Keeping Up with the Change in Healthcare

Lee Carmen, Associate VP for Information Systems and CIO, University of Iowa Health Care

Lee Carmen was appointed associate vice president for information systems in July 2007. Carmen oversees information technology services, including technical support, applications development, and clinical applications across the University of Iowa Health Care enterprise

As a CIO, what are some of the recent trends that you see in the healthcare space?

As the CIO of a large Midwestern quaternary care medical center, I have expertise in varied domains from electronic medical records (EMRs) and clinical systems to security, networking, data management, and analytics. As far as the recent trends are concerned, with the advent of technologies like artificial intelligence, healthcare organizations are highly interested in partnering with companies that have experience in managing and analyzing large data sets.

How do you keep abreast of the innovative technologies entering the healthcare space?

Fortunately, the information architecture at Iowa is quite similar to the architectures at peer institutions. They not only have the same EMR solution but also analytics tools, nurse call systems, clinical monitoring systems, allowing us to collaborate, inform and advise each other on new technology advances and implementations. To leverage more from this professional networking, we interface with our key vendor partners for EMRs,or clinical equipment and our ERP partners. We engage the early adopters of emerging technologies to reap the benefits of the services today as well as in the future. Being an academic medical center, we have many nationally recognized researchers, who share new technologies of interest or value with us. To gain more insight into the ever-evolving technology landscape, we keep an eye on the new patents being released, the venture capitalists’ funding, and the IPOs from a business angle.

What is your checklist for choosing technology vendors?

Many IT companies today have limited experience in healthcare operations, so one of the first things we check is the vendor’s experience in the space based on the customers they are currently working with. Since we operate with 850 beds, generating yearly revenue of $2.5 billion, a vendor for a 100-bed community hospital might not be a match. However, we further look at their viability, operational tenure, and funding model. Our team of security, data architecture, data networking, and user design experts works closely with the vendor, to ensure they both are on the same page of design, scalability, and architecture.

As we expand our technology footprint in a healthcare setting, we also need to train our workforce for implementing and supporting the technicalities

Elaborate on some of the current projects that you are currently overseeing, and what impacts do you hope to get out of them?

With provider productivity, efficiency, and burnout being the hot issues today, the introduction of additional technology into clinical settings can often have a negative effect on the healthcare providers. To ensure that the technology we bring in is a net benefit instead of a net detriment to the providers, we focus on designing, configuring, and implementing systems in a way that supports their everyday workflows.

While many new players are making their way into the healthcare communication space, there are established vendors refreshing their product lines on-the-move. Looking at the communication between clinicians and patients during treatment, we evaluate whether the tools in place are adequate to meet the care delivery needs, or do they need modernization. We provide patients with self-service tools, enabling them to schedule appointments and ask questions of their providers. We are configuring our existing enterprise systems to allow them to take inpatient data from network-enabled devices such as Apple watches or glucose monitors. Further, the next step is to augment this collected data in a safe, scalable, secure way that is relatively easy for our patient population to access.

Do you have any additional highlights on the challenges persistent in the healthcare arena?

There is a never-ending challenge to recruit talented technology professionals in the healthcare space. As we expand our technology footprint in a healthcare setting, we also need to train our workforce for implementing and supporting the Technology.

What are some of the leadership principles that you abide by to influence your peers and subordinates?

I believe I am here to work for my staff, rather than having them work for me. My role is to communicate between other leaders in the organization and my team about the strategic direction and operational needs of the company and accentuate areas of focus. Understanding my team’s requirements in terms of direction and resources to further meet the organizational needs, I act as a buffer between these two parties. I also attempt to remove the barriers for my technology teams, allowing them to bring out the best of their abilities and get solutions into production, as timely as possible. In addition, my responsibilities include working with and advising our executive leadership team on what we could develop or implement to support the growth of the organization.

How do you think the future of healthcare would turn out to be?

With healthcare in rural settings being a big issue for us, projecting forward, the focus will be on the telemedicine space and on the ability to deliver and receive care from providers at any geographic location convenient for the patient. Besides the advances in automation, we will be witnessing the rise of technology-enhanced alternate care delivery models, which will be different from visiting a physical clinic or an emergency room. At our organization, one of our physician-researchers has developed the first FDA approved AI device that screens patients for diabetic retinopathy by taking images of their eye and running it through an AI engine for a clinical interpretation. This device cuts down the physician's need to diagnose, freeing up their time to focus on more complex areas. Besides the development of tools like EMRs to accept different types of data inputs, advancements are occurring in the personalized medicine space and the ability to find diagnosis and treatment strategies for patients based on their unique requirements, all driven by data.

What is your advice to an aspiring CIO of a healthcare establishment?

Healthcare organizations are unique places to work in as you are surrounded by some of the smartest, most dedicated, and hard-working members of our society, such as doctors, nurses, pharmacists, and others. My advice to the junior staff is to take advantage of the environment they are working in, and understand how every different person and team interacts with a patient. Be it an outpatient world, an inpatient one, an emergency room, an intensive care unit, or an operating room—all come with different requirements; you need to be exposed to different health care delivery areas to understand its nuances. Aspiring healthcare IT professionals need to listen and absorb everything from the various clinical settings as it will have a significant impact on the services that they can ultimately deliver back to the organization.

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