John Kravitz, Chief Information Officer, Geisinger Health System
How do you see the benefits of cloud computing for the healthcare industry, and how have you embraced it?
The benefits of cloud computing in the healthcare industry have just recently began to be recognized. They consist of the ability to provide redundant applications since most cloud hosting vendors have multiple data center presence. It also provides for the ability to ‘spin up’ applications at a much faster rate than traditional on-presence hosting. The final benefit is a true cost of ownership since the resources needed to support the application are provided by the hosting vendor.
There is a potential downside of cloud computing as well. A healthcare organization must be certain there are proper security controls in place and that the cloud vendor follows security standards like those set by National Institute of Standards and Technology (NIST). This is critically important when hosting applications which contain protected health information (PHI) or personally identifiable information (PII).
We are beginning our journey of cloud computing at Geisinger. Some of our vendor applications are cloud hosted, again we take measures to make certain that the risk level is acceptable to the organization. We have not yet begun to migrate internally hosted applications to the cloud computing environment.
Hospitals have lots of information but can’t use it effectively to drive business. Data is both difficult to access and needed by more applications. How do you examine the effective and proactive use of data—how to consolidate, integrate and use it to drive business.
We look for IT to provide services which assist the operations of our organization be successful. We’ve initiated a journey where we have a strict governance process to identify solutions to problems stated in the business, utilizing our expertise to find the right solution to meet the business needs. We have also worked hard at defining a process to retire assets that are no longer providing value to the business.
Our organization has taken the integrated solution approach over the best-of-breed approach where data is not always available or must be interfaced to make it interoperable. The decision was made to support the needs of the organization at the most optimal cost.
What are some steps hospitals can take to foster innovation and/or growth? Also if you can share a few points on key technology areas that hospitals should focus on to follow the market evolution?
Innovation occurs in different ways in healthcare organizations. Sometimes it occurs with workflow process changes which take wasted steps out of a process by automating the process. Sometimes it involves code customization or development of specific workflow templates to accomplish in order to capture pertinent information during the patient episode of care.
Growth can be addressed as organic (growth of an existing service offered at a healthcare institution) or the acquisition of another healthcare institution. We’ve experienced both over the past five years resulting in doubling the size of our organization. We’ve taken steps to standardize the growth of our organization by utilizing the same workflow processes regardless of where care is delivered. We’ve also limited code customization where possible to result in an agile approach to future software upgrades.
Over the years, we have witnessed a massive change pertaining to the role of CIOs depending on the organization, the industry, the business strategies, the prevailing market conditions and the financial climate in terms of business value. How would you describe your own role as C- Level Executives has changed in the past couple of years?
The role of the CIO in a progressive health care organization is a dynamic one. The CIO is expected to understand the latest technology trends that may give the organization a strategic advantage. The healthcare landscape has been changing over the past three years moving toward consolidation through merger or acquisition, or by partnering. The intent of partnering is that we can leverage the strengths of two disparate organizations without investing heavily to own them. This places considerable pressure of the IT leadership to determine methods of sharing information and providing services without the risk of being out of compliance. I think the role of CIO will continue to evolve with a greater emphasis on aligning the IT strategy to the organizational strategy. Finding new ways that IT can facilitate business growth through process change or the use of technology to help facilitate.
With your rich experience of managing IT organization and steering technology for your enterprise, can you please share some of the unique lessons learned and your advice for fellow C- Level Executives.
I would say the most unique lesson learned is to spend time – a lot of time rounding through the organization. I’ve found this to be useful in getting to speak to providers and patients to determine how we can best meet their needs. This process was especially eye opening when we look at the ways that patients interact with our health system. One unique issue is getting appointments timely when care is needed. The expectation by leadership is that patients needing appointments need to be seen within 24 hours for a primary care appointment and within 10 days if it were a specialty appointment. We have undertaken a number of initiatives to determine the best way to approach this issue.
Advice to other CIOs. Be approachable by colleagues. Be willing to roll-up your sleeves and get to work as part of the Team to solve organizational problems and more importantly be part of the strategy to grow the organization.
Healthcare C- Level Executives have seen the onslaught of both digital content and mobile devices and need to insure their infrastructure is ready. What needs to be done in the area of infrastructure investment?
With the advent of cloud solutions and the transition to mobile technologies, often supporting or replacing the traditional desktop it is important to have an Enterprise Architecture that supports these initiatives. Traditionally most applications reside in the data center behind our firewalls. The world is changing rapidly with the opportunity to “spin up” new technologies quickly and tracking the resources expended to support them. This has been a traditional challenge in most IT shops where a lot of applications are supported, kept complaint for risk purposes and support by a large infrastructure staff. Today the organization wants to be nimble, connected and understand the cost of new initiatives, both implementation and on-going costs.
The progressive organization also needs to be security conscious as well. With the intensity of cybersecurity threats it is important that the cloud strategy being deployed is safe, quick to deploy and latency sensitive.