Why standards for IT system interoperability need to change: Q&A with Arnot Health CIO

Craig Wilhelm, CIO at Elmira, N.Y.-based Arnot Health, discusses the balance between innovation and financial stability as well as what he considers to be the most vulnerable part of a hospital's business.

Responses have been lightly edited for clarity and length.

Question: How do you promote innovation within your organization?

Craig Wilhelm: Although we are a small and somewhat rural health system, we have an innovation officer who also serves as the leader of our quality care programs. So, our mindset around IT innovation is infused with an emphasis on patient safety and quality of care using telehealth technology. For us, innovation must also consider the financial stability of the organization as we look to grow our business and reduce our costs. We must continue to find creative ways to better integrate our healthcare information and activities while lowering our costs. This often requires a level of innovation that is not in the playbook of larger organizations who aren't facing the same financial challenges.

Q: What is one thing you've learned about your patient population that's really surprised you?

CW: We are the main provider of behavioral health services for our region of New York state. This includes psychiatric care, along with treatment for both drug and alcohol dependency. What has surprised me the most is the number of children and teens who suffer from substance abuse and mental health issues. We also have the region's only neonatal intensive care unit, which provides lifesaving care to the newborns, including a growing number who have inherited the effects of substance abuse such as opiates, cocaine and alcohol.

Q: What do you see as the most vulnerable part of a hospital's business?

CW: As a CIO, I view the threat of either a large data breach or cybersecurity event, such as a ransomware attack, as an area of vulnerability for any healthcare organization. Either type of event would have a lasting financial and reputational impact on a healthcare organization. Hospitals need both the staff and technological resources to ensure their systems are always up, running and secured. In today's environment, that's a challenge, and it can put patient care in danger. Older technological infrastructure, lack of IT security resources and the proliferation of many new internet-connected medical devices are contributing to this vulnerability.

Q: What's one conviction in healthcare that needs to be challenged?

CW: Achieving IT system interoperability is an essential component for demonstrating EHR meaningful use toward patient care. While I totally support the need for better interoperability, the meaningful use criteria are becoming more difficult to achieve in organizations that can't afford an integrated EHR. Hospitals and health systems often purchase software products from more than one EHR vendor to meet the organization's unique needs within certain fiscal criteria. This often makes achieving interoperability within one organization very difficult, let alone on a regional and national stage. I'm discovering that many of our clinical system vendors have not dedicated the time and talent needed to achieve the standards around interoperability. Our government must find new and creative ways to incentivize these vendors as well as the healthcare providers who purchase their EHR products.

To learn more about clinical informatics and health IT, register for the Becker's Hospital Review 2nd Annual Health IT + Clinical Leadership Conference May 2-4, 2019 in Chicago. Click here to learn more and register.

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