Budgeting for an IT expansion: Beth Israel Deaconess Care Organization CIO Bill Gillis shares key areas for investment

Jackie Drees -

Bill Gillis, CIO of Beth Israel Deaconess Care Organization in Westwood, Mass., discusses how the health system is allocating its IT budget this year and details plans to expand its population health platform.

Responses have been lightly edited for clarity and length.

Question: What does your health IT budget look like this year? Is it trending up or down over previous years?

Bill Gillis: Our budget is trending up as we further invest in technology that will support our population health programs and our participation in value-based care models.

Q: How are you allocating the budget? What difference is there this year compared to previous years?

BG: For the last few years, our investments have been centered on getting our population health and data analytics platform live and seeded with all our clinical data feeds. We invested in improving the many EMR 'push' data feeds we built in the past by migrating to newer 'pull'-based technologies. The payload from a 'pulled' data set is much richer and less prone to workflow breakdown at the data entry/EMR level.

Now that we've laid that groundwork and built a solid foundation, our focus is on expansion. We plan on implementing additional features, tools and systems to augment the platform, specifically system and technologies that can directly interface using application programming interfaces. For example, we built interfaces with all EMRs used across our network so that we can begin bringing in scheduling data from our various clinical systems. Next, we want to implement a visualization tool with various dashboards to present and communicate real-time data so our providers can use the data to close care gaps and improve care quality.

Another area of focus in 2019 is on training clinician and staff on how to best leverage our population health platform. We also need to work on the presentation of analytics and continuing to refine our processes to develop the workflows that are simple and straight-forward for providers. We've only begun to scratch the surface when it comes to the potential use of data analytics in population health.

Q: What projects are you most excited about for 2019?

BG: I'm excited about building and supporting data-driven population health and clinical programs that directly impact patients and improve the care they receive. One of those projects revolves around enabling providers with access to real-time scheduling data to support proactive care management. For example, our practices will have a daily report pushed to them on their population of diabetic patients that need screenings and see which ones have scheduled appointments in the coming days and weeks to plan how those patients can get what they need. I see this as a critical puzzle piece that has been missing in accountable care.

In a risk-based environment, providers can't be limited to knowing a patient's past or historical data. They need to know what is happening now, to best advise on what may happen in the next week, month or even a year from now. Having access to real-time, network-wide data like scheduling data, regardless of the provider the patient is seeing for care, allows us to develop more holistic, predictive, data-driven strategies that can result in more efficiency and better patient management.

The next project I'm looking forward to working on will be to deploy a desktop module that allows users to view all existing data on an individual patient in an EMR with a single click within the EMR no matter where in the network that data originated in real time.

Q: How does your organization gain physician buy-in when it is implementing a new technology or solution?

BG: This is one of the biggest challenges in health IT. I've learned from years of clinical system implementation that you must engage with the providers. They need to be part of the process right from the beginning, not simply when you're rolling out a solution. Getting that buy-in at the beginning will smooth the road, but you will still have bumps. There will always be naysayers (sic), but if your trajectory is good and you can point them to how the solution aligns with mutual and organizational goals, everyone usually comes around.

One piece of advice is to be sure all your systems are tight and ready for prime time before you get into the field. If your provider loses faith in the system or data at the beginning, it is very difficult to win back their trust. And always make sure the system is fully ready before you go live in the practice setting. Deadlines are usually self-imposed, so it's best to delay a roll out until all the glitches have been fully addressed.

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