CHIME22: ‘We’ve Learned to Be a Bit More Agile’ and Other Health IT Lessons

From left to right: Moderator Liz Johnson, retired Tenet Healthcare CIO, appears on stage with John Glaser, Executive-in-Residence at the Harvard Medical School Executive Education; Theresa Meadows, Senior Vice President and CIO at Cook Children’s Health Care System; and Andrea Daugherty, Interim CIO at Dell Medical School at the University of Texas at Austin. Photo by Teta Alim

Lessons in Agility and Collaboration from the COVID-19 Pandemic

While Fort Worth, Texas-based Cook Children’s continues to see young patients in the emergency department for COVID-19 and flu-related illnesses, Meadows said that the experience in standing up drive-thru testing during the height of the pandemic improved her organization’s response speed. 

“We’ve learned to be a bit more agile,” she said. “I think we’ve learned a lot over the last two years that’s really changed our industry in thinking about things a bit more differently and how we get things to market quicker.”

For Daugherty, the pandemic also spurred the growth of virtual collaboration — with staff working remotely and providers offering virtual care — and refining processes beyond a health crisis. How can healthcare IT attract talent from other industries with remote capabilities?

As a millennial, she says, she expects technology to be available, readily accessible and operational, and she hoped that mindset could become more widespread in healthcare:

“How do you take that mentality and bring it into an industry that’s historically laggard?”

DISCOVER: How digital transformation is taking off in healthcare.

The Evolving Healthcare IT Landscape  

Meadows was positive about the changing industry, praising Daugherty and the next generation of healthcare IT leaders. “For those who’ve been in this industry for a while, it’s refreshing to have people who are thinking differently and really bringing new ideas to the table,” she said.

Earlier in his career, Glaser said it was common for other healthcare leaders to view IT as opaque and unknowable, but now that many have experienced the implementation of electronic health records, more executives have become discerning and inquisitive about IT.

“The CIO has gone from being a sport of the individual who’s carrying the organization across the finish line to a team sport,” Glaser said.

Still, the lack of diversity among healthcare IT leaders remains an ongoing issue. Daugherty hopes to be the leader that she needed when she first entered the field and realized just how white and male-dominated it is. “I’m happy to be the first, but hopefully I’m not the last, and that’s what’s important here,” she said.

When it comes to the technological aspect of the industry, Glaser said organizations are in an era of transformation that goes beyond a simple value-add to a brick-and-mortar business — it’s about retooling everything. And when the next phase arrives, it will be “digital, period,” he said, where organizations are no longer transforming to digital but are living and breathing it.

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For Meadows, the adoption of EHRs was transformational, especially when there was finally buy-in from clinicians and patients to be a part of the process. She said Cook Children’s has very engaged clinicians — a huge change for the industry from when clinicians would try to bypass IT solutions.

“I look back at that and see how far we’ve come from a clinical perspective in really getting them more engaged,” said Meadows, who has a nursing background. “I absolutely believe the foundation is there and we have to figure out how to continue bringing in that clinical input into our decision-making and our customers’ input — not just patients, but everyone’s input.”

The importance of cybersecurity in healthcare has also grown immensely. Daugherty said she became more focused on cybersecurity in 2017; that’s been critical amid the rise of cyberattacks against health systems, especially during the pandemic. And as more organizations adopt digital strategies, the value of patient health information will only increase.  

“Making sure that the workforce of the future has a security-first mindset, I think, is going to be really important,” Daugherty said.

Mitigating the Workforce Crises in Healthcare

Meadows also acknowledged healthcare’s workforce shortage, not just from a clinician’s perspective but also from an IT leader’s perspective. She said she has 90 open, highly competitive positions in IT at her organization. Now is the time for organizations to think more broadly about collaborating across environments and possibly sharing resources.

When it comes to staff burnout, Daugherty emphasized mental health support. Meadows added that staffing shortages could provide an opportunity for innovation.

“If you haven’t done a burnout survey in your organization, I would encourage that because you get a lot of rich data about why people are burned out and why they’re leaving and why the change is so hard,” she said. “And then you can start thinking about ideas that you can create.”

Some solutions might involve virtual nursing support or a job share program, Meadows added. It’s important to innovate in different ways beyond clinical care.

Daugherty said that she’s also approached nontraditional departments to recruit talent as an opportunity to add unconventional experiences to healthcare IT. “For some reason, there’s still this misconception that you have to be a technical person to be in technology, but you don’t.”

WATCH NOW: How Atrium Health’s virtual nursing observation program mitigates clinician burnout.

What’s Next for the Role of CIO in Healthcare?   

Disruption and innovation in healthcare don’t have to be science fiction fantasies.

“I think you can disrupt the things you already have,” Meadows said. At Cook Children’s, her team has been working on what she called a “mashup” of technology in which they collaborate with current partners to use what they have in different ways.

“It’s not always about the new shiny object that disrupts things. It’s about how we challenge the status quo to take things that we have and use them differently,” she said.

Disruption on its own is not a virtue, Glaser added: “Technology itself is usually not the disrupter. The business model that leveraged the technology — that is disruptive.”

So, for Glaser, innovation is fundamentally “invention at scale.” For example, with the invention of the Ford Model T, the innovation existed in the systems that supported the first automobile, from the creation of roads and gas stations to the emergence of car insurance, creating lasting impacts.

While companies in retail, finance and other industries have been redefining themselves as tech companies, healthcare organizations have largely outsourced innovation to vendors. But is that finally changing?

Daugherty acknowledged that the build-versus-buy conversation has been around for a long time, but recent lessons have shown that healthcare can develop internally. For instance, she said that she stood up her DevOps team before the pandemic. Though budgets are tight now for many healthcare organizations, teams need to learn how to do more with less.

Meadows added, “Development is not our core competency. The value we bring to the table is the workflow and the knowledge about how our environment works. So, work with partners who are willing to adjust with you based on your workflows, and be creative together.”

What’s the Top Skill a CIO Should Develop in Three Years?

Meadows cited relationship building, especially with the prevalence of remote and hybrid work. Even though collaboration is virtual, strong relationships are still necessary.

For Glaser, organizations that can effectively handle change management can secure a successful transformation process. So, CIOs need to think about improvement across an organization, not just limited to their departments. “How do I, as an IT exec, work with my leadership team to elevate our collective prowess as an organization?” he asked.

Daugherty named data management: “How do we know this was a good investment? How do we know we’re actually transforming patient care or improving patient outcomes? So really being comfortable with where data’s coming from, where it’s going, how to read it, how to transform it, how to analyze it — those are skill sets that a future CIO really needs to hone.”

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