C-Suite innovators discuss advances in technology, cybersecurity, interoperability, analytics, and more

April 25, 2018
Marc Harrison, MD, President and CEO, Intermountain Healthcare

What is your background up to your current role?
I earned my undergraduate degree at Haverford College and a medical degree at Dartmouth Medical School. I completed a residency in pediatrics and a fellowship in pediatric critical care through the University of Utah School of Medicine, working at Intermountain’s Primary Children’s Hospital. I later received a master’s of Medical Management from Carnegie Mellon University and completed additional study in management at Harvard Business School.

Responsibilities early in my career included serving as chief medical operations officer for Cleveland Clinic, where I was responsible for a broad range of clinical operations worldwide, and as chairman of Pediatric Critical Care. I most recently held positions as chief of International Business Development for Cleveland Clinic, and CEO of Cleveland Clinic Abu Dhabi. I’ve been at Intermountain since 2016.

What is the biggest challenge in the HIT field today?
I would say that the inability to share patients’ information between proprietary systems (often called interoperability) is the biggest challenge. However, that data must become interchangeable between systems to provide the best possible care to patients. Imagine trying to care for a patient who’s recently moved from one state to another, whose previous provider used a different EHR than you do, and you don’t have access to previous medical history. That’s not safe for the patient or the provider. There are many paths to solving the interoperability challenge. Whether that’s government mandates or an industry awakening to the need, remains to be seen.

Can you tell me about Intermountain Connect Care Pro?
Intermountain Connect Care Pro is our virtual hospital strategy. It brings together over 35 telehealth programs that have been implemented in various parts of the organization. In addition, we’re bringing what we call “Provider Support Services” such as the Transfer Center, Patient Placement, and Life Flight under the same roof. By doing that, we can streamline the delivery of care for patients, and support providers as they care for them. The goal is to keep patients as close to home as possible, and give providers the tools they need to provide the best care or optimize and easily transfer their patient, if needed.

What does all of this mean for the future of telehealth?
We really see telehealth as central to the delivery of care at Intermountain. It allows us to provide the same level of expert care at rural facilities as we have at our tertiary and quaternary facilities. As we look to population health, it makes sense to avoid transfers wherever we safely can, both for the organization and for the patients. Keeping patients in their local hospitals not only saves them money, it keeps them close to their support network of friends and family.

Are there any specific challenges related to telehealth?
It takes time for providers and patients to adapt to this technology being part of care. It took many years for Amazon to convince consumers that online shopping was safe, and some pushback from patients and providers is inevitable here too. Healthcare is much more complicated, and people need to see it as a safe and viable option for them.

Off the clock, what do you like to do?
I’m a big fan of family time and enjoy keeping fit through participation in endurance sports such as triathlons.

Michael Archuleta, BSIT, Chief Information Officer, HIPAA Security Officer, Mt. San Rafael Hospital, Trinidad, CO

What is your background up to your current role?
I’m a disruptor, innovator, and collaborator that is focused on patient-centric technology to improve the quality of life because patient care is No.1! My career spans 15 years in the areas of technology, systems deployment, implementation of business processes, and process improvement for technical infrastructure systems. I’ve worked as a consultant, field systems engineer, director of information technology services, and a chief information officer. I’ve been recognized as a Top Hospital and Health System CIO to know, and named Rising Star in Healthcare.

I currently serve on the board of directors for The Neural Network, a CXO advisory board facilitated by NetApp, am a Healthcare Ambassador for Fujitsu of America, and a past Board of Director for Colorado HIMSS Chapter. I’ve been an active member of CHIME, a cybersecurity advisor to healthcare startup companies, and an active speaker within the field of HIT.

In my current role, I oversee all aspects of IT and lead major organizational transformations. During my time as the technology leader, I’ve led and designed the first data center, while then adding virtualization efforts that reduced costs by 56% and improved uptime from 59% to 99%, which increased business productivity, operating efficiencies, and enhanced services, while reducing operating expenses.

Under my guidance and leadership, Mt. San Rafael, where I oversee the IT Department, became one of the leading Community Hospitals in the state of Colorado for leveraging advanced technology to enhance the patient and provider experience. Being goal-oriented, innovative, and having a driven approach, our organization met HIMSS Analytics State 6 recognition. Leveraging advanced IT to improve performance for value-based healthcare in the areas of infrastructure, business, administrative management, quality, safety, and clinical integration, the IT department at Mt. San Rafael has also been presented the 2015, 2016, and 2017 Healthcare’s Most Wired Award, which is given annually to the top hospitals in the country making the most progress in the adoption of HIT.

What is the biggest challenge in the HIT field today?
In my opinion, cybersecurity continues to be one of the biggest challenges in the HIT field today. Healthcare is the industry most frequently targeted by cyberattacks, and we are facing major challenges that require us to modernize, reform, and improve services.

It has become clear that truly effective security measures must take a more comprehensive perspective by providing a foundation of security information that focuses on formalizing processes, implementing intelligent security technologies, creating cybersecurity awareness training programs, and building teams that collaborate in helping change the culture in the organization. This then allows organizations to build a human firewall, which is one of the most critical elements in building a successful cybersecurity strategy. In the end, we need to remember that cybersecurity isn’t just about data security—it’s also a matter of life and death.

Where do you see the future of healthcare going?
A number of advances in technology now point to a new wave of “patient-centric” technology, redesigned and rethought from the very start to reflect what matters most to the patient. If the past several years have been about the “informed patient,” the future will be about the “involved patient.”

At the end of the day, we are all here for one reason and one reason only—we are here to save lives and improve patient care. The future of healthcare needs to see the patient as the organization’s new CEO who will disrupt the way we provide healthcare as a whole. If we can connect the dots between the technologies that meet their needs, involve the patients, and design patient-centric tools that improve their overall lives, we will earn their trust and loyalty. This is what the future of healthcare needs to be. We need to move away from informed patients and more toward the involved patient. The patient has to be at the center of our focus because patient care is No.1! We need to continue to develop asynchronous patient-centric tools focused toward patients that help them meet their needs and solve their problems to improve their quality of life.

Off the clock, what do you like to do?
Off the clock? What does that mean? Is this a trick question?

All kidding aside, I love spending time with my wife, daughter, son, Chihuahua, and beagle. We love traveling, skiing, relaxing on the beach, and living life to the fullest. We all need to remember to never be so busy making a living that we’re forgetting to make a life.

Indranil (Neal) Ganguly, VP and CIO, JFK Health System

What is your background up to your current role?
I started my career in the insurance industry and worked for NY Life and Empire Blue Cross for a number of years as an analyst in the underwriting and product development areas. After leaving the insurance industry, I went to work as a management consultant for a firm that did work in the hospital finance and receivables management space. That company broadened its focus to work toward the development of an integrated delivery network in New Jersey and I transitioned into a role where I oversaw the acquisition and development of the systems needed to support such a network.

That gave me my first real experience in directly managing IT solutions and I subsequently took an opportunity to join the IT leadership team at Elizabeth General Medical Center, where I reported to the head of IT. Elizabeth went through a merger a few years later, and I joined CentraState Healthcare System in central New Jersey as the VP and CIO. I spent almost 15 years there and my team was able to attain HIMSS Analytics EMRAM Stage 6 designation and multiple Most Wired Hospital awards during my tenure.

Since 2013, I have been VP and CIO at JFK Health where the team has also been recognized with multiple Most Wired Awards and is in the midst of an ambitious systemwide replacement of core systems.

What is the biggest challenge in the HIT field today?
Interoperability remains a challenge which the vendor community has been slow to respond to. The lack of true standards makes the movement of data between systems a labor intensive and expensive process. I’d say delivering more intuitive and usable systems for our clinicians has also been a challenge.

Where do you see the future of healthcare going?
Technological advances and cost reductions in diagnostic tools combined with mobility and the evolving mindset of patients as consumers will rapidly change how healthcare is delivered. Companies like Amazon, Google, Apple, and CVS are bringing deep pockets and tremendous knowledge of consumer behavior to the provider setting. These organizations are positioned to deliver intuitive and usable applications and diagnostic tools at an affordable cost, direct to the consumer. Hospitals and physicians must understand this coming change and chart a course to remain viable through this transformation in a way that does not try to hold onto old practices, but embraces what they do best.

I heard that recently you moved from a best-of-breed to an all Epic EHR environment. Can you tell me about this?
We are in the process of moving from a best-of-breed EHR model to Epic. Our health system recently merged into a larger organization that will ultimately deploy Epic throughout its network. Moving all providers to one platform will help to reduce some of the interoperability issues that exist today and give clinicians a more unified view of their patient’s information without having to go into multiple tools. Whether it is Epic, Cerner, MEDITECH, or one of the other vendors in this market, I think that the drive will be to look toward more integrated solutions until interoperability standards are agreed upon and take hold.

I also heard you are very knowledgeable when it comes to federal health IT initiatives. Can you tell me a bit about how you came to be so knowledgeable? Is there anything our readers should know about right now regarding federal health IT initiatives?
I used to be much more engaged in federal HIT policy matters, and honestly struggle to keep up with the pace of activity out of Washington. I am a member of the Policy Steering Committee for the College of Healthcare Information Management Executives (CHIME). We are fortunate to have a group of highly engaged CIOs and be shepherded by a very talented team of CHIME policy experts in DC.

Two of the issues that have focus at the federal level are interoperability and cybersecurity. I learn a great deal from the CHIME DC staff and my colleagues as we try to understand the thinking coming from the government. It has been nice to see how much legislators from both sides of the aisle value healthcare and are interested in learning about health information technology.

Off the clock, what do you like to do?
I started teaching a university class in HIT which has been fun. I like to spend time with my family and as time permits to travel and try my hand at photography. I’m also trying to get more physically active and started to run and cycle again recently—but have a long way to go to get competitive.

Feel free to share any other thoughts on HIT.
I have been fortunate to end up in the HIT space and am fortunate to have made many great friends in both the provider and vendor community. The business still has the ethos of a service-oriented community and (with few exceptions) HIT vendors, and provider IT teams collaborate to deliver technology and value. I look forward to seeing what is next for our ever changing industry.

Alex Mandrak, Director of IT Budgets and Business Intelligence, Maimonides Medical Center, Brooklyn, NY

What is your background up to your current role?
I started my career in Maimonides back in 1996 after obtaining my undergraduate degree in Accounting. I started as a billing clerk in patient accounting and a year, later was promoted into a supervisory role in charge of accounts receivable, cash control, and federal/state audits.

After being involved in various areas and processes, I decided to learn Excel and Access in order to streamline and automate some of the internal workflows, manual and labor-intensive processes, including reduction in human errors. After noticing positive results, and seeing both users and management using my templates, programs, and conveying their value to me, having a musical background, I fell in love with IT and its creative nature.

Several years after, I was given an opportunity by the interim director at the time and was promoted to manager with 22 direct reports to me and in charge of all aspects of patient billing. I decided to continue self-educating and started learning various programming languages and databases.

Five years later, I was able to land a position supporting the hospital’s billing system. After seeing a lot of inefficiencies, manual spreadsheets, and man hours to produce month-end reports, I decided to write a complete software package surrounding budgeting, contract management, and procurement. This software package tracked all aspects of budgeting and procurement including employee time sheets for labor capitalization on capital projects worked, contract management module, and automated month end reports for internal and external use.

A few years later, our Organization engaged Ernst & Young to conduct an IT procurement audit. At completion of the engagement, it was cited that the department has strong controls, processes, and procedures related to procurement and mentioned my software package as the main tool used internally to track and document all related work flows and reporting. Based on this audit, we were issued an unqualified opinion and very shortly after, I was promoted to director of budgets and business intelligence architect, which is my current role today.

What’s the most rewarding part of working in the healthcare field?
I think the most rewarding part of working in Healthcare, particularly in HIT, is that it gives you an opportunity to be creative, know that what you are building or supporting will ultimately help patients, and at the same time contribute to improving your organization and helping it grow and succeed. It also exposes you to meet and interact with a lot of different intelligent and talented people from different disciplines. With the vast variety of projects, you get an opportunity to not only learn new technologies but also challenge yourself in coming up with innovative, creative solutions to solving problems and knowing that at the end you are helping someone whether it’s a patient, a provider, or any other employee within your organization. This is my motivating factor and why I’m so passionate about this field.

It was mentioned you worked on the development of performance analytics dashboards that provide real-time, as well as daily graphical information. Can you tell me more about this?
At the request of senior leadership and the CFO, I’ve developed an executive performance analytics dashboard that tracks length of stay, average length of stay, patient days by service, and compares the results to budget and displays variances. In addition, the dashboard reports on patient volumes like number of admissions/discharges by service. The dashboard also displays trending graphs showing statistics over time and prediction on volumes for the next several months.

What project(s) are you currently working on?
I am currently working on several different projects including a bed capacity dashboard. This dashboard shows bed capacity and percent occupancy by different disciplines and nursing units with the ability for users to select different parameters for dates and service units. This data was based on vendor-provided software static reports. The challenge there was to find creative ways to scrape the data off the reports and automate the ingestion of data into our warehouse to be used as the basis for the dashboard. I had to use various technologies and ETL tools to accomplish this.

Another project is developing and modeling a database for housing our employee data. Leveraging our dashboard development tool, I’ve created front-end screens with different searching capabilities to look up information on our employees, including providers and their credentialed information. The Master Identity Management dashboard is updated in near real time with interfaces from various systems including HR and credentialing.

I’m also piloting a mobile app I developed for the hospital’s sick line. This mobile app enables the user to electronically log their out of office request with reason for taking time off and requires electronic employee signature. A daily report is then generated and forwarded to management via email with the call-out list and related information. This reduces administrative time in compiling this daily list manually and reduces errors.

Futher, I’m also developing a dataset model based on our Department of Health SPARCS data and joining it with other publicly available published data, where the executive office can analyze our data related to demographics, patient population, payor mix, DRG, etc. and compare it to industry standards and our peers to gauge our performance and identify areas for improvement.

Finally, as a member of our Clinical Informatics Committee, and in an effort to reduce length of stay, I was tasked with developing a real-time dashboard where physicians in different disciplines can monitor their patients and track their locations, length of stay by service within their current stay, care provider teams, and procedures. Continuing my effort in expanding our warehouse infrastructure and overseeing our big data analytics strategy, design, and implementation.

Off the clock, what do you like to do?
I like to spend my free time with my family… especially with my 7-year-old daughter, who I think is too mature for her age, but that makes it all the more interesting for me to interact with her and watch her grow. I love to keep up with new technology and constantly try to learn something new and enhance my own skill set by reading different technical books, articles, and whitepapers. I also enjoy playing the piano/keyboards and arranging music for musicians and creating backing tracks for vocalists.