In November 2013, Indranil (Neal) Ganguly joined JFK Health System in Edison, New Jersey, as its vice president and CIO. Prior to that, he had been CIO at CentraState Healthcare System in Freehold, N.J., for 14 ½ years. JFK Health System encompasses a 400-bed acute-care hospital, long-term care facilities, physician group practices, and home health. At JFK Health System, Ganguly has been helping to lead his colleagues forward in a broad number of areas, from beginning to develop strong analytics capabilities, to meeting the requirements of meaningful use under the HITECH (Health Information Technology for Economic and Clinical Health) Act.
Ganguly is also a member of the board of directors of the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), which held its CIO Spring Forum at the McCormick Place Convention Center in Chicago on April 12. During a break in the proceedings on April 12, Ganguly sat down with HCI Editor-in-Chief Mark Hagland to discuss the issues facing his own organization and CIOs more broadly. Below are excerpts from that interview.
Looking at the landscape right now, what do you see as the biggest issues facing you personally as a CIO, and more broadly, the biggest issues facing U.S. healthcare CIOs?
Interoperability is immediately top of mind. The fact that we’ve got so many tools developed for separate needs, even some that have been elegantly developed, but the fact that it remains very challenging to exchange data even within our own organization, let alone with other organizations, is really the top challenge. Certainly the ways in which vendors have architected their solutions really have made this an ongoing top challenge for CIOs.
The second issue that CIOs are facing has to do with consolidation. We’re seeing large health systems gobbling up the community hospitals. I think there’s a value proposition there, but there’s also a risk, in that healthcare delivery remains local, and how we protect and preserve that, is an issue. I’d also like to see us get out further into the community. Per Dr. Kraft’s presentation this morning [Daniel Kraft, M.D., a Stanford- and Harvard-trained physician-scientist with over 20 years of experience in clinical practice, biomedical research and innovation, had spoken on the topic of the explosion in consumer and other technologies, in his keynote address to CHIME CIO Spring Forum attendees that morning], I was very interested in that. But how do we make use of that data [data from consumer health devices and other devices functioning outside the realm of normal patient care organization activity]? We’ve been using the term ‘big data’ for years now, but few of us have really tackled the issues around big data. And, with regard to any lessons learned—how can the trailblazers make their insights available to the rest of us, so we can use them to help our communities? That’s one of the reasons I so like CHIME—that sharing that we do as fellow CIOs, with one another, in the association.
With regard to challenges around meaningful use specifically, where is your organization right now in terms of its meaningful use journey?
We attested for meaningful use last year; we’re still attesting this year under Stage 2; and we’ll be attesting to Stage 3 in 2016. We’re happy to see the 90-day proposed rule; I hope it sticks.
How difficult has it been to fulfill the meaningful use requirements, say on a scale of 1 to 10?
Between CentraState and JFK together, I would say probably a 5 out of 10. The fact that both organizations had already invested in the required technologies helped. It was not as heavy a lift as it might have been. And I think it added value to the healthcare system in pushing organizations that were behind the curve, move forward, including in potentially sharing information.
What have the biggest lessons learned been around meaningful use so far?
I would probably say that at the beginning, there wasn’t enough focus on interoperability. And the initial rules were specific, as opposed to being very broad and strategic. But it has been a massive undertaking that has been needed; and overall, a good job was done to get us where we need to be. And I don’t know how this has been compared to other industries in terms of receiving industry feedback; but I think that ONC and CMS [the Office of the National Coordinator for Health IT and the Centers for Medicare & Medicaid Services] have been responsive to industry concerns. There is this collaborative air around this from the federal agencies, and they’ve been trying to help us get there without breaking the spirit.
When you look at the next five years for CIOs, what do you see?
I really see the drive towards consumer-driven healthcare; as provider organizations take on more and more risk, we’ve got to rethink how we deliver medicine. And there are so many devices and technologies becoming available for use in healthcare, from Skype to wearables, to everything else. So we’ve got to focus on getting information into the home, and as Dr. Kraft said, we’ve got to become proactive rather than reactive; so I think we’ll see a sharp move in that direction in the next five years.
What are the biggest mistakes that CIOs are making these days?
Many people are still making huge investments in inpatient systems, whereas I think a lot of focus needs to be pushed to the ambulatory, and eventually even into home-based, forms of care delivery. And those organizations will be lagging when we’re bearing more risk.
What would your main advice be to fellow CIOs and other senior healthcare IT leaders, in the next few years?
I think we have to be able to execute very well as CIOs in terms of delivering to customers—our providers, our patients, our communities. I think we have to be open to sharing within our organizations, as in our c-suites, what we learn at conferences like this. That’s true across a wide variety of areas, such as in terms of genomic data and care, and in terms of how we need to take our organizations to where they need to be.
CIOs will have to be more and more embedded with clinicians and understand core aspects of care delivery. Am I wrong?
No, I think you’re right. And many of the most progressive CIOs have been thinking along those lines for years, staffing up with more clinical informaticists, working more closely with clinical informaticists. At the same time, on a broad level, we’ve got to drive cost down and quality up; and today, we’ve just hit the low-hanging fruit in terms of cost and utilization. We’ve got to look more aggressively at workflow and related issues. And we’re still constrained by the FFS payment system, which still encourages in-person care, when sometimes, that interaction…
Are vendors still in somewhat reactive mode?
It really varies based on the size and scope of the vendor. So the big houses out there, and I won’t mention names, but we know who they are, are slow to move. Now they’ve got a big customer base to manage. But in the end, they have to take an aggressive look at their infrastructure and core tools. But the small vendors, they’re moving forward aggressively in terms of population health and other issues. Then they end up being bought up by the big box vendors. But there is a risk that we’ll end up with the Blockbuster or Barnes & Noble model of business.
Would you agree that there could be a danger in over-consolidation emerging on the vendor side?
Certainly, the lack of a competitive environment puts us at risk because innovation tends to wane. But I think we create this huge gap with a few large vendors focused on shareholder value and P&L, and so on. And then you’ve got these little tiny vendors working with genomics and working with wearables, and suddenly, you’ve got little vendors offering breakthrough services like the fingertip prick-to-lab technology. So we really need these small, disruptive vendors. And my message to the big vendors is that if you’re not tracking this stuff and moving ahead with something, you’re going to end up like Sears. It’s a different world.
Is there anything else you’d like to add?
I think it’s an exciting time for all of us. For those who are open to change and aware of where things going—everyone’s using that Wayne Gretzky analogy about skating to where the puck is headed, I think we all need to be tracking the trends and moving towards them, so they’re not a surprise when they get here.
