Life of a healthcare CIO: Walnut Hill Medical Center's Aaron Miri
In collaboration with CHIME, Becker's Hospital Review's "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 Akanksha Jayanthi (firstname.lastname@example.org).
An interview with Aaron Miri, CIO of Walnut Hill Medical Center in Dallas.
(Note: Interview has been edited for length and clarity).
Question: Walnut Hill Med Center opened in April 2014, and you came onboard in February 2015, though your health IT career extends back to 2005. How has the health IT industry changed during that time?
Aaron Miri: The best way to describe that is in the early 2000s, what I remember most about healthcare IT is it was struggling to find a relevance in the executive leadership teamand was viewed as more about the cost of doing business. It has changed to be, as in the case with Walnut Hill, a strategic pillar that healthcare strives on. Now, other voices around the board table look to IT to help them achieve their goals.
Q: Forbes called your hospital "the hospital that Steve Jobs would have built." How do you or the hospital interpret this nickname/analysis? What does it mean to the organization?
AM: Walnut Hill was built around the premise of patient first, everything else second. It's about a rich patient experience, so much so that we have drawn concepts from widely disparate sources such as the hospitality and retail industries. One example is the creation of an incredibly friendly environment by following the "15 and 5 rule," in which eye contact is made along with a smile at 15 feet and the patient is greeted at 5 feet. Another core practice is taking Apple's "Five Steps of Service," used to enormous effect in their retail stores, and applying them to every interaction that every staff member has with every person who enters the hospital.
Customer service is the core of what we do. Our Healthstream HCAHPS scores show that. Technology is a catalyst of that customer service experience. We have fully integrated televisions in each of our rooms that the patient can interact with, and we can prescribe educational videos to the patients about their procedure. We can do a whole lot of various tech items built around enabling the patient as part of their care plan.
We take [Forbes' nickname] very seriously. One of the core reasons I came to Walnut Hill is because tech is the enabler for the 21st century patients and because of the servant-based culture derived from our leadership team. From the fantastic executive and physician leadership on down to the front line staff nurses and team members; each one of the employees are stewards working hard for the patients we serve. Those hospitals that get that servant-based culture are able to leverage technology appropriately to help the patient become part of their own care plan, to get better in their homes and monitor away from the hospital — those are the health institutions that will succeed in the 21st century with the patients of tomorrow
Q: As a new hospital, what do you see is the biggest area for potential and growth at Walnut Hill? What do you hope to capitalize on given this blank slate?
AM: We are able to define and build the road the way we want to. I've been in legacy health systems my whole career, and it's a wonderful thing. But sometimes changing 100 years of history is a lot more difficult than building the road for a very first time. It's amazing the kind of innovation you come up with when you don't have to say, "We've always done it this way." You can say, "We've never done it before, so let's do it the right way to begin with." We have [the opportunity] with clinicians, physicians and leaders to think about, how do we want to achieve this goal? How do we want to do this right? What lessons do we want to use from other places to apply here? It's an opportunity of a lifetime. Dallas, Texas, did not need another hospital. What it needed was the hospital of the future that cared about the patient, where everything else is secondary. That's what we've built here and are succeeding with. It's a beautiful thing to be a part of.
Q: What is the biggest challenge you're facing right now?
AM: In addition to growing a hospital, which is exploding at the seams with volume and our customer satisfaction scores, it's the regulatory landscape that's changing around us. Now you have proposed modifications to meaningful use stage 2, meaningful use stage 3 rules are out there and you've got ICD-10 that is happening Oct. 1. We are starting a new business that is incredibly successful and introducing a lot of change to clinicians who are already going through a lot of change because they're in a new environment and learning new technology. Here's one more thing on their plate. How do you keep clinicians who are already busy and successful from getting overwhelmed? Again, that rate of change becomes important. How do you do it in a way that doesn't have resistance so it is not a dictatorship? We have to be partners to the clinicians around the table, otherwise they'll never look to us for guidance.
Q: What is your favorite part of being in the health IT industry?
AM: My favorite part is helping to be a catalyst for innovative care. A CIO can either be somebody that truly gives constructive ideas and brainstorms with the executive leadership, is willing to discuss best clinical practice with physician leadership and truly engage with them, or sadly you can just be a paper pusher and hide in your office with the door shut. Personally, I would much rather participate and help deliver innovative care models. For example, a patient could become septic and you're able to develop care plans and leverage technology to make sure the patient doesn't become septic because you can intervene at an earlier point. This is something we are doing now and it's phenomenal to be a part of. You are part of that process to innovate and do something different.
Q: What is one lesson you've learned that you would like to share with other CIOs?
AM: The biggest lesson: participate. Participate in everything you can. Participate with your staff at the front line; talk with them. Participate in leadership discussions. Participate in legislation. Be part of advocacy. I'm the current vice chair and incoming chair of public policy committee at HIMSS. Advocacy on the Hill in Washington is so important because not only do we need to be change agents and participate locally at our own institution, we must participate in the way our country is developing regulation and legislation because our kids are counting on us doing this right. If we don't participate in every dimension, they will miss out, and that's just unfair. We must participate. We must be engaged.
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