For Christopher Longhurst, MD, the decision to leave Stanford University School of Medicine after more than a decade wasn’t an easy one. But the opportunity to leverage the knowledge he gained as CMIO to help lead UC San Diego through a period of unprecedented growth was too good to pass up. In this interview, he talks about how his team is working to support the strategic priorities of the organization while creating as much value as possible in the healthcare delivery process. Dr. Longhurst also talks about the collaboration taking place across the University of California Health System, the team he put together to help carry out the organization’s vision, why population health must be top-of-mind for all CIOs, and how the CMIO role has evolved.
- Transitioning from CMIO to CIO
- Learning from Ed Kopetsky
- Inheriting a “strong leadership team”
- Benefits of a physician background — “I understand the subtleties of how a new template can impact workflow.”
- Integrating informatics with operations — “It’s a key interest.”
- UC San Diego’s 3-CMIO model
I had a great mentor and CIO role model in Ed Kopetsky. I learned a lot from him, and together we evolved my role to assume increasing staff and budget responsibility. The experience leading analytics and clinical informatics teams really helped to prepare me for the CIO role.
All leaders are dependent on their team to be successful. I’m very fortunate because I inherited an incredibly strong leadership team in the information services department at UC San Diego Health.
As a practicing clinician who uses our EHR system, I understand the subtleties of how a new template can impact workflow as well as billing and reimbursements. And so, aligning with the strategic priorities of the delivery system while innovating and driving new technologies to take us to the next level is a sweet spot for me.
As the payment reimbursement models change, we all need to be thinking about how information technology can support the new value-based payment model.
Gamble: What has it been like to make the transition from CMIO to CIO?
Longhurst: It’s definitely a very different job. I spent a long time in the CMIO role at Lucile Packard Children’s Hospital, and it was a role I enjoyed immensely. But like with any job, over time, you look for new opportunities to expand. I was very fortunate, I had a great mentor and CIO role model in Ed Kopetsky. I learned a lot from him, and together we evolved my role to assume increasing staff and budget responsibility. The experience leading analytics and clinical informatics teams really helped to prepare me for the CIO role.
Gamble: What did you find to be the biggest challenge in stepping into the CIO role?
Longhurst: There are challenges with any role transition; some of those are more about changing institutions more than they are about changing roles. For me, coming back to UC San Diego, where I went to college, has been a lot of fun. I know the area, but it’s a brand new healthcare system spread across different locations, and so establishing relationships with key peers and clinician leaders throughout the system in a rapid period of time has been important and a challenge into itself.
Having a department of 300 people and a much larger budget than I’ve managed is not as much of a new role as it is a matter of scaling. I’d say probably the biggest difference is that in the CIO role, in addition to having responsibility for clinical information technology that I had in my CMIO role, I also have direct responsibility for our business systems, financial systems, revenue cycle systems, HR information systems, and the underlying technology infrastructure that makes it all run.
Gamble: Talk about the strategy you used to put together the right team.
Longhurst: All leaders are dependent on their team to be successful. I’m very fortunate because I inherited an incredibly strong leadership team in the information services department at UC San Diego Health, like our director of clinical applications, Adam Lyddane. I was also able to recruit a couple of additions with whom I had worked with previously, and that team is critical for keeping the lights on and the doors open and moving us to where we want to go.
Gamble: So in the areas where you may not have as much strength yet, it’s a wise move to hire those who do?
Longhurst: Absolutely. As a board-certified pediatrician, I don’t ever expect to be an expert in technology infrastructure, and so it’s critical to have those types of leaders who I can rely on and trust. One of the people who I recruited to join me at UC San Diego Health is my associate CIO, Mark Amey. Mark is a well-known technology leader who is key in evolving us towards a highly reliable and secure infrastructure as well as helping me to run operations.
Gamble: How have you been able to draw on your background as a physician in your new role?
Longhurst: First, let me say there are lots of examples of terrific CIOs who don’t come from a clinical background. What I hope to bring as a clinician helping to run the IT department is an intrinsic sense of where we can create value in the healthcare delivery process. For example, as a practicing clinician who uses our EHR system, I understand the subtleties of how a new template can impact workflow as well as billing and reimbursements. And so, aligning with the strategic priorities of the delivery system while innovating and driving new technologies to take us to the next level is a sweet spot for me.
In addition to being CIO, I’m also a faculty member in the department of biomedical informatics, and am working closely with the chair of that department, Dr. Lucila Machado, to figure out how we can best leverage the faculty, PhD students, fellows, and other trainees to bring their skillset to bear on operational problems.
Gamble: That’s a great resource to be able to tap; one that isn’t being leveraged as much as it could be in the industry.
Longhurst: That’s right. There are a lot of academic medical centers that have informatics departments, but they’re not always well integrated with operations, so that’s a key interest that I share with our CEO, Patty Maysent, and Dean, Dr. David Brenner.
Gamble: Is that something you’ve always been interested in?
Longhurst: It is. I have a Master’s degree in healthcare informatics, which I did during medical school, and I’ve always had a strong academic interest. Our primary goal is to serve the operational clinical needs of the healthcare enterprise, but contributing peer-reviewed scholarship as a byproduct is an important secondary goal for the clinical informatics team and helps align the health system with the school of medicine.
Gamble: And is this something you hope to try to drive forward on a larger scale down the road?
Longhurst: Yes. There are all sorts of opportunities to move the needle at the national level by participating in national committees and federal regulatory efforts, and things of that nature. Locally, we’re building an outstanding clinical informatics team. We have three CMIOs who were recently appointed at UC San Diego Health: Dr. Brian Clay is the CMIO for inpatient and hospital affiliation, Dr. Marlene Millen serves as CMIO for the ambulatory setting, and Dr. Amy Sitapati is the CMIO for population health.
Gamble: Can you talk about the work your organization is doing with population health? I imagine that’s one of your top priorities.
Longhurst: Of course. As the payment reimbursement models change, we all need to be thinking about how information technology can support the new value-based payment model. So I’m very lucky that Dr. Sitapati has been leading population health informatics efforts at UC San Diego Health for a couple of years already. Our work around using EHR-integrated registries to drive quality improvement across dozens of different populations has been truly industry-leading, and so I was privileged to be able to elevate her role into the CMIO level.