Health IT Expert to Hospital CEOs: Time to Pay More Attention to Your Consumers

Utterback has more than 30 years of diverse executive leadership and consulting experience in healthcare, academic medicine and IT, having hired more than 50 C-suite healthcare executives on five continents. At HIMSS15 at the McCormick Place Convention Center, Utterback discussed his experience in hiring healthcare executive leaders, giving his thoughts on where the industry is going and what C-suite executives need to be thinking about going forward. Below are excerpts of the conversation he had with HCI Associate Editor Rajiv Leventhal. 

Traditionally, our core has been CIOs, CTOs and CMIOs, but there has been a lot of innovation hitting our industry, so we are now seeing positions such as chief innovation officers and chief integration officers. We're really seeing a lot of focus on non-traditional candidates for the first time. CEOs that are hiring are saying, "find me someone outside of healthcare." With issues around interoperability and security, you can really gain knowledge from other industries. There is an increasingly growing perspective that the answers might not all be within the walls of healthcare. 

Oh yes, I'm a big believer and supporter of this. I think a lot of recruiters at executive firms are linear thinkers in that they look at a resume and use that to decide what you should be. I have never been about that. For me, it's not about looking at a resume, as I have always been a non-traditionalist in what I look for in talent. I think other industries that are highly regulated and have dealt with IT issues can offer a lot of knowledge. There is an increasing willingness to consider that non-traditional candidate and apply lessons from them. 

I don't think that's the issue. The challenge is that jobs are different than what they were pre-Affordable Care Act. You see a lot of young people getting into the IT world, and with healthcare taking up 20 percent of the GDP, there's a big area for employment and growth. So there are diverse markets under that healthcare umbrella. Good healthcare candidates are out there, but are they willing to adapt to change? Will they be able to move across the country? There are different requirements and a new world to consider now. 

At this conference, people are talking about different stakeholders and all that, but to me the elephant in this entire room is the consumer—there's just not enough discussion around the consumer. Patients are patients for 10 percent of their lives; you and I are both well 90 percent of the time. So why are we trying to build IT systems that get you registered better inside a hospital? That's a very narrowly defined view. My view is that healthcare is happening outside of the walls going forward more than inside these walls. It's all about telemedicine, patient-centered care, wearables, anything you can do to reduce costs. It was no accident that the opening speaker at HIMSS this year was the president of Walgreens. Here's a company that was never a healthcare competitor, but now they are absolutely are, as is CVS. They are all competing for patients. 

It's a fact that care is growing outside of the four walls of a hospital, but not enough people are focused on it. How many little surgical centers or radiology outsource solution centers do you drive by? Those are competitors. Talking to CEOs in the hospital world, my message is this: Stop worrying about what's inside your walls and start worrying about how to connect to your consumers who live outside your walls. 

That didn't surprise me, though you need to be financially stable as well, or you won't get the outreach you need. You better be thinking about the 90 percent of the time your consumer is not a patient. What are you going to do to get them into your mix? That's why you're seeing hospitals going into health risk management situations and becoming insurers of their own populations. Improve the financials, but also get to know and experience for the first time what it's like to deal with their consumers. The ones who understand this will be the ones who will be successful in this new healthcare. 

I think it's a narrow group that's really good at being both a fantastic physician and a fantastic business leader. Many are good at one or other, but a much smaller pool are great at both. To be great at both, you really  have to understand both sides and comfortably deal with things like the pressures hospitals are dealing with today as well as things like mergers and acquisitions (M&A). People are graduating school now and going straight to business school, though. Maybe 10 people per year at Harvard and five per year at Stanford and MIT (Massachusetts Institute of Technology) are doing this. So they are there, but it's a small pool. 

The CEOs will say the change from volume to value and the reimbursement issues that come with that. Also, things like M&A and revenue accounting, fundamentally those things that if you don't have in place, you won't have a successful business. CIOs will talk about system implementation, interoperability, and understanding that their stakeholders are a very long list of people for the first time. They are also figuring out the risks around cybersecurity and privacy in the world of wearables, devices, and 1,500 physicians that each have five things they want to bring in the hospital that they want to connect with. 

The modifications appear to be fair, and I think people are getting more confident. Meaningful use has put some significant stakes in the ground, but people will get there— it's more about how long it will take them to get there. I think people understand the value. It's moving from the incentive phase to the penalty phase, so its really getting people's attention.