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

* 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...