The convergence of technology and health care, combined with consumers' demand for smarter interactions with providers and health plans, puts a lot of pressure on the chief information officer (CIO) to modernize the infrastructure while maintaining the existing business. Optum® Advisory Services Senior Vice President David Chennisi draws on 30 years' experience in health IT to offer practical advice on how to transform your infrastructure — and still get your day job done.
How can CIOs prioritize their time to focus on digital transformation?
The question of how to divide your time between operations and transformation is a difficult one because engineering the technological evolution falls largely to the CIO. And the CIO is swinging back and forth from supporting legacy IT to planning for big data and analytics.
Take the digital transformation a step at a time. The first and most strategic step is to work with leadership to develop the use case — down to the possible sequence of interactions between systems and users in their particular environment and related to a particular goal. I know that sounds mundane, but it's a necessary step for envisioning the end state as well as identifying the barriers to reaching it, such as gaps in talent, processes and technology. Once the use case is defined, areas for build, buy or subscribe will be more clearly defined, along with guardrails for costs, timing and roles.
What does the CIO need to drive action and begin the transformation?
Once the business case has been established, the next step is the blocking and tackling effort of marshaling the resources, money, people and applications to accomplish what you've set out to do over a period of time. Without the first step, it's much more difficult to proceed.
The CIO is responsible for defining and enabling the technology to deliver what each stakeholder needs — for financial predictability, clinical quality, population health management, and growth — without slowing down core operations.
Pace and prioritization is important, and regular inputs from key stakeholders are critical. Most importantly, the CIO needs to understand where stakeholder needs intersect and how to synchronize multiple series of actions with technology.
In this climate, the CIO has a day job (business as usual) and a second, still primary focus: to ramp up rapidly but not recklessly. Consider which technologies are hindering coordination and growth, and which technology partners can match the demands of the organization in a responsible, affordable way.
Who can support the CIO?
It's a challenging reality. Both payers and providers need to be able to respond and adapt — to become unstuck — or resign themselves to obsolescence. During my time as a CIO, I set a goal to meet weekly with company officers to discuss planned and in-play initiatives. I set another goal to meet monthly with the medical operations department, claims department and call center, and with each of the five or six different major parts of the health plan.
Like most CIOs, I was always very busy, so I tapped my own network for answers, and often avoided new vendors and partners. If I could go back, I think I would do it differently. Instead of keeping such a high filter, I would advise CIOs to spend more time in periodic sustained conversation with health care technology consultants who have a depth of experience. It's a lot less complicated when people who have done this before help you identify which infrastructure can be offloaded, where economies of scale can be achieved, and what is realistically doable — rather than visionary — with existing resources and proven technology.
How much time do CIOs have to modernize their organizations?
We all know that the relationship among payers, providers, employers and members is deep-seated. But health care reform and technology disruptions are exacting changes in the way outcomes are achieved in the health ecosystem — which necessitates better collaboration and interoperability. For instance, cloud technology has already begun to give payers, providers and consumers a common view.
But in some ways though, the technology transformation is the easier problem to solve. The more difficult problem is how to help the leadership team and the deep-rooted culture shape a vision of the end state as the business model shifts from volume to value — and from a B-to-B sales model to a digital, consumer-focused model.
We know the shift isn't instantaneous. But in order to compete, plans and providers have to make decisions now about transforming their capabilities. Those who figure out how to collaborate, how to share information and use technology to enable higher quality and lower costs will win in this race. But it won't be easy — and not everyone will make it, that's the painful reality and the reason for urgency in our industry.
Learn more about how CIOs will streamline technology and operations for a competitive advantage.
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