On Nov. 23, 2022, the leaders at the 40-hospital UPMC in Pittsburgh made an announcement regarding their organization’s new chief clinical information officer. According to a press release posted to the organization’s website on that date, “UPMC has named John Fairbaugh, M.S.N., R.N.-B.C., to a new role as the system’s chief clinical information officer, effective Dec. 5. Fairbaugh, currently director of clinical and operational informatics/emergency services at UPMC Magee Women’s Hospital, will support clinical operations across UPMC’s 40 hospitals and 800 outpatient sites by enhancing technology applications and ensuring that they are meaningful to clinical users,” the organization announced. “A health care professional with more than 21 years of nursing experience and an extensive background in emergency medicine and informatics, Fairbaugh says, ‘I’m kind of the translator between the information technology leadership and the clinical leadership.’”
The announcement went on to note that, “A former paramedic, Fairbaugh notes that early in his life he considered a job in information technology but “fell in love with nursing” so he took that path instead, joining UPMC as a nurse in 2002. But after discovering a college program in nursing informatics, he realized that he could combine both of his passions. After completing a master’s degree in nursing informatics at Waynesburg University, he moved into that role at UPMC Shadyside in 2013.
“John is committed to open and strong communication and is inclusive of varying perspectives – critical qualities in ensuring the successful selection, deployment and continuing improvement of our clinical technologies,” said Maribeth McLaughlin, vice president and chief nurse executive of UPMC, who oversees the new CCIO position as part of the UPMC Center for Nursing Excellence, in a statement contained in the press release.
Recently, Healthcare Innovation Editor-in-Chief Mark Hagland spoke with John Fairbaugh about his professional journey, his new position, and his perspectives on the issues facing clinical informatics leaders. Below are excerpts from that interview.
Tell me a bit about your professional background.
I’m a nurse by trade. I’m 42 years old, and I’ve been a nurse for 21 years at UPMC, initially in ER and critical care. And I eventually shifted into an informatics role in 2013. And prior to this position, I was a director of informatics for the past six years at McGee Women’s Hospital.
Are you the first person at UPMC to hold the chief clinical information officer title?
There was one person in this role—it was called Chief Nursing Informatics Officer—who retired. They expanded it to cover all clinical technology issues.
You work closely with the CMIO, then?
Yes, I do.
Tell me about your new role as chief clinical information officer at UPMC.
As CCIC, my role is really to oversee the safe and secure implementation of many types of information technology. My teams understand the clinical workflows and applications and IS out there, and are constantly seeking to implement new systems. Informaticists—clinical informaticists—we really need to consider the combination of the healthcare practices and resources to make sure we can measure and improve outcomes, drive healthcare decisions and improve better outcomes for our patients and our providers.
What are the top priorities you’ve identified so far?
Everybody knows about COVID and how it’s changed the way we look at many aspects of our lives, and that’s helped healthcare leaders to see how vulnerable our organizations are, and the opportunities to transform and grow informatics in many different ways. My role is to position the organization to implement these technologies to better help enhance medical decision-making by providers and improve outcomes and enhance the patient experience.
What are the biggest challenges you’re having to face right now?
I’ve been in informatics with UPMC for over six years, so I’ve seen how things have been done. The biggest challenges will be around change management, and doing things this way because we’ve always done things that way. We need an enterprise-wide approach; and historically, that has not been the case with many of our business units, so driving change will be a challenge. There have been a lot of leadership challenges at UPMC, and things are becoming aligned, but that will be our challenge. We’re looking at more of a service line approach, with more of a service line model than a hospital-based model.
There’s a lot of balkanization in a hospital-based model?
Yes.
How many hospitals are in the UPMC system now?
There are 40 inpatient hospitals, and then I have some oversight over the outpatient setting, and there are more than 800 sites there.
Tell me about some of the leadership aspects of leading clinical informatics?
This role is a big step for me; the role itself has evolved from managing day-to-day operations, to being a key leader at the executive level. The decisions they make have ramifications on the clinical side as well. We want to make everything beneficial. And they’re not necessarily aware of issues around security, interoperability, etc. So having this voice at the table will help with decision-making. I can also be a voice on the clinical side as well, to show that I have the experience in both areas to help make decisions for the whole healthcare team collectively as well.
What are some of the learnings from your previous roles that are helping you to be effective in leadership now?
Working with a lot of clinical folks, more specifically nurses has been one area of learning; they’re not very technology-savvy, so they look to us to be that knowledge resource for them. At the end of the day, if I’m a clinical person at the bedside, I want the technology to work; I don’t want things to break down or cause problems. They depend on us to make sure things are functioning on a day-to-day basis. And I don’t think the clinical staff are really aware of all the things we do behind the scenes to make their lives easier. So w really need to sell our roles so they can understand how we’re helping the organization. Over the years, everyone gets what they want, and we keep adding on and adding on. So we as leaders need to take a step back to optimize and standardize systems to get nurses back to the bedside caring for patients, as much as possible.
When it comes to IT governance, what would you like to accomplish?
I think we really need to develop that service-line approach, so that we can standardize systems and get on the same page. And that has to come from a high level in our structure. IT, we should marry up and work collaboratively to design IT infrastructure to help patients communicate with their providers and help physicians communicate with one another and have the data to deliver care effectively.
What lessons did you and your colleagues learn during the pandemic?
The lessons learned are that we constantly have to change the way we think and work, and that we have to learn to adapt more quickly. Every day, technology is changing, and it’s changing how we work. And the way that providers deliver care will continue to be challenged, as consumers want increased access and cost savings and convenience. They want to be partners in their care. And I think we’ll see our organizations shift more from an acute setting to more of a population health-driven, ambulatory approach, which will intensify the need for certain types of technology, in that we’ll need to provide certain types of technology to help providers care for patients. And in my previous role, I was also a clinical leader, and had to work through day-to-day staffing crises. IT will be a leader also in helping clinical leaders to maintain their budgets and user and patient experience.
What would you say to clinical informaticist leaders around the country, as they approach some of the same issues?
I would say, don’t be afraid of change; you want to be innovative, you want to develop technologies that are patient- and provider-focused so that everyone taking care of our patients can have the appropriate tools to make the highest-quality decisions and promote the best outcomes for their organizations.
