In times of crisis, healthcare organizations often will turn to their veteran leaders to steer the ship in the right direction. At Intermountain Healthcare, a 24-hospital healthcare system based in Salt Lake City, Utah, CIO Mark Probst knows a thing or two about leadership.
Probst, 61, has, spent 32 years in healthcare IT, and just recently received the 2019 John E. Gall Jr. CIO of the Year Award from two leading industry associations—the College of Healthcare Information Management Executives (CHIME) and the Chicago-based Healthcare Information and Management Systems Society (HIMSS).
Probst is not a clinician but runs oversees operation of Intermountain’s IT department and is directly responsible for the implementation of key technology systems used by the organization’s clinicians. As the COVID-19 outbreak continues to rapidly spread across the country, IT leaders throughout patient care organizations are quickly realizing they need to shift their strategic priorities to help clinicians handle the pandemic. Probst recently talked with Managing Editor Rajiv Leventhal about those opportunities, as well as sharing other thoughts on the two final interoperability rules released last week and CIO leadership.
From a COVID-19 perspective, what is Intermountain doing on an informatics level so that it can best respond to an evolving crisis?
Well, first there are the practical things such as working from home, and making sure that our caregivers who can work at home have the right technology in place to do so. And that’s more complex than you might think, so we wanted to make sure all that was in place. We also have been working on a few projects for the organization; they wanted to [implement] drive-through assessment capabilities, so we’re setting up technology to support that and limit people coming into the facilities. So, that’s well underway and we are building out the technical infrastructure while [others] are building out the physical infrastructure to do this.
We didn’t have a COVID-19 test and now we are getting it, so we’re building it into the EHR so [clinicians] can order them. We also have put the right precautions in place so you don’t overorder the test. We have a good supply now, but not a massive one; and if the virus spreads the way they’re talking about it spreading, the supply won’t be big enough.
We’re also working on the lab side to help interface the lab equipment that will be used to conduct the testing. Another practical thing is that when someone comes in, now we’re asking them several more questions about where they have been. Have they been anywhere that would put them at higher risk for the virus? Another thing is dealing with the [employees] who might not be able to come in because someone in their family has been quarantined. So we are using our time-tracking tools to [monitor] that.
On the data side, we’re using technology such as AI [artificial intelligence] and machine learning to [analyze the data] we have. But that is more nascent; we have a germ tracker tool [called GermWatch] so we can use that, but this isn’t a proactive [tool]. It’s more about understanding where the germ is and what’s going on. We also work with a local company to look at lots of data sources that might help us predict where the next occurrence of COVID-19 might be, and as it starts getting broader we’ll see hotspots bump up and those kinds of things. So we’re doing a lot in that space; using data to understand, and if we can be more predictive of where [the virus] might be and where we need to focus our efforts from preventive and care perspectives.
Do you believe that if we as a healthcare system were more proactive in certain areas, the overall COVID-19 impact could have been lessened?
Maybe, but I don’t want to be too critical of our health system. Our reaction is more that this is a new disease. Regardless of what the disease [was], we would have had to create the tests and orders, and there are other pieces we would have had to put in place anyway. Could we have done more? Probably. Will we be better prepared next time? I think so, and given that the severity of COVID-19 illness in healthy populations isn’t high so far, maybe this is a good wakeup call in terms of how we handle things in the future.
How have physicians responded to some of these newer protocols?
We have daily calls on COVID-19 and the things we’re doing, just like I’m sure every other health system has. We have a very good protocol; if someone just shows up with symptoms that are similar to the flu, unless they’re critically ill, they won’t get the test, as far as I understand. There needs to be some pattern, such as were they in Italy or China, or one of the other hotspots? So they need to meet that [condition] as well as express the symptoms, because there is a limit. We can’t test the whole state now, so they’re using that criteria to apply whether or not to apply the test. In Utah, we have a lot of land, but our population is only a little more than 3 million people, so it’s likely a lot more manageable than New York City, for instance.
As a CIO, there is so much to take from the two interoperability rules that just were finalized. How do you view the balance that must be struck between data sharing and patient privacy?
I do believe there are valid [privacy] concerns, but for me personally, I’m not so concerned about them, because I want the benefits of interoperability and being able to put the data in some of these third-party applications to get the health value that comes from it. But there are people very concerned about the privacy of their data, and we have to pay attention to and respect that. So it’s an issue.
What do you see as the biggest challenge for healthcare CIOs today?
The biggest thing we’re dealing with today outside of coronavirus is getting our costs aligned with what the industry needs our costs to be, in a period when there’s so much desire for new technology. It’s tough; you have one side in which you need to get your costs down because reimbursement isn’t what it’s used to be, but then the other side is that you have so much more technology that our clinicians and business people need and want. In that balance, you need to make sure you keep these systems at the level of expectation because lives are on the line. There are a lot of pressures on the CIO, from a cost perspective to a liability perspective to an integration perspective. And it’s almost becoming a perfect storm in the CIO world.
What leadership advice would you give to your fellow CIOs as they look to navigate an ever-evolving industry?
I think we have to pay attention to becoming much more technically competent. The softer skills—the strategy, functionality, and training components of what we do—are moving to the business operations. There’s no reason to stop that; that’s a very positive thing and it suggests we have been successful over the past 30 years in terms of moving the needle on more technology and the benefits of it. But what [health systems] really need from us is people who really understand technology—such as networks, databases, and the cloud—so that we can keep these things reliable and fast. Our systems, such as EHRs, still continue to be relatively old in their foundations, and CIOs need to be leaders who understand the technical aspects of that. The business [side] can do much more of the strategic work.
