Weathering Hurricane Sandy and Other HIT Challenges: Q&A With CIO Kumar Chatani

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Kumar Chatani began serving as senior vice president of information technology and CIO of The Mount Sinai Medical Center in New York City in November 2011. Previously he served as CIO of the northwest region of Kaiser Permanente, based in Portland. Mr. Chatani has more than 30 years of experience in health information technology and business management, including many years of integrated expertise in healthcare, which has been evident during his short tenure with Mount Sinai.

Kumar ChataniIn July, the hospital was recognized by U.S. News & World Report as one of the nation's "Most Connected" Hospitals. Qualifying hospitals have been ranked in the nation as high performing in at least one medical specialty, according to U.S. News & World Report. Hospitals on the list also meet criteria for CMS' meaningful use program and have been recognized by HIMSS Analytics as stage 6 or stage 7 hospitals in their EHR optimization.

Here, Mr. Chatani discusses his first year goals as CIO of Mount Sinai, his preparatory plan for Hurricane Sandy and where Mount Sinai hopes to take its HIT initiatives in 2013.

Question: You began serving The Mount Sinai Medical Center last November. As a new CIO, what were some of your initial goals and focus points?

Kumar Chatani: The transition to Mount Sinai has been exciting. My goals last November were to assess and develop my leadership team, ensure that Mount Sinai had a strong and stable IT infrastructure, and develop a long range plan for IT.

I also wanted to respond to the key internal initiatives on population management and our accountable care organization called Mount Sinai Care.

At the same time, I had to focus on what was occurring in the industry. There are a lot of external trends like cloud computing and mobile devices management. I wanted to take advantage of these drivers.

Q: Infrastructure is critical for a hospital's HIT initiatives. How did you assess the state of Mount Sinai's infrastructure?

KC: We brought in a leading IT vendor to help us look at our data center, power equipment, networks and IT utilities. The vendor reviewed the hospital systems for a month or two and then gave us an assessment of where our gaps were. This gave me a good baseline of where we stood.  We didn't find anything controversial, but it was good to have an outside point of view. As a result of the assessment, we made specific investments to optimize our infrastructure.

Q: Mount Sinai recently weathered Hurricane Sandy, which had some unexpected consequences for hospitals in New York City. How did Mount Sinai prepare for Sandy?

KC: The IT department was ready for Hurricane Sandy because we had two days of warning. After Hurricane Irene in 2011, Mount Sinai began methodically preparing for another natural disaster situation. Our CEO leads a risk management committee that looks at the medical center’s risk from all angles, so our hospital is very focused on potential threats.  

From an IT perspective specifically, we have built significant redundancy into our systems. We have a disaster recovery site in New Jersey through SunGard, as well as other off-site redundancies. The hospital also has multiple incoming links for the phone infrastructure. When a switch downtown took a hit, we lost 500 lines, but because we had another 15,000 lines coming in from a different part of the city, we were able to continue operating our phone service. We planned our phone redundancy so that when a problem occurred, we only lost a portion of the phone lines.  

Overall, all hospitals and IT departments have to think methodically about disaster preparation. Where are the points of failure? How can one accommodate and compensate for those?

IT disaster preparedness involves a lot of hard work and a little bit of luck, but as they say, luck favors the prepared. Whether you are in New York City or California, you have to be ready for disasters.

Q: Looking toward 2013, what are you hoping to achieve in the IT space for Mount Sinai?

KC: One major thing we are focusing on is big data. We are using our expertise to look at our electronic medical records to perform macro analysis and discover new solutions. The medical center has rich EMR data, so we can mine this data and identify patterns. In fact, Mount Sinai's Biobank and BioMe stores de-identified EMR information on more than 21,000 patients.

Mount Sinai's Biobank stores de-identified EMR information on more than 21,000 patients that are used to build mathematical models aimed at understanding the dynamics of disease at cellular and population levels. Physicians have access to this genetic information that can better help them development treatment plans.

The medical center has made a huge investment and set up a super computer next to our primary data center. We have made the data warehouse and clinical records available to our researchers and other talented experts, so they can create algorithms to analyze the data and start solving problems. We will need this type of information going forward as population health management and coordination of care becomes increasingly crucial.

Q: What are your biggest challenges as CIO of The Mount Sinai Medical Center?

KC: I'm sure everyone else says the same for challenges. A big one is acquiring and retaining the right talent. New York is a competitive marketplace to recruit within.

It is also challenging to keep up with emerging technologies like cloud computing and mobile devices. However, we have to stay on top of such trends so we can leverage the right technology and become more efficient.

Finally, I think a challenge for the industry as a whole is developing advanced data analytics tools. The industry is not mature yet. We have to invent new tools or adapt the ones we have, making them applicable for healthcare. Being able to develop the right toolkit to answer the right questions is a creative exercise.

Q: What are some best practices you've learned in your experience as a healthcare CIO?

KC: Having just gone through Hurricane Sandy, I recommend an intense focus on disaster recovery and readiness.

Another thing I've learned is to go beyond the EMR and think of big data. How can we leverage our IT foundation with all the potential richness of the EMR? How can we improve decision making?  We have the foundation. Now we have to go to the next level of analytics. This is going to be the key to leveraging our massive investment in EMRs.

The third thing I've learned is to continuously develop a culture of innovation and improvement. Pushing your team to innovate and constantly improve their quality and delivery is crucial.

Q: What is the best piece of advice you have received?


KC: I attended a conference a while back and Benjamin Zander, the author of "The Art of Possibility" was speaking. He spoke about a few rules to bring creativity into everyday life, and I liked his rule number six — don't take yourself so seriously.  He advised us to keep our sense of humor and lighten up. This advice is good for me to remember because IT can be very stressful at times. It is important to maintain my perspective and humor in this business.

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