In collaboration with CHIME, Becker's Hospital Review'snew "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 Patrick O'Hare, senior vice president and CIO of Spectrum Health in Grand Rapids, Mich. (Interview has been edited for length and clarity.)
Question: You've been CIO of Spectrum Health since 1997. How has your job changed since you began?
Patrick O'Hare: Obviously healthcare in general has changed, the complexity has increased, and that's true here as well. And as the scope and complexity of what we offer has increased, so has our reliance on technology. The expectation now is that technology is always going to be available, and [it will be] technology that enables us as an organization to meet our strategic plans. That is as much of an issue today as it was 17 years ago, but it's really on high octane now in terms of being so much at the center of supporting what we're doing.
There's also the issue of patient engagement. We did not have the technology 17 years ago that would allow a patient to engage in their healthcare as we do today, and more importantly, as we will in the future. It's a change that's occurring in the industry, and it's not about a gadget or a downloaded app but about how patients will interact with the overall healthcare system and how the technology will enhance the overall patient experience.
Back 17 years ago, that technology was called a phone. So it certainly has changed drastically, though the complexity and the reliance on technology is not that different from how other industries have evolved.
Q: In your time with Spectrum Health, what has been your biggest accomplishment?
PO: It's difficult to pick one because for me it's not as much about the technology as it is about the relationships. In terms of the different people within the organization I have a relationship with, we didn't form the relationship because of technology but because of the overall mission and what we're trying to achieve, and that I've partnered with them to bring technology into their area of the organization in a meaningful way. When I think in terms of success, I think in those terms.
If I was asked this question a decade ago, I might have answered that we were an early Cerner client or a development partner for this app or other things we have accomplished over the years, but today I wouldn't really hang my hat on those things. Now it's about being high-quality and low-cost and helping others to recognize how IT is woven into the fabric of the organization.
I am also proud of my work with Michigan Health Connect, a health information exchange that now has 87 Michigan hospitals participating. The planning for the HIE began when myself and representatives from Trinity Health and Metro Health in Grand Rapids, Mich., decided to collaborate to share data with others in the region. We decided to step off the curb together, and the result is Michigan Health Connect.
Again, this is a success where I formed a relationship through Spectrum. Spectrum Health CEO Rick Breon in a status meeting once stated that we would not compete on the exchange of patient data. He concurred that we should collaborate on the exchange of patient information. And then he supported me in partnering with other organizations, and that resulted in the HIE.
The HIE is very viable. Grant funding accounted for less than 1 percent of our budget in the last four years. It's very functional, and it's all been done through community collaboration.
Q: What do you see as your biggest misstep or mistake?
PO: We've had certain projects that we look back on and see we didn't get a lift from the technology investment, or we tried to take on Project X and failed. Fortunately, when I have discussions about projects for which we struggled with other people in the organization, they discussions have been about how if we're going to be a successful organization we won't take calculated risks that might cause patient harm, but we will need to take calculated risks on certain projects if we want to be a leader.. We will have failures, and we have had challenges because we tried to do something too early as an early adopter or we had expectations that exceeded a vendor's abilities, but the number of those type of projects has been limited, and there haven't been any major ones.
Q: Looking back over the past month, what has taken up the majority of your time?
PO: The HIE is actually where I spend a fair amount of my time because not only am I the chair of Michigan Health Connect, but I'm also on the state-designated HIE's board. And Michigan Health Connect is in collaboration discussions with another HIE
There are also issues in terms of trying to align key strategies with key operational initiatives, like ICD-10 and meaningful use, and working with the team from a resource perspective to make sure we have what we need. Right now, we're looking at chronic care management and understanding how to be more effective and efficient and what technology we need to ensure we're providing care focused on medical best practices but also looking at technology needed from a population health or consumer standpoint.
Q: What is the biggest challenge you're facing right now?
PO: I think it's not different from my colleagues around the country that ICD-10 and meaningful use will be the two bookends of 2014. And for us, it's also about ensuring we're continually driving to greater levels of efficiency to manage costs. If you just look at the project dashboard at the sheer volume of information systems projects, staffing is a challenge, to find the right talent or identify creative ways to meet staffing needs. Those are what I think of when I think of the next 90 to 180 days, or more likely the next 12 to 18 months.
We're going to be quite busy, lots of changes with healthcare reform. Hopefully the federal government will get the physician compensation issue resolved, but there's obviously going to be changes locally and nationally with physician models and different ways we'll be partnering with providers in the community to continue to pursue our goals.
Q: What is one lesson you've learned during your tenure you'd like to share with other CIOs?
PO: Two weeks ago, I was with a group of CIOs from large organizations having a discussion on the challenges and likewise the opportunities facing us now. I am always amazed at the talent that exists in this field. The one trait they all had is they don't lead with the technology. CIOs are not focused on the gadgets but focused on helping realizing business value within the organization. When I think of CIOs I have reached out to or collaborated with over the years, it's been the ones who have approached their role from a business perspective and understood they're a strategic leader first and a technology leader second. That's one of the most important things for us, because at the end of the day it's not about the technology, the technology is the easy part. It's about the change management process required to benefit from the technology, and that's where leadership is required. Getting the best contract with the hardware supplier is assumed. That just allows you to have a seat at the table, the things you actually discuss there are the business value [of the technology]. CIOs that focus on that value have been the most successful, at least the ones I network with to see what's on their mind and see what they're doing.
More Articles on CIO Q&As:
The Life of a Healthcare CIO: OSU Wexner Medical Center's Phyllis Teater
The Life of a Healthcare CIO: KishHealth System's Heath Bell
The Life of a Healthcare CIO: Mt. San Rafael Hospital's Michael John Archuleta