"Here's to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes... While some see them as the crazy ones, we see genius... Because the people who are crazy enough to think they can change the world are the ones who do."
Lynn Vogel, CIO of the University of Texas MD Anderson Cancer Center comes to mind. Rather than sign on with one of the major commercial EHR system vendors such as Epic or Cerner, he chose to develop a one-of-a-kind patient records system from the ground up. Most commercial vendors are focused on either routine hospital or physician care, Vogel says, and don't incorporate the latest clinical research data into patients' records.
In cancer care, that routine just doesn't work, Vogel says. "It used to be a university would do the research. Five, six, seven or eight years later, it would show up in some clinical practice," he says. "We want to shorten that. When people have cancer, they don't want to wait four or five years." They want to learn about new research right away, so they can enroll in clinical trials. "That's what drove us," Vogel says about the center's work to incorporate research into clinical processes faster.
In a recent phone interview, he said the center's plan in the next few years is to do gene sequencing on every one of the patients at MD Anderson. Such massive amounts of individualized molecular data require a huge data repository. And it also requires a system that lets clinicians see that data at the point of care.
Critics will likely say that cancer care at a major university center is an exception to the rule in medicine, that such an approach to data management is overkill for most other healthcare providers. But as healthcare becomes more personalized and more genetics-driven, it's likely that the MD Anderson model will make sense in other specialties, and eventually in primary care. If that's the case, EHR vendors will have to rethink the architecture of their products.
The other "crazy" health IT leader on our CIO 25 list who comes to mind is Neil Calman, MD, co-founder and CEO of the Institute of Family Health in New York. Not only has the Institute been using a fully integrated practice management and EHR system for nearly a decade, it too has been using the technology for research. It's looking into the reasons people of a particular race, ethnicity, or income group have below average health outcomes.
"In 2002, I was convinced that the time was ripe for the implementation of health IT in our community health center system," says Calman, a practicing family physician for 30 years. Since the institute rolled out its EHR system in 2002, it has tracked quality metrics for more than 40 primary care and behavioral health problems, implemented clinical decision support software to increase patient safety, and reported on quality metrics based on race and ethnicity to spot disparities.
As InformationWeek Healthcare prepares to publish this year's CIO 25 list, we're looking for unconventional technology visionaries like Vogel and Calman--and they don't have to reside in the C-suite. Anyone come to mind? If so, please ping me at firstname.lastname@example.org.
Not every application is ready for the cloud, but two case studies featured in the new, all-digital issue of InformationWeek Healthcare offer some insights into what does work. Also in this issue: Keeping patient data secure isn't all that hard. But proposed new regulations could make it a lot harder. Download it now. (Free with registration.)