Last spring, incoming CHIME CEO Russ Branzell talked about his plans to guide the organization into the future and expand both its offerings and its presence in healthcare. A year later, he’s made serious headway in delivering on that promise. Under Branzell’s leadership, CHIME has announced several new initiatives, including a CMIO Boot Camp and the formation of CIO advisory boards — all while working to shape legislation to meet the needs of health IT leaders. In the first of our semiannual interview series, Branzell discusses the challenges of working with politicians, CHIME’s goal in partnering with other healthcare organizations, and the need to move forward after the “disappointing” ICD-10 announcement.
- CHIME Speakers Bureau
- Disappointment with ICD-10 delay — “Organizations literally were flipping switches as of that week.”
- Working with AHIMA
- Pushing for “reasonable flexibility” on MU 2
- New membership groups
- First-year success — “We were able to make some major ground in the industry.”
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One of the reasons we’re so disappointed is not necessarily about the specific technical details about needing to be on ICD-9 versus ICD-10, but rather the amount of workload, wasted energy, resources, and money that’s been spent.
You have to understand Washington politics to know that every once in a while out of nowhere, you’re going to have something like this to deal with.
What we’re hearing from the administration is that the hardship exemption might be all we get, but especially in light of what we saw last week, anything is possible.
They’ll have their own group of members. They’ll have their own initiatives. They’ll have their own advisory boards but they’ll all fall under the umbrella of CHIME to make sure we’re advancing a unified message of HIT for the whole industry.
Gamble: I wanted to also ask about the Speakers Bureau. What’s happening with that and what are your plans on that front?
Branzell: The Speakers Bureau is in the process right now of getting set up from a legality perspective — contracts, those types of things. We have our first cadre of speakers that are interested in participating and being represented by our Speaker’s Bureau. Given the time frame, we’re looking at launching out and having that available probably in the beginning of the summer, with probably about a dozen speakers right out of the gate, who will be available. These are very seasoned, experienced CIOs that really have a great story to tell and can be very entertaining, but also are very contextual experts in their field, to be able to represent us and represent the industry across any spectrum that might be needed.
Gamble: Obviously for those CIOs, this gets them exposure and helps promote them as leaders.
Branzell: It does. And in many cases, we — speaking as a past CIO — get lots of opportunities to speak in small segments or as part of a program. What this will do is really put some of the CIOs that are part of the Speaker’s Bureau out in the forefront to really, truly be nationally recognized keynote speakers of programs being brought into organizations. Even outside the healthcare spectrum, as people need to understand what’s going on in our industry from a transformation perspective.
Just as a small example, we were contacted late last year by a very large financial investment banking organization who was bringing hundreds of people together and said we need a speaker that can tell us what’s really happening from an HIT perspective in the industry right now. Fortunately, we were able to give them some names of people and they were able to fulfill that, but now we would fill that by saying, ‘We have a Speaker’s Bureau where any of these individuals would be available for you.’
Gamble: That’s a win-win that helps CHIME and helps those individuals too.
Gamble: Obviously, you guys have a lot in the hopper, and that’s just some of the newer initiatives or things that you’re building out but then you’ve also got everything on the legislative front and I’m sure it takes up a significant portion of your time especially during times like this, so I wanted to talk a little bit about that. I guess we can start with ICD-10, which was not an April’s fool’s joke, but a couple of days ago we found out we’re looking at it being pushed back another year. I wanted to get your thoughts on that and what are your concerns with the effect that this could have on health systems.
Branzell: As we’ve come out and said, we’re very disappointed in this delay, and especially how it occurred. Even as of the morning that we heard about this bill, Marilyn Tavenner, CMS administrator, was reiterating at a breakfast that ICD-10 won’t be slipping. One of the reasons we’re so disappointed is not necessarily about the specific technical details about needing to be on ICD-9 versus ICD-10, but rather the amount of workload, wasted energy, resources, and money that’s been spent to prepare organizations across all of our membership. For a few members I’m sure this is actually a relief that we haven’t gotten there. For some clinical folks we’ve heard that this is actually a small relief because they’d rather maybe wait to go to ICD-11 and be SNOMED-driven. But for a vast majority of our members who have spent millions and millions of dollars and were ready — and that’s the part that was so concerning; that they were ready, and in some cases, actually already doing dual-coding or back-coding from ICD-10 back to ICD-9 to make sure they had their resources sequenced up — now what do they do?
Again, this was very disappointing from the perspective that there was no real understanding from our view of what this meant from a resource requirement and timing perspective with other initiatives. It was an add-on to the SGR bill fix, and it was really almost added in for some reason and we still can’t even figure out why it was added in as kind of a give-back to other issues.
Gamble: Right. Like you said, that’s what was kind of puzzling about it.
Branzell: I was talking to a CIO of a small community health system and their original estimate was that this would cost a few hundred thousand dollars based on the government projections. They’re into two and a half million dollars. They’ve already got contractual obligations now with training programs that were supposed to start here within the next month or so to come in and train all their work force, their nursing staff and physicians — all these peoples’ schedules were built for this to move forward. They’re in a middle of a process, and now what do they do?
And we’re hearing that extensively. I’m sure there are a few, and I’ve heard from a few of our members — just a handful — that this actually is a good thing for them from a perspective of software delivery, maybe being a little behind the curve or switching systems — that it’s a good thing. But for a vast majority, they’re scrambling now to figure out what to do.
We’re going to try that work with AHIMA and others to try to put some transitional education and planning in place on how you can move from where you’re at, given where you may or may not be in your spectrum of readiness. But again, this is one of those times where you have to understand Washington politics to know that every once in a while out of nowhere, you’re going to have something like this to deal with.
Gamble: I guess the only thing to do now is to try to help organizations move forward, and it sounds like you’re working on something there where you can at least try to offer some guidance. It’s a head scratcher. It really is.
Branzell: There isn’t even a simple analogy to explain this as far as readiness. Organizations literally were flipping switches as of that week. And it would be different if somebody would have cast some level of doubt, but when the person in charge of the program even up until the morning of the day of the bill announcement was saying, ‘you need to be going full steam ahead, you need to be doing all these other things to be ready for this,’ and then it gets canceled… I was perusing several periodicals and publications last weekend, and two of them had full stories in there that said, ‘Are you really ready for ICD-10? Because if not, it’s too late.’ As it turns out, if you weren’t ready for ICD-10, it was good to be a laggard on this one, because look what happened.
Gamble: It makes it harder to take deadlines seriously if you’re thinking it could get delayed another time.
Gamble: I’m not sure how related they would be but does this now make it look less likely that Stage 2 will have any kind of push back?
Branzell: What we’re hearing at this point, and I’ll be traveling back up to Washington in a couple of weeks to meet with a lot of the officials on the administration side and in the federal agencies, is that we’re still hopeful that the hardship exceptions will be a tool that can actually help CIOs. We’re working even as of today on some meetings where we can discuss with the ONC as well as CMS administrator on how and what that might look like, because it’s still a very vague process.
We will continue to push though for reasonable flexibility for Meaningful Use Stage 2. At this point, what we’re hearing from the administration is that the hardship exemption might be all we get, but especially in light of what we saw last week, anything is possible. So we’ll continue to try to educate and push for a reasonable flexibility for those that are ready, as well as those that need more time based on software or internal processes, to try to give them the reasonable flexibility they need for Meaningful Use Stage 2 and 3.
Gamble: With everything we’ve just talked about, is there anything I’ve missed as far as some of the big focuses of CHIME? We’ve certainly have touched on a lot.
Branzell: We definitely have. I think the one other key initiative that we didn’t mention as far as CHIME moving forward — and we’re in the process of launching the first one — are the new membership groups for our chief security officers, application officers and technology officers. We’ll be leading this off early summer with the new chief security organization, and shortly thereafter a quarter or two after we’ll launch out with the new technology officers and new application officer organizations as well, which essentially, over a period of time, will represent about a quadrupling of the size of CHIME as an aggregate. Each entity will stand on its own, but as far as being able to support and lead the HIT executive leaders and organizations, we’ll really have a good broad spectrum of the C-suite.
Gamble: And you see those as being individual entities with their own leadership, things like that?
Branzell: The way that we’ll do it now is very similar to the model that was put in place at AHA a few years ago, which is with professional membership groups that still have the same overarching support system, communications, all that type of stuff, but they’ll have their own group of members. They’ll have their own initiatives. They’ll have their own advisory boards where they’ll be responsible, but they’ll all fall under the umbrella of CHIME to make sure we’re advancing a unified message of HIT for the whole industry.
Gamble: Will some of that spill in to the education offered for CIOs to make sure that they have that broad education of the issues that affect the CSOs, CTOs, CAOs?
Branzell: I think that like any other overlapping type perspective, there will be a certain percentage of all of them that will feed each other. As an example, one of things that we’ll be launching this year again and really dusting off is what we call our regional lead events. One of the things we’re looking at primarily focusing on this year is overall security requirements and security governance. That really could serve as a great overlap between the CSOs as well as the CIOs who really work together to provide that service to the industry and to their organization. And so yes, where possible, we’ll try to create as much synergy of programs that help support and in turn continue to support the CIOs to drive the industry where it needs to go.
Gamble: Okay, so a lot of good stuff going on. It sounds like it’s been a pretty successful first year for you. Overall, has it been a good experience?
Branzell: It’s been a wonderful experience. It really is an honor and a privilege to serve in this perspective, having been on the Board of CHIME and involved in the industry for so long, this lets me do that every single day. I’ve absolutely loved doing this job. I love working with our board and our CIOs, and the HIT professionals that are out there. The first year was not only a success for the organization and myself, but really, we were able to make some major ground in the industry, which really was what our goals were — to make a big impact and try to help fix this industry as a whole with all the problems that we have, but also start driving a positive message of all the good things going on. I felt like we did that this first year.
Gamble: Well, congratulations again on your first year, and I look forward to catching up with you a little later this year and see how things are going and what’s next for CHIME.
Branzell: Thank you very much. Thanks for all you do for our industry as well.
Gamble: Thank you, and I’m sure I’ll speak to you soon.
Branzell: All right, thank you very much.