A pharmacist by training, Lisa Stump admits that she never would’ve pictured herself in IT leadership. But after playing a key role in implementing an early CPOE system, she discovered her passion for “providing the right information to the people who can make the right decisions for patients,” and she’s never looked back. In this interview, Stump talks about why a largescale implementation is never really finished, the fascinating dichotomy of being an Epic client while also working with startup companies, and why she believes Yale New Haven’s focus on innovation will help recruit top IT talent. She also discusses her team’s groundbreaking work with patient engagement, the new skill sets that will be required as analytics and security bigger larger priorities, and why she ignores the word “interim.”
- Focus on turning data into “usable information”
- The new skill sets needed for predictive analytics
- Collaborating with vendors — “We’re tapping those relationships much more than we ever have.”
- The “scary” world of machine learning
- Security: “It takes a really good partnership.”
- Consumerism & the “double-edged sword”
- Humm cloud app
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For the better part of the last decade, the focus has been on implementing the EMR and consolidating systems. I think we are finally at the point where we’ve got all the tools in place to collect the data and create the data, and now, turning that into usable information is the exciting challenge.
It’s really a different set of skills that we’ve traditionally had in a typical hospital or health system IT department. There’s much more focus on data architects and data scientists who can help transform reams of data or petabytes and terabytes of data into meaningful information; it’s a skill set that I think is going to be in high demand for some time.
We are charged with keeping all of that data secure, but at the same time, making the data available to support research, and making it available to patients in a way that is transparent and easily accessible, and those goals are sometimes at odds with each other.
This is one area where I think the tool was important and the technology was important, but the culture around seeing and responding to the data, I think, was key.
Gamble: And as far as some of the analytic tools, it seems like this was a priority like right out of the gate. Can you talk about some of the work you’re doing with data warehousing and how analytics are being used?
Stump: Sure. Data and analytics is one of the top priorities for us as an organization, from support for individual patient care, to managing populations of patients and population health. And we are a large academic medical center, and so research is a key priority as well. And in terms of healthcare as a business, the data and analytics support appropriate business decisions, and so the focus on data and analytics has been strong really from the get-go, but I would say it has accelerated in the last two to three years, and will continue to do so.
Like most healthcare organizations, I would say for the better part of the last decade, the focus has been on implementing the EMR and other systems, and consolidating systems. I think we are finally at the point where we’ve got all the tools in place to collect the data and create the data, and now, turning that into usable information is the exciting challenge for all of us. And again, that ranges from the area of precision medicine — where we have the ability to target appropriate therapies or avoid therapies that might have a negative impact based on a patient’s genetic makeup and their DNA, to the ability to analyze data on populations of patients that allow us to better predict a patient who is likely to have an adverse health outcome, and ideally we can start to use the data to help prevent that.
We’re working on some exciting algorithms in areas ranging from oncology to orthopedics and even some operational ones. In a big, busy academic center, we want to be as efficient as we can be, and so it’s even being used for capacity planning and looking at the volume of visits in various locations and how we can better manage that patient flow. And that allows us to make the care more efficient and more user-friendly for our customers and patients, and respond to the demands.
So it’s a pretty exciting time around analytics, and again, it’s that balance of tools that are presented to clinicians at the point of decision-making for that individual patient, all the way out to the retrospective analysis that allows us to predict trends and intervene going forward, so we’ve put a lot of time and energy around building our team. It’s really a different set of skills that we’ve traditionally had in a typical hospital or health system IT department. There’s much more focus on data architects and data scientists who can help transform what are really reams of data or petabytes and terabytes of data into meaningful information; it’s a skill set that I think is going to be in high demand for some time.
Gamble: Yeah, that’s really interesting. As everything evolves so quickly, it is a different skill set to look for, and I can imagine that it can be a challenging thing to stay on top of.
Stump: It is. The traditional mindset, particularly in health systems, is that your IT department is, for the most part, hired and maintained within the organization. I think for a certain skill sets, we are going to be reliant on collaborating with vendor partners and with the industry. Certainly we have a unique advantage of being an academic medical center with the talent that exists within the university in those areas, but it is driving a lot more collaboration than the traditional way of hiring an IT analyst to do the work. And so I think we’re going to continue to see that evolve, but we are exploring and tapping those relationships much more than we ever have, both the industry collaboration as well as the university collaboration.
Gamble: It’ll be interesting to see if some of the education components change to really get more specific into those skilled areas.
Stump: Absolutely. And I think the other really interesting, if not fascinating, and almost scary aspect, is the area of machine learning. We analyze lots of data and we create an algorithm, but you want that algorithm to evolve and get smarter. And so as new data comes in, the algorithms are able to be modified, and that machine learning, I think, is a really fascinating area that will have great benefits for healthcare.
Gamble: It’s definitely interesting. I think we’re starting to see some organizations dip their toes into it, but that could definitely change in the next year or so.
Gamble: Of course when we talk about all these data, there’s that huge question of keeping it safe, keeping it secure, and dealing with that risk. Can you talk about your strategy there?
Stump: It’s another area where I would say it’s a growing area for career opportunity and skill set development. It is important, I think, to strike that balance. We are charged with keeping all of that data secure, but at the same time, making the data available to support research, and making it available to patients in a way that is transparent and easily accessible, and those goals are sometimes at odds with each other. I think having a talented security team who can balance that through its traditional means around firewalls and geo-blocking is critical, but it’s also a little bit of art in terms of striking that balance.
It takes a really good partnership. I rely heavily as CIO on my chief medical information officer to really have the clinical and research perspective, and then the chief information security officer, who really is guarding all of that data. Striking that balance really takes discussion and collaboration and partnership amongst those players.
We also recognize that, as a health organization, some of the biggest risks to the security of the data are our own employees — not because they’re ill-intended or trying to cause harm, but they often don’t realize the power of the data that they sit on and interact with every day. And so, our efforts include education for staff. We conduct our own phishing attempts internally. We unwittingly entice employees to click on links they shouldn’t or provide their passwords, and that allows us to give very focused intervention and education where needed. So it’s a lot to balance, but it takes all of those approaches.
Gamble: You’ve had a chief information security officer in place for a little while?
Stump: We have. I would say it’s probably been at least eight years that we’ve had a chief information security officer, and that role reports directly to the CIO. I try to keep that role very clean. Those folks are often — and mine is — from a very talented IT background, and could do lots of other things within the organization; they can manage applications and technologies. But I really keep that role pristine and focused really just on the security so that he is unbiased and objective and give the advice that we need, and the perspective.
Gamble: I’m sure there’s quite enough to keep busy with that role alone.
Gamble: I want to switch gears a little and talk about patient engagement or consumerism — whatever you want to call it—and how the organization is looking to engage more with patients. I read about the initiative where tablets are being used to complete digital surveys, and analytics are being used to get through to these results quicker to improve the experience. I wanted to get your thoughts on that.
Stump: Over the last year, the areas of consumerism, consumer analytics and patient engagement have been probably one of the more fast-moving areas where we’ve had a lot of demand from patients and consumers themselves, as well as our clinicians, to bring tools that would help in those areas. So that’s an area where we are collaborating at a new level with some startup companies and some tried-and-true trusted vendor partners to really collaborate around what those tools need to be. The fast pace has been a bit of a double-edged sword. I think there’s great potential — we’re bringing new tools into use, but at the same, time there’s that potential to overwhelm with multiple applications and really create a confusing approach for our patients and consumers. And so, we’re really trying to strike that balance between the right features and functions and tools, but sending it in a way that it’s as seamless and coordinated as we can. That’s where I think we still have a bit of work to do.
The product you mentioned, the Humm app, has been a good example of that. That was a product that originated in the restaurant industry. One of our clinicians came across it, actually, while he was out to dinner, and came back with the idea that it would be great to leverage that technology to get real-time feedback from our patients and families so that we could intervene in real time, rather than trying to respond to month-old data through traditional post-discharge surveys as an example.
So we’ve been working with that vendor for a little over a year now, working out the workflow aspect — how do you present the tablets to the patient, when do you do that, what’s the right staff member to do that. There’s always concern around over-surveying patients, and so we want to ask just the right number of questions that get us meaningful information without overwhelming them. And the data’s only good if someone’s looking at it and using it, and so the analytics around Humm have been key, along with the ability to present that visibly on the patient care units as our nurses are doing their hourly rounds and as our executives are doing their rounds. Having that data readily available and visible has been a big win.
We’ve seen on some of our patient care units that the Press Ganey scores and HCAP scores have materially improved through the use of that tool. So this is one area where I think the tool was important and the technology was important, but the culture around seeing and responding to the data, I think, was key.
When we first started, I think our clinicians viewed it as they sometimes can — that the technology was one more thing that they needed to do or respond to. But when we really focused them on the power of improving the patient’s experience, it flipped into the point where we now have a waiting list of patient care units that are asking when they could have the technology, which is exactly the problem we want to have.