Health IT one year from today: 8 CIO predictions

The pandemic has spurred a major shift in the importance of IT to healthcare organizations and their priorities.

Here, eight hospital and health system CIOs discuss what will be different about health IT one year from today and what will be the same.

Lee Carmen. CIO of University of Iowa Children's Hospital (Iowa City): A year from now I expect health IT will be focusing significant resources on improving support services for a remote workforce that isn't returning to on-premise work activity post-pandemic. These efforts will be trying to use technology to improve communication and collaboration among a geographically dispersed workforce, while also building and supporting organizational culture. Similarly on the care delivery side, health IT will be advancing technology and services to continue the growth of telemedicine, expanding the use of technology to reach patients in their home and enhancing the ability to collect data regarding the conditions in which people live and work that might impact their clinical care.

J.D. Whitlock. CIO of Dayton (Ohio) Children's: One year from now, we will be 10 months into the brave new world of Cures Act interoperability regulations. I expect that app developers will be fully ramped up with offerings to help patients manage their chronic diseases; patients will be requesting FHIR-based access to their EHR data; and provider organizations will be busy enabling that access. It will be a great leap forward in patients' access to their ePHI, and hopefully this enables better care. It may also mean a hot mess for providers that have not prepared well and for patients that share their ePHI with fly-by-night app developers that sell their data and are not beholden to HIPAA. Either way, fasten your seatbelts!

Tara Matthews. CISO and CIO of Einstein Healthcare Network (Philadelphia): The biggest and greatest positive impact coming out of the pandemic is healthcare will finally meet the patients where they are. This has been on roadmaps for years, and only a select few achieved, and only for a small percentage of outcomes. The increase in technology, innovation, regulations and needed culture shift has pushed this initiative over the tipping point. Those on the bleeding edge have forged the way for others, and the spontaneous collaboration efforts forged during this pandemic will lead to mission-focused positive outcomes for everyone.

Randy Davis. CIO of CGH Medical Center (Sterling, Ill.): OK, is everyone ready? Hold on to your seat. My answer is … not much. We deal with change year in and year out, so be honest here, what we face today isn't all that different. We too often try to impress others with how progressive our hospital system is. The truth seldom matches the words. The reasons could take a couple pages to adequately explain, I'll try to summarize:

1) Most hospital systems have invested millions in their primary systems (Meditech, Cerner, Epic). So for 'progressive' changes we, for the most part, have to sit back and wait on these vendors. That's nothing new for us, we've always relied on them.

2). Too many systems react to declining revenue with mandates to cut staff and expenditures. It's hard to try new things and make ourselves more accommodating to patients when budgets are being cut. In such an environment, status quo is just hoped to be maintained.

3). Governmental mandates continue to take wind out of the sails of many IT departments by consuming time. They always have and will continue to do so. Again, not a change from what we have today.

4). Hospitals, left to their own accord, take forever, years at times, to act on good ideas. Too many committees, too many competing interests and silos, too many people unwilling to try new things. It reinforces inertia aside from the typical upgrade cycles.

Movement to the cloud? Old news, nothing different there. 'Tele' initiatives? Despite the hype, once of the easiest things for hospitals to implement, not exactly something to take IT in a different direction.

OK, I'll come up with just one thing here that could fundamentally change the priorities of health IT. That change is the underappreciated consumerism that should finally wash over our industry. Consumers are fed up with inadequate apps and portals, tired of having to actually dial a number to communicate with someone, unable to access records when they move from a CareQuality provider to a Commonwell provider. They want multichannel communication, online form completion, virtual waiting, drop-in video at the bedside for both caregivers and relatives. They can't understand how they can track a package from Washington to Maine, but healthcare can't answer phones and communicate with them to give them the assurances and answers they seek.

Walmart can see when you pull up to a delivery spot and walk out with your order. Healthcare, representing nearly 20 percent of GDP in America, still has people checking in at the front desk. If I had to pick one thing, it would be health IT figuring out how to integrate all the features consumers have wanted for years into the infrastructure of their care-delivery system and do so without dealing with 30 different vendors.

Mark Lauteren. CIO of El Centro (Calif.) Regional Medical Center: One year from now, HIT will have moved on from the day-to-day problems of COVID-19. However, HIT will integrate many of the lessons and innovations we have learned. For example, the use of telehealth will continue to grow with certain populations of our patient base. HIT will bring back many of the projects that were put on hold by the focus on COVID-19.

HIT will be looking for ways to further integrate the advanced analytics implemented to manage during the COVID-19 surges. The use of robotic process automation will continue to grow at a rapid pace as machine learning is applied to more processes within the healthcare continuum of care. Due to the need to track COVID-19 patients, population health outcomes tracking will be expanded significantly. Clinical trials will expand significantly into populations of diverse ethnic backgrounds. This will bring clinical trials to parts of the country that have not had much exposure to them.

This will be a new set of HIT challenges for those organizations that had not been exposed to the HIT needs of clinical trials in the past. With the expanded library of genomic mapped outcomes data, HIT will be pressed to find ways to present more patient genetic-specific and relevant outcomes research to caregivers at the point of care.

John Hendersen. Vice President and CIO of Children's Hospital of Orange County (Orange, Calif.): A year from now, IT organizations that have not been considered a strategic partner in their organization will be viewed in that way, or will have made greater progress toward that type of status in their organization. I believe IT organizations will have the opportunity to lead or co-sponsor enterprise operational initiatives that are not necessarily technology-focused, based on how IT demonstrated its leadership during the pandemic. I think that, depending on how IT leads and transforms service delivery during COVID-19, will position them as individuals that can lead any type of initiative.

I think IT will be expected to be more nimble or agile in terms of technology acquisition and delivery based on what their organizations experienced during the pandemic; however, there may need to be some level setting on this; as it is always easy to be nimble when you have a singular focus like a pandemic. The hard part is continuing to be nimble once the major, unplanned event is over, and that leads to whether your organization takes advantage of the opportunity to fundamentally change its operating model.

Additionally, I think remote work will become a more standard operating model in healthcare, where there has been such wide variation in its adoption, pre-COVID. The addition of tools to enable reserving on-site workspace, various collaboration options, such as virtual whiteboards, virtual ergonomic assessments and methods for remote support, will be in place and provide a tremendous benefit to efficiency and value post-pandemic.

I believe health systems will be forced to rethink their approach to employee engagement and create virtual programs that support not only their remote workforce, but also those that remain on site. Finally, I believe that health systems that have not embraced diversity, equity and inclusion as a core part of their values in a structural way will have to make that transition, as the current climate of social justice that has been supported in such a multicultural and diverse manner will require it.

Ellen Swoger. CIO Applications in the Department of Information Systems at the University of Mississippi Medical Center (Jackson): Based on what's happened this year, I believe there will be an increase in the number of IT staff that will be permanently working from home or remote settings. This will allow health organizations to reduce space requirements and thus expenses for health IT. This new work ecosystem will require newer or more robust project management and communication tools, or better use of the existing tools. We in health IT will need better ways to motivate and manage remote staff.

Amelia Marley. Vice President of Information Services and CIO of Bassett Healthcare Network (Cooperstown, N.Y.): One year from now we will have settled in completely to our teams working remotely in an agile manner to deliver and use digital tools focused on taking care of patients where they live, work and play. It's about friction-free access and patient self-service 24/7. Within the hospital walls, it's about complete and accurate information delivered to a mobile care team, using devices that are pocket size, personal and easy to use. It's all about complete patient and staff safety while creating the best patient experience possible. And we will wonder, why didn't we do this years ago.



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