Becker's Speaker Series: 4 questions with 4sight Health CEO, David W. Johnson

David W. Johnson serves as CEO for 4sight Health.

On Saturday, September 23, Mr. Johnson will give a presentation at Becker's Hospital Review 3rd 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 September 21 through September 23 in Chicago.

To learn more about the conference and Mr. Johnson's session, click here.

Question: Looking at your IT budget, what is one item or expense that has surprised you in terms of ROI? How so?

Johnson David Headshot

David W. Johnson: The returns on EHR systems have been downright anemic compared to their promise. That’s disappointing because they are essential not only at the point of care but used for important population health functions within and across sites of care. So, what’s going wrong? Healthcare venture capitalist Bill Gurley points out that technology disrupts industries when it solves important problems, but healthcare technologies generally focus first on optimizing revenues over advancing clinical delivery and population health goals. EHRs will achieve their potential when they become truly interoperable and seamlessly integrate into care delivery across the continuum. That’s the path to solving “big problems” in healthcare.

Q: Finding top tech talent is always a challenge. Say a CIO called you up today to ask for an interview question that would distinguish the best candidates from the mid- to low-performers. What question do you suggest he or she ask?

DJ: Health systems understand IT but haven't embraced the disruptive technologies that Silicon Valley companies offer. Technology companies (Google, Microsoft, etc.) don’t understand healthcare. They've lost billions of dollars trying to get health systems to operate on their terms. Tech talent needs to be "bidextrous" in IT and healthcare. I’d advise CIOs to select candidates who understand healthcare and the system’s future state vision. Beyond this, the most important question to ask is how the candidate ensures the intended technology users — clinicians, executives, care managers and patients or consumers — actually adopt the selected applications within appropriately redesigned workflows. Without adoption, there are no results and no ROI.

Q: We spend a lot of timing talking about the exciting innovation modernizing healthcare. It's also helpful to acknowledge what we've let go of. What is one form of technology, one process or one idea that once seemed routine to you but is now endangered if not extinct? What existed in your organization 2-5 years ago but not anymore?

DJ: In the past few years, without technology to produce real-time performance reports, provider quality meetings have become testy and defensive at times. Without holistic patient reporting, patients with many care gaps often received multiple calls or postcards. Sadly, much of the effort to produce suboptimal clinical quality reports and manage disease registries, even with EHRs, was still manual and performed by physicians, nurses and other staff whose expertise and passion is in patient care, not spreadsheets and leaving voicemails.

Progressive health systems that are adopting Lean transformation methodologies expect technology to become, in effect, a member of the care team to help all members work to the "top of their license." Many health systems have redesigned workflows to eliminate waste associated with highly trained staff doing manual work better left to technology, enabling them to move measurably to better outcomes and more joy in practice.

Q: Tell us about the last time you were truly, wildly amazed by technology. What did you see?

DJ: On my way to a MedX conference in Silicon Valley, I shared an Uber with a startup founder who’d developed a virtual-reality device that calmed cancer patients during infusion treatments. Their product was transporting. Putting on the goggles, I found myself swimming with dolphins, meditating and breathing more deeply. I became so immersed, I left my cell phone behind in the Uber, but didn’t care because I was so relaxed. Imagine how helpful that tool will be for cancer patients.

In the non-virtual (aka "real") world, I’m wowed by technologies that advance human decision-making. It's not "people or machines," it's "people and machines." Michael Furdyk terms this DAMM, or “Decisions Almost Made by Machine.” A great example is Zipnosis, a company that triages online patients through decision-tree analytics to guide diagnosis for routine medical conditions. By the time the clinician and patient connect, the diagnosis is 90 percent complete. The clinician validates and prescribes. DAMM makes care delivery more consistent, efficient and effective.

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