Dan Kinsella serves as Managing Director of Healthcare and Life Science for Deloitte.
On Saturday, September 23, Mr. Kinsella will moderate two panels at Becker's Hospital Review 3rd Annual Health IT + Revenue Cycle Conference. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place September 21 through September 23 in Chicago.
To learn more about the conference and Mr. Kinsella's sessions, click here.
Based on his experience as Chief Information Officer, Mr. Kinsella found the following to be true.
Question: Looking at your IT budget, what is one item or expense that has surprised you in terms of ROI? How so?
Dan Kinsella: As a new CIO, I was encouraged by my boss to have a consulting assessment conducted. While not within the first 100 days, we did invest in a Business Impact Assessment (BIA) that paid dividends throughout my term as CIO. Briefly, a BIA serves to categorize each of the applications in the portfolio as belonging to one of 4-5 tiers. Tier 0 for example, such as electricity and internet should almost never be down. Tier 1 applications tend to include the EMR and solutions used to enable complex care delivery such as surgery. Organizations invest in high availability infrastructure (redundant data circuits, power generators and hot back up with fail over) for Tier 1 applications. Most organizations cannot afford high availability architectures for all applications, nor with proper planning, does it make business sense. Tier 4 applications, while important, can be in downtime for 3-5 business days.
Getting the health system on the same page regarding the tiering of the applications was helpful in many ways. Beyond rationalizing the high availability and fault tolerant investment, this same framework was helpful in considering opportunities for application rationalization. If we had multiple applications from different vendors with equivalent functionality and they were classified as Tier 3 or 4, it should not be as big a deal to drive enterprise standards to consolidation on a single instance or at least a common vendor for that application. This same framework helped bridge the interdependent accountability between the business and IT. Whereas IT was accountable for Disaster Recovery, the Business was accountable for Business Continuity Planning (BCP). Applications were linked to business functions, which were linked to the operating departments. The departments were accountable to ensure that downtime procedures existed, were updated and periodically drilled – just as mass casualty drills in the local high school gym. Even a Tier 1 app required the users to be ready for as much as a 4 hour down time. The ROI on the investment in the BIA was tremendous when you consider all factors.
Q: Finding top tech talent is always a challenge. Say a CIO called you up today to ask for an interview question that would distinguish the best candidates from the mid- to low-performers. What question do you suggest he or she ask?
DK: Tell me about the people you have helped develop in their careers – on your teams, in your network. What are they doing today and what would they tell me about you?... Tech skills are fleeting and new technologies emerge rapidly but what remains constant is the need to nurture and develop others in addition to yourself.
Q: We spend a lot of timing talking about the exciting innovation modernizing healthcare. It's also helpful to acknowledge what we've let go of. What is one form of technology, one process or one idea that once seemed routine to you but is now endangered if not extinct? What existed in your organization 2-5 years ago but not anymore?
DK: Best of breed technology – departmental solutions while optimizing the part, don’t often contribute to optimizing the enterprise. When you consider support costs, integration costs and other components of “technical debt” the best of breed solution should be much more of an exception today in organizations who have an effective IT governance process. We have as an industry invested too much on enterprise platforms such as ERP and EMR to frequently allow departments to purchase boutique solutions. Over the past 5 years, IT has become a critical enabler of most core operating functions in the extended healthcare enterprise. Value from that investment is optimized by keeping as many modules as possible on those core enterprise platforms. There will always be exceptions, but they will be driven by other factors. Implementing a solution today includes the technology, but also people and process. Selecting the “best rated” application does not ensure optimum value if the overall solution is not considered and managed. Conversely, equal or better value can be realized from a technical solution that was not “best of breed” but was one that was implemented well.
Q: Tell us about the last time you were truly, wildly amazed by technology. What did you see?
DK: I saw a 3D printer create a scale model (including color and texture) of a 2 year old’s heart. The image was captured the day before by a cardiac imaging machine and expert team. The surgical team used the model to practice prior to successfully completing a complex surgical procedure on the child the following day. Think of the collaboration required across specialty areas: from diagnosis to image capture to model construction to the surgical team and the team who provided for the needs of the child and the family. This is why we work so hard in healthcare IT – to enable those who take care of our patients. #whyIworkinhealthcareIT