In collaboration with CHIME, Becker's Hospital Review's new "Life of a Healthcare CIO" series features leading hospital and health system CIOs from across the country who are sharing their experiences, best practices and challenges.
To recommend a CIO to be featured in this series, please contact Helen Gregg (hgregg@beckershealthcare.com).
An interview with Mary Anne Leach, senior vice president and CIO of Children's Hospital Colorado in Aurora. (Interview has been edited for length and clarity.)
Question: You've been CIO of Children's Hospital Colorado for six years. How has your job changed since you began?
Mary Anne Leach: The pace of change has accelerated, and I think all of my colleagues and I would agree the demands are increasing and forcing us to be better, smarter, faster and more cost-effective. Right now is a great time for technology leaders to be agents of change and leverage technology to provide better, safer care, more cost-effective care, and to engage our providers, staff, patients and families in new ways. While it's a challenging time, it's an exciting time as well.
Q: In your time with Children's Hospital Colorado, what has been your biggest accomplishment?
MAL: We've really worked hard to introduce analytics over the years. When I arrived we already had an electronic health record system implemented, so my role was to leverage that technology, harvest the value, enhance the platform and employ analytics to use all that data. We still have a fairly "fledgling" program here, and we still have a long way to go, but we have, at least, started this important journey.
We have an enterprise data warehouse, new analytics capabilities, registries, dashboards, universes, new reporting and data visualizations tools. When I first came here, people said they couldn't get to the data. We don't hear that as much anymore. We might not be meeting everyone's data demands just yet, but one of the things I'm most excited about is the potential that we are unleashing; this will be a game changer, and we can’t get there fast enough.
We've also achieved meaningful use stage 1, and we'll probably aim for stage 2 sometime in 2014 or 2015. I think we're fairly well-positioned for ICD-10 (though I don't want to jinx it!). We started our ICD-10 readiness efforts several years ago. We still have a lot of work to do in terms of clinical documentation improvement and computer-assisted coding. And then once we're on ICD-10, we'll be focused on leveraging the data [analytics] from the new ICD-10 codes and from greatly improved clinical documentation.
Q: What do you see as your biggest misstep or mistake?
MAL: Probably not enough communication. There's so much going on, and the organization's attention is already "stretched," so communication in our environment is already a challenge. Our organization has many initiatives underway, and already a lot of information is bombarding our staff. The organization is growing rapidly — we’re opening new hospitals and network of care locations. IT leaders need to fight for the headlines to make sure we're communicating what's necessary, but also that we're "telling the story" about how we're adding and harvesting value from IT investments. We definitely don't do enough value-based communications.
And it's about communication in a broad sense, in a variety of ways. It shouldn't just be in an email newsletter, but in face-to-face rounding, talking with staff and meeting with clinicians. We need to do more rounding on a regular basis.
The other day I was with the providers' advisory council, and I surveyed them on how they wanted to connect with us, and then had a real-time dialogue with them on the results and what we can be doing more effectively. It was very fruitful and very helpful; I think there's more we can be doing for them, and we've prioritized that work in our 2014 plans. It's very easy to get busy with budgets, strategies, plans, governance — but we really need to stay in front of the customer and understand their needs and find the opportunities to leverage our capacity to help them.
We're also trying to communicate more effectively around realizing and harvesting the value that we're creating. Sometimes when we do great work we say, 'OK, on to the next project,' and sometimes we don't realize all the value possible if we don't market it more effectively, or communicate the "value potential" more frequently. We're getting better, but communication, particularly around value realization, is something we will always be working on.
Q: Looking back over the past month, what has taken up the majority of your time?
MAL: It's hard to pick any one thing. We had 70 go-lives this year, some were tiny, some were huge. I wouldn't say any "one thing" has preoccupied my mind other than ["everything"], because in addition to routine operations and resource stewardship, it's my job to be forward-looking, looking ahead a couple years out and anticipating needs and how they will change.
I always need to be looking ahead and doing strategic planning; it's about carving out time to look ahead and assess new and emerging technology as well as our changing needs, and understand what it means for us and how we can meet challenging new requirements, or leverage emerging technologies in new ways.
Healthcare is undergoing enormous change. The pace of change is being driven by payment reform but also by consumers. Consumers are much more educated about healthcare now, and it's about how we engage and partner with them in their care.
So — there's not a "single thing" that's really preoccupying me, it's all of it. As CIOs, we have to be adept at juggling all of it.
Q: What is the biggest challenge you're facing right now?
MAL: I think the biggest challenge for me right now is balancing the desire for more automation, more technology and more advanced analytics with the business need to reduce expenses, deliver value and help transform IT into a strategic competitive advantage. That's our biggest challenge as an industry, doing all that while finding ways to reduce expenses. It's hard, but we have to keep at it.
Some of our resource stewardship approaches include re-negotiating vendor agreements, reducing operating expenses, and managing staff productivity more effectively, but some of also has to do with more aggressive portfolio management. Like you would manage a financial portfolio, we need to more aggressively manage our project, application, asset and "discovery" portfolios to ensure they're delivering the value we anticipated.
Resource stewardship also requires that we more routinely measure and communicate value. When we deliver a new system, we need to measure pre- and post-project outcomes (more regularly) so we can prove value-add or return on investment. It's tough in health IT; it's not an ROI-friendly business because it's sometimes hard to measure the ROI impact of an application supporting quality, service or patient safety (like an EHR, for instance). But we can tell what's better, what's improved, what makes nurses or providers more efficient – and we need to make the investment in measurement and value realization. It's a challenge to reduce IT expenses, but we can't be short-sighted about it – we need to invest in IT when appropriate, then help the organization harvest value from that investment.
Q: What is one lesson you've learned during your tenure you'd like to share with other CIOs?
MAL: I'm in constant dialog with my peers; we're always helping each other. I think the biggest lesson we all need to keep in mind is this is a time of opportunity. It can be a very challenging and demanding time for CIOs, and I think we need to turn it on its head and think about the opportunities here. Where can we be catalysts or agents of change? Where can we really be the chief innovation officer?
We have a lot to do, but we need to keep thinking about what's the right thing to do, right now. That's how I look at it. Yes, there are landmines, but we can navigate through that and leverage our capabilities. We have a lot of tools in our toolbox now, and a lot of ways to leverage technology and analytics to make care more effective and more efficient and ways to reach more people through telehealth and mobile apps. We have new, exciting ways to change outcomes. It's a great time for CIOs.
More Articles in the "Life of a Healthcare CIO" Series:
The Life of a Healthcare CIO: Baptist Health's Roland Garcia
The Life of a Healthcare CIO: Mount Sinai Health System's Kumar Chatani
The Life of a Healthcare CIO: Spectrum Health's Patrick O'Hare