To describe the current state of the healthcare CIO role, Jim Turnbull uses the military-inspired acronym VUCA: Volatility, uncertainty, complexity and ambiguity.
Turnbull, CIO for University of Utah Health Care, says it's an "intense" time for hospital IT departments. As a result of the federal meaningful use incentive program, most have been busy with electronic health record (EHR) implementation. Most have hired outside help for this purpose as well.
IT teams have had their heads down for the last three years, he says. "When they lifted up their heads, they realized the world had changed dramatically."
EHR software remains top of mind, yes, but now hospitals must consider (among other things) the impact of wearable technology, the principle of accountable care, the challenge of patient engagement, an evolving business model, the ICD-10 conversion, omnipresent security threats and shifting reimbursement models.
If anything, "intense" may be putting it mildly. "There really is too much going on at once," says Rick Schooler, vice president and CIO for Orlando Health. "What's going on in our organizations is really nuts. Our people are getting jerked around almost endlessly."
Collaboration, Partnership the Name of the Game
Schooler, Turnbull and Edward Marx, senior vice president and CIO for Texas Health Resources, addressed the topic of the evolving role of the healthcare CIO in a panel discussion at the recent College of Healthcare Information Management Executive's annual CHIME CIO Fall Forum.
All three cite the need for partnership and collaboration. (So, too, did many audience members, based on the results of real-time polling.) Schooler deems it the No. 1 expectation of healthcare CIOs as leaders within their organizations. "We need to have a genuine desire to enable the success of the people we serve," he says.
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This concept of service works both up and down the organizational chart. Trumbull recommends informal meetings with fellow executives – informal because of the jam-packed nature of the typical executive's calendar – to chat about the challenges they face. Marx, meanwhile, takes the time to learn the names of executives' children and grandchildren, along with tidbits such as their favorite wine. "Knowing people on a human level really makes the difference," he says.
Looking down the corporate ladder, meanwhile, Trumbull encourages his staff to pursue opportunities to excel – even if they aren't commensurate with their title and even if they have to leave the organization to do so. "Leaders don't strive to create followers," he says. "They strive to create other leaders."
Doing so means setting aside the Type A personality traits so common among executives, Schooler says: "That ego's got to be directed at the success of others."
A Vision of Healthcare in 2020
That collaborative approach will matter to the healthcare CIOs of 2020, as it will parallel the collaborative approach to patient care that many foresee – and that, in fact, the Affordable Care Act encourages.
What's more, technology will play a part in this new order. Schooler envisions "healthcare on demand," available to patients through telehealth and mobile health on their terms, when they need it. In fact, he adds, the "planets [are] lining up" so that patients will actually stat to think of themselves as consumers.
When health systems think of patients as consumers, they can begin what Dr. Glenn Steele, president and CEO of Geisinger Health System, describes as a "straightforward attack on the total cost of care."
This attack, as it were, began when Steele took the CEO job at Geisinger in 2001, a time of both financial and clinical quality uncertainty for the system. Spurred, Steele says, by a 2003 Rand report suggesting that less than 55 percent of adults receive "recommended care," Geisinger set out to establish evidence-based best practices for treating common conditions.
Steele describes that as a feat of "clinical reengineering," one that required baking best practices into Geisinger's EHR system so they could be accessed at the point of care. The program, known as ProvenCare, is served to up in a variety of high-frequency care episodes, including perinatal care, COPD, hysterectomies, and hip and knee replacements.
Add to that Geisinger's ProvenHealth Navigator, an advanced version of the patient centered medical home, and its participation in OpenNotes, which opens clinical progress notes to patients, Steele says, and you see how Geisinger developed a "fundamentally different" and "active" relationship between patients and providers – one that couldn't have happened without "electronic enabling."
With the evolving healthcare business model set to reduce the number of acute care beds by as much as 25 percent, in Steele's estimation, and with healthcare providers and payers aligning without fully understanding each other, it's important for healthcare CIOs to identify the outcomes they want and work with vendors to deliver the technology to get them there.
Put another way: Hospitals should invest in a tailored suit, not an ill-fitting one pulled off the rack.