Technology is taking center stage as an integral part of the overall care delivery system, creating a new level of demand on high-level IT experts. In this eBrief we explore how some of the top healthcare IT leaders are successfully navigating this changing landscape.

THREE METHODS HEALTHCARE TECHNOLOGY LEADERS USE TO SUCCEED

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Whether you’re a CMIO, a CIO, or an IT VP/Director, it’s no secret that the workload and challenges of your position have been increasing at a record pace over the last several years. From government initiatives such as Meaningful Use to the everyday functioning of code calls in your hospital, more and more projects are dividing your time and attention. And beyond being a specialist in your individual field, you are now expected to be equal parts technology expert, business executive, and social psychologist.1

In an EMR world, the work of technology leaders in healthcare has become further complicated by the question of how to bring multiple systems and information pathways together for simplified workflows that support faster, more efficient, and safer patient care. Charles Christian, CIO at St. Francis Hospital in Columbus, Ga., noted that he is now involved in most operational meetings at his organization, not to discuss technology, but to discuss process. “We are now starting to use technology to create operational excellence, whereas before we were just putting in applications."2 And Ed Marx, Former CIO at Texas Health Resources in Arlington, said that with the digitization of information, technology now infiltrates nearly everything. “We put in these systems. How do we

optimize our investment? How do we make sure everything is integrated?”2

This expanded view of technology as an integral part of the overall care delivery system creates a whole new level of demand on high-level

technology experts. So how are some of the top healthcare IT leaders navigating this changing landscape? In this eBrief, we explore some of the ways experienced healthcare IT experts prioritize projects, the skills they employ to be successful, and some of their tips to stay afloat. Then we offer an enterprise-wide communication example that applies these skills.

INTRODUCTION

“We are now starting to use technology to create operational excellence, whereas before we were just putting in applications.”Charles Christian CIO at St. Francis Hospital

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Whether the projects on your plate are about workflow efficiencies, access to information, or meeting government initiatives, prioritizing them can be tricky because they’re all important. Ed Marx (former Texas Health Resources CIO) tries to sort the pile by distinguishing between the things that are strategic and those that are distracting. “I always make sure that whatever I focus on is really aligned with where our organization is headed. And that eliminates a lot of things that I'd spend my time doing that don't necessarily add value."2

Marx is not alone. Many CIOs are now tasked with supporting strategic initiatives that leverage technology throughout a health system.3 A common driver of these system priorities is cost savings. Although traditionally strictly within the purview of the CEO and CFO, IT leaders are also becoming key players in the finance realm as healthcare becomes increasingly technology reliant.4 The most successful of these are no longer just tech experts, they

are also business leaders who work closely with the full executive team to develop technology strategies that support the entire

organization.5 In the 26th Annual HIMSS Leadership Survey, 85 percent of respondents identified ‘sustain financial viability’ as a top business objective right behind ‘improve patient care/quality of care’ at 87 percent.6

Another way IT leaders prioritize work is to focus on outcomes. For example, Stanford’s clinical informatics fellowship program

is about more than just helping medical professionals

with a penchant for computers; it’s about driving improved

healthcare delivery outcomes. The mission of the program is to train the next generation of healthcare leaders in the skill of informatics so they can approach healthcare with a macroscopic view of technology that supports patient care and clinical decision-making. By nurturing the big picture, Stanford hopes to bring positive change to the value of care across the U.S., and produce enhanced analytics to support population health management.7

PRIORITIZATION

“I always make sure that whatever I focus on is really aligned with where our organization is headed. And that eliminates a lot of things that I'd spend my time doing that don't necessarily add value.”Ed Marx Former CIO at Texas Health Resources

Leaders identify 'sustain financial viability' as a top objective-2015 HIMSS Leadership Survey6

85%

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IT roles are shifting from project implementers to full collaborators. Charles Christian (St. Francis Hospital) aptly identified that his role is now very much process focused, and the sentiment is mirrored by other IT leaders in the industry. Dr. David Levin, who was CMIO at the Cleveland Clinic Health organization from 2011 through 2014 (and is now a founder, partner, and consultant at Amati Health, a consulting firm in Virginia) admits that the last several years have largely been about implementation. However, he sees the future for CMIOs as being “about performance management, about envisioning a better future and

achieving better performance.”8

Along with this shift to strategic planner in support of larger goals comes the need for specialized skills. Among these skills, said Dr. George Reynolds, retired CIO and CMIO of Children’s Hospital Medical Center in Omaha, Neb., are interest, passion, and enthusiasm. And the most important competency he identified for these emerging leaders: building team trust. “Have you ever noticed that there are an awful lot of intensivists in informatics? …Both of these specialties are team-based specialties—you care for patients as part of a team—and you know how to lead

a team.” For people trained in clinical practice going into CIO, CMIO, or CHIO roles: “They should know how to develop a team, build consensus, and establish relationships of trust.”9

And Dr. John Halamka, CIO at Harvard Medical School, believes in the need for innovation to be part of a CIO’s routine. In fact, a Harvard survey found that 57 percent of technology and business leaders see IT as an investment that drives not only growth, but also

innovation.10 Halamka argues that IT leaders need to adopt the long

view and not only look at the needs of today, but also ask “what innovations we’ll need in the next few years, which will enhance productivity, and possibly serve as generalizable tools, reducing the number of requests for niche systems.” He also noted that where there is a choice to build innovation versus buy it, “If practical, we should procure these services from… service providers.”11

THE SKILL SET

“You care for patients as part of a team. [You]should know how to develop a team, build consensus, and establish relationships of trust.”Dr. George ReynoldsRetired CIO and CMIO at Children’s Hospital Medical Center

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Time is a finite resource. Some of the top leaders in the field of healthcare technology keep from sinking under the volume of projects by networking with industry peers to help save valuable time. Many top IT executives are also conscious of the risk of burnout and make an effort to balance work and home lives.

Pat Skarulis, CIO at Memorial Sloan Kettering Cancer Center in New York, is an advocate of preserving some open time every week to allow for reflection and the opportunity for unscheduled discussions with colleagues about new ideas. "You have to learn how to work smarter; you have to learn how to acquire information in better ways." And another key part of being a great problem solver? Being active in a network of peers. "We ask questions of each other. ‘What are you doing about this?' You'll get responses back from everybody. Those kind of sources will save you enormous amounts of time."12

At the University of Michigan Hospitals and Health Centers in Ann Arbor, CIO Sue Schade is also focused on networking and time-savings.13,14 She encourages her staff to apply lean concepts15 and eliminate some meetings, or at least reduce the time devoted to them so they can spend a larger portion of their day focused and efficient.16 And Schade is a big supporter of finding the right work-life balance.17

Another method to help technology specialists stay afloat is to find a sustainable work-life balance. Breaks from work provide a mind refresh

to see a problem from a different angle, as well as the ability to work more efficiently with greater focus. Another reason healthcare IT leaders need to balance their work and home lives? The job is a marathon, not a sprint. Tim Zoph, who spent more than 20 years as CIO at Northwestern Memorial Hospital in Chicago managing an IT team of 300 people, is conscious of the risk of burnout. He has taught CHIME’s CIO Boot Camp twice annually for a decade and emphasizes work-life balance as a key ingredient in a successful IT

career. "It's important…to step away from work as your sole purpose in life…You are a better leader and more productive person."18

STAYING AFLOAT

“It's important…to step away from work as your sole purpose in life…You are a better leader and more productive person.”Tim Zoph Former CIO at Northwestern Memorial Hospital

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Dr. Robert Wachter, an instructor and practitioner of internal medicine at the University of California Medical Center, understands the other side of technology – the side of the users. These are the people who tech leaders must influence to adopt new technologies. But an important thing to keep in mind, Watcher observed, is that while technology has gotten better and better, people don’t always like the changes. Why? Because workflows need to be reimagined in tandem with IT advancements. “You are actually transforming the nature of the work, and if you’re trying to get it right, you need to think pretty deep about the process.19

One of the largest contributors to clinical workflows over the past 10 years has been the advance in mobile technology. Smartphones and tablets give users access to email, patient records, test results, and important reference applications—all information that was previously accessed through books or computers in static locations. By using these functions at any given moment, providers are trimming time from their work that was previously spent searching for a phone or a computer. But there is still a need for improvement.

The Joint Commission published a Sentinel Event Alert in March 2015 about the use of health information technology (health IT) in hospitals. An analysis of the reported sentinel events between Jan. 1, 2010 and June 30, 2013 identified workflow and communication as leading contributing factors. Twenty-four percent of the reported cases related to issues with health IT’s support of communication and teamwork.20

Communication is vital for a care team, and many IT leaders are looking at ways to enhance mobile workflows even further. Returning for a moment to the evolving role of IT leaders, consider the system-wide nature of communication. Beyond texting and phone calls, there is a strategic opportunity to break free of silos and bring more information to the fingertips of personnel throughout the enterprise.

Consider all of the people involved in a patient’s journey through a hospital. Housekeepers prepare the room before a patient can be admitted. Transport staff move the patient. Nurses, physicians, and specialists provide direct care and treatment planning. Technicians administer tests, which are interpreted by pathologists, radiologists, and others. Nutrition services provides meals, conscious of allergies and restrictions. Pharmacists dispense medication. And there are so many other areas that may be called upon, such as the blood bank, infection control, rehabilitation, and any number of on-call staff.

An IT leader might look at all of these seemingly disparate workflows and recognize that they share a common thread: They all rely on relevant information being communicated to the appropriate staff, at the right time. From providers securely texting one another to consult on a treatment plan, to a housekeeper receiving notice that a room is ready to be prepared for an admittance, the timely transfer of information is key to efficiently handling all aspects of the patient journey. By seeing the commonalities and assessing not just the technology, but also the workflows, an IT leader can search

for solutions that support the goal of efficient communications now and into the future.

AN ENTERPRISE-WIDE EXAMPLE: COMMUNICATION

VIDEO This video shows how effective communications can support an entire care team throughout the patient journey.

Sentinel events related to issues with IT support for communication and teamwork-The Joint Commission20

24%

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Technology is taking center stage in key hospital initiatives. Seventy-four percent of healthcare executives said they could credit IT with helping them achieve success in care coordination, and 69 percent said it was helping them with primary care provider efficiency.21 But being a successful healthcare IT leader demands more than a penchant for technology. Here is a summary of what we’ve learned are essential requirements, gathered from top leaders in the field today.

SUMMARY

Prioritizing Projects

• Distinguish strategic initiatives from distracting ones

• Identify cost-saving initiatives

• Focus on projects that improve care delivery outcomes

The Skills

• Employ strategic thinking and planning

• Develop a team and establish relationships with trust

• Plan for the long term with investments that allow for growth and future innovation

Staying on Top of the Pile

• Network with peers to exchange ideas and save time not reinventing the wheel

• Cut unnecessary distractions and spend more time focused on solving problems

• Find a sustainable work-life balance to prevent burnout

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