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Digital transformation takes on an extra dimension when an organization measures its results in something other than profits.
The pharmaceuticals industry attracts incredible minds with high integrity who want to cure people's illnesses and improve their lives – and I was attracted to the idea of using technology to enable that. But after a while I realized that pharma was still very much focused on financials, while I wanted to be even more patient-centric. That's what drew me to healthcare, and specifically to not-for-profit hospitals, which don't have to satisfy Wall Street expectations but do offer compelling opportunities to use technology to enable better care.
It became apparent to me very quickly that neither pharma nor hospitals have the deep engagement, collaboration, or exchange of data that would make current treatments better and cheaper or would accelerate the discovery of new treatments. The pharmaceutical world often sees big nonprofit hospitals as clueless and mired in bureaucracy, while the hospitals in turn see pharma as an industry that makes profits on patients' backs. I was surprised to discover how few people have brought to a nonprofit environment the experience of large-scale industrial proven practices in technology, and I wanted to break down that wall.
The CIO's shifting role
Obviously, the main thing that makes a good technology leader is being competent in your domain. But you also have to be like an athlete, where you've mastered that bedrock requirement so you don't have to focus on it anymore and can instead concentrate on using it to generate more value or contribute to the greater objectives of the organization you're a part of. So in healthcare, IT leadership is about managing technology as a business so it becomes the enabler of patient care that it should be.
The role of the IT leader has changed in multiple ways in my career, but the biggest is IT's shift from being a utility keeping the back office running to being the enabler of desired outcomes by transforming the business quickly. Both in pharma and in healthcare, the role of the CIO used to be to head a team that managed and controlled everything IT-related. Today, the idea of "shadow IT" is obsolete, because there's no longer a boundary between what is and what isn't related to IT. The CIO's job is to look at possibilities and deliver value as quickly and efficiently as possible within an ecosystem of not only technologies, but partners. A CIO has to be able to enable the organization to create partnerships in a very fluid way.
One of the questions that arises frequently about managing this ecosystem of networks and people is how to decide what to outsource. It's mainly evaluated based on the cost of labor measured in man-hours, and for me that's the wrong question. We're now in a world where everything is about how you leverage all your available capabilities as quickly and reliably as possible. So the question is really about how you develop partnerships within IT and how you engage with external companies, not in a transactional way, but in a way that's like selecting individuals and developing their potential. I think that's one of the most important parts of the CIO's job.
The first steps to transformation
There are a vast number of domains where the possibilities of digital technology are still at the experimental stage. In patient care, it's around making patient engagement a more positive experience. Then there's the area of medical data and health data, using that to provide better care, and also enabling pharma companies to use that data to improve their drugs or discover new ones. And then you have all the tech-enabled devices like wearables and implantables, technologies to help clinicians perform surgery, and so on. The technology in these areas isn't necessarily experimental, but the use cases are still being developed.
Our opportunity and challenge is making sure we have a framework and infrastructure to support those new use cases, like the necessary levels of reliability and cyber security protection. Unlike a consumer company, a healthcare organization can't just react to a network failure by saying, "Oops, sorry!" And yet because we're not for profit, that affects how we manage our assets. We need to deliver services while taking cost challenges into account, which is a fascinating and exciting challenge. While we grow and enable those future use cases, we also have to bring our current capabilities up to date—for example, by enabling patients to schedule their visits online without having to call or email us.
The growth of applications and solutions that help people improve their lifestyles is creating a direct relationship between patient engagement and future healthcare business models. We need to provide ways for patients to get a complete view of their data that doesn't lock them into one organization and provides a simpler, lower-cost patient experience that's also more transparent. And I'm cautiously optimistic about the possibilities of automation to help clinical practitioners interact with patients and make decisions. But as we deploy new technologies, especially at a large scale, we also need to address the financial and patient risk they create if their data is stolen.
A nonprofit in a for-profit world
The American healthcare environment is complex, and unlike some healthcare systems, CHI is both faith-based and non-profit. It was formed in 1996 when a collection of Catholic hospitals aligned around a mission and set of principles about managing their assets better to take better care of patients overall. The organization grew by absorbing more hospitals into that network. Today, we're organized in seven independent business regions, each with their own administrative center, and an eighth division for home health care. I'm in charge of the IT services for all eight of those divisions, making sure we deliver the best services from end to end.
We've grown by associating multiple hospital systems over time, so we don't have the same structure, governance, and decision authorities that a large for-profit organization might. We have a broad asset base with many applications and data centers, but because we're focused on local patient experience and care, we haven't had a structure to integrate all those systems together. Our IT environment is vast and complex.
As a faith-based nonprofit , we focus on the most vulnerable patients with the greatest needs, so that brings us a lot of goodwill from partners like suppliers and in our public relations. But we also have more stakeholders to answer to. Our stakeholders include the communities across the nation where our hospitals are located, the governments at every level from local to national, and religious authorities as well. That requires us to pay a lot of attention to where and how decisions get made and problems get solved, but it also creates opportunities to adopt greater efficiencies and deliver our care better. We don't have quarterly results or obligations to meet analyst expectations. On the other hand, our stakeholders pressure us to make sure any large enterprise-wide program gets delivered as promised.
The question is, how do we harness all this technology and make it affordable and available to everybody? The notion that everyone should have access to care challenges the idea that people with more resources should have more access to services to help them live better than those with less – the idea that healthcare is a consumer product. And that brings me back to my two-track professional experience – to my desire to merge the technology best practices of for-profit pharma with the patient-centric focus of nonprofit healthcare. It’s this blended mission that makes my work so satisfying.
IT's job has shifted from keeping the business operational to transforming the business quickly in support of strategic goals.
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In a fragmented, global, cloud-based IT universe, CIOs must be skilled at forming, leveraging, and dissolving internal and external partnerships quickly and at scale, when and as needed.