City of Hope's chief digital officer on crafting a strategy that avoids 'digitization for the sake of digitization'

While the chief digital officer position has been around in other industries for quite some time, only recently have hospitals and health systems begun to make room among their C-level leadership for the role.

In general, the CDO differs from other technology-focused executives — the CIO, CTO and chief innovation officer, to name a few — in that they are typically tasked with spearheading the organization's overall digital transformation and strategy, rather than overseeing the actual deployment of individual tech initiatives.

At City of Hope National Medical Center, Mark Hulse, MSN, does exactly that, coordinating the efforts of the technology, analytics and digital health teams to advance the Duarte, Calif.-based organization's digital strategy. The ultimate goal, as in every other aspect of healthcare leadership, is to use that digitization to improve outcomes and the patient experience.

Here, Mr. Hulse explains how the digital transformation he has implemented since being appointed to the role in early 2018 is not merely about bringing City of Hope into the digital age, but rather part of a much larger effort to achieve the center's goals of rapidly advancing cancer care and research.

Editor's note: Responses have been lightly edited for clarity and length.

Question: As City of Hope's first chief digital officer, how have you come to define the role over the past year and a half? How does this role compare to your past positions?

Mark Hulse: We had a fairly comprehensive job description developed as I started in the role at City of Hope, so there was clarity both around the broad responsibilities of the role, as well as the teams and departments that would report to me, including IT, informatics and analytics and business intelligence. From the beginning, the charge was to develop and lead an overall digital transformation strategy for City of Hope and align our technology, analytics and digital health resources to deliver on that strategy.

As with my prior roles as CIO, leadership around the most impactful use of data and emerging technology is a key component of the role. However, the chief digital officer has the added responsibility of promoting a digital transformation culture, which involves a particular lens in how we see ourselves as an enterprise.

Q: How have your priorities shifted since you first started as CDO? What is your main focus now?

MH: City of Hope has made a commitment to advancing precision medicine, which is tailoring the medical treatment around the individual characteristics of each patient. It shifts the clinical treatment paradigm from a one-size-fits-all approach based on a cancer diagnosis to the right treatment for that individual, based on everything from their genomic profile to their personal preferences. And the concept is being expanded beyond personalized treatment, to precision early detection of disease and prevention. This requires significant strength in how we manage data, provide deep analytics on that data and ultimately inform clinicians and patients so they can make the right individual decisions and take the right actions.

My main focus is architecting a digital strategy that advances our engineering of data generated from our EHR and other clinical systems (real-world data), establishing the data science and deep analytics capabilities to derive insights and predictions (real-world evidence), and creating the decision support tools that will surface this evidence at the time when it will be most impactful for care (real-world action). These actions, of course, generate more data, and so it becomes an ongoing feedback loop that we can continuously learn from: a precision oncology continuous learning platform. 

Q: What are the major obstacles keeping you from achieving your goals for the role, and how do you avoid or overcome them?

MH: I think the one major challenge I would identify is, given all of the truly transformative work going on at City of Hope, how do we maintain our focus and execute? To address this, we have matured our governance processes across the enterprise and now have a well-defined process for decision-making and prioritization. That being said, the field of cancer care is multidimensional and evolving very rapidly. So, like City of Hope overall, our digital efforts have to be highly agile while still aligning to an overall strategic framework.  

Q: What can hospital and health system CDOs do within their organizations to improve digital strategy and increase enthusiasm around digitization?

MH: Every organization needs to develop a digital strategy that is unique to them, but ultimately, we all want to be part of something that is bigger than ourselves, while still knowing what our individual contribution to that something is. So, the CDO has to establish a clear vision for digitization and be able to articulate to different audiences what the future looks like and how the individuals they are speaking to will help create that. I would advise against digitization for the sake of digitization. The digital strategy has to support and enable the organization's overall strategy and mission.

Q: Who else in the C-suite have you found yourself working with most closely? How does your role overlap with other executives in the technology space?

MH: Our CIO, chief informatics officer and vice president for analytics and business intelligence report to me, and together we form our digital strategy leadership council. Given how our digital efforts touch all areas, I can't say that I work more closely with one C-level officer than another. But I am hugely fortunate to be at City of Hope during a period of rapid growth and expansion. That includes not just the growth in our locations and facilities, but also, more importantly, the level of leadership talent we have attracted and the transformative ideas being generated here that are positively disrupting the fields of cancer care and research.

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