Throughout the last year and a half, healthcare chief information officers (CIOs) have had to continuously and rapidly innovate in a number of ways to meet the twists and turns of the pandemic. Now, although the darkest days of the crisis are behind us, clinical IT leaders are feeling intense pressure to not only unify care coordination, but also optimize digital health expansion amid the COVID-19 financial aftermath, according to a recent survey conducted by health IT consulting firm Stoltenberg Consulting Inc.
Stoltenberg, which cohosted the 2021 survey with the College of Healthcare Information Management Executives (CHIME), also noted in their report, “Health systems that fail to deliver on the digital experience could struggle to attract new consumers following the pandemic. The potential impact: loss of competitive position and difficulty regaining financial health.”
What’s more, just 14 percent of CIOs in this survey said AI is their top area of focus, which signified a major drop from the previous two years’ iterations of the report; in 2020, nearly 43 percent of CIO respondents chose AI/machine learning as their top priority.
To discuss the changing priorities amidst the pandemic, how his health system is investing in AI, and the challenge of meeting evolving consumer demands, Healthcare Innovation recently spoke with Scott Arnold, executive vice president and CIO at Tampa General Hospital (TGH), who has been in an executive leadership role at the organization for over a decade. Below are excerpts of that discussion.
What are the core CIO priorities in this current moment at TGH, from an operational perspective?
In terms of looking through the lens of technology, one [big priority] is getting out of the data center business and moving as much infrastructure as possible into a cloud setting. We have multiple data centers, but there is one specifically we have in the hospital that takes valuable real estate we could be using for patient care. So we want to prioritize that, and if you have ever seen our hospital, we are literally landlocked and surrounded by water, which is not a good place for our data center to be anyway, out on a peninsula in Florida.
What are the digital health innovations that specifically caught your eye during the pandemic?
If you talk to 100 CIOs, you will probably hear 100 times that analytics [must be] part of our future. The focus on analytics is very front and center for us, so much so that we've dedicated real estate to something we call the ‘analytics hub’ that brings together technology professionals, operations professionals, and finance and marketing people together in one place where they can collaborate.
Analytics is also the foundation for the more advanced functions with predictive analytics or AI. An AI lab is also something that we're working on now, but it's not exactly what it might sound like; we're not trying to duplicate IBM Watson Health. But what this AI lab will do for us is help us integrate a lot of the [technology] we've already bought. AI is a very large umbrella, but there are elements of AI in things that we're buying now, but we are not fully unwrapping and integrating all of that, and taking full advantage [of their capabilities]. Taking that to the next level will [entail] creating new insights that we will use to treat patients.
What do you see as the most promising AI use cases right now?
We have spent a ton of time with IBM. In 2019, I took the CEO, some of our board members and some of our senior leaders to IBM, when Ginni Rometty was still the CEO. So we met with her, and we got really serious about being a very large and strong partner with IBM to take their Watson Health set of products—specifically the ones that bring precision medicine or some of those predictive models to light, especially around oncology—to the next level and significantly invest in it. For any health system that feels like they can do this on their own, I think they're [going to struggle], given that IBM is still having a hard time doing it despite all the investments they have made in AI. It still comes back to who's teaching the AI, and there's bias in whomever is teaching it.
To that end, how do you determine who makes those best partners and who you should be investing in?
Generally, the best partners are not determined solely by the technical teams, engineers, or IT folks, but it's the operators and finding a good personality connection between a partner and our providers. Our operations folks have to use this stuff every day, and they really help us define who the best partners are. Of course, we do the technical due diligence and the architecture around it, and then when it all comes together, we have a good partner. Philosophically, I would tell you that our philosophy is generally to have few parts partners and [maintain] very deep relationships with them.
The pandemic has highlighted that healthcare IT operations were previously lagging in terms of digital transformation. So going forward, will we see more of an acceleration in this area, or could IT budgets make that a challenge?
The financial constraint is always a concern. In the past, the way for us to be innovative was when our partners could prove very quickly that there was value in their innovations which we could easily derive. That’s a low-risk approach to innovation, but [sometimes] that’s all the money you have. Then, last January, we as an organization decided we're going to get much more serious about innovation. So we created an innovation fund, which is its own company called InnoVentures. We appointed someone to run the fund, to help us make investments in startups, and generally guide us on where we should place our bets.
But this is a separate bucket of money; we've agreed with our CEO and board of directors that this is the amount of money we're putting aside for the next five years to place some of these bets. We're expecting to get value out of them, but we're going to take a little more risk than what I would call the lower-risk approach. I think that will give us a lot more room to fail at some things without too much [pain] to the organization, because we have set aside money to do this now.
How can CIOs respond to the trend of consumerism?
In some cases, the CIOs lead, in other cases CIOs are in the backseat, and in others, they are collaborators. I would drift more towards the [approach] where the CIO is around the table with other collaboration partners—people who really understand the patient experience and the digital experience. This includes marketing and technology [folks], and then people on the other end who have to use the technology, and frankly, the patients and families themselves. We also have a permanent focus group of patients and families that gives us feedback on those investments we make. Here, I'm a leader of consumerism, but it’s led by an executive group that has a makeup of what I just described. A CIO cannot and should not do that on their own, because it would be a superhuman who would have all those essential skills to really understand a consumer. It’s a vital role, but it should be complimentary to all of the other disciplines.
What would you say is the biggest challenge you face yourself today as a CIO?
The biggest challenge that I don't [think] anyone is doing very well is what I'll call an ‘experience center.’ I think we have a long way to go here as an industry to really ramp up that patient experience, whether that’s a physical manifestation, a digital experience, or both; and I see both in our future. The analogy I always use is the airlines because the airlines got this right years ago when they shifted the load back onto consumers, which we love. We love picking our seat, buying our ticket online, and not having to make a call and be on hold. I don't think healthcare is going to get there because healthcare's much deeper personally, and everyone has a different fingerprint around their healthcare. The airlines now have a very small percentage of people who go stand in line at the airport to buy a ticket or check their luggage; the majority are down that digital path.
I think our future will be a 50/50 [model], where there's a digital pathway with navigation. There needs to be navigation, so it's not episodic; guidance and navigation ties everything together. So if you're an oncology patient, and you have regular checkups, labs, radiographs, and whatever else is involved in that series of care, wouldn't it be great if that were all put together for you in a plan that's handed to you? Maybe you can manage that on your phone, like with OpenTable, or if you're uncomfortable with that, you have an experience center to call to guide you through it. That is the biggest challenge in front of us, and we’re working very hard to come up with some great ideas on how to do it right.
