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,