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The “Most Influential Women in Health IT” Share Words of Wisdom and Issue a Call to Action

March 29, 2017
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Receiving an award is often a recognition of past accomplishments and achievements, but several leading women in the health IT industry see their recent award recognition as a call to action and an expectation to continue their work to solve big problems in healthcare through the use of technology.

On Tuesday, I attended a webinar sponsored by the Chicago-based Healthcare Information and Management Systems Society (HIMSS) highlighting the inaugural recipients of the HIMSS’s Most Influential Women in Health IT Award. It was an inspiring, thought-provoking panel discussion about leadership, specifically within the health IT world, and how to champion and equip the next generation of leaders. Several of the award recipients shared their insights about solving problems and sharing ideas as well as how they transformed from mentees to mentors, and then leaders.

HIMSS announced the award recipients in December and they were honored during an event at HIMSS17 in Orlando in February. The inaugural group of recipients represent a diverse group of leaders at various stages in their careers—Shareefa Al Abulmonem, head of eServices, King Faisal Specialist Hospital and Research Center, Saudi Arabia; Marion J. Ball, Ed.D, senior advisor, IBM-Center for Computational Health; Rachelle Blake, CEO and managing director, Omni Med Solutions, Germany; Christina Caraballo, senior healthcare strategist, Get Real Health; Karen DeSalvo, M.D., acting assistant secretary of health, U.S. Department of Health and Human Services; Karen Guice, M.D., acting assistant secretary of defense for health affairs, U.S. Department of Defense and Lisa Stump, chief information officer, Yale New Haven Health and Yale School of Medicine.

Carla Smith, HIMSS executive vice president, pointed out that the award does not focus solely on leaders in senior roles. “HIMSS believes women can be influential at any stage in their career,” she said when opening up on the panel discussion during the webinar.

And, while many of these names were already familiar to me, it was insightful to hear about their unique journeys of transformational change and innovation in the health sector. And, to me, it’s exciting that the awards not only acknowledge the difference women are making in this industry, but also to recognize how each of these leaders is profoundly transforming healthcare through IT.

As an example, Smith pointed out that Marion Ball, considered to be a “senior stateswoman” in the health IT sector, is known as an educator, leader, mentor and champion with a “tremendous body of knowledge and expertise.” Ball, who is on the editorial board at Healthcare Informatics, has been recognized for 30 years of service and major contributions to the field of healthcare informatics, and she has authored/edited 30 books and published more than 250 papers.

“When she got started, the opportunities for women were far less than they are today, and it’s because of women like Marion, that women like me have opportunities today,” Smith said.

Ball started her career as a math major, she said during the webinar, and a first step into health IT was being in charge of installing a system to automate a pathology lab which led to becoming the director of computing as she continued to work with hospital and financial systems.

Asked for her advice on professional development in the health IT industry, Ball said, “I’m a big believer in apprenticeship programs, and life-long learning.” She added, “Without the knowledge of how to use technology and bring it to the bedside and to the research bench, we cannot proceed. Women are playing a huge role in not only in learning but also the training,” she said.

Throughout her years in health IT, Ball said one foundational element still holds true—technology should be built to enable providers to do their jobs better. “Unfortunately, [today] we’re serving the computer rather than the computer serving us,” she said.

Stump, the CIO at Yale New Haven Health and Yale School of Medicine, said that the HIMSS award inspired her to focus on future achievement rather than just recognize past accomplishments. “This award was wisely named ‘most influential women,’ and that’s incredibly smart because it’s not just about accomplishments that have already been achieved, but really a call to action around what is next, an expectation that we will continue to influence the way that technology is used to the benefit of patients. This is one award I think about every day,” she said.

Blake, CEO and managing director, Omni Med Solutions, agreed, saying “This is not just retrospective, but something that is an expectation. How do I continue to be influential and how do I help those that are coming after me as well to be influential? This is a great way to really underscore not only what we’ve done but what we need to do. This is not about how old you are or how senior you are, but what you can achieve.”

I had previously profiled Stump last May after she gave a presentation detailing how the health system is using data and health IT to drive value to patients. In an interview, Stump, then interim CIO, drilled down into the health system’s health IT strategy as it continues its journey to value-based care. A pharmacist by training, Stump has had a unique journey to the CIO role, but key to that journey, she said during the webinar, was thinking as a clinician first, and leveraging technology resources and data to drive health care. “I wasn’t traditionally trained in healthcare IT, or IT, per se, but I was asking the right questions about why can’t the technology do what we need it to do? And that opened those doors, it’s about not being afraid to ask those questions or being afraid that you might look silly, and recognizing the talent of people around you to answer those questions and that creates empowerment to solve big problems. And we still have big problems in healthcare and I encourage everyone to think that way, to think outside the box.”

And while I think it’s definitely worth listening to the entire webinar, the award recipients shared some words of wisdom about leadership that I think bear repeating here:

“’Keep your head down and do the job.’ I took me a few years to take the advice and appreciate it. And what means is, don’t be distracted, by politics, by other people’s competing priorities, by naysayers, but to really focus on the goals, focus on what’s important, on the people who could help you advance those goals. The more you do that and build your credibility and reputation, the path before you becomes open.” – Lisa Stump

“Change management lies in opportunity conversion. My mentors said, ‘When you can change a challenge into an opportunity that is when you will succeed.’” –Rachelle Blake

 “The advice that was given to me, ‘Don’t bring me a problem without bringing me a solution.” –Karen Guice, M.D.

“Education is important; learn the tools of the trade, the secret is to get the certification, get trained in the language, whatever you’re trying to be good at.”— Guice

Regarding the assets that women bring to the health IT industry: “The inclusion. Women always include everyone, and everyone has a role and is important. We’ll help you achieve your goals.” – Shareefa Al Abulmonem

On measuring the future success in health IT: “Technology has the power to shift the way we look at healthcare. When I look at how we measure success in technology, we need to look at it in a phased approach. We’re making doctors understand technology. As technologists, we get it; doctors went to medical school, we studied information technology. We need to listen to these challenges, such as around workflow. We have a lot of work to do right now, as technologists, delivering these tools in a more practical way.” – Christina Caraballo

Here is a link to the webinar on the HIMSS Learning Center site: http://www.himsslearn.org/meet-most-influential-women-health-it#

 

 

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The Evolving Healthcare CIO: Innovation Over Information

November 15, 2018
by Rajiv Leventhal, Managing Editor
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The pressure is on CIOs and others in the health IT C-suite to become organizational leaders, while delivering in ways different from ever before

The healthcare CIO is the correct initialism for “chief information officer,” but as the landscape continues to shift—with the focus now on digital and strategic optimization, transformation and innovation—some observers are now wondering if “information” is really the most appropriate word for all that encompasses the modern-day CIO.

For the past two decades, Chuck Podesta has been a healthcare CIO, spending the last four years at UC Irvine Health, the integrated health system at the University of California-Irvine in Orange County, California. Podesta recalls the days when the CIO had a more IT-based title and financially-related job in healthcare, since clinical IT wasn’t a strong focus at that time. But with the evolution of EHRs (electronic health records), says Podesta, “The focus became clinical and the job suddenly had a broader scope. It’s not just the day-to-day running of the systems anymore; the CIO is now needed from the standpoint of strategy development because he or she is affecting the entire organization.”

Some would refer to the early-day healthcare CIO as an IT engineer of sorts, someone very technology-focused whose core responsibilities centered around hardware and software implementations, and getting servers up-and-running within the organization. Then came the influx of EHR deployments across hospitals and health systems, and now that there is near-universal possession of EHRs in U.S. hospitals, the tide is once again shifting.

“In the past, the CIO had more of a technical role and the focus was more on the operational side of the house—things such as enterprise resource planning (ERP) and the billing cycle. But the widespread advent of EHRs changed so much of that,” says Dave Levin, M.D., a former chief medical information officer (CMIO) at Cleveland Clinic and current chief medical officer at health technology company Sansoro Health. “When you deployed the EHR, it tightly linked clinical operations to IT. And that’s obvious. But it also put IT in the middle of enabling all kinds of activities and strategies. So, this requires strong enterprise governance and strong IT governance, and it requires that they fit together. A lot of organizations are struggling with that, and that’s reflected in the role the CIO plays,” Levin says.

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Podesta notes that when the CIO title first came about, many directors of IT in healthcare organizations wanted the “chief” designation. But to Podesta, there was a key difference between IT directors and CIOs:  good directors of IT spend 80 percent of their time managing day-to-day operations and 20 percent of their time on strategy, but for “true” CIOs, it’s the opposite, he says. “There was a period where there was a ‘filtering out’ of individuals who tried to become CIOs, but were really IT directors and couldn’t make that leap into the strategy world. That led to a changing of the guard,” he says, adding that much of the new focus turned to developing EHRs and then becoming an equal player in the C-suite on the strategy teams. “You have to be able to work on IT strategy and develop it in conjunction with the business strategy,” Podesta attests.

Today’s CIO—One of the Scariest Jobs in Healthcare?

For the modern CIO, priorities are indeed changing and becoming more complex, and with that comes increased pressure. For instance, in addition to all of the technical aspects of the job, today’s healthcare CIO must also stay out in front of various up-and-coming health IT innovations, while maintaining a much-needed big-picture view of how digital transformation will affect business operations.

And then there is the cybersecurity factor; a 2016 survey of 100 healthcare CIOs from Spok and the College of Healthcare Information Management Executives (CHIME) revealed that 81 percent of CIOs said strengthening data security was their top business goal for the next 18 months. Put all together,

“The CIO role in healthcare is one of the scariest roles there is because of the high risk involved, and the fast pace of technology,” offers David Butler, M.D., founder of healthcare consulting firm Calyx Partners, and a former clinical IT executive at Sacramento-based Sutter Health. “The cost of healthcare IT has gone up tremendously. [The days of] just buying Epic’s EHR and having your job be safe are long [gone],” Butler adds.

Butler notes that an EHR go-live, and the optimization that follows, are typically the most transformational things that occur in a CIO’s life, and the audience for these deployments are what he calls the CIO’s "golden geese”—physicians and nurses. “So there is more pressure on the CIO than ever before,” Butler attests. He adds that in addition to all of the clinical and IT considerations, it’s unfair to expect CIOs to be privy to all of the regulatory requirements that come from CMS (the Centers for Medicare & Medicaid Services) as well. “There is just no way that CIOs can know all these things. I think expectations need to be reset,” Butler says.

New Considerations

As such, experts believe that the “new” healthcare CIO must have a broader understanding of healthcare. “Smart organizations are looking for a more strategic role for the CIO, and think that they should be in the C-suite and in the middle of strategy discussions,” says Levin. "CIOs need to understand both where the organization is going—so that they can think about the technology that can enable that [vision]—while also informing and expanding on the thinking of the folks that are considering strategy—things that might not have been considered without that [CIO] expertise in the room,” he adds.

A core part of a healthcare organization’s vision going forward will certainly involve strategies on transitioning to a value-based care environment. Indeed, the emphasis on accountable care has increased the need for hospitals and health systems to collect and analyze data to drive improvements in quality and efficiency—leading many hospitals to ask more of their CIOs.

To this end, Podesta notes that the industry has been operating in a fee-for-service world for so long now, and in most cases, IT is an enabler of the business strategy, so once the business strategy starts to move toward value-based care, IT needs to come into play from a strategy perspective. “If you don’t have that background or the ability to understand it, you will be left behind,” he attests.

Podesta adds that in some instances, he is seeing CIOs play in both the medical provider and payer world, since lots of healthcare systems also have their own insurance companies. “You will see more and more of that in the future, and as a CIO, you will need to understand what risk means and how to manage risk,” he advises. “It’s a completely different way of caring for patients, and being able to sift through all the technologies out there for your organization, without making huge mistakes and spending the money in the wrong place, will certainly be a challenge,” he adds.

What’s more, all the sources interviewed for this article were quick to point out yet another new business consideration for CIOs: the influx of non-traditional players looking to move into healthcare. Podesta brings up the new Apple Health Records feature that allows patients of hundreds of hospitals and clinics to access medical information from various institutions organized into one view on their iPhone. “Lots of organizations are signed up for [this], and we have actually started to create apps; five years ago, you wouldn’t have been thinking about that. But now you have to model your organization to make sure you have the people to utilize these technologies as they are coming out,” he says, adding that hiring the right people who can work in these environments will be crucial. “The time for the sequel programmers is coming to an end. You need data scientists now.”

And as Butler bluntly puts it, “Apple, Amazon, Google and Microsoft have been watching this $3 trillion [healthcare] prize for a long time, but have not touched it because of HIPAA and other over-regulated [barriers] that prevented them from innovating in this space. But then you had deductibles go from $1,000 to $7,000 before the insurance kicks in, so the patient turned into the customer. And these disruptors said to themselves, ‘We know customers, we don’t know patients. So now we will go for it.’”

The CIO-CMIO Partnership

As CIOs continue to take on more responsibilities, experts believe that another clinical IT role in the C-suite, chief medical information officers, or CMIOs, are also ready to take on an increased role, especially as IT becomes much more critical to support value-based care and other quality initiatives. Indeed, as CMIOs have become more engaged in healthcare organizations, the interaction between these key IT players is expanding and continuing to evolve.

Levin recalls that in the early days of EHR deployments, folks saw the CMIO as the person that should go deal with the “angry physicians.” But now, post-deployment, as the tide turns to thinking about getting the most out of these IT systems, the partnerships between CIOs and CMIOs are stronger and more equal, Levin says.

“You are even seeing CMIOs migrating into the CIO role, which was rare in the past, but becoming more common. You are also seeing CMIOs migrate into other C-suite-type roles such as chief health information officers, chief quality officers, chief transformation officers, and in some cases, chief medical officers. And that makes sense, since there is an increasing emphasis on the intersection of clinical and operational, and the role of IT in supporting all of that,” he says. Podesta agrees with Levin’s premise; quite a few  CMIOs are becoming CIOs, he notes. “A lot of them have gone back and gotten MBAs to understand the business side [of healthcare].”

Podesta is also seeing another trend: that some organizations, such as academic medical centers, are struggling with clinical IT, and are thus recruiting for CIOs who are physicians, to get a level of credibility with doctors to help them with issues around physician adoption and EHRs. “I get lots of calls from recruiters, and when I talk to them about different positions out there, many are looking for clinically-oriented people. I am seeing that more and more,” he says.

To some, the evolution of the CIO-CMIO relationship also paints a bigger picture of just how tightly linked everything has become—particularly the dependency that a healthcare organization has on IT for its success. “It’s never been greater,” says Levin, who believes that the CMIO “is a unique beast, and one of the few healthcare roles in which you sit at a crossroads and have a view of the world that is different from other C-suite leaders.” He adds, "And that view might not be better; it’s complimentary. The typical CMIO has practiced clinically, has been involved in IT, and many have had operational backgrounds as well, or a medical affairs background. They are kind of ‘unicorns’ in a way, and I think they match up nicely with the way the governance and strategic needs of the organization overlap,” he says.

What the Future Looks Like

In a myriad of different ways, it’s been quite the evolution for CIOs, CMIOs and others in the healthcare IT C-suite. With all of the challenges and increased pressure that experts believe have mounted in recent years, comes opportunity for certain individuals to thrive.

Levin says the qualified CIO going forward will need the necessary “soft skills,” leadership ability, and strategic knowhow. It will be less about the technical aspects of the role. “The ultimate challenge everyone is facing is the pursuit of the Triple Aim and doing it efficiently, so a lot of the [job] is about how you can do more with less,” he says.

These roles also have another kind of unique balancing act, in that so many of them try to maintain a clinical practice, which Levin notes “is admiral,” but because they have also taken on these important administrative and leadership roles, he has seen many of his colleagues struggle with the balancing act. “Too often, they think the clinical/administrative ratio is 50:50, but in reality, it’s 75:75 and they are working at 150 percent capacity,” he says.

Adds Podesta, “It’s not just understanding the IT world—the programming and the infrastructure—but you have to understand the business side as well. To be in that C-suite and in those meetings, you need to be able to add value to items that maybe aren’t under your control. But you need to be that thought leader within the C-suite—just like the chief operating officer, chief medical officer and others are.”

Podesta believes that the “information” part of the chief information officer title is simply no longer indicative of all the CIO must do now, and what will be required of the role moving forward. “People view the CIO role as ‘you must work in medical records’ or even that you are in marketing, so yes, I think we probably do need a better title,” he acknowledges. Podesta notes that titles such as chief digital officer are making the way into healthcare organizations, and given the digital landscape, it’s actually more appropriate. “The CIO might move to ‘chief innovation officer,’ and that makes a lot of sense,” he says.


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Vanderbilt Announces Health IT Leadership Transition

November 6, 2018
by David Raths, Contributing Editor
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Patel to succeed Johnson as leader of VUMC HealthIT

Vanderbilt University Medical Center HealthIT has announced a change of leadership. In January 2019 Neal Patel, M.D., M.P.H., who has been VUMC’s chief health information officer, will succeed Kevin Johnson, M.D., M.S., as HealthIT leader.

HealthIT’s responsibilities include informatics support for a broad scope of VUMC’s health system demands. Tools supplied and supported through HealthIT help enable VUMC to achieve its strategic objectives within the clinical, educational and research enterprises.

Johnson, Cornelius Vanderbilt Professor, will continue to serve as chair of the Department of Biomedical Informatics (DBMI). A professor of pediatrics, he joined the Vanderbilt faculty in 2002 and has been chair of the DBMI since 2012. He was named Senior Vice President for Health Information Technology in 2014.

During his tenure, Johnson served as leader for the multi-year, system-wide effort to replace its homegrown EHR with Epic, which went live in November 2017. Patel joined Johnson as co-lead during the Epic launch.

Through this leadership change, Patel will now report to John F. Manning Jr., PhD, MBA, Chief Operating Officer and Corporate Chief of Staff. “With Dr. Patel succeeding Dr. Johnson in this role, there is an assurance of continuity as we move forward. With our Medical Center and health system at an important inflection point, and in a period of significant growth, I want to express my appreciation to Neal for assuming these new responsibilities,” Manning said in a prepared statement.

Patel joined the faculty of the Department of Pediatrics in the Division of Pediatric Critical Care in 1997. He was named Chief Medical Informatics Officer in 2006. His responsibilities in this role included leading efforts for translating the Medical Center’s healthcare delivery, quality and patient safety goals into informatics strategies to optimize the delivery of patient care.

 

 

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CHIME’s Russ Branzell: A Tech Revolution is Coming to Healthcare

November 2, 2018
by Rajiv Leventhal, Managing Editor
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The president and CEO of CHIME said at the association’s Fall CIO Forum this week that collaboration and being a community will be key steps to succeeding in the new healthcare

Healthcare CIOs, CMIOs and other top IT leaders are under increased pressure these days for a variety of reasons, and staying out in front of emerging health IT innovations, while maintaining a big-picture view of how digital transformation will affect business operations, are right at the top of the list.

Russell Branzell, president and CEO of CHIME (the Ann Arbor, Mich.-based College of Healthcare Information Management Executives) for the last six years, leads an executive organization which has a membership of a few thousand CIOs, CMIOs and other senior healthcare IT leaders. And with so much happening these days around technology innovation, new entrants into the market—some of which could be seen as potential disruptors—in addition to policy considerations and cybersecurity challenges, associations like CHIME are relied on to drive clinical IT executives in the right direction.

At the CHIME 2018 Fall CIO Forum in San Diego this week, Branzell sat down with Healthcare Informatics Managing Editor Rajiv Leventhal to discuss the challenges and opportunities that lie ahead for CIOs, and what skills will be critical to success going forward. Below are excerpts from that interview.

I am sure you would agree that it’s both an exciting and anxious time in healthcare. What is top of mind right now for your members?

Yes, I think there is a duality to this that is exciting and scary at the same time. There are practical and technical challenges we are being faced with now, with one of the biggest being cybersecurity and the threats and pains in those areas. Organizations are changing to new models [of care], and there is also consumer engagement that is unique to this time period; it’s not the same old game we have always played.

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The most interesting thing coming at them, though, is this next wave of what we refer to as “fourth revolution technology” that’s on the way. So that means 5G [technology], robotics, biosensors, genetic manipulation, and neural networking. These are buzzwords, but the reality is that they are real. Things are coming at us, and we have not been able to deal with at this level of advanced technology before.

What we have done in the past is incrementally gain the existing technology that has been in play in healthcare for the last 30 years. So we are trying to keep the trains on time, advance the organization, help them get benefits realization, and move to a new care model of consumerism and value. But we also see this other thing coming down the track that will dramatically disrupt all this. While it’s a unique time, and a little bit scary, scary is another way to say “great opportunity.”

Is the traditional/current CIO ready for this revolution? 

We have always been able to keep up with the small, incremental learnings. We have had the CIO 2.0 model out for 15 years, and that brought people from the traditional technology environment to driving change in organizations. The difference now is, the new things coming at us will require us to learn at a pace we have never learned at before. There will be disrupters in the industry for us to adapt to and understand at a pace we have never understood before. Undoubtedly, the CIO 3.0, the health IT leader 3.0, and the digital leaders of the future will monumentally change their internal skillsets and how they work.

On the policy front, lots of relevant regulations are set to drop in the next few months. The administration has been aggressive thus far in its proposals for promoting interoperability, but some would argue that fundamental data sharing challenges need to be ironed out first. What is CHIME’s stance on this?

There is still a strong degree of gap between the reality of today and the things that need to be put in place to enable [interoperability]. Some of those things are relative to standards and the universal transport across the country from an information sharing perspective. The government is trying to say there shouldn’t be barriers to inhibiting things that we are being successful in.

San Diego offers a good example in that things are well put in place, health systems are willing to share, I would say that there is no ubiquitous information blocking here, and the organizations generally all want to do the right thing for the patient. So in this micro-environment, though a big city, they do a good job of sharing information and being interoperable with each other.

But now magnify that across California, and it’s a scale issue in which we don’t have in place the universal standards, identification, transport layer, agreements, and multi-state consent. So many things still need to be addressed, whether that’s through administrative rule, law, or presidential order, some things need to be addressed at a macro level to accelerate that last 10 percent. About 90 percent is being done in local environments. Most people don’t often leave their local environment to seek care. But for the 10 percent or so that do, these things are not quite in place yet.

I’ve been interested in reading CHIME’s comments on aligning 42 CFR Part 2 with HIPAA, though this provision was not passed in the recent opioids package. Could this be reconsidered down the road?   

We were disappointed that it wasn’t [included], but we also considered different areas of statute ownership, within the government, relative to this and we [knew] they had to get [the bill] out. We will still advocate for the alignment in these areas so that we could accelerate solutions and service the people who need the help. This was ubiquitous across all our membership, and this was something that could have been addressed, but what we heard was, and I understand this, that they needed to get this out [now], and then possibly the [alignment] piece could be bolted on later.

In this pressured current moment, what advice could you offer to CIOs?

Like never before there is a need for people to hone and advance their skills, and become educated in what’s coming down the tracks as far as advanced technologies, while also getting the solutions they already have in place to higher degrees of success. The answer to all of this will be about us being a community.

We have been successful here at CHIME for almost [three decades] in building this network, building the relationships, and building the trust environment that we need. We need to lean on each other. People do this in small pockets and big pockets, and to survive in the future, we will need to ubiquitously share with each other. You don’t want to have everyone invent and innovate locally; not that we shouldn’t in a micro sense, but in the macro sense, we have to share in ways that we never have before. 

I’ll use opioids as an example. If Anne Arundel [County in Maryland] and Geisinger Health System are the two best in the country [at fighting the opioid epidemic], why would the other 5,000 or so places go and start from square one. That makes no sense whatsoever, but that’s the way our industry has worked for a long time. They key to us solving problems is communication and collaboration.


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