'Think, build and run': 4 IT leaders discuss the future of the industry

At the Becker's Hospital Review Annual CIO/HIT + Revenue Cycle Summit in Chicago, leaders from Allscripts, CHRISTUS, Capella and Cadence discussed their top priorities and shared some advice for colleagues.

Led by Scott Becker, JD, CPA, publisher of Becker's Healthcare, the panel included Paul Black, president and CEO of Allscripts; Luke Webster, MD, vice president and CMIO of Irving, Texas-based CHRISTUS Health; Alan Smith, senior vice president and CIO of Franklin, Tenn.-based Capella Healthcare; and Dan Kinsella, executive vice president and CIO of Winfield, Ill.-based Cadence Health.

Where IT leaders spend most of their time

At Capella Healthcare, one of Mr. Smith's priorities is integrating — or sometimes eliminating — the IT systems of newly acquired hospitals. This is a common question for the health system, which is currently contemplating two to four more acquisitions.

"Do you go in there and 'rip and replace' each time [you acquire another hospital]?" Mr. Smith asked. He said the for-profit system is working with a hospital that went live with its EMR system two months ago. "Are you really going to take them off what they have?" Mr. Smith said. "It's incredibly disruptive to put in an EMR. It's not just the IT costs. There are a lot of discussions around training [costs, as well]."

Like Mr. Smith, Mr. Kinsella is also spending time building strategies that drive all IT decisions and processes. Cadence Health is working around its merger with Chicago-based Northwestern Medicine, which closed in September 2014. "I always think about the work in IT as 'think, build and run,'" he said. "When I have the choice, I try to focus on the 'think' work, interpreting the strategy and making sure we have repeatable, stable processes for the rest of IT."

On the vendor side, Mr. Black said Allscripts is working on how its EMR systems can become more interoperable. "From an architectural standpoint, it's difficult to rip everything that's old out and put something new in. Even if you do that with one brand, you still need to have connectivity with a [hospital's] affiliated entities. That is something we need to focus on — structure and architecture in a connected community."

Talent development and retention
Dr. Webster said one of his biggest priorities is developing the skills and people on the health system's IT team to meet the challenges associated with implementing and integrating different EMRs.

"Informatics at CHRISTUS is still in its infancy," said Dr. Webster. "Learning this consumes a lot of time."

As IT professionals become experts in certain EMR systems, it is possible they will be "Cerner people," "Epic people" or "Allscripts people" for years to come. While some IT workers may find this frustrating and restrictive, others will see the demand for their expertise as positive, Dr. Webster said.

Talent recruitment and retention will continue to grow in importance in the future. In the past, hospital and health systems' IT departments directed recruitment efforts at people with deep technological and informatics knowledge and experience, but this focus is broadening. Instead of solely seeking candidates with technological experience, Dr. Webster said CHRISTUS looks for employees who understand people and processes.

What's more, finding talent is it's own challenge, as location often determines the talent pool. For example, Dr. Webster said recruiting is easier in highly populated cities like Dallas or San Antonio, while it is much more challenging for hospitals and health systems in smaller communities and rural areas.

Big data and analytics
Another health IT "hot topic," as Mr. Kinsella called them, is data analytics. "There's a lot of high-powered analytic products out there that dice and slice and do juliennes, and they overlook that challenge of data rendering, which is getting data from all the disparate sources. That's the big pothole on the road to nirvana."

Providers often find the way EMRs present patient information as overwhelming and frustrating. According to Mr. Black, basic interactions with EMRs inhibit physicians as they seek the necessary information to inform clinical decisions.

"A physician clicks on a patient's tab [in the EMR] and gets 'shouted at,'" said Mr. Black. "They get all of the patient's information since birth — not what's relevant to what a physician wants at that moment. Physicians want to get in and out very quickly, without having to log in and out from every system."

Best advice

Given their cumulated years of professional expertise, these health IT leaders shared pieces of advice for other healthcare leaders.

According to Dr. Webster, it is very difficult to deliver on the various IT-related functions and capabilities required to prosper in the future. He suggests investing in building intellectual capacity in both people and technology.

Similarly, Mr. Smith said a good investment in people, coupled with flexibility, is key. "Flexibility in mindset which is also flexibility in tools," he said. "I don't think the pace of change is going to get harder — it's going to get more complex. With that, you've got to think about your people. If you don't have good teams, the rest of the strategy doesn't really matter."

Overall, healthcare technology is a vehicle to improve the patient care — both quality and experience, which Mr. Kinsella said should be the focal point for organizations when considering investments.

"I've been in this industry for as long as I've been because technology in healthcare only makes a difference to the extent it enables those who take care of our patients," he said. "IT therefore is an indispensable enabler of key capabilities in our enterprise that can really make a difference. If you're looking for value, really understand your company's position, their strategy."

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