Trump Nominates James Paul Gfrerer for VA CIO | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Trump Nominates James Paul Gfrerer for VA CIO

July 30, 2018
by Rajiv Leventhal
| Reprints

On Friday, President Trump announced his intention to nominate James Paul Gfrerer, former executive director at Ernst & Young, as assistant secretary for information and technology at the Department of Veterans Affairs (VA).

If confirmed by the Senate, Gfrerer will take the place of former VA CIO Scott Blackburn, who resigned from his position in April. Blackburn, who had been appointed as the department’s acting CIO since October 2017, said at the time of his resignation that his departure a “bittersweet moment” in his career without getting into more details about why he would be leaving. The VA replaced Blackburn with Camilo Sandoval, a former Trump campaign director of data operations.

As CIO, Blackburn was in charge of VA’s Office of Information and Technology, and when he took over the role last year, one of his top projects was replacing VA’s legacy EHR (electronic health record) system, called VistA, by adopting the same platform as the U.S. Department of Defense (DoD), a Cerner EHR system. That contract was finally signed in May.

Now, it will be Gfrerer’s turn, assuming he is confirmed. Prior to joining Ernst & Young, he served in the United States Marine Corps for more than two decades and was a Department of Defense Detailee to the Department of State leading interagency portfolios in counterterrorism and cybersecurity, according to the White House statement.

Gfrerer’s nomination comes just a few days after the Senate confirmed Robert Wilkie, a nominee of Trump, as VA Secretary. For about four months, Wilkie had been the acting VA secretary following Trump’s dismissal of former Secretary David Shulkin, M.D. in late March. Wilkie, who is also the Department of Defense undersecretary for personnel and readiness, was Trump’s second nominee for the VA position.

Following the dismissal of Shulkin, the resignation of Blackburn, and others, the Trump administration has been looking to fill the gaps held in top VA executive positions. Indeed, acting officials have been holding nearly all of VA’s top leadership positions, including the secretary, undersecretaries for the Veterans Health Administration and Veterans Benefits Administration, and the CIO. Many of those positions have been open for hundreds of days.

The Health IT Summits gather 250+ healthcare leaders in cities across the U.S. to present important new insights, collaborate on ideas, and to have a little fun - Find a Summit Near You!


/news-item/leadership/trump-nominates-james-paul-gfrerer-va-cio
/article/leadership/industry-leader-drex-deford-leadership-innovation-time-embrace-your-inner-weirdo

Industry Leader Drex DeFord on Leadership for Innovation: “Time to Embrace Your Inner Weirdo”

October 22, 2018
by Mark Hagland
| Reprints
At the health IT Summit in Seattle, industry leader Drex DeFord speaks of the need to “feel uncomfortable” in order to lead change

In his featured presentation at the Health IT Summit in Seattle, being held at the Grand Hyatt Hotel in downtown Seattle, and sponsored by Healthcare Informatics, healthcare IT industry leader Drex DeFord shared with attendees on Monday lessons learned from a professional lifetime innovating in IT. Speaking of lifelong learnings of lessons around leadership, DeFord, who has been an IT leader both on the military and civilian sides of healthcare, told his audience that sitting in discomfort, and getting others to sit in discomfort, is not only a good thing; it is in fact essential to creating innovation. In other words, as DeFord put it to his audience, “It’s time to embrace your inner weirdo.”

DeFord, president of the consulting firm Drexio Digital Health, delivered a presentation entitled “Relentless Innovation: Everything I Know About Innovation Was On Display at Burning Man,” sharing insights across decades of experience in the armed services and in the healthcare industry, encouraging his audience of healthcare executives to take risks and upset the accepted order of things in order to push for clinical and operational transformation in healthcare. He spoke from four decades of experience, beginning when he enlisted in the Air Force as “a farm kid from Indiana,” through to his pursuing first an undergraduate degree, and then resigning as a commissioned Air Force officer, pursuing a master’s degree in informatics, becoming a healthcare IT leader in the Air Force, and eventually a CIO in civilian hospitals, including Scripps Health in San Diego (three years), Children’s Hospital Seattle (three-and-a-half years), and Steward Health in Massachusetts (14 months), and then into consulting.


Drex DeFord

At every turn in his career, DeFord made unexpected choices, even choices criticized by others at the time, for their being too unusual. And, dipping deeply into his own personal narrative, DeFord told his audience, making unexpected choices has been true of his thought processes from the very beginning. “I came from a very big extended family,” he told his audience. “I was an only child, but had tons of cousins on both sides of my family. And I was a farm kid from Indiana—and one of the first even to graduate from high school. And I wanted to go to college, but didn’t have any money, so I enlisted in the Air Force; and that was a weirdo thing to do in my farm community. Then I found that I was unusual in the military for not coming from a military background,” he recalled.

DeFord further broke molds by pursuing a civilian undergraduate college after his time as an enlisted member of the Air Force, and coming back as a commissioned officer, whereas most Air Force officers had gone to the Air Force Academy or entered through the ROTC in undergraduate college. Next, he ended up, following service in Desert Shield/Desert Storm, in an Air Force hospital, in the IT department. That, too, was seen as an unusual choice; but it opened up new horizons for him. “We built web pages before web pages were a thing. And we were beta testers for Mosaic. And we deployed the first EHR [electronic health record] in the DoD. That was a weirdo thing, too.” Next, DeFord decided to pursue a master’s degree. And, he said, “That’s much more normal now, but at the time I did it, I got pounded for being a weirdo for getting a master’s degree from a university health informatics program.” But he found the experience—at the University of Alabama-Birmingham, in healthcare informatics—to be precisely what he needed to move to integrate certain types of formal learning into the healthcare IT experience he had already obtained.

Webinar

Integrating Data Sources for Successful Care Delivery

The advances in and availability of data from disparate sources create new opportunities and frontiers in care coordination for complex patients. These can range from mobile health/Internet of...

At this point, DeFord paused to note that, “While I’ve been a weirdo across my entire career, one of the things I discovered in the Air Force is that I was allowed to be a weirdo in certain areas, as long as I showed massive compliance to other norms. My uniform was always pressed, my shoes were always shined, I blew away the physical fitness test every time. And I found out that it was OK to be a weirdo if you got stuff done.”

Next, he recounted, as he was graduating from the UAB health informatics program, he got a call from Jackie Morgan, M.D., a flight surgeon, a colonel, and the surgeon general of that Air Force region, who ran the health informatics program for that southern-U.S. region. Col. Morgan had to fight to get DeFord named to that director position, as he was a captain, and the position’s description was tagged to the lieutenant colonel rank; but, he recalled, she felt he was just the right person for the position. And, in that position, he said, “I came up with the idea that we should take money from the hospitals, pool it, and create centralized IT systems. Sounds logical, right? But at the time, we got a lot of grief for it, and that generated a lot of frenzy, and at one point, the Air Force Surgeon General, the top guy, had to get involved, and Jackie Morgan said, you’re going to have to present what you’re doing, ‘cause it’s got everyone in a tizzy.” But DeFord’s presentation to a cadre of senior officers turned out to be so successful that the Air Force Surgeon General determined that that model should be implemented Air Force-wide, and the AFSG asked him to come to Washington, D.C. and help his colleagues implement the plan across the Air Force.

Once again, DeFord made an unexpected decision, asking first to work at an Air Force hospital on the front lines, in order to fully understand the implications of the implementation plan. “What would a weirdo do? I said, ‘No, I want to eat this dog food!’” he shared with his audience. Thus, he spent 23 months at Travis Air Force Base, which had the Air Force’s second-largest medical center, and then after that time, moved to Air Force Command in Washington, D.C. as chief technology for Air Force Health (a global enterprise spanning 78 hospitals).

Following his time in the Air Force, DeFord then spent over a decade in civilian hospital organizations—Scripps Health, Seattle Children’s, Steward Health in Massachusetts; and after a brief time helping to establish a vendor platform, has been happily and successfully consulting for the past three-and-a-half years.

Looking back at the trajectory of his career, DeFord told his audience, “In the end, I decided that the best thing to me was to embrace ‘weirdness.’” Indeed, to put that statement into context, he said this: “The folks in this room who have worked with me have heard me say this many, many times: ultimately, a good part of being an innovator is being comfortable with your uncomfortableness. There are a lot of weird aspects now to our industry. All this stuff that is happening right now with telehealth; all this with disruptive entrants in healthcare. I spent a lot of time working as a consultant, working with the Cedars-Sinai Accelerator, for example. It’s a really uncomfortable industry to work in. Every day, some new thing is going on,” he said.

“So as an innovator in healthcare, in order to innovate, you have to become comfortable with uncomfortableness. What’s more,” he said, “you have to be comfortable not only with your own uncomfortableness, but also, you have to become comfortable making other people uncomfortable. You have to challenge people. I wrote an article on LinkedIn, about antibodies to change,” he said. “It’s almost as though we have people in healthcare whose sub job description is, activating antibodies to change. And for me, I realized that those two things kind of applied to me early on.”

DeFord also spoke about the collaborative innovation he saw firsthand at the Burning Man festival in the desert this summer, in which participants work for the greater good, and come up with innovative ways to solve in-the-moment group effort challenges.

Following his presentation, DeFord spoke one-on-one with Healthcare Informatics Editor-in-Chief Mark Hagland. Below are excerpts from that interview.

Things are moving forward so fast now. What would your message be to CIOs and CMIOs at this moment in healthcare, as they’re being asked more and more to become change leaders, not just technology experts?

A lot of it just boils down to, don’t be afraid of change. You’re probably already very involved, as the CIO in your organization, in seeing the change coming. You see the customer experience in lots of different organizations, and then you go back to your own organization and have to roll your eyes at the unwillingness to change. So, don’t be afraid to change. I think we’re moving into a time where 75-80 percent of the CIO’s job now is the people and process part, no longer the technology part. How do I help people understand where the organization should go, strategically speaking? And help people figure out what the underlying problem is, and help them realize that it involves process change?  Unfortunately, often, you wind up with CIOs who have fallen into the rut of being CTOs who are so overwhelmed by the day-to-day technology issues that they are marginalized and are no longer at the big table.

How do you light a fire under CIOs, to help them become true change leaders in their organizations, in that context?

If you’re not in the right position, you may need to think about whether you need to stay. You may be in an organization where you’re always going to be marginalized, if you started out in a particular role and are viewed that way. And if you move, make sure you’re perceived correctly. We’ve gone from this model of business and clinical people coming up with their business and clinical strategies, and IT’s job is to make it go faster; but we’re moving to a situation where the CIOs are at the table to begin with. That becomes a big part of the job, and that makes other people uncomfortable.

One of the biggest challenges, which industry leaders have been talking about for years now, is the shift in the role of the CIO from being a technology manager to needing to become a true strategic leader in the patient care organization.

Yes. The strategic need now is about the people and process stuff, and about the business and clinical model we should be creating. Where do we compete and not compete? It’s about organizational strategy. The movement from fee-for-service payment to value-based care is a game-changer, and is definitely happening, and will continue. The only question is at what speed, and a lot of that will depend on who’s in office, etc. But we’re going there. We’re talking about it in terms of the CIO role, but we also need the CFO and all the other leaders thinking strategically about how to create better care for patients and families. If you have an army of people who think like that in your organization, you’ll end up being the acquirer, not the acquired.

 

 

 


More From Healthcare Informatics

/news-item/leadership/head-ibm-watson-health-steps-down-stat-reports

Head of IBM Watson Health Steps Down, STAT Reports

October 22, 2018
by Rajiv Leventhal, Managing Editor
| Reprints

The head of IBM Watson Health, Deborah DiSanzo, is leaving her role, STAT News reported late last week.

According to the report, “The circumstances of DiSanzo’s departure were unclear, but Watson Health has been seeking to rebound after a series of stumbles. IBM executives have said they have bet much of the company’s future on its success in healthcare, and improving Watson Health’s standing in the industry is seen as crucial to that effort.”

IBM Watson, an artificial intelligence supercomputer, was launched into the world of healthcare just a few years after it won in Jeopardy! against record-setting champions in 2011. Watson Health, a unit of IBM, was launched at the 2015 HIMSS conference and employs thousands of people.

DiSanzo was brought into the company in 2015 to be the general manager of Watson Health, and according to the STAT report, will be succeeded by John Kelly, senior vice president for Cognitive Solutions and IBM Research, who will step into DiSanzo’s role in an acting capacity, current and former employees told STAT.

Along with the popularity of Watson has come intense scrutiny, especially in the last year. As Healthcare Informatics covered in one of its Top Ten Tech Trends this year, it was a STAT News report from September 2017 that became one of the first major stories detailing how Watson has been performing in hospitals, specifically examining the company’s Watson for Oncology solution.

That piece found that Watson for Oncology has struggled in several key areas, noting that while IBM sales executives say that Watson for Oncology possesses the ability to identify new approaches to cancer care, in reality, “the system doesn’t create new knowledge and is artificially intelligent only in the most rudimentary sense of the term.” And a more recent report, also from STAT, included internal documents from IBM Watson Health which indicated that the Watson for Oncology product often returns “multiple examples of unsafe and incorrect treatment recommendations.”

Last week, IBM also released third-quarter earnings, which showed that revenue from cognitive offerings, like Watson, was down 6 percent from last year, according to the STAT report. To this point, reports surfaced this spring that some IBM Watson Health units were experiencing significant layoffs. IBM officials have maintained that things are not as bad as has been reported, while attesting that its artificial intelligence remain quite popular worldwide.

According to this latest STAT report, “Watson Health has sought to shift its focus in recent months, scaling back a part of the business that sells tools to hospitals to help manage their pay-for-performance contracts. Following layoffs In June, DiSanzo sought to reassure employees that the company was on the right track,” the report noted.

Related Insights For: Leadership

/news-item/leadership/amia-honor-informatics-leaders

AMIA to Honor Informatics Leaders

October 17, 2018
by David Raths, Contributing Editor
| Reprints
Cerner’s Overhage to Receive Lindberg Award for Innovation in Informatics

At its 2018 Annual Symposium in San Francisco next month, the American Medical Informatics Association (AMIA) will honor several informatics luminaries with its Signature and Leadership Awards.

 

AMIA Signature Awards

• Donald A.B. Lindberg Award for Innovation in Informatics
J. Marc Overhage, MD, PhD, Chief Medical Informatics Officer, Cerner Corp.
Overhage joined Cerner in 2015 with the Siemens Health Services acquisition. Prior to Cerner, he was the Director of Medical Informatics at the Regenstrief Institute and the Sam Regenstrief Professor of Medical Informatics at the Indiana University School of Medicine. He helped create the Indiana Network for Patient Care, which contains data from laboratories, pharmacies and hospitals in central Indiana.

• Don Eugene Detmer Award for Health Policy Contribution in Informatics
Julia Adler-Milstein, PhD, Associate Professor and Director, UCSF School of Medicine
Adler-Milstein is an Associate Professor and Director of the Center for Clinical Informatics and Improvement Research (CLIIR). She is an expert on policy and management issues related to the use of IT in healthcare delivery. Her research assesses the progress of health IT adoption; the impact of such adoption on healthcare costs and quality; and the relationships between market, organizational, and team structure and health IT use. A core focus of her work is on health information exchange and interoperability.

• William W. Stead Award for Thought Leadership in Informatics
George Hripcsak, MD, Professor and Chair, Department of Biomedical Informatics, Columbia University
Hripcsak’s current research focus is on the clinical information stored in electronic health records and on the development of next-generation health record systems. Using nonlinear time series analysis, machine learning, knowledge engineering, and natural language processing, he is developing the methods necessary to support clinical research and patient safety initiatives. He leads the Observational Health Data Sciences and Informatics (OHDSI) coordinating center; OHDSI is an international network with 180 researchers and 600 million patient records. 

• Virginia K. Saba Informatics Award
Bonnie Westra, PhD, RN, Associate Professor, University of Minnesota School of Nursing
Director of the University of Minnesota’s Center for Nursing Informatics, Westra’s research includes terminology development, application, and evaluation; knowledge discovery in databases; predictive analytics for outcomes; and evaluating and deriving new evidence based guidelines from EHR data. 

• New Investigator Award
Jeremy Warner, MD, Assistant Professor, Vanderbilt University
Warner directs the Vanderbilt Cancer Registry and Stem Cell Transplant Data Analysis Team. His primary research goal is to make sense of the structured and unstructured data present in EHRs and clinical knowledge bases to directly improve clinical care for patients, with a focus on oncology. 

AMIA also announced the following Leadership Award winners:

Sarah A. Collins, PhD, RN: For leadership in developing and championing AMIA’s applied informatics recognition program (FAMIA).

Jeffrey A. Nielson, MD, MS, FACEP: For leadership in developing and championing AMIA’s applied informatics recognition program (FAMIA).

Lucila Ohno-Machado, MBA, MD, PhD: For steadfast leadership of JAMIA as editor-in-chief (2011-2018) and decades of commitment and service to AMIA.

 

 

 

See more on Leadership

betebettipobetngsbahis