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Ed McCallister’s Vision for UPMC: “The Patient Has To Be At the Center”

Ed McCallister’s Vision for UPMC: “The Patient Has To Be At the Center” | Healthcare and Technology news | Scoop.it

While both Edward W. McCallister and HCI Editor-in-Chief Mark Hagland were participating in HIMSS15 last week at the McCormick Place Convention Center in Chicago, they had the opportunity to sit down for a conversation on April 14. McCallister, who became chief information officer at the 21-hospital UPMC (University of Pittsburgh Medical Center) Health System in October, has spent nearly 17 years with the organization, most of those years with the organization’s 2.5-million-member health plan, of which he was CIO for several years prior to October 2014. He now oversees information systems for the entire system, including its 21 hospitals, 3,500 physicians in medical groups, and other outpatient services, and its 2.5 million-member health plan, and has over 1,400 professionals reporting to him across the vast UPMC organization. Below are excerpts from their interview.


There is a lot going on at UPMC these days. Now that you are CIO of the entire organization, what is your vision for the organization over the next few years?


Part of what’s going on right now is the whole restructuring of UPMC—it’s become a much flatter organization. I’m over the hospitals, medical groups, and insurance division, and am a customer/partner with the Technology Development Center, which has become our development arm, under the name UPMC Enterprises. But the vision is, with the alignment, with the move towards consumerism and population health, it’s putting the patient and consumer at the center. So the 50,000-foot strategy would be to recognize the opportunities to recognize the person.


When people come into the UPMC world as consumers of healthcare, we’re able to treat them in a way that is unique because of who we are. We address the consumer experience in three ways. First, we address it n terms of guidance: we provide the transparency tools, the cost comparison tools, and so on, to help them make decisions about their health. The second piece is supporting them in terms of motivation. For example, we actually have a platform that’s very device-agnostic, and gives them a place to capture data from their wearables and devices, through the insurance division, MyHealthOnline. And the third piece would be the convenience. You might be interested in all your information, and you might not necessarily want to have to pull up a portal, so you could get your information on a mobile device.


The pressures on CIOs in the new healthcare are intensifying. What must CIOs do in today’s evolving operating environment?


You bring up a good point. The role of the CIO—the changes have accelerated. Oftentimes, information technology  is seen as an expense—a necessary expense, but an expense nonetheless.. I think the CIO has become a chief innovation officer and chief integration officer, and other things, all at once. So you need to start with the business leaders of your organization, and be at the table for the discussion from the beginning. Instead of CIOs being reactive, I think the role of the CIO involves being at the table in the first place, defining the future together with other senior leaders. And that makes the role of the CIO much more interesting, and much more valuable. That sets the stage, and then the CIO and his or her executive team, they’re able to figure things out together. It makes it more all-inclusive.


What are your biggest challenges at UPMC, going forward?


I think that the most difficult thing is to realize all of the opportunities and sequence them in a way that’s much more meaningful to the consumer, because at the end of the day, the patient has to be at the center of everything we do. That means sitting down with the business leaders of the organization and focusing on the consumer experience. And I think the excitement over the opportunity outweighs the fear of the challenge. I do see the challenges and opportunities. Think about telehealth and telemedicine:  short five or ten years ago, the technology was the barrier in getting it done. The technology’s there now; it’s no longer the barrier to getting some of these things done. And partnering with the business is why you’re able to do this today. And I meet regularly with our telehealth director, Natasha Sokolovich. That’s a great example of what can be done together. The same goes for our ongoing collaboration with Dr. Shapiro [Steven Shapiro, M.D., UPMC’s chief medical and scientific officer since September 2010], in terms of the development of clinical pathways, as another example.

What are your top few strategic priorities as CIO?


We obviously want to do the business of IT. You start with the business of great care, and supporting 21 hospitals and 3,500 docs, and the health plan with 2.5 million members; and the international arm. So you want to drive efficiencies in our core business. Things like telehealth. The consumer always has to be at the forefront. So then, meeting the consumer where they expect to be met.  And analytics. We continue to have a very focused approach to what we’re doing in analytics. The enterprise analytics initiative is an example of that. We spent the first few years building the foundation. It was more of a data warehouse initiative at first. Now, with the initiative with the University of Pittsburgh and Carnie-Mellon [in March, UPMC announced a new partnership with Carnegie Mellon University and the University of Pittsburgh called the Pittsburgh Health Data Alliance, to leverage big data for healthcare innovation], that provides the opportunity for more advanced analytics work as well.


Meanwhile, you continue to move forward on population health and accountable care as well, correct?


Yes, those ongoing initiatives are also focused on putting the consumer at the center. With regard to patient-centered medical home development, previously, we didn’t necessarily have the right model to address the patient in the right way. We were defining the PMCH and how the patient would be engaged, but in the move towards a more consumer-centric environment, it’s how the consumer can be engaged. It’s partly going to be about mobility, moving everything to the phone. And for the younger generation, their primary care doc is their phone. There’s so much self-diagnosis going on. My kids are in their early twenties, and the first thing they’ll do is to take a picture and do a web search. There’s so much self-diagnosis and education online, that the consumer’s more part of a care team. The PCMH was a great term at the time, but now it has to become a consumer-centric care team model.


Do you have any comments on the current policy and regulatory environment?


Any policy or regulatory activities that happen, in some fashion impact UPMC, so we have to be very aware, and we’re in a very good position to address them. We’ve attested to Stage 2. I think meaningful use was directionally a good thing. I think it moved people in terms of the direction of EMRs.  So we’re moving in the right direction, and meaningful use is an example of a regulatory development that got the industry moving in the right direction, and it’s our responsibility to continue to move that forward to do what’s right for the patient.

You and your colleagues at UPMC have really helped to lead the way in so many areas when it comes to leveraging healthcare IT for innovation. What should your CIO peers be thinking and doing in the next few years?


I know I’m in an enviable position here. When you work for a company in which innovation is in the DNA of everything you do, that makes it great for a CIO. But for other CIOs, I would say, first, be at the table for the early discussions so you’re part of formulating the strategy with the business leaders in your organization. And not only is it more functionally efficient to do things that way; it’s much more proactive and cost-efficient. You need to be much more proactive than reactive. And my advice would be, be prepared around the consumer-facing applications that are out there. The traditional business platforms are becoming a commodity. And the investment should be on the consumer-facing side. And I would say, 10 years ago, HIMSS was much more about product. It was a shopping-cart technology. Now, you start with a strategic partnership with a vendor or the vendor community, and you need to start not with a product but with a problem. And I think the right product will evolve forward if you have the right discussion. And starting with vendor partners, that’s a much different prospect.


You seem very optimistic about the future.


I think the healthcare industry is at a tipping point in a very good direction. You hear a lot of talk about the unsustainable cost trajectory, but when you place the focus on the consumer, the conversation changes. It does come down to higher quality and lower cost, and a customer service wrapper that creates a good experience for the consumer. That’s where you start. And mobility will be an incredibly important element in all this. But I think we’re in a great industry today, we have tons of opportunity, and if we do things the right way, it will create an amazing experience for the consumers of healthcare. And analytics will drive action.


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How one health system is putting an end to insider snooping

How one health system is putting an end to insider snooping | Healthcare and Technology news | Scoop.it

Insider snooping into patient records is nothing to take lightly. It often ends in a compliance nightmare – costly and time-consuming – not to mention the patient trust levels that take a serious hit. By making patient privacy an utmost priority, executives at the West Virginia United Health System have tackled this issue head on through a variety of different avenues and have already seen marked success. 

There's no one magic bullet to ensuring patient record snooping doesn't happen, said Mark Combs, assistant chief information officer for the West Virginia United Health System. But by implementing a host of initiatives, comprehensive training and tapping into information technology for audits, Combs and his team have shown it can be done.

Combs, who will be presenting WVU Healthcare's privacy case study at HIMSS15 this April in the session "Stop Insider Snooping and Protect Your Patient Trust," says the six-hospital healthcare system goes far beyond the traditional computer modules that have a privacy component, as "there's no real learning that occurs in that; it's more of just a sign off," he said. Rather, they get to all employees as soon as they come on board with the organization. They have a privacy officer present to all new employees about the importance of patient privacy and what their responsibilities and expectations are.

What's more, the health system sends out monthly security reminders that come from the individual hospital's privacy and security officer. They also have digital media boards with privacy and security reminders; they present to enterprise management and leadership groups within the organization. And even more significant? They're not afraid to audit their employees.

There's an old saying Combs loves to use that describes his philosophy: "What's measured is what matters," he said. "So people know we're measuring and watching their access; it gives them pause when they start to consider to do something like this," he added. And it certainly doesn't hurt that the health system's HR department has been supportive of this all along.

Audits are done at the organization "almost daily," he said, amounting to several millions of accesses audited each year. The access audits from multiple applications enterprise-wide are consolidated, and then, as Combs described, WVU has an application that consolidates those and runs reports, which are analyzed by a special team.

And though their efforts have been successful, this holistic approach to curbing unauthorized access into patient medical records did not happen overnight, Combs explained. 

“It's been many years in the making. We keep striving to improve, and we keep looking at our risk assessments, and we keep looking at our surveys, and we keep looking at our incidences and situations that do occur in the organization that drive us to change,” he said. “And I think that's one of the most important things: it's an iterative process. You can't just set up a program and walk away and expect it to run. It takes people that are dedicated, people that are focused and people who really care about the privacy and security of the patient's information.”


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A Hospital Is Already Giving Apple Watch To Its Patients

A Hospital Is Already Giving Apple Watch To Its Patients | Healthcare and Technology news | Scoop.it

The Apple Watch began arriving in homes and businesses across America on Friday.


And in New Orleans, one doctor immediately strapped it to his patient’s wrist.


“We need to fundamentally change behavior,” says that doctor — Richard Milani. “And the Apple Watch has the potential to [do] it.”

Milani is the Chief Clinical Transformation Officer at Ochsner Health System, and overseeing what the hospital calls a first-of-its-kind trial: Giving Apple Watch to patients who struggle with high blood pressure, and seeing if it prompts them to take their medication, to make positive changes in lifestyle, and simply, to just get up and move around.


And Milani believes that the potential opportunity is huge: More than 80% of U.S. health care spending goes toward chronic disease. And many of those diseases are exceedingly preventable.


Apple Watch part of Ochsner’s broader strategy

While it doesn’t have the national profile of some health systems, Ochsner has been working hard to be a leader in digital medicine.


  • More than a year ago, the hospital launched an “O Bar” — deliberately modeled on Apple’s Genius Bar — to help patients pick through the thousands of health and wellness apps available to them.
  • Six months ago, Ochsner became the first hospital to integrate its Epic electronic health record system with Apple’s HealthKit software.
  • And in February, Ochsner launched its “Hypertension Digital Medicine Program,” a pilot program where several hundred patients regularly measure their own blood pressure and heart rate ratings using wireless cuffs, which then send that data through Apple’s HealthKit (and collects it in their medical records). Based on the results, Ochsner staff then make real-time adjustments to the patients’ medication and lifestyle.


The new Apple Watch trial builds off the hospital’s existing digital medicine program, Milani says. And he began Friday’s pilot with his longtime patient Andres Rubiano, a 54-year-old who’s spent the past twenty years trying to manage his chronic hypertension.

Rubiano says that his two months participating in Ochsner’s digital medicine program have been “comforting” — he enjoys the constant monitoring — and have already led him to make changes in diet and exercise.

“It’s been a life-changer for me,” he says.

But the Apple Watch has the potential to go further. Its customized alerts and prompts encourage immediate interventions. When we spoke on Friday afternoon, just six hours or so after he began wearing the Apple Watch, Rubiano raved about the subtle taps on his wrist.

“It’s like I have Milani as my buddy right next to me,” Rubiano said, “just nudging me to get up off your [behind] and walk around, or saying, hey, take your meds.”

Milani acknowledges there’s limited evidence that wearable technologies can directly lead to the health improvements he’s hoping to see.


But he plans to quickly enroll about two dozen patients in his Apple Watch trial, in order to begin collecting data on whether the Watch is actually making a difference. (Other patients in the hypertension program will act as the control group.) And he’s optimistic that wearable technology will pay dividends in health.

“For whatever reason, health care doesn’t do a very good job of creating [the necessary] behavior change,” Milani says. “But many of these new technologies have that ability.”

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