affect ONC?
I think any short-term delay will have minimal impact on the overall scheme. The part I’m concerned about is things like timing flexibility. With no one there, no one is working on that issue, and we have no one to work with. We will overcome that, but I’d rather be working on that now. But unless it’s shut down for a long period of time, I don’t see any major impact on health IT.
Is there anything else you’d like to add?
I think we’re in a very unique place in healthcare right now. It’s an exciting time, with exciting opportunities, and challenges. But I’d rather have the challenges than be bored. And I don’t know anyone in healthcare right now who’s bored!