Exploring the limitless field of health information technology with some of the best and brightest

Nov. 14, 2017
Chris Akeroyd, CTO, Children’s Health, Dallas

What’s your background up to your current role?
I have over 22 years of IT leadership experience, with the last decade being focused on Healthcare IT. I currently serve as the VP/CTO for Children’s Health in Dallas. Prior to the healthcare industry, I had experience as a VP/CIO for a national mortgage company and a global telecommunications organization.

What has been the hardest project you have worked on to date? What did you learn from it?
Projects that introduce workflow, process, or healthcare delivery changes are among the most challenging and rewarding. Implementing an electronic health record (EHR) is a tremendous challenge because you’re automating processes that may have been on paper before.

Children’s Health began implementing its EHR in 2007. Since that time, the expansion and use of our EHR system has permeated our health system operations, as we’ve worked to leverage this technology as a means to deliver on our mission of making life better for children. We continuously strive to improve processes, so just implementing the EHR wasn’t the “end” of the journey—we have continued working to optimize workflows to drive efficiency and improve delivery of care to our patients.

With the continued growth of the “mobile” workforce, we’ve made changes to the way we deliver applications, including the EHR. This transition has yielded some important lessons—most notably the importance of user acceptance testing and full lifecycle integration testing. Changing the way people work is often met with resistance and requires significant training and user acceptance.

In your opinion, what’s the most interesting thing going on in healthcare IT today?
Analytics and interoperability are quickly evolving and becoming the basis for providers to deliver healthcare. Analytics are an integral part of our efforts to improve patient safety, as we are able to use data to identify opportunities for improvement and to understand trends. I also believe analytics and interoperability are an absolute necessity as we work to develop new care delivery models, including population health, telemedicine programs, and other proactive care delivery approaches. When you combine strong analytics with the ability to easily and securely share data across the continuum of care (and between providers), you improve your level of safety and sustainability.

Shauna Coyne, Director of Innovations,NewYork-Presbyterian Hospital

What has been the hardest project you have worked on to date? What did you learn from it?
The most challenging and exciting project I have worked on is launching our NYP OnDemand telemedicine program. We are in an environment where people are still getting used to the idea of delivering care virtually. Implementing the technology is one thing, but on a national level, telehealth laws and reimbursement policies vary. We didn’t have a playbook to follow, so we really were paving the way to develop a comprehensive suite of digital health services.

When working at a large health system with two academic medical centers and 10 hospitals, scalability is key. When you are introducing new technology and a new way to practice medicine, you need to make sure that you are able to regionalize the program across all clinical workflows.

What advice do you have to give to those looking to enter the healthcare IT space?

  1. Having the best technology is important but there is so much more to healthcare IT. Understanding the operations, processes, and people, really distinguishes a successful program or product.
  2. Never underestimate the importance of measuring quality and data. It is too easy to fall down the trap of finishing a project and moving on without taking a moment to deep-dive into the outcomes.
  3. Healthcare IT is always changing, so you need to be able to adapt to stay on top of the curve.

What do you hope the healthcare space will accomplish in the next five years? 10 years?
In the next five years, hospitals are going to be less dependent on the physical infrastructure. Healthcare is moving toward virtualization by creating the sense of a ‘virtual hospital’. I also think providers will have more adequate tools to make efficient decisions such as artificial intelligence and machine learning.

Dustyn Williams, MD, Co-Founder and Lead Educator,OnlineMedEd and Co-Founder and Chief Medical Officer, DoseDr

What’s your background up to your current role?
I earned my undergraduate degree from Yale University, then spent two years as a paramedic before entering Tulane School of Medicine. While there, I helped Tulane rebuild in the wake of Hurricane Katrina and picked up several awards for my work.

It was in my third year when the flash-point moment happened that would lead to OnlineMedEd. I was sitting in one of eight two-hour lectures that I was forced to endure during my OB/Gyn rotation; this one on contraception. I walked in knowing only what I had seen on TV and walked out knowing even less—despite being lectured on every nuance of oral contraception. It wasn’t the lecturer’s fault. A reproductive endocrinologist, he taught what he knew and wanted to teach. And he was really good at it. But it was way over our heads. We were seven years away from considering if reproductive endocrinology would be our chosen field and most of us wouldn’t even do OB/Gyn.

I walked away from that lecture asking why we were wasting our precious time learning things that we didn’t need as third-year students. What if there was a way to strip out everything that was better left for residency, and instead focus on teaching what students need to know, at the level they need to know it? What if we could do it in a way that actually promoted engagement, understanding, and retention? What if it was taught by people who were both great doctors and great teachers?

Inspired, I grabbed a white board and camera, and talked my girlfriend into handling the filming. Those first lectures were so awful and so boring that she literally fell asleep while the camera was rolling. The website wasn’t much better. Nonetheless, people watched. Then came back for more. Because as bad as those first videos were in production quality, they were better than what most students were getting in classrooms and lecture halls.

I had the passion, I felt the need, and it was through my mentors and my experience that I found the way—Wiese’s Clinical Coaching, a monthlong course designed to sculpt medical educators is the center of my style. Brought to Tulane from UCSF, Wiese’s philosophy and methodology were exactly what I believed was needed.

Things clicked into place. I was given the opportunity as a student and resident to teach at Tulane, which further advanced my skills. A failing intern’s request that I tutor her birthed the Intern Content that is still available on OnlineMedEd. All the while, I was making videos in my “spare time.” OnlineMedEd was born, but it was still just me, making videos.

Enter Jamie Fitch, a clinical epidemiologist and longtime friend who challenged me to think bigger—to create a self-sustaining platform for the new-and-improved videos that could serve as the launchpad to bring them to more students.

Today, I’m OnlineMedEd’s Lead Educator and a full-time hospitalist, in addition to my academic responsibilities. The company’s more than 70 hours of comprehensive medical education videos across 19 specialties have attained essential-resource status for more than 80% of medical students in 191 countries who are preparing for clinical rotations and board exams. We have over 100,000 unique users on the site every single month. We’ve also worked to create hundreds of pages of companion notes, thousands of clinical vignettes and flashcards, clinical cases, and more to provide a single hub for students to learn everything they need to thrive in their clinical education.

Everything I do is with one singular purpose—to make someone a better doctor. It’s not about recognition or validation. It’s about empowering medical students; taking away their anxiety, disseminating knowledge and skills, and giving them the strength and confidence to survive medical school and become better doctors.

What has been the hardest project you have worked on to date? What did you learn from it?
The first two iterations of OnlineMedEd were the hardest. It took endless amounts of talent, time, and stamina to get the job done.

These two iterations also taught me that accomplishing our goals could not be done in a vacuum. It may be my face on the screen, and my 10,000 hours spent developing and sculpting the content. But our students demand excellence, which requires a community effort. Our physician-writers could earn far more money moonlighting in an urgent care clinic, but working on behalf of the students who rely on our videos feeds their passion. Our notes, flashcards, and questions have all been contributed by attendings and vetted by medical students who pounce on any error, typo, or omission. The students keep us honest by poking holes in our content and sharing information—whether it’s something learned from their attendings or in response to questions on our message boards—that guides future content.

What advice do you have to give to those looking to enter the healthcare IT space?
First, reconsider. It requires navigating a rigid, slow-moving, gargantuan beast fraught with regulatory red tape, archaic fee structures, and entrenched in outdated processes.

Second, ignore that first piece of advice. Healthcare needs technology. It needs revolutionaries and entrepreneurs willing to shake off the shackles of the status quo, and fight the good fight to effect meaningful change.

If you have the ingenuity, commitment, and determination to slog it out, healthcare IT is a huge untapped market that is ripe for change. It represents the ability to revolutionize the way healthcare is delivered, by making it possible to accomplish the same tasks more effectively and efficiently than was thought possible just a few short years ago.

Renee Fosberg, CIO, Emerson Hospital, Concord, Massachusetts

What’s your background up to your current role?
I have always wanted to work in healthcare and pursued a degree in healthcare administration. To get my foot in the door, I took an entry level job as an IS analyst at a Boston hospital. I am not a “techie” by trade, but collaborating with people and being able to adapt to change have proven to be invaluable skill sets that have allowed me to have a successful career in information systems.

What has been the hardest project you have worked on to date? What did you learn from it?
There are many projects that I have worked on in this category. One of the hardest ones was implementing a new state-of-the-art perioperative and anesthesia medical records system here at Emerson. We were the first hospital in New England to have this solution. We needed a new solution to deliver a comprehensive system that would help our clinicians optimize their workflow and deliver high-quality, coordinated care through the perioperative environment.

Electronic documentation is collected at the point of care, which includes real-time integration with our vital sign monitors. Because we have advanced technology solutions, perioperative information is now viewable throughout the OR and family waiting areas on “big boards” to ensure that timely information is available to all caregivers, family members, and loved ones. This project was the first at Emerson that integrated biomedical equipment and patient monitors to an Electronic Medical Records system. Bringing different departments together to implement this project was not simple. Having solid project management, documentation, and communication skills is instrumental for all projects, and I learned that these skills are invaluable, particularly when working on challenging strategies and implementations.

What advice do you have to give to those looking to enter the healthcare IT space?
You need to be able to adapt to change. We are in the most transformative years in the history of healthcare in the U.S. This transformation is coming from multiple directions with consolidation of healthcare systems and changes in insurance reimbursement models, all while managing a shift where healthcare is becoming more consumer-centric. Organizations that want to successfully respond to these challenges need to have IT on their leadership team and have IT be part of its growth strategy.

Graham Gardner, MD, MBA, Co-founder, Chief Executive Officer,Kyruus

What’s your background up to your current role?
I am a cardiologist by training—drawn in at the age of 8 to the world of medicine and its mission to help people and make the world a better place. After completing my clinical training in internal medicine and cardiology at Beth Israel Deaconess Medical Center and Harvard Medical School, I began to realize that there was an opportunity to impact healthcare at scale—an ability to align public health and business in a way that could drive sustainable improvements to the way in which we deliver care to patients across the world. Yearning to understand more about how to build and scale companies, I went to business school and subsequently joined Highland Capital Partners, a venture capital firm that proved to be a great platform from which I could start companies.

During my first year at Highland, I co-founded Generation Health, a genetic benefit management company that facilitated the optimal utilization of genetic testing. Serving as the Chief Medical Officer through its acquisition by CVS Caremark confirmed my passion for creating new solutions to improve healthcare access and delivery. During my tenure, I was also fortunate to recruit and work with Julie Yoo, with whom I would later go on to found Kyruus.

After selling Generation Health and hiring my replacement to lead the clinical program going forward, I reconnected with Julie and began exploring opportunities to bring a data-driven approach to matching patients with the right providers. We saw an opportunity to borrow what the airline industry had learned around capacity utilization to help ensure that modern health systems were driving the same supply/demand efficiencies within healthcare. Just as the Sabre system, Travelocity, and Kayak had empowered consumers to find the right airline seat, we hypothesized that a similar platform could patients find and book with the right providers. Today, our search and scheduling solution powers the coordination of patient care for over 350 hospitals around the country.

What’s your favorite piece of technology?
I am watching advancements around conversational UI and chatbots closely. Scheduling a doctor is more difficult than scheduling a trip to Florida. In healthcare, patients don’t know that they want a 7:30 a.m. flight to Miami. Instead, they might just know the equivalent of “wanting to go somewhere warm for spring break.” Automated chat offers an opportunity to not only help triage patients with “fluttering in my heart” to the right cardiologist, but also promises to perform the action without the need for a person to answer a phone. As such, health systems might be able to provide more customized care management while actually reducing costs and inefficiencies.

What’s the most rewarding aspect of your current role?
It’s very important for me to know that I am making a difference in the world. Practicing cardiology offered a tangible and direct way of understanding the impact that you had on a person’s life. I spent the first part of my career training to ensure that I would be ready in that moment when my actions might help to save someone.

At the same time, knowing that you can empower the work of colleagues across the country is equally humbling. We founded Kyruus on the principle of “Moneyball”—the idea that we are all different, all beautiful in our own way, each with our relative strengths and weaknesses. I see our work as a platform to unlock each provider’s potential—matching them with the right patients to allow them to practice what they are uniquely trained to deliver. Helping a traveler find the right airline seat means that they get to the right place on time; matching a patient to the right provider can mean the difference between life and death. That responsibility inspires me.

Maia Hightower, MD, MBA, MPH, Chief Medical Information Officer,University of Iowa Healthcare

What’s your background up to your current role?
I attended Cornell University for my undergraduate education. My interest in medicine was triggered much later than most. It was sparked by an “aha” moment when I was studying abroad in Kenya as an undergraduate student. I remember the exact moment like it was yesterday. “Aha” moments are like that.

I was in the Masai Mara-Serengeti, sitting on a hill on top of a plateau that overlooked what felt like a thousand-mile expanse of the dry semi-arid desert below. In the far distance, I saw a Masai woman. She was balancing a jug of water on her head, and a baby swaddled onto her back. The distance between the woman and that village seemed so far. This was her fate. She was destined to the same life as her mother and her mother’s mother. The distance between that Masai woman and me was worlds apart. But we were connected. By age. By gender. By race. Yet, there I was, the world before me with infinite opportunity. Infinite choice. At that moment, I chose a path where the work I do supports the fundamental right to health. I chose to be a doctor.

Ultimately, I specialized in Internal Medicine and Pediatrics, caring for adults and children across life’s continuum, cradle to grave, individual to populations.

After completing my residency training at University of California San Diego, I joined a private practice close to my family in Oakland California. I quickly realized that I needed an additional set of tools to impact the business side of medicine. I attended Wharton’s executive MBA program at its San Francisco campus. I was the only physician among a class of entrepreneurs, venture capitalists, financiers, and engineers. It was there that I was able to mentally connect the dots between myself and that Masai woman so many years ago. Today, she has a smartphone. Today, she is connected to the world through a digital platform that enables the flow of data seamlessly from one corner of our globe to another.

Soon after completing my MBA, I became an Assistant Medical Director at Stanford Health Care’s University healthcare alliance, a growing clinically integrated network created to expand Stanford’s footprint outside of Palo Alto to neighboring markets in the San Francisco Bay Area. Stanford has been recognized as an early implementer of an epic electronic medical record system. One of many was to assist in the adoption responsibilities as an assistant medical director of Epic, by medical practices newly integrated into Stanford’s network. Stanford does a great job of investing in training for its physician leaders. At Stanford, I was able to put into use effective management and leadership skills.

I subsequently was approached by a recruiter to consider an opportunity to join the faculty at the University of Iowa Healthcare as Chief Medical Information Officer.

The digitization of healthcare is fueling a radical transformation in medicine, allowing shifts from a fee-for-service model to one that is based on value. Patients value high quality, great experience, and a fair price. As CMIO, my hope is to provide clinicians, researchers, educators, and learners the information technology tools, processes, and systems they need to thrive in this new era of medicine. The rate of change in medicine is only accelerating.

What advice do you have to give to those looking to enter the healthcare IT space?
For physicians who are looking to enter the health IT space, I recommend becoming a physician champion in your specialty. We are always looking for physicians interested in technology that can demonstrate EMR best practices, find more effective and efficient ways of using the tools, and share their knowledge with their colleagues. Compassion is key here. We are trained to be compassionate toward our patients, but not always so toward our colleagues.

I think one of the coolest, newest professions out there is data science. If I could do it again, I seriously would consider becoming a data scientist. Healthcare IT has all of the challenges of a Google or Apple, except we are 100% dedicated toward helping people, often at the most vulnerable times in their lives. The healthcare mission is a noble one that should resonate with anyone interested in making a positive difference in our world.

What do you like to do off the clock?
Spend time with my family. We are an active and adventurous bunch. We love to travel and experience new cultures. We value cultural exchange of ideas. We also value health, fitness, and appreciation of the arts. Skiing, tennis, and music are favorite pastimes. We like to tinker, and consider ourselves makers.

John Bass, Founder, CEO,Hashed Health

What’s your background up to your current role?
I began my career at Vanderbilt University Medical Center’s Division of Trauma. After spending a few years pursuing a clinical career, I developed an interest in IT projects. This was the mid-’90s, so it was an amazing moment of technical change. I could not consume enough information about the internet and how it was creating new business models. I was hooked.

So, in 1999, I was fortunate to join a startup called empactHealth.com which was a B2B marketplace for healthcare. We used the internet to bring efficiencies to inter-company supply chain activities. It was interesting because that was the first time healthcare trading partners sat down and talked about how they could share an operating system.

When the market consolidated, we were in good position because we had rolled out too many large healthcare systems such as HCA. We were acquired by Medibuy, and then a year or two later, we merged Medibuy with Global Healthcare Exchange (GHX).

I left GHX after about nine years to help start another collaborative technology company called InVivoLink. This time we were focused on collaboration across surgical episodes of care. InVivoLink was focused on reducing costs and improving quality of care by creating a patient registry. We encouraged providers, manufacturers, and others to share a common clinical and financial performance management system that laid across the episode and its many constituents. Turns out it was a great fit for bundled payment programs here in the U.S. We sold InVivoLink to HCA around two years ago.

Therefore, my background has been primarily focused on collaboration and shared operating systems in healthcare. I love the idea of creating what Michael Porter calls “Ecosystems of Shared Value.” To me, it seems counterproductive for companies to look at themselves in isolation, when they are all part of a connected system that is supposed to be treating patients. In many ways, I feel like many of the successful companies in healthcare today have begun competing with the consumer. I think that’s a dangerous position for the company and for the sustainable care of people in our society. That’s what drove me to connect with blockchain and start Hashed Health. Blockchain is a way to reshape the ecosystem with the consumer at the center. Blockchain is the only thing I’ve seen that can truly change the conversation. We are entering an age of collaboration and blockchain is going to play a major role.

Where do you see the future of the healthcare IT space going? Five years from now? 10 years from now?
I think we are at another special moment in time, similar to the one I mentioned earlier in the mid ’90s. We have these amazing emerging technologies like AI, Machine Learning, and IoT.
These technologies are possible because of the internet. Add mobile devices to that, and you have incredible possibilities. Anchor these technologies to a blockchain, and you have something truly transformative on par with, or potentially greater, than the internet itself.

For example, we are looking at a transformation of how payments work. Using blockchain to change the payments container, we can think about how we can remove limitations imposed by banking, claims systems, and flat currencies. This goes way beyond improving how value-based payments are administered. We have the opportunity to create whole new economies that can be designed to do all kinds of interesting new things such as integrating to payments and benefits, enabling micropayments, machine-to-machine transactions, and streaming payments.

The same concepts can be applied to medical records assets, supply chains, the pharma value chain, venture capital, and many other areas.

I predict all these markets and value-chains will be affected and re-arranged. Much of the digital infrastructure that is currently privately controlled and focused on value-extraction will be replaced with open public infrastructure.

In terms of the incumbents, the winners will be those who look at themselves as technology companies who are collaborators in networks.

I also predict that whole new distributed and decentralized markets will be created. It is not possible to really say what this looks like in 10 years; much like it was not possible in the ’90s to predict Airbnb, Uber, and Facebook. But it’s clear that it has the potential to empower consumers, and my hope is that, with all the potential disruption, the consumer is the real winner.

What advice do you have to give to someone looking to enter the healthcare IT field?
If you are in school, learn to write code. Hide in a room for a few weeks and read as much as you can about blockchain. Go to blockchain meetups (the Nashville Blockchain Meetup I founded has gone from 10 to almost 600 people in the last 10 months). Go to conferences. Become part of the conversation. The great thing about blockchain and distributed ledger technologies is that much of the conversation is happening out in the open. It’s a lot easier to become a contributing part of the community. Tokenization concepts can actually reward you for doing so.

Raj Toleti, CEO, HealthGrid

What’s your background up to your current role?
I come from an extended family that has more than 20 physicians among its ranks. As you can imagine, when I decided to pursue healthcare in a different capacity than was the norm in my family, it was met with some skepticism. Being exposed to so many physicians and hearing firsthand some of their frustrations gave me an idea that IT could revolutionize healthcare in a way that had never been seen before.

Over the course of my career, I have led three successful startup ventures including Galvanon (acquired by NCR in 2005) and Cytura Corporation (acquired by Mobius in 2002). The Galvanon and Cytura teams were among the first to develop technologies that improved patient experience.

Prior to founding HealthGrid, I worked as the President of Coordinated Care Solutions at PatientPoint. The work I did there solidified my vision for creating a complete enterprise patient engagement platform.

I currently serve as an Advisory Board Member of the Association for Executives in Healthcare Information Technology (AEHIT), am a professional member organization of CHIME, and I am a Board Member of the University of Central Florida (UCF) Foundation.

What advice do you have to give to those looking to enter the healthcare IT space?
Health IT is a very crowded space. You must find your calling and really have the staying power to realize your dream. Starting a company in Health IT is not for the weak-hearted (no pun intended). The journey from concept inception to revenue and sustainability is now reaching five years. Every year, over 95% of the Health IT startups fail. To recognize success requires significant vision and focus. Having said all of this, I am not trying to scare away young entrepreneurs. Rather, I am saying you need to go into this space eyes-wide-open and completely and truly believe in your mission.

What’s your favorite technology right now?
I am a strong AI/Bot advocate. In the early ’90s I wrote my Master’s thesis on utilizing AI to help navigate autonomous vehicles on different terrains and in different traffic patterns. Over the course of my 20-year career, I have been inspired and motivated by the work I did on that thesis. Today I am getting a chance to use AI to help patients navigate the traffic patterns of their care journey—making that thesis a reality!

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