1.
Overcoming the Top 3
Challenges in Health IT:
Cost, Privacy and Adoption
Pathways to Leadership Series
May 15, 2014
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2.
Agenda
• Housekeeping
• Speaker Introductions
• Presentation
• Q&A
• Conclusion
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3.
Speakers
Jennifer Covich Bordenick
CEO
eHealth Initiative
Washington, D.C.
Russell Branzell
President & CEO
College of Healthcare Information
Management Executives (CHIME)
Geoffrey Brown
Chief Information Officer & Senior Vice
President
Inova Health System
Northern Virginia
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4.
Serving as CEO of eHealth Initiative since 2009,
Ms. Bordenick provides leadership for all the
research, education and advocacy components
of the eHealth Initiative and its foundation.
Working closely with executives from across the
spectrum of healthcare, she helped refine the
organization's strategic focus to concentrate on
the use of data and analytics; accountable care;
data exchange; and technology tools for chronic
care conditions. She has played an active role in
educating the industry about the impact of
healthcare reform on health IT, interoperability
concerns and meaningful use regulations.
Jennifer Covich Bordenick
CEO, eHealth Initiative
4

5.
Russell Branzell is a Certified Healthcare CIO, a
fellow of CHIME and HIMSS, and board certified
through the American College of Healthcare
Executives (ACHE). He has served as the
president & CEO of CHIME since April 2013.
Previously, he was the CEO of Colorado Health
Medical Group, a division of University of
Colorado Health. In 2010, he was honored with
the CHIME State Advocacy Award for his work in
bringing together stakeholders across Colorado
to further the advancement of HIT.
Russell Branzell
CEO, CHIME
5

6.
Mr. Brown has 35 consecutive years of
progressive experience in information technology,
management, consulting and strategic planning.
Brown is in the unique position of having work
experience as a CIO in public, for profit and not-
for-profit healthcare organizations. He is known for
delivering real results through improved utilization
of technology and people. Inova Health System
(IHS) is the largest not-for-profit healthcare system
in the Washington D.C., metropolitan area with
history dating to 1872.
Geoffrey Brown
Chief Information Officer & Senior Vice
President, Inova Health
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7.
What are the Issues?
Cost :: Justifying the price tag of new
healthcare technology
Adoption :: Ensuring proper
implementation to ensure ROI is achieved
7
Privacy :: Keeping pace with
emerging technologies, especially
mobile and telehealth

8.
IT Challenge #1: COST
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9.
Cost: The Challenges
9
… while
savings mostly
go to insurers,
patients.
Providers
pay
Health IT can
improve patient
safety, healthcare
quality, and
efficiency of data
collection while
restraining rising
costs. But …

10.
… and the stakes are high.
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Full implementation of healthcare technology could
bring efficiency savings of $77 billion – but only after
the initial 15-year adoption period. (RAND Corp.)
A nationally interoperable system would
cost $150 billion over five years.
As reimbursements shrink, the need to
carefully analyze each purchasing decision has
never been more urgent.

11.
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Strategies for Justifying the
Cost of Health IT
Position as a
clinical/business
decision – not a
technology
initiative or
purchase
Treat technology
as an agent for
change; a solution
that drives clinical
and operational
improvement
Don’t waste time
justifying your
“plumbing”
(network upgrades,
new PCs, etc.).
Get that on a
schedule so you
can spend time on
true improvements.

12.
1. Prioritize your financing. Not
enough IT departments do this.
2. Collect as much data as
possible. The more data you
collect, the more you can
document how you’re saving
money with technology – or how
much you’re losing without it.
Strategize, Prioritize, Quantify
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What’s
the
priority?
ICD-10
Meaningful
Use 2
Health
Exchanges
Healthcare
Reform
Patient
Engagement
Revenue
Cycle
EHRs
40% measure ROI on their EMR
implementations
only 36% of this smaller group is
convinced their ROI calculations are
accurate.
Source: 2013 Beacon
Partners survey of more
than 200 hospital CIOs:

13.
Making the Business Case
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Step 1:
Capture Your Current State
• Financials, Revenue, Quality, Process, Workflow
Step 2:
Show Where Changes Would Bring
Value or Improvement
Step 3:
Understand the Full Impact on Your
Organization
• Deployment, Equipment, Licensing,
It is difficult to
make a
business case
for disruptive
technologies
But it can be
done …

14.
CASE STUDY:
Lakeland HealthCare
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Provider: Lakeland HealthCare, 4-hospital system in
Western Michigan
Technology: $50 million EHR implementation over 5 years
 The board at Lakeland wanted to see the value of investment beyond the fact that
EHRs are mandated by Meaningful Use.
 Plan of Action
1. Hired a consultant.
2. Consulted with peers, developed a governance structure and identified KPIs approved by
leadership team
3. Created a team to measure financial and clinical returns
• Teams meet regularly, report to board quarterly
• To measure, established baseline and tracked over time.
“If you don’t want to be
seen as just another
cost center, you must
evaluate and report on
investments in IT.”
 Results
• CPOE had immediate cost impact - $1 million savings in the
first year – due to reduced need for transcriptionists
• Improvements in sepsis care as a result of barcode scanning
saved 32 lives

15.
IT Challenge #2: Privacy
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16.
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• What is your organization’s
biggest privacy challenge?
• mHealth applications
• Sharing data with third parties
• Regulatory compliance
• Organizational culture
• Other
POLL

17.
Privacy: The Challenges
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Current policies were developed
for a paper-based world.
Consumers are more aware of
data breaches, and the cost is
huge: Last week New York
Presbyterian and Columbia were
hit with the largest HIPAA
settlement at $4.8 million after
6,800 patient records were
released on the Internet.
Privacy
Challenges
Data
breaches
Policy not
keeping
pace
HIPAAMobile Use
BYOD

18.
Privacy: Whose Information?
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Consumers
trust health
providers the
most with their
information:
Who do you trust to store or
access your healthcare
information?
27% federal agency
27% private firm like Google or Microsoft
71% hospitals
99% primary care
doctor
Source: Ponemon Institute

19.
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Strategies for Addressing
Privacy Issues
Convince
leadership to
invest in
technology that
protects
privacy,
associate with
the bottom line
Conduct a solid
risk
assessment,
many privacy
programs at
early stage of
development
Consider your
organization’s
existing culture,
determine
weaknesses
and integrate
efforts within
existing privacy
policies
New privacy
policies should
reflect your
organization’s
priorities

20.
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Provider: Sutter Care at Home, a California-based home care and
hospice agency whose 1,300 caregivers service nearly 100,000
patients in 23 counties
Technology: Android 4G 7-inch tablets for at-home caregivers
 SOLUTION: Mobile device management (MDM): Sutter installed MDM
software on their tablet devices that allowed them to apply security policies
and controls; to track device inventory and usage; to manage software
distribution; and to remotely wipe a lost/stolen device.
1. IT department has greater level of control over the tablets versus laptops.
Tablets are password protected and encrypted; if a tablet is lost or stolen,
Sutter Care at Home can wipe the device clean of information remotely, in
a matter of seconds.
2. The system also alerts the IT department if any unauthorized app is
downloaded by a user, and the device repeatedly prompts the user to
delete the app until it is removed.
“There are
always issues
with security
compliance with
any device.
When our
security office
wants to know
whether a device
was encrypted,
we can tell them
exactly when,
and we can issue
a wipe command
and erase the
device
immediately. We
have a level of
security that we
never had with
laptops.”
CASE STUDY:
Sutter Care at Home

21.
Addressing BYOD
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Nearly everyone owns smart technology now – and they want to
use applications on their own device to provide care OR
receive care (in the patient’s case).
This, however, creates privacy concerns as our devices are
used for multiple functions, for lots of sharing, and are not
encrypted or protected properly.
Your job:
1. Help hospital leadership understand there needs to be a
policy – sooner rather than later. BYOD is not something that
can be ignored.
2. Define your risk tolerance level, and build a policy around
that level. If the banking industry can do it, healthcare can do it.

22.
Addressing BYOD at Inova
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BYOD is like mobile with new policy and
control issues.
 Technologies are the same (devices, security
controls)
 Employee ownership of device raises issues of
control & management
How should it Easy answer is to treat
employee devices as another external
Internet connection
 Problem: Mobile apps provide better user experience
but require internal connections to your production
environment
Where do the risks come from?
 Sensitivity of data on the device (e.g. Patient Records)
 Impact of loss or misuse (e.g. data breach reporting reqs.)
Inova Health:
5 hospitals
1,700 beds
16,000 employees

23.
IT Challenge #3: Adoption
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24.
Barriers to Technology
Adoption
Barriers
Physician
Preference
Staff
Resistance
Unqualified
Workforce
Lack of
Time
Interoper-
ability
Fear of
change
“Technology cannot do anything
alone. When the patterns of its use
are not tailored to the workers and
their environment to yield high
quality care, the technological
interventions will not be productive.
Any IT acquisition or
implementation should, first and
foremost, be an organization
change.

25.
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• Find physician champions.
• Highlight benefits for different groups.
• Maintain realistic expectations.
• Make tools user-friendly.
• Recruit Subject Matter Experts.
• Use a Communications Plan.
Implementation Best Practices

26.
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• Does your organization use a
formal communications plan
when rolling out new technology?
• Yes, always
• Yes, sometimes
• No, but we are considering it
• No, never
POLL

27.
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Why do I need one?
This is a huge change management exercise – not an IT “project” or
simple technology switchover.
What should your Communications Plan look like?
Robust enough to cover the necessary information,
but not so dense that no one will actually read it.
How will my Communication Plan succeed?
By involving everyone upfront. Most training plans end up being reactive
to complaints and issues – adoption is more successful when your
communications plan anticipates obstacles.
How will I communicate my Communications Plan?
In multiple formats and several places. In person. Via newsletter. Emails.
Everyone adapts differently, so providing multiple avenues helps ensure
more people will grow comfortable with the technology.
Your Communications Plan

28.
Measuring Results & Impact
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Measuring results and impact is
important because …
• You need to understand your
organization’s level of adoption to realize
further improvements
• You will be reporting back to the C suite
on the value of the investment
• You can leverage the information to
justify future technology investments
TIPS:
 Take a “before” picture
so the “after” picture is
an accurate measure of
improvement.
 Define: What does
success look like? All
measurements should
relate back to this model
.
 A project doesn’t end the
day you go live – it’s just
the beginning.

29.
CASE STUDY
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Step 1 :: Implementation team was formed across departments
Step 2 :: Phased implementation and strategy to encourage use
 Obstacle: Nurses were recording medication information hours after it was
given; this practice would have to change with the safety system
Reasons for Success:
 Made it easy for the nurse to “make the better choice” by understanding
medication recording process and reforming it through the nurses’ eyes
 Units and users that achieve 100% scan rate are honored
 Units and users that achieve low scan rates are given extra training
 Project was billed as a Patient Safety Initiative made possible by the IT department
– not an “IT project” – and was driven by clinicians
Provider – Cook Children’s Medical Center, Ft. Worth, Texas
Investment – Barcode bedside medication verification system
Goal – Provide another layer of safety to augment the experienced staff

30.
Q&A
Jennifer Covich Bordenick
CEO
eHealth Initiative
Washington, D.C.
Russell Branzell
President & CEO
College of Healthcare Information
Management Executives (CHIME)
Geoffrey Brown
Chief Information Officer & Senior Vice
President
Inova Health System
Northern Virginia
30