Technology played a critical role in health systems' COVID-19 response to coordinate resources, deliver telehealth and enable remote work. The pandemic also underscored the need for a strong IT infrastructure and a culture of innovation as mission-critical for healthcare organizations.
Below is a list of 22 Q&As the Becker's health IT team conducted in the last several months with the most interesting predictions, trends, operations and advice they shared.
Editor's Note: This is not an exhaustive list of the Q&As published by Becker's.
Predictions
Stephen Klasko, MD. President and CEO of Jefferson Health (Philadelphia): This is healthcare's Amazon moment. If you are a provider and think you're going to go back to your business model solely being based on hospital revenue and not relevant to people who want care at home, I think you will be out of business. If you're an insurer and think you can just be the middleman between the hospital and the patient, you'll be irrelevant. If hospitals believe that innovation can be just this cute little thing that they do in the background, but the real business is just getting heads in beds, they're nuts. I think we were always wondering what the big disruption would be that got us to join the consumer revolution, and I think this is it.
B.J. Moore. CIO of Providence (Renton, Wash.): While the concept of 'hospital of the future' caught so much attention when our strategic alliance [with Microsoft] was announced [in 2019], the reality is that our focus is much broader. From the beginning, we defined this within our strategic framework of simplify/modernize/innovate. In the innovate space, we are focused on the future of care delivery, a future that has the patient, not the site of care, at the center; with innovations on how care is delivered. For example, around telehealth and home monitoring scenarios, and innovation on the way we enable care providers for greater experience and outcomes. An example emerging from the collaboration with Microsoft is natural language processing and cancer treatment.
We will showcase some of the partnership in an acute care setting, time and location to be determined, but you will see the innovations from the Microsoft strategic alliance in many facets within our health system.
John Halamka, MD. President of Mayo Clinic Platform (Rochester, Minn.): We were talking about healthcare in 2030. But what we are seeing now is that 2030 is going to arrive in 2021 because COVID-19 has reshaped the culture and the policy around the use of technology, and anything we thought would take a decade to do is going to be an expectation for next year. We're going to have more demand for telemedicine, telehealth, hospital-level care in the home, wearables and the ability to apply machine learning and artificial intelligence to new data sources for cure plans. That's going to be here very soon because we have changed so much, so fast with COVID-19
Kristin Myers. Executive Vice President, CIO and Dean of IT at Mount Sinai Health System (New York City): Delivering the patient experience so that patients and families strengthen their relationship with the health system is our best opportunity. Technology can be an enabler when there is a holistic experience. From scheduling all the way through to discharge and remote monitoring at home will be an important part of our strategy. The key to all of this is providing a seamless patient experience, one that is easy, clear and from the tech perspective, not fragmented. Pulling all that together is a challenge, but patients will become more empowered in the future, and they will expect the kind of consumer experience that they get in retail and other sectors.
Sony Jacob. CIO of SSM Health (St. Louis, Mo.): The definition of care delivery today to a large extent is symptom management. It's not cure. When I think about innovation today I ask the question: Can you use DNA sequencing to drive personalized medicine to the end consumer? If you're able to do that, now you have changed the scales on how to control access in healthcare. If the patient can get the care that they need by the second visit and doesn't have to come back for more visits, now you've changed the equation on how to create more cost-effective access in the delivery system.
Zafar Chaudry, MD. Vice President and CIO of Seattle Children's Hospital: I can see [Walmart's] capabilities scaling with developing markets because of their retail exposure in the remotest of communities. I'm a true believer that giving consumers low cost, better and expanded access to primary and urgent care will lead to better community access, reduced hospital admissions and, therefore, lower healthcare costs.
Observations
Ryan Smith. CIO of Intermountain Healthcare (Salt Lake City): It's been fascinating to watch how rapidly key technology and digital solutions have been implemented [during the pandemic] to address massive changes in healthcare over the past several months. This has ranged from rapidly adding thousands of new clinician and nonclinician workforce members to remote working infrastructure, to huge increases in virtual visits and telehealth, to implementing all kinds of new clinical workflows and analytics supporting COVID-19 efforts. One of the lessons I've learned is just how responsive teams can be when an urgent need arises and the whole company aligns around priorities.
Edward Lee, MD. Associate Executive Director at Kaiser Permanente and Executive Vice President of IT and CIO at the the Permanente Federation (Oakland, Calif.): It's important for the healthcare industry to recognize that AI algorithms trained on insufficiently diverse data can lead to AI bias. At a time when we are incorporating more and more AI in medicine, this bias can inadvertently contribute to the widening of healthcare disparities. One of the first steps we need to take is to be intentional in looking for bias. If we don't look, we'll never find it, so understanding that AI bias can be part of any algorithm is essential.
Because bias can be introduced at multiple points throughout the algorithm development process, careful consideration is needed during all of the steps. This can start as early as building a diverse team that can bring different perspectives and expand thinking about the way data is collected, curated and analyzed. Additional key mitigating steps are including as broad a dataset as possible, and continually validating and revalidating results of an AI algorithm to confirm the output makes clinical sense.
Ultimately, I consider AI to be augmented intelligence and not simply artificial intelligence. It is most impactful when used as a tool for physicians to augment, assist and complement their clinical decision-making rather than a standalone technology.
Michael Pfeffer, MD. Assistant Vice Chancellor and CIO at UCLA Health (Los Angeles): We know that social determinants of health play a critical role in health outcomes, but often are hard to capture fully with in-office visits. But now I have a lot of physicians commenting to me about how they are able to connect with patients on a different level with video visits and better obtain this key information.
Jason Joseph. CIO of Spectrum Health (Grand Rapids, Mich.): There is still a lot of variation in care processes that gets in the way of digital transformation. For example, while we have a high degree of automation and digitization within our health system, we still use faxes in healthcare to communicate with other providers. That fax is essentially a giant red flag sticking up saying a process somewhere around here is broken because I have now resorted to the least common denominator of communications.
Hans Keil. CIO of Beaumont (Southfield, Mich.): Our EHR is our source of truth for coronavirus patient data — it is the only way to guarantee integrity, consistency and security. This is accomplished by each of our IT departments, from infrastructure to applications to security, being in lockstep with operations and each other to ensure any COVID-19-related operational changes, such as room reconfiguration, lab test creation and bed transfers, are swiftly and accurately reflected in technology.
In addition, auxiliary data is carried from enterprise resource planning, regional demographics and other sources, such as custom web tools and mobile apps, to further enrich our data. The data itself has four primary uses: operational reporting, corporate command dashboard analytics, governmental reporting and forecasting used for modeling labor capacity, and critical personal protective equipment levels.
Dwight Raum. Interim Vice President and CIO of Johns Hopkins Medicine (Baltimore): For community [COVID-19 vaccine] distribution, we're streamlining and automating as much as we can. The candidate vaccines are more complex to deliver than influenza vaccinations, and for this reason, we opted to use the full EMR for this process.EMR changes will support everything from new regulatory reporting requirements to unique vaccine workflow and the carefully timed second dose.
Lara Jehi, MD. Chief Research Information Officer at Cleveland Clinic: My ultimate goal is to bridge research and patient data with clinical care. Our patients trust us with their lives. We owe it to them to deliver the best care. A cornerstone of that oath is that we will always strive to learn and develop better ways to provide care. This is where I see the critical role of research, in its continuum from basic science to studies of different healthcare delivery systems. My role as chief research information officer is simply to accelerate this research at Cleveland Clinic. This requires establishing and sustaining a robust digital research infrastructure that facilitates research and collaborations in a strategic, meaningful, productive, compliant and transformative fashion.
Trends
Michael Restuccia. Senior Vice President and CIO for Corporate Information Services at Penn Medicine (Philadelphia): As our region, state, country and world react to the spike in COVID-19 cases, we have recognized that our corporate IS team's top priority is less project- focused, but more focused on mirroring the behavior of our front-line caregivers and leadership team. Although this second wave of coronavirus was somewhat predictable, the environment we are operating within is different than the initial COVID-19 spike in the spring of 2020. Our healthcare teams are still fearful, but there is an extended level of fatigue and frustration among the community. In addition, new variables, such as resurgence, widespread testing, vaccine availability and distribution require thoughtful decisions guided by data and technology. As a result, together, we all need to be nimble, available and flexible to adapt our systems, technologies and processes in support of our community and front-line caregivers.
Jonathan Shoemaker. CIO of Allina Health (Minneapolis): Healthcare groups probably aren't going to be pushing to get people back [to working in the office after the pandemic]. I've talked to CIOs in other industries, and they're thinking they have to get people back sooner to manage staff, but I think healthcare is going to be somewhat in that space like Google and Amazon. There is no intention to get people back in the office if they don't have to. We've pretty much come to the conclusion that it wouldn't make sense to ask people to start driving back into an office, given what we've been able to accomplish by having staff working remotely. We're seeing that our ability to support them as well as employee engagement is high, and we believe that productivity of folks is also high, so I think we have a permanent change.
Heather Nelson. CIO at the University of Chicago Medicine: We don't have the luxury right now to do the 'nice to have'; we need to focus on what's the most critical thing for our patients, physicians, care team members and healthcare workers to make sure we can continue to be the best healthcare provider in the region and keep our patients and employees safe. That's what we need to focus on. I have complete buy-in with my peers and team members; we're all in this together. I don't see it as an IT issue but rather a healthcare operational issue that we all play a role in supporting.
Stephanie Reel. Former CIO of Johns Hopkins University and Health System (Baltimore): We are all getting weary of the term artificial intelligence, but in fact I think that's what we need to achieve this transformative use of technology, and more importantly the transformative use of information. When I think back over 30 years, we've been incredibly focused on how to make tech functionality more focused, better and interoperable; now we're finally at the point that it's the information coming in and out of all our systems that is earning our respect. The information is making a difference for physicians, nurses, care providers, educators and researchers.
We launched a precision medicine initiative that is focused on using data wisely for every patient individually. It's so amazing that we are finally at this point, and it's one of the most exciting times in my experience that we recognize the value of information in decision-making. For the first time, it feels like information is what it's all about. It's inspirational to see what we can do with that information to advance in science and patient care. We can make quicker, wiser decisions.
Advice
Gianrico Farrugia, MD. CEO at Mayo Clinic (Rochester, Minn.): It's now up to us to design a system where people can seamlessly move among various care models to get exactly the right care at the right time — delivering satisfying patient experiences and better outcomes at lower costs for both individual patients and the nation as a whole. But like a stiff rubber band, once stretched, healthcare will reflexively snap back unless we intervene.
Adrienne Boissey, MD. Chief Experience Officer of Cleveland Clinic: In a sea of technology solutions, if I had to double down on something, and something I'm spending a lot of time on now, it would be deeply understanding who we serve. Technology applied en masse doesn't work for the populations we most need to reach right now. Taking the time to invest in understanding both the patients that you serve — who are they? Who are their personas? Why don't they use virtual? What would they rather use? Do they need a phone call?
Understanding their preferences around access and trust and what empathy feels like for them is a space I really don't know that we've spent enough time in. The same for our own people. We have an opportunity to apply the same principles to our own people. We should know their birthdays. We should know how they like to be outreached to. We should apply that interest and curiosity to our own people as well as the patients we serve. That's my investment.
Darren Dworkin. CIO of Cedars-Sinai (Los Angeles): Our encounters with our patients are often at a time when they are most vulnerable and looking for answers. One of the most helpful technologies we have found to engage patients in their journey with us is real-time information — whether it be test results, viewing a doctor's note or even simply seeing the names and faces of their care team. We have continued to focus on every possible way to get our patients and their families access to real-time information via web portals, mobile apps and even tablets when they are at our facility. We follow the mantra that knowledge is power as we continually seek ways to give our patients access to their medical information.
Andrew Rosenberg, MD. CIO of Michigan Medicine (Ann Arbor): Disruptors should be recognized for their value to disparate employees even if there is some effort to adopt. Disruptive technologies, services and information methods should be immediately identified as valuable and even provide a sense of joy and awe in their use.
Tanya Arthur. Senior Vice President and CIO of Summa Health (Akron, Ohio): Health systems, including ours, will need to think differently. We need to think more like other industries. We are dependent on our reimbursement models, but I think there is significant opportunity to direct how we drive revenue. It's all about reevaluating the whole financial model, thinking more broadly about the value of improved health outcomes and leveraging data to improve care. COVID-19 has been a wake-up call for all of us, and what is in front of us is the opportunity to make significant and sustainable change in ways that will improve the health and wellness of our populations.