CISOs know that all the technology in the world won’t make for secure organizations unless they have fostered a culture to match it. But what does an organization with such a culture look like? How is the org chart and governance structured? How well is its info sec team funded? How are employees educated on cyber-hygiene, then tested on what they’ve learned; and what are the consequences when they don’t make the grade? In this important webinar, we’ll look at all aspects of what constitutes a sound security culture and discuss how you can move your organization from here to there.

Speakers:

* Erik Decker, AVP/CISO, Intermountain Healthcare

* Julian Mihai, CISO, Penn Medicine, University of Pennsylvania Health System

* Shankar Somasundaram, Founder & CEO, Asimily

 

When David Kaelber took on the role of MetroHealth System’s first CMIO, he believed that if he could identify one or two issues and solve them, he could help transform care across the organization. What he learned, however, is that healthcare is far more complex than that. “There is no one thing that’s going to change healthcare,” he said during an interview with Kate Gamble, Managing Editor at healthsystemCIO.com. However, “if you do a whole bunch of things well and intelligently, you’re going to move the needle in a way that was impossible to do without health IT.”

At MetroHealth, his team has led several initiatives to help improve care delivery, care quality, and clinician efficiency, whether it’s through medication adherence flags, electronic support for adverse event reporting, or sepsis prediction tools. It’s all part of the overarching goal of getting technology to work for the healthcare system, said Kaelber, who strongly believes “IT’s value is in being a strategic partner.”

During the discussion, he talked about his evolving strategy as CMIO; the critical role social determinants can play in shaping the health of the community — if leveraged properly; the enormous value he gleans from having regular meetings with stakeholders and listening to their concerns; and why imitation is a good thing, particularly now.

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Key Takeaways

* When it comes to understanding population health, collecting data on social determinants is critical, said Dr. Kaelber. “You don’t want to make guesses; you want to make decisions based on the data.”

* Once social determinants have been established, the challenge for providers is connecting patients to social service agencies. One solution? Startup exchanges such as UniteUs and Aunt Bertha.

* For IT and clinical leaders, the goal isn’t to find the problems, but rather, to identify tools that can help solve problems that have already been defined by health system.

* “As the technology leader, have to take a very different psychological approach; even the way you interact with peers, VPs, or those above you, has to be different.”

* Although predictive analytics can be extremely useful, they’re often complicated to implement for one simple reason: “the rules are based on other peoples’ data.”

Q&A with CMIO David Kaelber, Part 2 [Click here to view Part 1]

Gamble:  You mentioned earlier social determinants; can you just talk a little bit about some of what MetroHealth is doing there?

Kaelber:  First, you have to have a good way to assess social determinants of health factors. It’s like the saying, ‘no data, no mission.’ Everybody thinks social determinants of health are really important, and yet, when you ask people what social determinants of health look like in their population, most have no idea.

MetroHealth’s SDOH strategy

The first step was to systematically come up a tool and a process to collect the information. Epic has what they call the social determinants of health Wheel with about a dozen different domains, including education, transportation, substance use, food insecurity, and social isolation. Each one only has one or two questions; the key is, if you already having a dozen different domains, that’s already a few dozen questions. It’s just supposed to be screening, so we built the tool as the foundation.

Now the question becomes,

Some CISOs have described the ransomware attack that took Kronos offline as a “gut punch” that’s forcing them to reevaluate the risk posed by the third-party vendors they rely on. That reevaluation includes doing a better job of vetting new vendors before they come on board and figuring out a way to review the dozens, or even hundreds, of vendors they already work with. It’s a mountain of a task, but one that must be done if health systems are to avoid getting knocked out in the future. In this timely webinar, we’ll hear from leaders who are making the revisiting of third-party risk a top priority.

Speakers:

* Shefali Mookencherry, CISO, System Director of Information Security, Edward-Elmhurst Health

* Teresa Tonthat, VP of IT & CISO, Texas Children’s Hospital

* Ryan Witt, Managing Director, Healthcare, Proofpoint

There are times in which it’s wise to think small. Creating a digital health platform is not one of those times, according to Aaron Martin and Sara Vaezy.

It was one of many areas covered in 2022 Digital Predictions, which was published by Providence Ventures earlier this year. “We expect a platforming of digital health solutions — moving digital efforts from execution of tactical point solutions to development of strategic digital infrastructure within the health system,” the authors wrote.

It’s a trend Martin has already noticed at Providence, where he served as Chief Digital Officer for nearly six years before recently announcing his return to Amazon. “If you only tell someone like me the small story” — for example, a solution that focuses specifically on appointment scheduling — “I’m not interested, because I don’t want to have a point solution forever. I want to know where it’s going.”

In the report, he and Vaezy (Chief of Digital & Growth Strategy at Providence) shared insights on what they believe is coming down the digital pike, based on conversations with leaders from Providence and other organizations, as well as entrepreneurs and venture capitalists. Recently, they spoke with Kate Gamble, Managing Editor of healthsystemCIO, about their key findings — particularly around the workforce crisis; the use cases for artificial intelligence that they believe can be a valuable assist to clinicians; and how technology can be leveraged to help physicians use their judgement.

Key Takeaways:

* For Providence Digital Innovation Group, publishing the Digital Predictions report “is a way of putting our thoughts out there, getting the industry to react to it, and gathering situational awareness.”

* One of the key findings? “The workforce crisis is front and center — that is by far the biggest challenge we’re seeing right now as a health system.”

* Getting a digital platform up and running is important, but without a plan to engage between episodes of care, organizations open themselves up to “becoming a very sophisticated price taker in the market.”

* What other industries often get wrong when trying to enter the healthcare space is that “it’s not just the cost of the technology. It’s the cost of implementing it and reimplanting it.”

* When leveraged properly, AI has the potential to become a true asset to clinicians by taking on the “boring, repetitive tasks” that can lead to burnout.

Q&A with Aaron Martin and Sara Vaezy of Providence

Gamble: Can you start by telling us how the report came about?

Martin: We do this every year. We also publish a lot of thought pieces around what we’re seeing in the market. Particularly during Covid, we published a lot of content around our thesis of where things are headed.

The reason why we do this is that on the health system side, we’re regionally competitive. We can share a lot of information, because of the 200 or so large health systems, we don’t compete with the vast majority. It’s a way of putting our thoughts out there, getting the industry to react to it, and gathering situational awareness — that type of thing. This is much more of a forward-looking version of that. Sara and I always say that predictions are always combinations of things you’re actually predicting and things you’re actually working on. It’s a little bit of both.

 

Guerra: That’s interesting. Can you talk about the process and how you gather information?

Martin: It’s a lot of conversations with our internal constituencies and with industry experts and other health systems. We speak with two to three health systems a week, just trading notes and understanding what’s going on. Sarah, what would you add?

Vaezy: We do this on a continuous basis. We’ll do a refresh,

When the Guthrie Clinic hired Terri Couts as VP of Clinical Applications in 2016, it was for a very specific reason: her Epic expertise. To say that the Epic implementation hadn’t been going well is a massive understatement. Clinicians were leaving in droves — in many cases, citing the EMR as a key factor.

Couts, however, believed it wasn’t the technology itself, but rather, the way in which it had been deployed. And so, she led an effort to revamp the entire process, “from the time we onboarded a new clinician all the way through upgrades,” and focus heavily on building relationships with users. The strategy quickly paid dividends, as clinician satisfaction rates skyrocketed, and the organization achieved STARS 10 Epic Status.

Even more importantly, a playbook was established for future projects, helping to ensure that Guthrie would be able to roll out projects more efficiently in the future. During a recent interview, Couts talked about how her background helped prepare her for the CIO role — which she took on in July of 2021, why it’s so critical to focus on the end user, and how her team hopes to lessen the documentation burden on nurses through its Nightengale Initiative.

LISTEN HERE USING THE PLAYER BELOW OR SUBSCRIBE THROUGH YOUR FAVORITE PODCASTING SERVICE. 

Key Takeaways

* “It wasn’t the EMR; it was how we deployed it,” said Couts, who was recruited for her Epic knowledge and asked with “right-sizing the ship.”

* Going from 2-star to 10-star status with Epic required taking a hard look at “where we were, how we customized, and how we delivered changes,” and revamping the entire process.

* When it comes to training staff on a new system, leaders need to take “a salesperson approach where you’re not going to get that the sale on the first visit. You need to build that relationship.”

* Individuals with strong network and infrastructure skills aren’t always the best leaders or collaborators. “You need somebody to understand the depth of what’s happening and be able to relate it to your core team.”

* The unintended consequence of physician burnout initiatives? They increased the documentation burden on nurses, which Guthrie Clinic hopes to alleviate through its Nightengale Initiative.

Q&A with CIO Terri Couts, Part 2 [Click here to view Part 1]

Gamble:  Can you talk a little bit about the role that you had before as VP of Clinical of Clinical Applications? I imagine some of the focus is similar to that of CIO; did that experience help prepare you for the CIO role?

Couts:  When I first joined Guthrie, I joined for my Epic knowledge. They hired me because there had been a fair amount of physician turnover; part of the reason, as they learned during exit interviews, was related to the EMR. But if someone is leaving an organization because of the EMR, it doesn’t mean you’re not going to end up at another organization that doesn’t use an EMR. The fact of the matter is that it wasn’t the EMR, it was how we had deployed it.

My main task was to right size that ship. It’s hard to recruit, so we don’t want to lose clinicians due to technology that’s poorly deployed. At that point, I had clinical applications under my purview. Guthrie became at Epic customer in 2003; it was one of the first inpatient go-lives. We had been a longstanding customer and have continued to deploy modules.

“We revamped our total process”

I’m not sure if you’re familiar with the Epic stars rating,

Jesse Fasolo believes there are two types of leaders: those who “sit back and allow the vendor to come to them when they need something,” and those who do the legwork. In fact, by the time he speaks with a prospective partner, he has already done his due diligence, Fasolo said in an interview with Anthony Guerra, Editor-in-Chief of healthsystemCIO. “I want to be the person who’s proactive; who has the vision, the strategy, and the roadmap, and knows how to plot the steps required to get down the road. I don’t wait for a vendor to tell me what steps to take.”

During the discussion, which took place at ViVE22 in Miami, Fla., he spoke the critical role frameworks play in ensuring organizations remain compliant; the pros and cons of migrating to the cloud; how he works with his CIO to “build a vision”; and the advice he would offer to other security leaders.

LISTEN HERE USING THE PLAYER BELOW OR SUBSCRIBE THROUGH YOUR FAVORITE PODCASTING SERVICE. 

Bold Statements

Infrastructure and security go hand in hand. You obviously need to secure the infrastructure to ensure security across your whole system.

At the end of the day, you want to ensure confidentiality, integrity, access, and availability for your data. It just so happens that in healthcare, all of your data is really compromised into your EHR.

The framework I landed on, NIST, is really the breadcrumbs for the trail to bring you onto the roadmap. It is essentially what sets your organization up to become compliant. It gives you every list and every question that you need to follow, and the items and toolsets you need to put in place.

It’s a whole new skill set to learn the ability to manage workloads in the cloud, regardless of what provider you choose.

In alignment with my CIO, Linda Reed, we strategize, and we build a vision. I give tactical and strategic direction on how to get things done and where we should go. Where does the future see us in the next couple of years?

I would be investing in technology, faster networks, faster capability, and storage, so when the time comes to add more artificial intelligent systems, I’m prepared. That’s my thing. So far, I’ve been successful at staying two steps ahead as to when things come out and are available.

 

Guerra:  Hi Jesse, thanks for joining me today.

Fasolo:  Thank you, Anthony.

 

Guerra:  Can you tell me a little bit about your organization and your role?

Fasolo:  I represent St. Joseph’s Healthcare. We’re based in Paterson, N.J. We serve and underprivileged, underserved community. We’re approximately a 1,000-bed system across two acute care facilities and about 30 or 40 practices that we support.

 

Guerra:  Do you work for my friend, Linda Reed?

Fasolo:  I do. Linda Reed is my mentor and direct supervisor.

 

Guerra:  I’ve known Linda for many years; she’s wonderful. So you have a big purview with security and infrastructure. From my experience talking to a lot of security folks and CISOs, I’ve seen that a lot of them come out of infrastructure. Was that your path?

Fasolo:  I started out full infrastructure. I went through networking and system architecture, and I got to the point where I started using my knowledge of infrastructure to then secure it, and then I transitioned and absorbed information security and cybersecurity.

 

Guerra:  We are here at ViVE22, which is done in conjunction with the CHIME Spring Forum. This is the first iteration of the show. What are your thoughts so far? You’re on some panels and I’m sure you’ve had a number of conversations.

When David Kaelber took on the role of MetroHealth System’s first CMIO, he believed that if he could identify one or two issues and solve them, he could help transform care across the organization. What he learned, however, is that healthcare is far more complex than that. “There is no one thing that’s going to change healthcare,” he said during an interview with Kate Gamble, Managing Editor at healthsystemCIO.com. However, “if you do a whole bunch of things well and intelligently, you’re going to move the needle in a way that was impossible to do without health IT.”

At MetroHealth, his team has led several initiatives to help improve care delivery, care quality, and clinician efficiency, whether it’s through medication adherence flags, electronic support for adverse event reporting, or sepsis prediction tools. It’s all part of the overarching goal of getting technology to work for the healthcare system, said Kaelber, who strongly believes “IT’s value is in being a strategic partner.”

During the discussion, he talked about his evolving strategy as CMIO; the critical role social determinants can play in shaping the health of the community — if leveraged properly; the enormous value he gleans from having regular meetings with stakeholders and listening to their concerns; and why imitation is a good thing, particularly now.

LISTEN HERE USING THE PLAYER BELOW OR SUBSCRIBE THROUGH YOUR FAVORITE PODCASTING SERVICE. 

Key Takeaways

* As a CMIO and practicing physician, Kaelber’s core objective is “to get technology to work for the healthcare system.” It starts by identifying the key constituencies, then determining how technology can make an impact.

* Everything we do is “based on a technology framework. We would not be doing as well as we are in value-based care without the informatics or health IT foundation.”

* By utilizing medication adherence flags, clinicians can access information about whether a patient is taking (or even has filled) a medication, which can “change the whole tenor of the conversation.”

* Contrary to widespread belief, there aren’t one or two things that can transform healthcare. Instead, “if you do a whole bunch of things well and intelligently, you’re going to move the needed.”

* One of the biggest problems technology can help solve? Helping patients get routine care such as screenings, Kaelber said.

Q&A with David Kaelber, MD, CMIO, The Metro Health

Gamble:  To start, can you give a very high-level overview of MetroHealth just in terms of where you are and number of hospitals, things like that.

Kaelber:  The MetroHealth system is an integrated healthcare delivery network in Northeast Ohio. We pride ourselves on our ability to take care of people regardless of their ability to pay, and so we consider ourselves a safety net or essential hospital, which is a very practical matter. It means about three-quarters of our patients are either Medicare, Medicaid, or self-pay, and only about a quarter are commercially insured.

In terms of our geographic footprint and our patient footprint, we’re one large academic medical center affiliated with Case Western Reserve University in Cleveland, and we have two smaller hospitals. We have a couple dozen outpatient clinics throughout Northeast Ohio, and four emergency departments.

We do a lot of special care; school health is a big component, along with correctional health and foster care health. In terms of some of our big sort of numbers, we have about 325,000 sort of unique patients that we would take care of on a yearly basis, probably on the order of about something like one-and-a-quarter mi...

One of the most difficult aspects of being a CIO is in making sure teams recognize the affect their work has on patient care. What often happens, according to Ray Lowe, is that IT professionals “get lost behind the bits and bytes and don’t see the impact.” However, when they are able to see that technology can change peoples’ lives, “it’s really rewarding,” said Lowe during a recent interview with Kate Gamble, Managing Director at healthsystemCIO.

A perfect example is the work AltaMed Health Services is doing to improve health equity by leveraging social determinants of health data. It’s an area he believes is “ripe for opportunity” — and one in which his organization has an edge because of the partnerships they’ve established with community-based organizations.

In the interview, Lowe spoke about how AltaMed is incorporating SDoH data to provide individualized care — and why that’s so critical; the need for CIOs to incorporate three “I’s” into the role; and what he considers to be his ultimate objective. He also talks about AltaMed’s laser focus on social justice, and why it’s more important than ever for healthcare leaders to share knowledge.

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Key Takeaways

* With AltaMed’s Health Equity Accelerator, one of the key goals is to create customized SDoH screenings based on data and partner with community-based organizations.

* The challenge? Finding the right people and startups that will enable them to identify and address needs at the individual level.

* For Lowe, the appeal in coming to AltaMed was clear: “Social justice is at our core,” and “culturally sensitive care is one of our hallmarks.”

* One of the most important aspects of the CIO role is in helping IT teams see the impact of the work they do. “Oftentimes we get lost in the bits and bytes.”

* As healthcare leaders, “we have to help each other. We have to generously share what we’ve learned so we can all help each other and continue to change the way healthcare is delivered.”

Q&A with Ray Lowe, CIO, AltaMed Health Services, Part 2 [Click here to view Part 1]

Gamble:  One of the areas you said you’re focused on is the Health Equity Accelerator. Can you talk more about that?

Lowe:  We’re working looking at the data to create a customized SDoH screening so that we can do positive and negative screenings and really partner with community-based organizations. We want to partner with government policymakers as well, so that we can have proper legislation changes put into place. It really looks at how do you recognize the individual in addressing social determinants of health? And I think the term ‘SDoH’ may evolve and morph into something else, like perhaps personal determinants of health, so we can better understand what each person needs versus a generic population. It’s very genericized when we use these broad terms — we need to focus on how we impact the individual.

 

“Just scratching the surface” with social determinants

Gamble:  What phase is the Health Equity Accelerator in right now?

Lowe:  We’re aligning with the Health Equity Institute; we’ve actually done quite a bit of research around what are the opportunities we have to leverage data within our patient population. It’s very rich. We live in a market where we know, through the social vulnerability index,

Under the weight of the pandemic, health systems have been hit especially hard by the nationwide labor shortage. With less folks to do the work, it’s become more important than ever to automate some of the more repetitive tasks that make for a welcoming digital front door. Those tasks include Covid-related ones, such as scheduling vaccines and testing, along with ever-present duties, such as IT ticketing. In this timely webinar, we’ll hear from leaders who are leveraging technology to maintain the patient experience despite having fewer hands on deck.

Speakers:

* Joel Vengco, SVP & Chief Information & Digital Officer, Baystate Health

* Nassar Nizami, EVP, Chief Information and Digital Officer, Thomas Jefferson University & Jefferson Health

* Amber Fencl, VP, Digital Health & Engagement, Novant Health

* Israel Krush, CEO, Hyro

When the Guthrie Clinic hired Terri Couts as VP of Clinical Applications in 2016, it was for a very specific reason: her Epic expertise. To say that the Epic implementation hadn’t been going well is a massive understatement. Clinicians were leaving in droves — in many cases, citing the EMR as a key factor.

Couts, however, believed it wasn’t the technology itself, but rather, the way in which it had been deployed. And so, she led an effort to revamp the entire process, “from the time we onboarded a new clinician all the way through upgrades,” and focus heavily on building relationships with users. The strategy quickly paid dividends, as clinician satisfaction rates skyrocketed, and the organization achieved STARS 10 Epic Status.

Even more importantly, a playbook was established for future projects, helping to ensure that Guthrie would be able to roll out projects more efficiently in the future. During a recent interview, Couts talked about how her background helped prepare her for the CIO role — which she took on in July of 2021, why it’s so critical to focus on the end user, and how her team hopes to lessen the documentation burden on nurses through its Nightengale Initiative.

LISTEN HERE USING THE PLAYER BELOW OR SUBSCRIBE THROUGH YOUR FAVORITE PODCASTING SERVICE. 

Key Takeaways

* For Guthrie, the primary focus in 2022 is in three key areas: patient experience, quality and expanding virtual care. “By meeting patients where they are and having high quality outcomes, everything else will follow.”

* Both Couts and Guthrie’s new CEO, Edmund Sabanegh, Jr., previously spent time at Mayo Clinic, and are applying some of the same philosophies. “We’ve changed our thinking.”

* Unlike in years past, CIOs don’t necessarily have to understand all aspects of technology. What’s more important making sure the end user – whether that be patients or caregivers – in focus.

* Through the increased use of virtual care services and remote monitoring, Guthrie is “transforming to more of a holistic approach to care versus providing the traditional task-oriented care.”

* One of the positive impacts of Covid? “It has made us more agile. In healthcare, we have a tendency to overthink and over analyze everything, and it slows down our ability to deliver on a product.”

Q&A with Terri Couts, SVP and CIO, The Guthrie Clinic, Part 1

Gamble:  Thanks so much for putting aside some time to speak. Can you start by giving a high-level overview of Guthrie in terms of the types of care you provide, where you’re located and things like that?

Couts:  Guthrie is an integrated health system offering the full spectrum of health services. We’re located in Pennsylvania and New York, kind of where the southern and northern tiers of both of those states mesh together. We have five hospitals — two in New York and three in Pennsylvania, and about 36 associated multispecialty clinics. We are primarily rural care and we serve a large population over a wide geographic area.

 

Gamble:  So you cover the gamut of care. I imagine that’s one of the biggest appeals of the organization.

Couts:  It is. When I first started here, I wasn’t that familiar with the organization. But I committed to listening because I was recruited by a colleague I had worked with before, and I just fell in love with the organization. They’re very family oriented. They have a philosophy based off the Mayo Clinic; it’s very physician focused as far as managing practices. And the culture was very appealing — that’s why I joined. I’ve been here about six years.

 

3 Core Objectives