How the CIO role is evolving

A healthcare leader explains why the CIO role is changing for the better.

Joel Klein, MD, is the senior vice president and chief information officer at the Baltimore-based University of Maryland Medical System. 

Dr. Klein will serve on the panel "How Will Big Tech and Wall Street Affect Healthcare?" at Becker's 7th Annual Health IT + Revenue Cycle Conference. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place Oct. 4-7 in Chicago. 

To learn more and register, click here

Joel Klein, MD, is the senior vice president and chief information officer at the Baltimore-based University of Maryland Medical System. 

Dr. Klein will serve on the panel "How Will Big Tech and Wall Street Affect Healthcare?" at Becker's 7th Annual Health IT + Revenue Cycle Conference. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place Oct. 4-7 in Chicago. 

To learn more and register, click here.

Question: What are you most excited about right now? 

Dr. Joel Klein: Now that our health system is on one integrated EMR, we have begun a large, board-backed digital health initiative to build out and fully deploy all the patient-facing digital tools and features that patients and their families expect. This means a consistent experience in all clinical sites for patients to learn about our different available providers, select the right one for them, get an appointment, and check in on their phones, computer or tablet. There are a ton of nuances in some practices, and working through these will take some time, but in the end, it will be as easy as getting a plane ticket and checking in for a flight based on our first several hundred providers already live. We are told that much less than 10 percent of appointments are made online nationally, which blows my mind. We think when we are done, we will be way higher, our patients will love it, and our staff will be freed up to take care of more serious and complex work.

Q: What challenges do you anticipate over the next two years? 

JK: Where to begin! We have to stay the course on our security journey, which will require a lot of fiscal discipline and institutional focus. We have to figure out how to manage vendors on whose ecosystems we risk dependence and find ways to prioritize our work. This last issue is probably going to be the hardest. Now that we have fewer all-of-system efforts around COVID-19, many complex projects held in abeyance for several years are coming forward. Most of them are really good ideas and have lots of potential, but they can't all be done simultaneously. Even though my organization has a fairly robust IT governance process, it is still a challenge to sort through what can be dozens of competing ideas and figure out how to lay them rationally into a schedule that works well enough for everyone. Finally, we have to communicate well about all these decisions. Nurses, doctors, and other caregivers around the country are exhausted, and we owe it to them to keep them informed about how we are trying to make their lives easier and simpler. Getting a consistent message to a diverse workforce of students, voluntary medical staff members, contractors, faculty, board members and employees can be tricky. Still, we must search for new and better ways to do that.

Q: Where are the best opportunities for disruption in healthcare today?

JK: My experience as a hospital-based doctor (emergency medicine) for many years tells me that we can walk through any hospital in the country and find lots of patients who have recovered enough from their initial hospitalizing condition to move on — to a skilled nursing facility, to rehab, or their home with varying degrees of support. But on any given day, those patients will stay another day in an overly medicalized, costly hospital environment because of one little thing that stopped their progress. I believe a critical way to unlock our capacity is to find the one thing preventing a patient from leaving — a key conversation, an insurance approval, a home infusion setup, transportation arrangements, a lost laboratory result, or a signoff from a specialist. This is the "for want of a nail" problem — all we have to do is find one little thing that could let a patient move forward, and IT is uniquely positioned to work on this issue. If we made progress here, we could start to decompress our nursing staff, our emergency departments, and truly our entire system so everyone could start to take a breath.

Q: How is your role as a CMIO evolving? How are IT teams changing?

JK: I actually love what is happening with my role, which puts our teams and me more and more front and center with so many parts of our organization. Once you earn the trust of your organization, then you are asked to help design solutions and be part of the design or redesign process on the front end, rather than brought in after the fact; the latter does still happen but much less often than it used to. This change means we end up being involved with almost everything, which in turn means our days are never the same and the challenge of diversity keeps climbing. I think many of us in IT welcome this evolution, but those who prefer to stay isolated from the clinical or business front lines will struggle more and more. It's not that our server operators or security engineers need to spend a bunch of time themselves on a patient floor. Still, they need to understand and embrace their direct connectedness to the mission of our organization and its people. It's the flexible thinking, responsiveness and excitement at being close to really helping our community that is changing most with our teams.

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