The CIO role has only grown in stature and responsibility, and with that comes an ever-expanding workload. The Becker's team took the exhibit floor at HIMSS and set out to discern CIOs' priorities from distractions.
We asked the following individuals this question: What emerging technologies are CIOs overinvesting their time and resources in?
If you'd like to add your thoughts to this compilation, please email jcohen@beckershealthcare.com.
Don Woodlock. Vice President of HealthShare with InterSystems (Cambridge, Mass): AI and blockchain are overhyped for sure. I'm optimistic, especially about AI, as being a good thing, but it's certainly overhyped at the moment. Cloud is not really overhyped because I think it's a good idea to leverage professionally run data centers instead of running your own, but I think some of the ancillary things people talk about with cloud are not necessarily true, like cost structure and things like that.
Manish Muzumdar. Senior Vice President of Product Development for Sunquest (Tucson, Ariz.): It tends to be whatever the big topic of the year is. In my experience, it is always a curve. There is some silver bullet with marketing around it, then there is period of disillusionment where it doesn't meet the hype, then some people do the hard work to bring it to life and people move on it.
Mark Johnston. Director of Global Business Development for Healthcare and Life Sciences for Amazon Web Services (Seattle): Enterprise data warehouses. The majority of customers I speak with are challenged to operate them. They are complex; they require special talent; [and it's] hard to recruit and retain these folks. So, the realization and promise of the investment hasn't quite been there.
Kyle Armbrester, Chief Product Officer of athenahealth (Watertown, Mass.): I've seen an increase in folks picking up on big data concepts, and really trying to build their own data lakes, data warehouses, et cetera, but where this industry needs to go is ensuring data liquidity is top of mind — the ability to get information from point A to point B. Just focus on the outcome, what you want to derive. A massive data jigsaw puzzle isn't going to solve any problems unless you have things that are actionable that can drive a specific, tangible result.
Eric Chetwynd. General Manager of Healthcare Solutions for Everbridge (Burlington, Mass.): Their EHR. I saw recently that 38 percent of CIOs rank the EHR as their top investment priority. While the EHR can serve a key role in the hospital, the technologies being deployed today seem ill-suited to the challenges of coordinated care across multiple locations and specialties now inherit in the move to value-based care. As Seema Verma noted in her keynote at HIMSS, EHRs have yet to realize the vision of shared health records across providers or enabling significantly better communication and collaboration among those providers. If the move away from hospital care to at-home care continues to advance, these gaps in EHRs will be even more pronounced.
Joel Gleason. Senior Vice President and Global Market Head of the Provider Segment at Cognizant (Teaneck, N.J.): Generally speaking, Cerner and Epic control the vast majority of the EHR marketplace. I continue to see press releases where health systems are merging together to create scale, and one organization is leaving its system to go to the other. For me, at this stage of the game, I can't seem to understand what the return on investment is to make that expense to spend the hundreds of millions of dollars to migrate one capable system to another. I can't create the return on investment to do that; I would rather invest in digital systems that allow those stable systems to communicate with each other.
Paul Stinson. Chief Growth Officer of Sunquest (Tucson): CIOs are absolutely overinvesting in ancillary solutions that may not return an ROI, but are a component of the enterprise medical record. There is extreme drive to facilitate specific vendors without going into the depth of knowledge that is important in learning these departments. That is overlooked, and it's impacting patient care. Large enterprise solutions think they can provide a solution in every corner of the hospital, when that is not where their domain expertise is.
Patrick Yoder, PharmD. Cofounder and CEO of LogicStream Health (Minneapolis): The one thing I've always questioned is the whole population health world, and those tools. It seems like there is a lot of investment there and they haven't gotten a lot out of it.
Roy Schoenberg, MD, MPH. President and CEO of American Well (Boston): Content distribution. Not so much in terms of how CIOs interact with healthcare industry, but the investments CIOs are making in creating a lot of content internally — newsletters, medical encyclopedias, lengthy explanations about services, large text-based patient portals — are probably missing the mark because people are significantly more transactional these days. They want to read less and do more. We live in a world that is experiential, not educational or content-based. I think at the end of the day, people expect to get things done over technology. Invest most of your time in creating technologies that solve the problem, not just tell a story.
Gordon Moore, MD. Senior Medical Director of Clinical Strategy and Value-Based Care with 3M (Maplewood, Minn.): I'm thinking the overinvestment right now is in technologies that have great buzzwords. It is exhausting walking around HIMSS looking at things that do not fit into the greater enterprise of what the system is trying to accomplish. [Technologies that have] to be bolted on or don't quite interface well. Teams can invest a lot of time on really cool machine learning stuff that can as easily pump out spurious results as it can meaningful information. What I see CIOs and CMIOs struggle with right now is figuring out what is hyperbole, what is junk, what is useful, and thinking about that in a really strategic way. What are we really tying to accomplish, and how do we get our systems to work together?
Neal Singh. President and CEO of Caradigm (Bellevue, Wash.): EMRs — not being able to figure out this notion of one EMR is not reality. If we are really taking on risk, you have to operate in an ecosystem of multiple partners. Many of our partners are clinically integrated networks. You can't mandate one EMR in a situation like that.
Eric Sullivan, Senior Vice President of Innovation and Data Strategies at Inovalon (Bowie, Md.): I want to say EHRs. It's their biggest investment. I don't know if it's overinvesting, since that suggests they shouldn't be doing it, but it's unfortunate to be investing so much of their energy in standing up and maintaining EHRs. It's unfortunate, but it's the reality. There's also a lot of energy around pop health right now, which kind of comes and goes. I don't know if it's energy well-spent, or if it's rehashing the same population health disease management approaches from 20 years ago. It's taking a lot of energy, and I'm not sure if it's applied the right way.
Fritz Haimberger. Global Industry Leader for Healthcare Providers with Appian (Reston, Va.): Currently, I don't know that there's any one technology [that CIOs are over-investing in.] Right now there is a kind of coming to terms, a grappling, with all of the new emerging technologies out there. CIOs are actually looking to see what is going to interface and integrate best with their core investment, i.e. the EMR. We are starting to see some significant traction in the robotic process automation space, in the artificial intelligence space and machine learning space, whether it be with referrals management or claims status checking. A lot of things over on the finance side of the house, the revenue cycle management side of the house, are definitely showing a big investment. I don't know that I would necessarily say that it's an over-investment at this point, but I think the potential payoff is yet to be quantified.
Andrew Mellin. Chief Medical Officer of Spok (Springfield, Va.): The industry has gone from best of breed to single vendor and pushing everyone out to now this time of innovation. We see organizations now — with good reason — exploring lots of different areas and dabbling in lots of different things, but my worry is to have a rational approach to choosing where to do this. You have to balance this ability to innovate, try new things and fail while not putting yourself in a place of chaos in the future.
Jennifer Esposito. Worldwide General Manager of Health and Life Sciences at Intel Corporation (Santa Clara, Calif.): I do think there is still a lot of infrastructure that needs to be built. Maybe take a seat back to think about what your underlying analytics and data infrastructure will look like for the next one to five years so you are future-proofing it and running multi-use cases on a single framework. Sometimes you see point solutions that address a single-use case, and you haven't thought about how to address others.
Marc Wilson. Cofounder and Senior Vice President of Global Partners and Industries for Appian (Reston, Va.): One of the traps people continue to fall into is the idea that for every problem you have there's a nifty piece of software that can solve that problem … You look up and realize well, I have 15 problems, and now I have 15 different pieces of technology, one for each of my different technology problems. … [It requires] really planning for the future and planning for change, as opposed to trying to check the box for what the problem is today.
Drew Schiller. Co-founder and CEO of Validic (Durham, N.C.): An area where CIOs are probably spending too much time and potentially money is trying to treat the EHR as more than a data repository rather than trying to leverage it as a data source and bring in other partners who can augment those capabilities in a faster or more reliable way. As a result, you see a lot of wheels spinning and waiting for EHR vendors to make improvements that are out of their wheelhouse. We could move faster as industry if EHR vendors focused on what they are good at.
Peter Bonis, MD. Chief Medical Officer for Clinical Effectiveness at Wolters Kluwer Health (Philadelphia): I'm not sure I'd say there is an overinvestment as much as an opportunity to harness the digitization of healthcare and the new workflow, which has evolved from EMRs. At present, it is hard to point to success. There is a lot of resentment and pushback from the implementation of these systems, particularly among frontline providers. But still, there is digital workflow and digital health records, which afford new opportunities to do things for people. Harness information that guides patients and consumers toward better care and safer patient care, and also help with the economics of healthcare. This is an area I think deeply about.
Richard Cramer, Chief Healthcare Strategist at Informatica (Redwood City, Calif.): We're seeing a significant market shift — a good market shift — away from spending millions of dollars up front on big packages, taking years to implement and potentially getting to value years later. Implement a solution to a meaningful business or clinical problem, solve the problem and then, based upon the success of that, grow it. Don't overinvest in big enterprise software licenses for stuff that you don't know is going to work. Invest in doing smaller implementations that get to value, and then invest based on success.
Kim Jackson, Vice President of Strategy, Products and Governance of St. Joseph Health System (Irvine, Calif.): Consider how mature the use of your current applications are. I don't think continuing to cycle through application after application after application is wise. We need applications in every core part of the business we have, but the churn is a waste of money.
Jeff Hayes, Executive Vice President and Co-Founder of Koan Health (Dallas): Blockchain. There's lots of hype, but no applications yet. Most CIOs will not see blockchain impact performance in their lifetime.
Brent Newhouse, Co-Founder and Head of Customer Success at Qventus (Los Altos, Calif.): I'd probably say data warehousing. To be storing large volumes of data and archiving is great, you need to have some kinds of means of pulling back old data so that it can be used — but in and of itself, the value doesn't come from storing data, it comes from how you're using it. Today, data warehouses are seen as enablers of future solutions, but the truth is they're not real-time, so it's hard to use them for real-time interventions. I think making investments with an eye toward how they will be used to change the way care is delivered in the moment is a lens that should be used when deciding where to allocate dollars.
Tim Smith, National Leader for Healthcare IT Practice at Deloitte: If I don't hear blockchain again in however many months, I'd be happy. I hate to always sound like a cynic, but I really don't think our industry is ready for blockchain. I'd like to think it is, but there's so many barriers with regulatory, vendor alignment and other things. The system's not really ready for it.
Will O'Connor, MD, Chief Medical Information Officer of TigerConnect (Santa Monica, Calif.): I would say the EHR space. There are organizations that have spent hundreds of millions of dollars with very unclear return on investment, and most of these tools do not make the lives of clinicians better. EHRs are harder to use than traditional methods that a physician would use to document care, like simply writing a note, so those technologies have produced unclear ROI, have been very expensive and many of them have resulted in clinician dissatisfaction and burnout.
Jason Considine, Senior Vice President of Patient Collections and Engagement at Experian Health (Franklin, Tenn.): I'm still uncertain about blockchain. It's something people are pretty interested in, and it has applications in spots, but I think people are chasing it in areas they don't necessarily need to, or where it may not be the solution.
Cory Costley, Chief Product Officer of Avizia (Reston, Va.): Hospitals have made so many massive investments in EHRs and expect so much from them. It feels like major resources are tied up in that, and it's stifling a little bit of innovation. I just don't know if it will be able to keep up with some of the other technologies that health systems are going to need for patient care.
Mike Coen, Vice President of Engineering at TeleTracking (Pittsburgh): Unfortunately, IT departments and CIOs are, to a degree, afraid of what the transition to the cloud means to them from a career perspective. "What does it mean for my job — If we no longer maintain IT, where does my network engineer go?" They continue to invest in that infrastructure internally, because they're afraid of what the cloud is. They use excuses like compliance, and security, when the reality is cloud environments are actually more compliant, more secure, and the vendor is telling you they'll maintain it for you. If you continue to invest in legacy IT approaches right now, I think that's not a very wise investment. You should be moving yourself to infrastructure-as-a-service in the cloud.
Laurie Eldridge, Partner Executive at Ricoh (Malvern, Pa.): One of the main things CIOs are focused on is cost reduction. I know some CIOs who say they have to cut, every year, 17 to 20 percent, asking themselves, "How am I going to do that and continue to grow the way my executive team wants me to grow?" It always ends up with some sort of outsourcing agreement, but if you're just outsourcing an antiquated system, it's not good. A lot of times, and it's not just at the CIO level, we automate things before we fix them. Everyone says, "Let's let someone else keep doing it the same way, with the same systems," instead of looking at new ways of doing things.
Carl Dvorak, President of Epic (Verona, Wis.): A lot of energy is on AI, but what can AI actually deliver today? As a computer scientist, AI itself is not actually all that intelligent, but the idea is we can use AI to peak over the horizon, into the future, to make predictions. A lot of people are selling the idea, although they're not doing it yet. Also, blockchain is almost entirely hype. It's a technology that doesn't fit well into a specific use in healthcare, so it's a solution looking for a problem. Another area of overspending, though maybe appropriately so, is cybersecurity — you never know when enough is enough, and you always live in fear of a cyberattack, so people are always spending.
Maulik Purohit, MD, Senior Vice President and Chief Medical Information Officer of University Health System (San Antonio): For the entire C-suite, not just CIOs, the one thing we need to look at, really, is how we can collapse multiple applications into the minimum number of applications possible. As an example, EMRs are getting better, with Epic and Cerner, so it's asking if we are able to enforce a better data governance around how we get data into the EMR. Then, we can really reduce the number of clinical applications that we have that extract that data. I think we're underinvesting in data organization and data governance, and overinvesting in data extraction, as a result of that.
Chrissa McFarlane, CEO and Founder of Patientory (Atlanta): Application programming interfaces. It can get cumbersome if you have multiple APIs, so ask yourself to evaluate it as a solution, and ask what problems it's solving.
Susan Taylor, Vice President and General Manager of Healthcare and Life Sciences at Pegasystems (Cambridge, Mass.): Reporting intelligence, maybe. Right now we're doing a lot of reporting using "dirty data," so we need to be thinking a little bit deeper about cleaning house before we believe too much of our own reporting.
Paul M. Black, CEO of Allscripts (Chicago): The industry should be looking at sustainable platforms. Make sure everything is not necessarily tied to the EMR supplier, because you will get a much broader landscape of connectivity if you work with somebody who works with everybody, rather than somebody who's building their own thing that's predicated on having the EMR first. These other platforms have to be EMR agnostic, rather than derivative of one EMR, because you have to connect to the rest of the world. If you're managing populations, and those populations go throughout the community, you better be really good at communicating with the outside world and receiving information about your patient who's been seeing other clinicians. You have to bring that all together to really provide good quality and cost-effective care.
Vinay Vaidya, MD, Vice President and Chief Medical Officer of Phoenix Children's Hospital: Chasing things that are not fully mature. There are buzzwords — artificial intelligence, machine learning — and those are all good, but they should be kept a small proportion of your portfolio right now.
Chris Sullivan, Global Healthcare Practice Lead at Zebra Technologies (Lincolnshire, Ill.): Hospitals are spending a lot of money on locationing technology, tracking people and things in real-time. That's wonderful technology, and it's in general a good area to invest in, but hospitals are making fragmented investments on locationing technology. Departments are picking separate solutions for the locationing of a specimen, or of a patient as they leave the operating room, or of IV pumps, so you're getting many different types of real-time locationing solutions, and none of them coordinate and work with each other. It's hard to get them to interoperate with the EHRs and the patient management systems. The technology is wonderful, but they're not coordinated effectively and working together. You end up wasting money, because even though it locates and tracks items, no one is using the data that's coming from it.
Nicolas Schmidt, Head of Healthcare Products at Nokia Technologies (Sunnyvale, Calif.): A hospital's patient-facing apps and portals are an area where there's a bit of overinvestment right now. It takes quite a lot of energy to get to widespread adoption, takes a lot of technical resources and product marketing, and you already have some companies that are well-established and that consumers already use. I would think, rather than trying to create a white-label version of this, use the apps that have the data to know what makes consumers tick.
Tony Thomas, President and CEO of Windstream (Little Rock, Ark.): One area we think CIOs in healthcare might be overinvesting is blockchain. It comes down to: What's the use case? What's the benefit to the healthcare organization? You can speak to blockchain, a lot of people do, but how do you apply it in a practical way? In blockchain, that hasn't been apparent. That will change with time, but right now, we believe it'd be best to sit back, wait, let those use cases develop and then begin investing more time into those efforts. There needs to be more of a migration from the land of theory, to practice.