10 big ideas in health IT

Technology is playing a big role in healthcare providers' response to the COVID-19 pandemic, from accelerating virtual care and data analytics efforts to supporting remote work and supply tracking efforts.

Now health systems are preparing for continued surges of COVID-19 through the winter months and eventual vaccine distribution. Long term, they are also aiming to continue digital transformation and preparing for a future of technology-enabled care.

Here, 10 executives from hospitals and health systems across the U.S. share their big ideas in health IT.

1. Cris Ross, CIO of Rochester, Minn.-based Mayo Clinic, said in a September podcast that although the health system transitioned to Epic EHR between 2015 and 2018, it will continue to invest in making relevant and usable updates to meet the needs of clinicians. The health system will also invest in IT that doesn't have an immediate payoff, such as investing in information security and becoming a more digital organization. It is also planning on focusing more on artificial intelligence capabilities.

"We've been doing AI at Mayo Clinic for a long time and we always have a couple hundred projects underway, but [our AI factory] will be an opportunity for us to focus all that to one environment with rich data sources and lots of tools, so we are excited about the opening of that," he said.

2. Alistair Erskine, MD, chief digital health officer at Mass General Brigham in Boston outlined how the health system's priorities changed during the pandemic to boost virtual visits and generate real-time dashboards to track supplies and redistribute assets systemwide in a Becker's Healthcare podcast. The pandemic helped the system think through making healthcare services more convenient. The key questions moving forward are: "How do we better tune artificial intelligence in an unbiased way toward all patients we take care of so that we can help with decision making? How do we drive the decision-making going forward, especially in real time, as it was necessary during COVID to be able to get a situational awareness of what is going on when resources are getting tight?"

3. Chris Stenzel, vice president of national business development and innovation at Oakland, Calif.-based Kaiser Permanente, noted in a Becker's Healthcare podcast that the high levels of virtual care reached during the pandemic will likely decline and level off as patients are able to safely reenter the clinical space. However, he doesn't want to lose the gains experienced during the pandemic toward digital transformation and is looking to apply artificial intelligence and machine learning to better use consumer-level equipment that patients can take home to capture biometric information.

"We've done some really interesting things around high-risk pregnancy where for relatively low-cost devices we can monitor high-risk moms from home. For the short term, the opportunity is to implement what we know works and what is affordable and capture the gains in consumer acceptance are our priorities for 2021," he said. "Beyond that, we will continue to add new technologies and explore entirely new ways of thinking about care delivery."

4. Tony Ambrozie, senior vice president and chief digital officer of Baptist Health South Florida in Miami, left his executive position at Walt Disney Co. to join Baptist Health South Florida in October, and he sees many similarities between digital transformation at both organizations. In an interview with Becker's, he noted both have a focus on customers and creating a meaningful experience with digital technology as a foundation to achieving meaningful interactions.

"Technology must work for our customers, not the other way around," he said. "Start with the customer – needs, services, experiences and interactions – and walk back to what the technology needs to be and how it would work and work well. Customer engagement really requires being where the customer is and wants to be."

5. Darren Dworkin, senior vice president of enterprise information services and CIO of Cedars-Sinai in Los Angeles told Becker's in an October interview that the pandemic hasn't halted IT growth. The health system has bolstered its data analytics, cybersecurity, clinical systems and EHR analyst teams to bring on individuals with backgrounds in implementing and optimizing complex tools for healthcare delivery.

"We will continue to invest in many areas as we continue to depend on technology as an enabler to our mission. We will see growth in data analytics, bioinformatics and in particular roles that will deepen our expertise in the visualization of complex information," he said. "Cyber will continue to be an area of growth as we expand our efforts in the face of growing threats. And last but not least, we will see growth in our investment in digital consumer talent as we move faster to expand our patient facing offerings."

6. Eric Yablonka, CIO of Stanford (Calif.) Health Care, said the health system added a new executive role to focus on developing a contemporary architecture to enable initiatives for the health system and school of medicine. The company is developing advanced strategies for data and system interoperability to connect and trade information with other organizations. The health system also added an executive director of the program management office to centralize and develop a new PMO that will drive organization wide value and execute strategic initiatives as well as alignment through best practices in IT governance.

7. Nick Patel, MD, chief digital executive and vice chair for innovation and business affairs at Prisma Health in Greenville, S.C., said during a panel at the Becker's HIT + Revenue Cycle Virtual Event on Oct. 7, "Don't start [new projects] with the technology, start with the deep understanding of the problem you're trying to solve. It has to be patient-centered and provider-driven. One of the top three reasons for burnout for physicians is EHR. And the last thing you want to do is add layers and layers of different technology that is disjointed, disconnected, with multiple logins or multiple places to document all of these different things."

8. Mitch Parker, chief information security officer at Indiana University Health in Indianapolis, said during a panel at the Becker's HIT + Revenue Cycle Virtual Event on Oct. 7 that leaders must be continual and intentional about setting expectations to solve definitive problems when implementing new technologies.

"Instead of saying, 'this is a nice to have,' [think about] what problems are you solving? How are you making it easier for a physician? And do you have CMIOs or physician technology leaders capable of articulating and translating between the clinical world and the technology world?" he said. "My experience has been when you have strong technology leaders in place that are also physicians, it makes your job a lot easier because you focus on what's important with implementing the technology, cutting out the waste and focusing on the customer's needs."

9. Alan Hsiao, MD, vice president and chief medical information officer at Yale New Haven (Conn.) Health, said the health system is using predictive analytics to model patient volume, OR case load and expected admission rate for the length of stay based on patient comorbidities during a panel at the Becker's Health IT + Revenue Cycle Virtual Event on Oct. 9. The data helps project volumes and bed availability, but he wants the health system to move toward prescriptive data and automatic interventions that alert a rapid response team or nurse to evaluate patients as soon as they show signs of becoming sicker.

"We are doing that on a small scale with our teleICU, but really need to do this for all of our patients in all of our beds," he said. "It's definitely a journey to get there, but I think the future in analytics will really help us take much better care of our patients and have computers watching 24/7 for the smallest little changes that might be really significant, but might not be picked up by a human until later."

10. Megan Ranney, MD, director of the Brown-Lifespan Center for Digital Health in Providence, R.I., said the requirement to demonstrate specific return on investment in a short time frame is among the scenarios to shut down creativity. It's a challenge to balance the budget after the first year while also taking the creative risks that could lead to great developments, she said. She also mentioned the lack of interdisciplinary expertise and diversity in experience and perspective as creativity killers on innovation teams. She also touched on necessary logistics to support innovation.

"Innovation does not occur in a vacuum; it occurs because it has a bedrock of great science or great operational expertise or great community partnerships that have set the stage for innovation to happen," she said. "So the third thing that I think can really kill creativity is to expect people to go off and be creative without them having that underlying foundation of preexisting good science or business expertise or work-community partnerships. You really can only build great things if you have some sort of a starting point that's based in reality to go from."

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