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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.


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...

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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CHIME Hands Out Innovator, Transformational Leader Awards

October 31, 2018
by Rajiv Leventhal, Managing Editor
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At the College of Healthcare Information Management Executives (CHIME) 2018 Fall CIO Forum in San Diego, health IT executives were recognized today for their transformational and innovative leadership.


Omer Awan, senior vice president and CIO, Navicent Health in Macon, Ga., joined the patient care organization two years ago, but in just that short amount of time, he has changed the culture in his department and has elevated the profile of IT within the ranks of Navicent’s executive leadership, giving him a seat at the table as they carry out Navicent’s vision, according to CHIME officials who presented Awan with this year’s Transformational Leadership Award.

Awan said he institutionalized a framework that called for simultaneously strengthening their IT foundation, advancing the culture and innovating, always keeping in mind Navicent Health’s business needs. IT staff embedded themselves within other groups to better understand their programs and get more involved in problem solving and decision making. This process changed mindsets within the IT department and throughout the organization.

“IT has broken out of the shell of technology,” Awan said. “It is all over the place. It is in business; it is in the clinical areas. All of my IT managers and directors rewrote their job descriptions. They are not just managers and directors, they are solution partners. It was incumbent on them to know as much about their respective clinical and business areas.”

One of the organization’s specific IT-related successes has been the rollout of a real-time care coordination platform that serves as a one-stop shop for surgical staff and patients. The program, utilized for OrCarestra, Navicent Health’s surgical patients, has eliminated the use of faxes, phone calls and hand-written requests and added standardized processes. OrCarestra has shortened scheduling times, decreased scheduling errors, sped up financial clearances and allowed them to complete more cases faster, according to CHIME officials.

Also this morning at the Fall CIO Forum, CHIME presented Simon Lin, chief research information officer at Nationwide Children’s Hospital in Columbus, Ohio, with its Innovator of the Year Award, citing Lin’s innovative approach to help pediatric burn victims through their recovery.

The Ohio patient care organization collaborated with the Center for Pediatric Trauma Research and the Pediatric Burn Unit at Nationwide Children’s to develop and pilot test a virtual reality app that immerses young patients in a game while clinicians remove and replace dressings. Preliminary results showed a dramatic reduction in reported pain scores compared to controls—a reduction achieved without altering pain medication.

Burn patients already are in distress from the pain that can occur during dressing changes, Lin said. Watching the process may intensify children’s trauma. The game, which requires patients to wear a headset, distracts them while the headset shields their view of the clinical activities going on around them. Patients can passively watch the game or they can actively engage in it using breathing controls that substitute for hand consoles.

The app itself has been well received, based on study results: 96 percent of patients reported satisfaction with the game; 100 percent of parents were satisfied; and 83 percent of physicians reported that virtual reality is helpful. Lin and his group are now conducting a larger study that stratifies children into three groups: active participants, passive watchers and a control group that will receive standard care. The long-term goal is to be able to reduce or eliminate the use of pain medications such as opioids in this patient population by using innovation.

“Simon’s virtual reality app is a perfect example of patient-centered care,” said CHIME Board Chair Cletis Earle, senior vice president and CIO at Kaleida Health. “They developed a tool that children will respond to–a game– and worked with clinicians to make sure it fits within their work flow. The result is a better experience for the patient with no added burden for clinicians. This is a win for everybody.”



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Pronovost Leaves UnitedHealthcare for University Hospitals

October 29, 2018
by David Raths, Contributing Editor
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Former Johns Hopkins exec to become chief clinical transformation officer

Earlier this year patient safety expert Peter Pronovost, M.D., Ph.D., left the Armstrong Institute for Patient Safety and Quality at Johns Hopkins University to become chief medical officer at UnitedHealthcare. Now, after only a few months in that position, Pronovost announced he is joining 18-hospital University Hospitals in Cleveland as its first chief clinical transformation officer.

"Dr. Peter Pronovost is a renowned figure in medicine. His innovative work has saved thousands of lives and shaped the delivery of health care nationally and internationally," said Thomas F. Zenty III, CEO of University Hospitals, in a prepared statement.

Pronovost's scientific work, leveraging the use of checklists to reduce central venous catheter-related bloodstream infections, has saved thousands of lives and earned him high-profile accolades, including being named one of the 100 most influential people in the world by Time Magazine and receiving a coveted MacArthur Foundation "genius grant" in 2008.

At UH, Pronovost will develop and lead strategic initiatives to improve value across the health system. He will be the clinical lead for population health and lead high-reliability medicine, with direct responsibility for the UH employee accountable care organization.

He will direct teams that will engage UH providers and employees in care models leading to improved outcomes and a healthy workforce while reducing the cost of care. He also will lead the growth and adoption of digital health – including telehealth and virtual health – solutions to better serve the patient and provider communities.

Before his brief tenure at UnitedHealthcare, Pronovost served at Johns Hopkins Medicine for 20 years, most recently as Senior Vice President for Patient Safety and Quality and the founder and director of the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality.

Allen Kachalia, M.D., J.D., previously the chief quality officer and vice president for quality and safety at Brigham Health in Boston, is succeeding Pronovost as director of the Armstrong Institute for Patient Safety and Quality and the senior vice president of patient safety and quality for Johns Hopkins Medicine.


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