Mary Alice Annecharico, RN, CIO of Detroit-based Henry Ford Health System, didn't envision her future in IT.
"Ever since I was a child, I wanted to be a nurse," she says. "I was very, very focused on that being my professional aspiration — my inspiration and my vocation."
But while working as a critical care director at an academic medical center, the new vice president pulled her aside, and asked her to lead the transition from paper records to EHRs. It was the mid-1980s, and Ms. Annecharico was skeptical — most of her computer experience had been managing patients' with cardiac systems in the ICU.
"My response was: 'Computers? There are two words I know, hardware and software, and I don't know the difference between them,'" she recalls. "He started laughing, but that's where I was. I hadn't opened my mind to thinking about anything other than my clinical care relevance in the healthcare environment."
Since then, Ms. Annecharico has served as CIO of multiple leading healthcare organizations, including the Perelman School of Medicine at the University of Pennsylvania in Philadelphia and University Hospitals of Cleveland. She was appointed senior vice president and CIO of Henry Ford in 2011, where she was a member of the team that spearheaded an enterprisewide Epic implementation across the health system's six hospitals, ambulatory environments and included the revenue cycle transformation.
Ms. Annecharico spoke with Becker's Hospital Review about her background in nursing and why she believes interoperability is the future of healthcare.
Editor's note: Responses have been lightly edited for length and clarity.
Question: How does your background in nursing inform your work as a CIO?
Mary Alice Annecharico: I loved and embraced my role as a nurse, and I was in nursing leadership for most of my years at the bedside. When I took the role in IT, I thought it was a wonderful opportunity, and a challenge for me to lead the organization in implementing systems and organizational workflows in a way that was just revolutionary. It was a confusing time, but it was an exciting time.
My banner in the '90s was: We need to put the tools of technology in the hands of our clinicians. I could envision connecting the dots — managing the outcomes of care with technology — far before the rest of the industry did, because I had been in the footprint of where a physician, nurse or any other caregiver was. I'd lived and breathed in that environment so passionately for a number of years.
Q: You've been involved in a few efforts to create statewide health information exchanges. What is the significance of this type of data sharing?
MAA: In Ohio, I helped start a public-private partnership, known as OHIP, to determine what pathway we could use to create an HIE. The goal was to enable larger provider organizations and smaller provider organizations to gain access to the same information, which would help us manage our patient populations more efficiently. When I came to Michigan, I saw that we had a number of competing HIEs, and in my mind, it seemed like we were doing much more work by requiring health systems to pick and choose one solution over another, rather than trying to bring us all to the same table.
Ultimately, we moved from five different HIE platforms to a single data exchange platform. Sharing this data is really important under value-based care, because we need to make sure we're working in a lean environment, not replicating services that we're not going to be reimbursed for. We need to look at what data is essential for us to exchange, so we know if someone's care rendered at one organization is associated with something another organization has done.
Q: What is one of your main goals for Henry Ford Health System this year?
MAA: A year ago we merged with Allegiance Health, a healthcare system in Jackson, Mich., about 85 miles west of Henry Ford Health System. They have a portal strategy that enables us to share information directly with providers who aren't on Epic. However, a major goal — and one we are looking to with excitement — is the integration of their EHR environment to Epic. The conversion will be effective in August, and later we will transition their financial systems and their business-related applications to our environment, as well. That's the beginning of our journey to creating harmony between the systems, which is really at the top of the immediate horizon throughout this year.
Q: As a CIO, what are a few health IT trends you want to learn more about?
MAA: I love the idea of advancing standards, especially within HIEs. I believe HIEs will give way to real interoperability across the EHR environment, and we're seeing national standards that we're all agreeing are most practical with CareQuality and Commonwell, which will lead the variability of how different systems exchange data to become more simplified. I see national, and even international, data sharing arising within the next couple of years, because it's already beginning to play out right now.
There are also a number of questions around the ways we use data. How do we leverage the information we have to make better clinical and business decisions? How do we look at cohort data to manage populations? We're looking at precision medicine, especially in our freestanding cancer hospital, which is under construction. How can we look at a patient's genetic makeup in a way that helps their care team know what's most important in managing their specific cancer? And can we manage that internally, or do we need to be dependent on vendor relationships to compete in those spaces?
The future is a pearl that we are ready to explore and whose outcomes will become more data-, quality- and cost-driven. Our bottom line is the prediction that care will be navigated through analytics that will enable us to predict and prescribe the most effective pathways.