Baystate Health's CIO on the Key to Solving Healthcare's Challenges

April 14, 2015
The HIMSS15 buzz has been around population health, patient engagement and HIE, but according to Joel Vengco, vice president and CIO at the Springfield, Mass.-based Baystate Health, many healthcare leaders are forgetting a core piece to the puzzle.

At the Healthcare Information and Management Systems Society (HIMSS) conference this year, the buzz throughout the halls of McCormick Place Convention Center in Chicago has been largely around population health, analytics, health information exchange (HIE), and patient engagement. But according to Joel Vengco, vice president and CIO at the Springfield, Mass.-based Baystate Health, many healthcare leaders are forgetting a core piece to the puzzle—access to data.

Vengco has provided the vision, plan, and execution behind the December 2014 launch of the Springfield-based TechSpring Innovation Center, a collaborative initiative that will match private enterprises with partners from Baystate to take on some of healthcare’s most difficult challenges. Vengco says that TechSpring offers partners flexible space to work and the ability to collaborate directly with care providers from Baystate Health on their projects, assessing providers' needs and creating solutions to address those needs. On April 13 at HIMSS15, Vengco sat down with HCI Associate Editor Rajiv Leventhal to talk about this project, as well as what's further needed for the healthcare industry to meet its growing challenges. Below are excerpts of that interview. (Note: Vengco was also part of the HIE Symposium on April 12 at HIMSS15, covered here).
HCI: Tell me more about the idea behind and goals of TechSpring. 
Vengco: We want to crowdsource innovation. There are so many problems in healthcare as a result of this new focus on value-based care. Don't get me wrong, these are good problems, but with them comes lots of challenges, and you need a lot solutions to address those issues. The vendor market today does not have all the answers, so TechSpring is an invitation for the globe to partner with health systems like Baystate Health to utilize assets including data, experts, the environment and clinical organizations, and bring solutions that we absolutely need in healthcare today. In today's environment, failing fast is a good thing. Inventing quickly and winning big is a capability that our systems have provided to us. So TechSpring is focused on bringing those solutions to market. 
What kind of solutions? 
Solutions beyond the electronic health record (EHR)—features and functions that are needed for caregivers that can take their  work and engagement to another level. Take a look at other industries that focus on consumer services, and think about how we can deliver solutions to our patients to enable us to engage with them. Consumer-based products such as Uber and OpenTable are examples of what we can address and achieve today in healthcare.  
The other part of this is around patient engagement and mobile apps. It's about turning hospitals and care delivery into the experience of the future; no longer are the four walls of buildings the way you should deliver care. How do we invite other industries to help us develop capabilities that consumers use to engage with us frequently? And of course, analytics is a big deal too. I don't believe that we have solved the big data issues, so let's bring in vendors and start-ups from this industry and others to utilize the data for these kinds of models. People from other industries can say, "Hey I've done this in the financial sector and it's worked." 
Can this kind of idea be the gateway to an open healthcare ecosystem?
Absolutely. It's a way to liberate the data, and a platform for innovators to develop solutions to create an ecosystem of capabilities and solutions for providers and patients to access. One of the things that's the focus is to fail fast and win big. Part of what we want for innovators to understand is when you come in to TechSpring, it's up to you to solve some of these challenges, in the way we believe we can solve them. It's okay to fail. Healthcare software in the past has been plagued with the idea that everything is part of a larger system, and that's an issue when you want to make everything so perfect. The life cycle becomes a multi-year journey. You can get to solutions in sprints as well. 
There's a huge issue to getting access to data from sourced systems, such as legacy EHR systems. Having access to data is paramount to getting to population health, analytics, and new care delivery models. We often forget about that core piece of the puzzle. TechSpring is pushing different ways to get there, via FHIR (fast healthcare interoperability resources) standards, and asking our vendors to move with application program interfaces (APIs). All of these pieces are critical for us. 
The feds have certainly put great pressure on vendors, though. Is that why they try to be so "perfect?"
You're right. Innovation has been stifled because of mandates that have have forced people to put resources into addressing problems such as EHR certifications and meaningful use, and not other challenges in healthcare. Even more relevant is to have the ability to crowdsource innovation. These larger vendors should feel compelled to grow inorganically to partner with these other innovators that are coming up with solutions.
Vendors are reluctant to open up their databases, as they want to be the solution provider for everything, though that's not possible. So many commercial vendors and start-ups are out there that can deliver solutions. There was a study a few years ago on the impact that holding onto data has on healthcare. They found that if data was open for innovators to get access to, it would be a $40 billion industry. There is lots of innovation still to be done. 
You presented yesterday during HIMSS' HIE Symposium. How is this lack of data liberation affecting data exchange?
We started a regional HIE, Pioneer Valley Information Exchange (PVIX), in western Massachusetts, and the single biggest issue right now by far is the cost of creating the connection from the EHR to the HIE. EHR vendor costs are inhibiting members to joining—smaller practices are finding the costs outrageous. The problem isn't the technology, it's that the up-front costs and transaction fees from EHR vendors makes interoperability expensive. I would say interoperability should be free.
Legislation won't change it. The feds won't develop legislation to force vendors to open their data, nor should they. But they can do different things to put pressure on vendors such as pushing open APIs, and pushing ways to access this data, perhaps through certification measures and through meaningful use. 
So you would say the biggest challenge in healthcare is...?
Access to that data is the single biggest challenge. There are cultural challenges as well, as sharing data with competitive organizations is still something that providers don't like. It comes back to the idea that we shouldn't be competing with the data, but instead what we should do with the data. Vendors should start to create larger alliances, and by that I don't mean just CommonWell with 60 percent of the patient population. It should be CommonWell plus Epic plus everyone else, so you have 100 percent of the population. But Epic may not ever agree to that, they may believe that their 40 percent share will continue to grow and be interoperable. But having data available will create more opportunities for patients and providers. 
So the "buzz" at HIMSS will focus a lot on patient engagement, and vehicles to engage patients like mobility. There will also be analytics buzz. Those two pieces bring you to population health management. However, what I'm really focused on is how these vendors and how these innovators are going to help us get access to the data. I'll be speaking with many of our vendors and partners to move the needle on data liberation. That is most important thing in healthcare today. We aren't there yet with the data, and that's the biggest issue for us. 

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