Agency Leadership Update: Collins Stays at NIH, Bindman Leaves AHRQ | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Agency Leadership Update: Collins Stays at NIH, Bindman Leaves AHRQ

January 20, 2017
by Heather Landi
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As President-elect Donald Trump is sworn in as the United States’ 45th president at noon today, there has been an ongoing administration shuffle as agency leaders have stepped down as part of the presidential transition.

AHRQ - Andy Bindman, M.D., who has served as the director of the Agency for Healthcare Research and Quality (AHRQ) since May 2016, is leaving the agency and returning to the University of California San Francisco as a primary care physician and health services researcher. Deputy director Sharon Arnold, Ph.D., will serve as the agency’s acting director. According to AHRQ, Bindman’s tenure at AHRQ featured “an emphasis on the learning health care system, a concept that calls for the increased use of evidence to improve the quality, safety and value of heath care.”

In his final blog post, titled “Bringing Moneyball to Medicine,” Bindman wrote about transforming healthcare through health IT, highlighting how major league sports have integrated data analytics into their workflow to improve team performance and the parallel opportunity in health care. “For the most part, clinicians function like baseball ‘scouts.’ We bring a special knowledge to improving health informed by our experience. We are underperforming, however, by not making a stronger commitment to a data-driven, evidence-based approach,” Bindman wrote.

“While patients are the ultimate beneficiaries of increased use of evidence, AHRQ is focusing its efforts toward the clinical leaders of health care organizations. We believe these individuals can become the Billy Beane change agents who can support local efforts to ensure evidence becomes a routine part of everyday practice," he wrote, and further stated, "As I prepare to leave, I am not only gratified by the gains we’ve made in my short time, but also deeply optimistic about the agency’s prospects for advancing its mission. AHRQ is not a payer or a regulator, but a facilitator that uses research and evidence to support constructive improvements in health care."

As previously reported by Healthcare Informatics, AHRQ is facing proposed budget cuts. In June, the Senate Committee on Appropriations approved for Senate consideration a bipartisan spending bill that among other things, would cut AHRQ funding by $10 million to $324 million. Last year, AHRQ saw its 2015 budget of $364 million cut by about 8 percent. The research agency has long been disliked by some members of Congress who feel that the organization's work has not led to proven results. There was even a point last year when there was discussion that AHRQ would be terminated completely.

CDC – In a year-end review with Reuters posted Dec. 30th, Thomas Frieden, M.D., director of the U.S. Centers for Disease Control and Prevention (CDC), said he would hand in his resignation today, inauguration day. Frieden was appointed by President Barack Obama to run the CDC in 2009. President-elect Trump has not, as of yet, announced who he will appoint to replace Frieden. Anne Schuchat, who was chief health officer during the H1N1 pandemic and has been principal deputy director since 2015, will take over as acting director.

CMS – Patrick Conway, deputy administrator for innovation and quality at the Centers for Medicare & Medicaid Services (CMS), who leads the Center for Medicare and Medicaid Innovation (CMMI), will serve as the acting administrator of the agency starting today and through the transition, which outgoing CMS acting administrator Andy Slavitt reported on Twitter yesterday. President-elect Donald Trump has nominated Seema Verma to head CMS, but the Senate Finance Committee has not yet scheduled a confirmation hearing. While Verma, current president, CEO and founder of SVC, Inc., a national health policy consulting company, may be unfamiliar to the health IT world, Healthcare Informatics’ Managing Editor Rajiv Leventhal wrote a piece detailing past insurance programs she has designed.

HHS – President-elect Trump tapped Tom Price, M.D. (R-GA) as U.S. Department of Health and Human Services (HHS) Secretary. Price, 62, a retired orthopedic surgeon and an early Trump supporter, has been a leading GOP voice against Obamacare, which the President-elect has promised to “repeal and replace.” This week, as reported by Healthcare Informatics, Rep. Price faced very rigorous questioning from Democratic Senators during a courtesy confirmation hearing in the Health, Education, Labor and Pensions (HELP) Committee in the U.S. Senate. The Senate Finance Committee is the confirming committee, the committee that will actually vote on the Price nomination, and that hearing is scheduled for Jan. 24.

NQF – The National Quality Forum named Shantanu Agrawal, M.D., as the organization’s new president and chief executive officer. A board-certified emergency medicine physician who has worked in both academic and community settings, Agrawal is the former deputy administrator and director for the CMS' Center for Program Integrity (CPI). Agrawal will succeed Helen Darling, NQF interim president and CEO, on January 30, 2017.

NIH – Francis Collins, director of the National Institutes of Health, will remain in his post, at least temporarily, according to The Washington Post, citing an announcement from NIH. The agency said that Collins “had been held over by the Trump administration,” and did not provide any further details, according to The Washington Post article posted Thursday.

ONC - Vindell Washington, M.D. had a brief tenure as National Coordinator for Health IT as he was appointed back in August and he submitted his resignation in December, effective today. Leadership of ONC will now pass on an interim basis to Deputy National Coordinator Jon White, M.D., until the incoming Trump administration makes their appointment to fill the position. ONC chief privacy officer Lucia Savage also stepped down. Healthcare Informatics’ Leventhal wrote last week that questions have arisen in recent days about the future of ONC, the health IT arm of the federal government. “While there is strong belief in political circles that the agency won’t be dismantled or severely disrupted in any way, there is uncertainty surrounding who might take leadership positions at ONC after Trump takes over at the White House in nine days,” Leventhal wrote.

 

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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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