Pragmatic innovation: CIO Dr. Andrew Rosenberg's approach to new tech investment

Innovation in healthcare often requires a technology component and significant cultural change. As a result, it's not always possible on a tight timeline.

However, new initiatives focused on solving real and immediate problems in the healthcare space will gain priority and the necessary resources to get the job done. Andrew Rosenberg, MD, CIO of Michigan Medicine, has first-hand experience making large scale innovative changes at his academic health system.

Here, Dr. Rosenberg discusses how he views innovation in healthcare and the most important aspects of engaging with pragmatic transformation.

Question: How do you separate the truly useful and innovative technology from the hype when new tech crosses your desk?

Dr. Andrew Rosenberg: When my colleagues and I look at new technologies and pitches brought to us we want them to solve existing problems. They have to be grounded in solving a problem as opposed to a higher, more abstract or conceptual idea. Both are reasonable ways of approach technology development, but I find it more pragmatic to do so based on solving real problems than a theme, such as 'mobility' or 'blockchain.'

I find that there are so many existing workflows and investments, that even if I decided we wanted to become a cloud-based system and move everything to the cloud, it wouldn't happen for a long time. I tend to ground innovation discussions in problems that can be solved, and that we need solved, in the near term.

Q: How do you set innovation discussions for your team?

AR: I'm big on frameworks to help my team have complex discussions. For example, we may discuss how to view IT investments across all domains. We use an IT maturity framework to figure out which servers we are working on systemwide and which need to be replaced, which every CIO has to think about. If we decided we want to move to the cloud, I wouldn't go to the CEO and say we should make that move and push it as an innovation. Instead, I would point out that we don't have to be cloud-first, but we could move things incrementally to the cloud as it makes sense, like using the cloud for our supply chain or enterprise resource planning.

Then I would take that idea and recognize that for our research, we have huge storage needs, especially with imaging. That is truly big data and we can't keep up with something as mundane as storage for it. As a result, our research data is an area where we have a problem and we can solve it by taking an innovative approach with the cloud-based storage system.

A further example is cybersecurity. The problem is that we are trying to secure protected health information. I'm looking at the new techniques that fundamentally may innovate in the way we think about data. There are a few firms that we are working with that previously only existed with secret government agencies but now they are becoming public. We are looking for technologies that can help us secure PHI and manage data differently. Instead of just implementing better and better encryption and mobile device management, all of which are not innovation, we are trying to develop a way to make the devices U of M employees use quantum resistant. This is encryption that is scalable across of their devices and the first we are going to work with are absolutely, fundamentally innovative in what they do to solve a real problem.

Q: What are the best examples of companies that really provide an innovative edge for you?

AR: I want to see healthcare organizations trying to disrupt themselves. Virtual care is a good example of that because technology can help us provide care at home in a way that we have never done before. We can combine new data types in healthcare, digital imaging, molecular diagnostics and genomics for more personalized healthcare. Those are areas where we find very specific new ways of providing care in our pilots and experiments.

There aren't massive fundamental changes in the healthcare space for us. We still have a lot going on in health IT right now to solve specific problems. At many of the IT meetings I attend, there is a lot of talk about digital transformation, which is easy when you have a mobile field where everything is based on disruption, but large organizations still have a lot of legacy technology. We need leaders that can be innovative but also translate between the clinical and IT worlds to execute on those initiatives.

Q: What is a good example of a pragmatic innovation?

AR: One example that comes to mind is communication and notification for physicians. Many health systems are still deeply dependent on paging. Yet, paging is an antiquated but cost-effective technology. We are moving away from that and more toward unified communications that include secure modern mobile devices like iPhones and secure texting with alert notifications and Wi-Fi-based security. All of those themes have an element of innovation, but the idea of switching the pager for the iPhone isn't innovative; there is a huge amount of change we have to do.

The idea of the pager is one part of the multidisciplinary communication platform that requires a lot of infrastructure across a large health system as well as workflow change, which can be complicated. Most people don't think of using their iPhones or Androids as a single communication system as innovative, but it's transformative and we are spending millions of dollars on it.

Q: Are there any clinical innovations you're supporting?

AR: We are doing experiments in genomics and making that data available in the EHR. Additionally, there are innovations to the infrastructure that support new technology on the back end for things like logistics or storage. If we want to keep up with the advanced artificial intelligence for imaging radiology, we need vendor-neutral archives. We have to figure out how to move from a vendor-specific pack workflow infrastructure to a vendor-neutral archive so we can view a larger amount of data, which also includes OR imaging, tele-imaging, ophthalmology imaging and other types of tele-care.

More articles on health IT:
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The build vs. buy debate: 5 key thoughts from health system CIOs
The big opportunity in AI, genomics & precision medicine: UPMC clinical analytics chief Dr. Oscar Marroquin

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