What happens in organizations where the analysts report to the operators and the CIO doesn’t have input? “Those places that have gone to the operator model find that begins to break if they don’t keep a consistent relationship with the technology folks,” he responds.
Tension in the C-suite
There is a tension between everything that CIOs must do to keep the lights on in hospitals and other parts of healthcare systems and the complex demands of supporting PHM, Weaver acknowledges. “But it’s not different than what else the CIO has to do,” he says. “There’s also a tension between the CIO and the CFO to make sure all the functions around revenue cycle management work. There’s a tension between the CIO and the CMO when the EHR goes down. That’s just the role of the CIO. I don’t know that I see that tension has changed dramatically. Now there’s the population health management component, which is the new ‘customer,’ if you will, and they’ve got to service that as well. But the good CIOs do it.”
Where a lot of healthcare organizations go wrong, Weaver notes, is in not striking the right balance between clinical and business intelligence – which are closely interrelated in PHM. “In the clinical component, you’re looking at [health] risk stratification, clinical decision support, disease registries, gaps in care, and outcomes measurement, but many organizations have focused too much on the clinical side and haven’t focused enough on the financial side. What revenue is being generated, whether it’s fee for service or risk-based revenue, and what’s the cost of those operations?
“Healthcare leaders are focused on population health and the analytics that go with it. But I think they’re too focused on the clinical analytics and they need to focus more on the financial component.”
These are the kinds of strategic decisions that C-suite executives must make as they enter the new, uncharted realm of population health management. Here again, they will need to rely on the expertise of CIOs who understand what is involved in analyzing data for both their clinical and financial implications.
In interviews with InformationWeek Healthcare three years ago, leading CIOs said that they were taking an increasingly important role in their organizations’ strategic decisions. For example, Ed Marx, then senior vice president and CIO of Texas Health Resources (THR), said he was helping to shape THR’s business strategies as a member of its leadership council. He estimated that about 70 percent of his job was strategic and 30 percent was operational.
Marx also emphasized the need to ground health IT in clinical knowledge. He and his senior staff members all “rounded” regularly with clinicians in one of THR’s hospitals to understand the nuances of clinical workflow, he said.
Sign up for CIO Asia eNewsletters.