AG: Why did you decide to move from St. Joseph’s to CHW?
BW: Well, first of all, I am really excited to be in CHW. I am moving from a great organization to a much larger and widespread organization. St. Joseph’s health system has 14 hospitals and CHW has around 41 hospitals. I saw it as a fantastic opportunity to continue growing and developing as leader, but also to bring the great experiences that I enjoyed at St. Joseph’s into helping CHW, particularly in IT strategy and care-redesign kinds of areas, as well as building a strong IT model.
AG: What kind of due diligence did you perform on CHW to make sure it was the right fit?
BW: One of the things you realize is that in Catholic healthcare, we’re all connected to some degree. So I was very aware of CHW and its great mission. I was aware of the leadership. CHW has a great process for developing its ministry leaders — which are our executives — so I already had some great interactions with leaders here over the last several years.
AG: How has the role of CIO evolved over those years?
BW: First of all, I think the year 2006 — that period of time — there had been a lot of transitions in healthcare in terms of CIO leadership. I think that is connected to the fact that healthcare IT is evolving. It’s moving up and maturing, so there is a greater demand on CIOs to be business leaders and innovators and know the business and know the challenges and parameters. I think when you sit down with the operational leaders, and the financial folks, and you talk their language and understand the challenges that they are having and how you could help, it goes a long way of building a mutual relationship with your peers.
I think that’s a key element. I think a lot of times technology is so complex and is not often understood. One of the best things you can do when you’re listening and conversing is also being able to educate the organization and the leaders, particularly not on technology, but more on outcomes and investments, and how we can help transform new ways of thinking about process and technology.
Managing, operating and maintaining IT departments and your data center and that kind of thing is one skill set, but I think healthcare IT is far beyond that now in terms of what the expectations are. It’s been a discovery process. I am really strongly emphasizing the education here. Organizational leadership wants to understand and know how IT works on a business level, what decisions go in. They want the same level of rational and accountability that they expect from any other business process. But I think it’s often been a mystery because it’s difficult to understand its acronym and jargon, and there is a lot of fluff and puff and promises in the IT industry that don’t necessarily translate to better outcomes in healthcare. So I think the CIO has to not only be a great relationship builder, but also an educator.
AG: Some clinical systems are better sold to the executive committee as patient safety must-haves, rather than pure-play ROI deals. How do you handle that situation? What standards are you being held to in terms of establishing ROI for all your investments?
BW: I think ROI is typically the way we assess how we are going to invest, but in a limited area where capital is capitated we only have so much to invest. So I think we also need to build a case for how we are improving quality outcomes. I think the investments that we are making into CHW are a great testament to our mission of improving care. I think as healthcare continues to transform, the acute care model most likely is going to change in the longer run. We have to position ourselves for how we are going to reach the communities and how we are going to equip the physicians in an extended network of care.
And I think those kind of discussions are greater and broader than pure ROI. ROI is very important. We want to know that the millions we are spending in clinical-care areas have a financial impact. I think we quantify that in terms of increasing efficiency, reducing lost charges, making sure we eliminate redundancy and lost tests and information. But more than that is the satisfaction of the caregivers and the patients and improving safety. And I explain the investment from an educational standpoint — technology by itself is not going to change healthcare, it’s only a way to equip and enable.
I think part of that is educating the organization and the industry to lay the foundation for care improvement. This is done by first building the infrastructure and redesigning process, which is very critical, and beginning to automate and improve the quality of information at the source.
The second paradigm is now that we have done these foundational systems — we have improved, automated, and redesigned — now that we have the information, what do we do with it? How do we continue to reduce variability of care, how do we ensure that we are providing the most effective outcomes with this information?
There is a lot of data being generated. Certainly in a system as large as CHW, with so many hospitals and so many areas we participate in healthcare, we have a lot of data for us to aggregate. When we do, we begin to see patterns which gets us to the most transformative part of clinical care change, and that is the transformation of the medical practice of care and that is where you use this data, you have the variability patterns and you can actually see and compare the indications and the provisions of care into higher quality outcome. That’s been the elusive goal that healthcare has spent a lot of time and money on over the past four or five years. We are really looking for that goal — how to change the quality and outcomes of care, but it really has to be done in a very deliberate and measured way.
