LIVE FROM HIMSS16: Time for a "Full Tune-Up" on IT Governance Processes

Oct. 4, 2016
At HIMSS16, Ernie Hood and Kenneth Kleinberg of The Advisory Board Company share their perspectives on IT governance and management, population health, and other key topics being discussed at the conferernce

During HIMSS16, taking place this week at the Sands Expo Center in Las Vegas, countless discussions are taking place around healthcare IT governance and operatiions. On Wednesday, HCI Editor-in-Chief Mark Hagland spoke with Ernie Hood and Kenneth Kleinberg of The Advisory Board Company, the Washington, D.C.-based consulting and services firm. Hood is senior director, research and insights, for The Advisory Board Company; and Kenneth Kleinberg is managing director, research and insights, for the firm. Below are some excerpts from that discussion.

When you look at some of the biggest discussions taking place at HIMSS16, which topics most stand out for you?

Ernie Hood: One big one is the evolution of meaningful use. In the DeSalvo/Slavitt talk (the session Tuesday with Karen DeSalvo, M.D., National Coordinator for Health IT, and Andy Slavitt, Acting Administrator of the Centers for Medicare & Medicaid Services), they appeared to be minimizing the significance of meaningful use going into the future, and seemed instead to focus on quality reporting. We think that that aligns with what we're seeing. We think that quality reporting will be a big focus [for the U.S. healthcare system, and for federal healthcare officials] in the coming years.

Ernie Hood

Kenneth Kleinberg: Two areas of great importance that everyone's talking about here this year are EHR [electronic health record] optimization and interoperabililty. This idea that we need big data and analytics for populatiion health is very exciting, but the lack of interoperability remains a major hindrance.

Hood: Value-based purchasing, quality reporting, analytics, population health, telemedicine, and mobility--all those phenomena are tied together. We'are also looking at IT-driven transformation. I call it the "Uber-ization" of healthcare, meaning that IT will be a facilitator of transofrmative concepts.

Kleinberg: Related to that, we have to fortify the infrastrucutre now. Not surprisingly, for all the reasons we all know, data security is becoming a board-level concern now in patient care organizations natiownide.

Kenneth Kleinberg

Hood: What's very important is that you have to "tune up" all your processes, from governance to operations, to IT. It's very important to have an applications portfolio, an IT infrastructure portfolio.

Does that mean rationalizing  your IT assets?

Hood: It actually starts with simply cataloguing your assets. It's actually surprising how many organizations haven't developed an inventory of what IT assets they have.

What are your thoughts on what some (including myself) are calling payer-provider convergence--that is to say, the new alignment of payers and providers around collaboration for population health and care management in the context of accountable care organization (ACO) and other kinds of risk contracting?

Hood: The thing that surprises me a bit is how many provider organizations are actually stepping into risk via creatining their own provider-owned plans, rather than partnering with existing health plans. Some are doing so without even having actuaries. I have to say, I find that rather naive.

Kleinberg: With regard to the convergence, both providers and plans are finding that population health is the way forward for them, and that's why you're seeing the alignment.

Hood: One area in which provider organizations are moving forward early is in terms of starting ACOs with their own employees as the covered lives/plan members. Meanwhile, one area of conflict that is emerging is over providers being edged out of narrow networks.

What should CIOs, CMIOs, and other senior healthcare IT executives be doing right now in the context of all of this?

Hood: You've got to do a full tune-up around governance and strategy. And you've got to demand clarity from the organization around what you should be focusing on. That includes areas like population health and mobility. You've got to have the full c-suite clarifying the priorities and supporting you in your work.

Kleinberg: And it's never been more importnat [for CIOs and CMIOs] to have a seat at the [c-suite] table.

Are either of you surprised by anything you're seeing this year at the HIMSS Conference?

Hood: I've been a bit surprised at the number of sessions on cybersecurity.

Of course, given all the incidents breaking into the news, perhaps the timing is turning out to be good, in that regard? The Hollywood Presbyterian ransomeware story has been receiving a huge amount of attention.

Kleinberg: Yes, cybersecurity/data security is of course very important. Millions of dollars are being spent [by patient care organizations] right now on data security. That being said, one hospital spending $17,000 in a ransomware situation, in that context, is a relatively small amount.

Hood: Per that, one important thing to mention is that data security is no longer about compliance; it's about risk. A patient care organization's board of directors needs to hold the discussion and to set an acceptable level of business risk. Where do you want [the CIO and IT team] to draw the line? that's a key discussion that needs to be had, and many organizaitons aren't having it. Meanwhile, CIOs and CMIOs seem to be playing a game of "whack-a-mole," reacting to situations, rather than strategizing.

Also, I'm very happily surprised, but it is a bit surprising the level of prominance being given to the concept of data governance--that's a good thing. There have been a bunch of educational sessions on data governance. Even Karen DeSalvo mentioned it in her keynote address. The fact that we're having these discussions around data governance and around data security--that shows a maturing in the industry.