Iowa Health already has as an accountable care organization, which contracts with Medicare and private payers for the care of more than 100,000 patients. So it's crucial for the organization to harness IT to improve care coordination and do population health management.
But it's not the IT department driving initiatives, Grosser says. Iowa Health consistently seeks feedback from its doctors, nurses and administrators looking for how IT can support the organization. In fact, Grosser is the only IT representative on the system's 20-member IT governing council.
"We want our strategic plan to be enabled by IT and information, but not to have compromises to that strategic plan made by IT," Grosser says. "We want to drive side by side with the providers."
Grosser comes out of hospital operations, and despite having spent more than 20 years in health IT at various institutions, she has never forgotten her experience in operations. "You have to think about the need for information on the planning side: What are we trying to accomplish?" she says. "Strategic planning and IT planning go hand in hand and have always been part of my mantra."
-- Ken Terry
CIO, Dana-Farber Cancer Institute
On the research side, Dana-Farber is trying to create personalized cancer treatments, combining genomic, clinical and other kinds of data. Other organizations are doing this as well: Memorial Sloan-Kettering, for example, is partnering with IBM to use Watson supercomputing for analysis. But Dana-Farber is using its own software and equipment. "Data storage is an issue," Kessler admits. "But even that is manageable with tiered storage solutions, keeping the data you need with immediate response times in the higher-cost tiers and moving less frequently used data to lower-cost tiers."
On the clinical side, Dana-Farber uses the homegrown Longitudinal Medical Record of Partners Healthcare, since there isn't a well-developed oncology EHR on the market, Kessler says. At Dana-Farber's urging, Partners has added oncology enhancements such as an advanced chemotherapy order entry system. Partners is switching to Epic EHR.
Kessler, who became CIO 11 years ago after stints with UMass Medical Center and Cabrini Medical Center, gets strong executive support to serve his multiple goals. The leaders "recognize that the institute's strength is the ability to balance all our missions, including research, education and community outreach," he says. "That makes the job easier to balance."
-- Ken Terry
Turnbull led the team to successfully bring the ordering system live. He displayed the same can-do attitude when it came to integrating Cerner with the Epic system that the University of Utah's primary care clinics had been using since 1999. The IT team used a custom-built interface that lets users pull up information from one system while working in the other one, a project that won the organization a Most Wired award from Hospitals & Health Networks magazine.
But that level of interoperability isn't enough. The University of Utah has begun converting the entire organization to Epic, a move it expects to complete by spring 2014. Turnbull explains that clinicians will be able to use a single integrated system more easily, because they will always have the same view of a patient's chart, no matter where they are or what they're doing.
Turnbull's efforts have earned him recognition as the 2012 John E. Gall Jr. CIO of the Year from the Health Information and Management Systems Society. Turnbull is a former president of HIMSS and former chair of the College of Health Information Management Executives.
Turnbull agrees with those who say that the government should slow down the Meaningful Use incentive program and allow healthcare providers to learn lessons from the progress made to date before moving on. "We're dealing with complex organizations, and the biggest concern is the pace of change," he says. "I don't think the biggest pushback is on the standards. It's more about the pace."
-- Ken Terry