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CIO Chat - Russell Branzell, CHIME

This is a guest post provided by Russell Branzell, CEO and President of CHIME. Huntzinger periodically invites its clients and partners to contribute to The Huntzinger Blog.

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By Russell Branzell, FCHIME, CHCIO
CEO and President
College of Healthcare Information Management Executives

How long have you been in your position at CHIME?
About five years.

What do you see as the key challenges facing healthcare?
Certainly cybersecurity comes to mind. I don’t think we’ve ever faced such a challenge in healthcare that has the potential to cause so much destruction. Despite our knowledge of the threat — as we’ve seen breaches in other commercial sectors — healthcare has become a bigger target for hackers as they’ve learned the value of the information within medical records. As an industry, we weren’t prepared for this. As soon as an organization implements a new system, it’s already at risk, as someone is looking to hack it. A bad guy only has to find one loophole in the entire ecosystem, while we have to protect against all of the loopholes.

We often get asked by people how much they should spend on cybersecurity. We tell them to spend enough so that they feel they’ve mitigated the risk and done enough to take care of the average risk because you can never spend enough.

Another key challenge is the fundamental shift occurring within the industry. It’s not necessarily population health, it’s more the value shift that is going on. If we in health IT have done our jobs well, we should be primed to take on this challenge — we should be prepared and be a couple steps ahead of the organization. Some organizations slammed in EMRs to get a government check instead of looking to improve patient outcomes. This type of mentality can leave organizations unprepared. The organizations that make these investments for the right reasons — such as improving patient care and engaging patients, etc. — will be better prepared.

How do you believe HIT can impact those challenges?
Once again, cybersecurity comes to mind. We have to start thinking about the global or macro level of best practices and shared information when it comes to cybersecurity. We don’t have to go it alone. When an incident happens at an organization, the alert should be communicated across the entire community. And this is starting to happen, as the provider community is sharing information in such a way that we’re able to be proactive. And CHIME has been very involved in a public/private effort to drive cybersecurity best practices. Look for more information on the outcomes of this coming soon.

Information sharing remains a challenge for some organizations, but the National Health Service (NHS) in the United Kingdom has set a great example for our industry. Last year’s WannaCry ransomware attack hit the NHS before it was prevalent in the United States. The NHS alerted the U.S. healthcare community, showing that the global community could rely on each other to combat issues like WannaCry. I can’t help but wonder what could have happened if healthcare IT leaders didn’t work together in a collaborative way to prepare for this issue. It would have been much worse. We still have a way to go to build an environment that allows organizations to share freely without concerns about punitive downstream impacts, but we are making progress.

As far as the industry’s shift to value, the organizations that have taken a knowledge mindset will be better prepared for the challenge. Helping organizations accomplish this is an important part of our jobs as part of the health IT community. Those who don’t take the time to map their systems and understand their IT environments will have greater challenges. Care coordination is, in effect, taking on a whole new meaning when it comes to the power of technology to drive value and better outcomes. Care doesn’t occur only in a hospital or doctor’s office. We as healthcare IT leaders can use our expertise to help healthcare systems bridge the multiple settings our patients encounter in their journeys and then coordinate that care. This will lead to lower costs and better experiences for those patients.

What do you view as the single most significant HIT advancement that will impact healthcare?
Our ability as IT professionals to aid, and actually lead, in the advancement of precision medicine. A lot of this has become possible with our recent advancements in health IT. Now we’re able to map precision drugs for chemotherapy — something that didn’t occur just a few years ago. We’re approaching the concept of a digital human being who can be treated with best practices that are shared across the global community. Maybe the best treatment for a patient is in India, New Zealand, or somewhere else. We have the opportunity to learn from each other and accelerate the adoption of best practices. We’re not at that level yet because payment for health services is local. Going forward, health IT will play a huge role in precision medicine and we’re going to see a huge adoption of it in the coming years.

Also, machine learning and artificial intelligence (AI) are all part of the macro-level technologies that will lead to innovation. Although AI concepts were developed decades ago, computing speed and capacity are finally catching up to the theoretical concepts to do it.

Home-based tests and treatments are also making an impact. People are now starting to receive real healthcare in their homes. Pair that up with AI and we will see rapid improvements and changes in care.

What do you see as the greatest inhibiting factor to HIT progressing more rapidly?
Cybersecurity comes to mind, again, but we’ve already addressed that. Another issue is that IT budgets and staffing are being cut across the board as organizations get ready for value-based reimbursement that may cause payments to decrease. This will be a problem, as the organizations that fail to invest in technology to help them with these changes are unlikely to do well in the future. The best technology requires financial resources. Making these investments will be particularly difficult for smaller or rural hospitals. Surviving on Medicare rates, they can’t afford AI and other new technologies. Are the academic medical centers and large health systems going to invest in the technology to prepare for the future?

What role can CHIME play in assisting HIT to positively impact healthcare?
We’re a community. Part of that community is accelerating the adoption and collaboration through friendships and trust. Many describe us as a family. People come into CHIME in a position of trust and a willingness to share at a much more pervasive level than I’ve ever seen.

There are also some tactical things that we do to further our impact. We have an active policy group with some the best leaders in the country who come together each week. It takes lots of commitment for these leaders to review current policy and trends on a weekly basis. Over the last few years we’ve shifted from being reactive to being very proactive. We now help leaders draft policy or provide them with education on the topics.

Programmatically, people are willing to drop their competitive nature and present ideas. Our Opioid Task Force is a great example. It has four major EMR vendors and many health IT leaders coming together to figure out what they can do to solve the problem. We’re going to put out a challenge to all the organizations in CHIME to find ways to apply the Task Force’s recommendations. If only a percentage of them do this, then the result can have a huge impact on the industry and human lives. Additionally, we work to evolve comparative analytics such as assuming leadership for the Most Wired award and collaborating with HIMSS Analytics on TransformIT.

What is the most important role CHIME can play in assisting HIT professionals?
We changed our mission statement a few years ago, from a technology-driven organization to a professional organization. Our mission is: Exceptional leaders transforming healthcare. Our job is to find ways to help every CHIME member excel in the work that they do. Everything we do should be laser focused on the first two words in our mission: exceptional leaders. The quality of the educational opportunities that we offer, and the quality of our events, should be exceptional every day. We want leaders to be far more empowered to accomplish what they do.

CHIME has evolved into an international organization — how will that evolution impact HIT and CHIME members?
In 2014, CHIME was in four countries. Now we’re in 51 countries. This expansion was a deliberate effort of our board. We can’t presume that the United States — with the world’s highest-cost healthcare — has everything figured out. We want to attract exceptional leaders from around the world, and make sure they’re a part of us, so we can all help with the learning curve that we’re experiencing.

As we’ve expanded into other countries, we’ve discovered that the problems organizations are facing are about 90% the same. It doesn’t matter what form of government, what payment model, or what ecosystem that they’re in. We’re all in this together to present the best data as fast as possible to help improve patient care.

What do you perceive as CHIME’s greatest challenge to having a continued impact on HIT?
As we’ve become global, our biggest challenge is to scale our services to meet the needs of an international community. We haven’t come across too many language barriers as many international executives speak English. In cases where they don’t, the local membership assists with communication.

Technology is also aiding our global expansion in that we can effectively communicate without physically having to be at remote locations.

What will CHIME look like in the future?
We aim to never lose what makes CHIME special — the one-to-one relationship. We never want to lose that intimacy that has been central to our organization. How we meet as a group or a team is something that we want to recreate in different places in the world.

For example, I was recently in India and they have their own version of CHIME. Yet, I would have thought that I was at any other CHIME event due to the structure, the networking and the sharing. We want to break down regional and cultural barriers to make that level of idea exchange possible throughout the world. I think we have the ability to create a footprint in nearly every country.

There’s also one unique thing about CHIIME that I always try to reiterate. Although we’re in 51 countries, we only have 28 or so staff members. That’s the same or less number of staff members than we had years ago when we had less of a global reach. That’s possible because of what CHIME is — a community of committed people who want to come together and work toward our mission.

Topics: CIO Chat