Mayo's approach to patient data management, security and digital health: Key thoughts from CIO Cris Ross

During his time as CIO of Mayo Clinic, Cris Ross has transformed the Rochester, Minn.-based health system's IT strategy and led a systemwide medical record conversion program.

In September, Mayo Clinic announced a 10-year partnership with Google to provide the health system with technological support including cloud computing, data analytics and artificial intelligence. The partners aim to expand Mayo's virtual care, data-driven research and precision health initiatives through an innovative approach to solving the big problems in healthcare.

The health system will transition its EHR to Google Cloud, but all data will be kept securely within the system. Here, Mr. Ross discusses patient data management, security and what's ahead for Mayo Clinic's digital health initiatives.

Question: Over the past few years, Mayo Clinic has made great strides in gathering patient feedback and becoming more efficient with automation in the rounding process. How do you track return on investment for these types of initiatives and continue to refine?

Criss Ross: As a nonprofit organization, Mayo Clinic will use any revenue it receives to support its not-for-profit mission in patient care, education and research. We have measured ROI of our large Epic EHR implementation and were pleased with the results. But as we look forward, we are thinking about how to extend hope and healing to more people in new ways.

Q: From a workforce management standpoint, how do you integrate new patient experience technologies?

CR: We've been pretty successful with the Mayo Clinic Patient App, with has more than a million users and offers good statistics around patient engagement and use. We have introduced some 'interactive care plans' that help with pre- and post-physical care, cancer survivorship tools, and created a platform for an online community where people can share experiences and find support from others who were in similar situations, or take in educational events. In almost every one of these offerings, there are ways for patients to communicate directly with clinicians, which creates some new opportunities and some extra work for clinicians. So, we must work on making all of it efficient.

Q: What types of technologies are most useful to the patient experience and what comes across your desk that isn't worth the investment?

CR: With respect to what is worthwhile, I think it's relatively simple: a patient experience technology is only useful if it measurably improves clinical outcomes and/or consumer experiences. There's a lot we can do to improve our digital front and back doors and create a seamless experience for our patients. But you know, some technologies just don't resonate with patients, or clinicians find that they don't improve outcomes. I've got a bunch of apps on my phone that I use constantly. Some others I used for a while, and then found they weren't as important to me anymore. Healthcare will be judged by consumers in the same ways.

Q: How do you see the digital health landscape evolving and what will Mayo Clinic's role be?

CR: We think the potential of digital health is enormous, and we are on a cusp of digital revolution in healthcare. Our analysis of the market sees a couple of trends and forces which inform our work. We think the capability of accurate diagnosis anywhere, anytime is arriving. We believe consumerism will continue to advance in healthcare as people want seamless and convenient care. We believe virtual interactions will become increasingly common. We know that research, education and collaborations accelerate cures. And we think that old business models will become obsolete.

Our role has been a world class patient care, research and education institution. Our additional emerging role is to become a healthcare platform company in which we will connect innovative solutions with patient needs. Solutions will come from many places, including outside Mayo Clinic, so we will work with partners on these transformative new models. As a result, we will be able to reach many more patients around the world than we are able to treat in our destination medical centers. We want to be a leader in the provision of digital health and believe that the best way to do this is to disrupt traditional markets and processes.

Q: Mayo has worked with Google, Amazon and other big tech companies to improve healthcare. What are the benefits and challenges of being on the cutting-edge of digital health?

CR: You could look at any of these trends and forces and see both benefits and challenges. We work with several technology companies, but our primary relationship is with Google, which we announced in September. We will do two main things with Google. First, we will use the Google Cloud as a host for the Mayo Clinic Cloud Platform, which will contain copies of all our data, controlled by Mayo Clinic and used only by Mayo Clinic. Second, we will collaborate with Google in the development of new healthcare solutions. Both of our organizations have published research in the application of machine learning and AI to radiology, cardiology and many other areas of medicine. We will collaborate to accelerate that work.

Q: How are you protecting patient information and data as technology becomes more integrated in healthcare delivery and improving the patient experience?

CR: We are pursuing two goals.

First, we know that more data drives more cures. One of our pioneering physicians, Dr. Henry Plummer, is credited with being one of the originators of the modern medical record. Instead of private notes kept by individual physicians, Dr. Plummer and his collaborators had the insight in the 1910s that medical records kept in a systematic way could help physicians collaborate but also support research. So, we're continuing what we and other leading academic centers have been doing for more than a century. We're doing it now with the power of modern data management and data analysis tools that let us discover remarkable things.

Second, we need to maintain the security and privacy of patient data. We have invested a lot in security, and we also feel confident that using the Google Cloud for data storage makes our data even more secure. Privacy needs to be patient-directed. Many people get their care from multiple care organizations. Most care organizations depend on specialized outside organizations to provide services critical to patient care. So, to receive the kind of care patients expect from us and other healthcare organizations, data is needed for collaboration on behalf of the patient.

We have well-established and painstaking processes for governing and managing data, supported by strong technical and operational controls. We depend on these processes and controls to help us meet both of our goals.

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