Five health system executives focused on IT and innovation share the big challenges ahead and factors that could hinder technology growth.
All five executives featured in this article are speakers at the Becker's 7th Annual Health IT + Digital Health + Revenue Cycle Conference in Chicago. Learn more about the event and register to join them here.
Question: What challenges do you anticipate over the next two years?
Craig Richardville. Senior Vice President and Chief Information and Digital Officer of Intermountain Healthcare (Salt Lake City): Like many others, we try to turn some challenges into opportunities. First and foremost, I think the largest issue for us is our labor shortage, as the burnout and the ease of people transferring between jobs put a lot of pressure on the human component of delivering healthcare. [For] most of us, between 40 and 60 percent of our expense structure is in people. When there's a shortage of people, that strains those still there and increases the expenses by trying to find people to come in temporarily. Secondly, I think the whole aspect of what's impacting many of us, whether you're a patient or an employee, is inflation.
A key component of delivering value-based care is understanding other things outside healthcare that impact people's behaviors and actions. Inflation, housing, transportation, and many other factors will influence people's behaviors and actions, increasing the focus on social determinants of health. Some stressors happening in our economies and communities will potentially accelerate that, which is why, in my opinion, value even becomes more and more critical to our industry.
Richard Zane, MD. Chief Innovation Officer of UCHealth (Aurora, Colo.): The biggest challenge is going to be bending the cost curve, the regulatory curve and the adoption curves. When we want to deploy technology in healthcare, it is very different than deploying technology in the travel industry, banking or shopping because of the requirement for exactitude and because healthcare change management is much different than in other industries. But the biggest challenge we have, in addition to what I described, is the regulatory and payer environment is years, or even decades, behind where healthcare is going from a technology perspective. So there are perverse disincentives in healthcare that are headwinds against the adoption and deployment of technology, and they are regulatory and financial.
Joel Klein, MD. Senior Vice President and CIO of University of Maryland Medical System (Baltimore): Where to begin! We have to stay the course on our security journey, which will require a lot of fiscal discipline and institutional focus. We have to figure out how to manage vendors on whose ecosystems we risk dependence and find ways to prioritize our work. This last issue is probably going to be the hardest. Now that we have fewer all-of-system efforts around COVID-19, many complex projects held in abeyance for several years are coming forward. Most of them are really good ideas and have lots of potential, but they can't all be done simultaneously.
Even though my organization has a fairly robust IT governance process, it is still a challenge to sort through what can be dozens of competing ideas and figure out how to lay them rationally into a schedule that works well enough for everyone. Finally, we have to communicate well about all these decisions. Nurses, doctors, and other caregivers around the country are exhausted, and we owe it to them to keep them informed about how we are trying to make their lives easier and simpler. Getting a consistent message to a diverse workforce of students, voluntary medical staff members, contractors, faculty, board members and employees can be tricky. Still, we must search for new and better ways to do that.
Daniel Nigrin, MD. CIO of MaineHealth (Portland): I anticipate more staffing shortages, relentless financial pressure and insatiable demand for more of everything from IT. But I'd like to focus on one more issue — new work models are now here to stay; remote work and hybrid approaches are the norm and expected. However, being able to keep those care team members engaged and linked to our overall healthcare mission is now even more difficult when they are so far removed from care settings. We will need to think of novel ways to keep our teams connected to what we are here to do. "Keyboard to bedside" has always been a difficult challenge for us in IT — it's now even more challenging when most of our team members never leave their homes to work.
Daniel Durand, MD. Chief Clinical Officer and Chair of Radiology at LifeBridge Health (Baltimore): Inflationary pressures are going to wreak havoc on health system bottom lines — going "upstream" with value-based arrangements and getting more efficient with automation will become increasingly important.