Gary Zegiestowsky didn't begin his career in the healthcare industry. But after spending his early years working in consulting and strategy, Mr. Zegiestowsky made the switch over to healthcare and helped co-found Nashville, Tenn.-based Informatics Corporation of America, a provider of interoperability solutions across the care continuum.
Here, Mr. Zegiestowsky, CEO of ICA, discusses his unconventional entrance into healthcare, challenges and barriers to health IT and his future vision of how interoperability would, ideally, play out in the U.S. healthcare market.
Note: Answers have been edited for length and clarity.
Question: You co-founded ICA in 2005. What were some of the driving forces behind your desire to found this company?
Gary Zegiestowsky: I came from outside of healthcare prior to this. I spent some time with GE, Anderson and their strategy consulting group and time with a larger organization as COO of one of their divisions. As I was looking where I wanted to go next, I met Harry Jacobson [MD], who was, at the time, COO of Vanderbilt [University Medical Center in Nashville, Tenn.]. Healthcare was an industry I had always had an interest in, and I wanted to do something where I believed what I was doing could make a difference. When I met Dr. Jacobson, he and some of his colleagues were looking for someone to lead a new venture – a company to take some of the technology Vanderbilt had developed in their informatics [program and introduce that to the broader healthcare market. They were looking for someone who wasn't bound by the biases of the current healthcare industry and instead offered, 'Where can we go with a fresh look?' Past the introductions, what I saw in what they had is something I believed would really add value and make a difference in healthcare as a whole.
Q: How does your non-healthcare background help you in your current position?
GZ: What I came with [to the healthcare industry] was a good balance of strategy and operations experience, but also skills in managing a large base of consumers for a different category of products. I brought a good perspective on the strategic value of what we could do combined with how [to] execute that for a scalable population of patients.
If there's one thing we've seen in our emerging client and prospect base, it’s more diversification of leadership and stakeholders coming from outside of healthcare. They're bringing a new set of eyes and asking questions that prompt more thought in that continuum.
Q: How do you see the overall role of IT in the health industry?
GZ: From the very beginning, one of the things we looked at is technology. Dr. Jacobson is a physician, and we have had a lot of physician leadership and involvement over the years given our association with Vanderbilt. From the very beginning, we realized care is delivered by the providers, but technology can be a key enabler for those providers to be more effective; not only for each patient but for the broader populations they serve. We never saw ourselves as being the key to solving a problem; rather, a key component [that] in supporting the right people delivering care and using technology in the right way. One of our early guiding principles that has not wavered is that value must succeed effort at every stage. The value we can deliver to help enable those providers to deliver better care has to exceed the effort they have to exert to use the technology. If that equation is upside down, they won't use it. If you look at health IT adoption, fundamentally it comes down to ease of use as a driving reason for why some things are well-utilized and why some are not.
Q: What are some of the barriers to implementing health IT into organizations?
GZ: First and foremost is the complexity of [health IT]. The multitude of technological tools available is one of the first barriers; there are many problems to be solved and technology can help. , But sifting through the overwhelming number of options is very hard. It's a big challenge for provider organizations and their leadership teams to determine the right technology to address specific issues and now more than ever before, how those technologies must work together. If you go beyond your base [electronic medical record] technology, there are many pieces, parts and components required beyond that to achieve care coordination and reporting required by health reform. Knowing how to select capable vendors and prioritize investments is a significant challenge given the multitude of options.
The second is once you pick a solution, it's effectively implementing it, which is not just getting the technology up and live, but getting it aligned with workflow for those who are using it. That barrier is probably the bigger one because what that really means is you're changing how physicians or other care providers deliver care each day.
In the midst of that, providers are tasked with improving quality and reducing the cost of care. That means technology has to make sense not only from the quality side of the delivery equation, but financially as well. Add to thatthe fact that there are limited dollars in each organization today, and [organizations] have to make choices on where to spend dollars on technology as part of that equation.
Q: What are your goals for the future of ICA and the healthcare industry in general?
GZ: First and foremost we said we believe we can make a difference; our technology is an enabler for providers who want innovative ways for their care teams to connect – who want to change the way healthcare is deliverd.. We look at the top line from that standpoint. If I look at more tangible or tactical goals where we have evolved in the last two years in parallel with the emergence of meaningful use and the [Patient Protection and Affordable Care Act], we've got to be leading edge in the breadth of interoperability services we provide so we can connect varied systems and meet all standards as foundational to delivering interoperability in today's market. Taking that further, what do we have to have in our toolkit that says at a baseline we can meet the needs you have for your part of the equation in that process? Ultimately where I see ICA fitting is as the foundational component for population health management. We're not the whole continuum of tools, but we are foundational to that because we're connecting thousands of caregivers, building comprehensive views of the patient as well as effectively leveraging that information for better care delivery.
Q: Can you describe your ideal health IT landscape for the future?
GZ: The ideal vision is that ICA would be the core interoperability platform across the healthcare industry. Can we be some part of that equation? I think we are uniquely in a position to capitalize on that goal, and that's where we're heading.
Just as the healthcare industry is at a turning point, I would say our company is in a similar place given the PPACA and meaningful use; both are driving a strong need for our technology, but also providing a clearer roadmap for what has to be accomplished in the management of care for patients. I think the industry is now aligned with key drivers out there to a point we haven't seen before. This alignment between clinical and financial incentives creates a good basis for moving forward to take advantage of and bring value to a broader group of players than has been provided in the past. While we're doing a lot of good things from a technology standpoint, we will always make sure we keep in close touch with those in the trenches every day providing care. There's need for every piece of that equation to work effectively together, and I think we see that emerging more each day. We're confident that we're on a solid track from an industry standpoint and doing the right things.
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