For Fernando Martinez, the key to getting the most out of the interim CIO role is simple: “I never approach any job as interim.” The philosophy has served him well, as he now holds the permanent position at Parkland Hospital & Health System, an organization that has earned a solid reputation for its innovation. In this interview, Martinez talks about the groundbreaking analytics work being done in-house, the construction project that will double the size of the hospital, and how he deals with audits. He also discusses why he wanted to come to Dallas — even though it meant leaving Florida, what today’s CIOs need to be successful, and what he gains from teaching.
- Analytics for disease management
- Innovation at a safety-net hospital
- Internal & external risk assessments
- MU audits — “You design and develop programs knowing you’re going to be audited.”
- Building a replacement hospital
- “I think it’s probably the best CIO job in the country.”
LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED
It’s not the kind of question that you would answer by saying ‘oh yeah, we’ve got bulletproof security.’ That’s like an invitation for individuals that want to take on a challenge.
You design and develop your programs knowing you’re going to be audited. It’s just a matter of maintaining good documentation and being prepared.
It nearly doubles the size of Parkland , and it’s a very impressive organization being built with a lot of thought towards the emphasis on quality care and optimal conditions for the delivery of care and clinical outcomes.
The development in the field of technology is incredibly fast, so we’re only now starting to make actual product selections, because if you made them too early, they would be obsolete by the time you use them.
Gamble: Are there other areas in which you’re using analytics, either now or planning to in the future?
Martinez: I’m sure I’m limited as to how much I can say because a lot of the development work that they’re doing is being done internally and under some level of development protection. But there are definitely other clinical areas that we see the potential — some of which have been brought up by others, not even brought by us — for using this type of predictive analytic solutions to address other chronic diseases, sepsis, and asthma.
There are a bunch of different chronic diseases that we can potentially have a very positive impact on using this type of predictive analytics technology. We’ll just have to stay tuned to see where PCCI (Parkland Center for Clinical Innovation) focuses their attention and where it is that they continue to expand the use of the application, but yes, there’s a lot of potential. We see it and the industry sees it.
Gamble: It’s really exciting because this is what you want to see — having this data and using it for this type of purpose is a really exciting thing.
Martinez: I think it’s very notable and it’s especially fitting that this is coming out of the public sector — from a county hospital, safety-net type of environment. Because the individuals that are most underserved in terms of the resources that they have available to them and that can be brought to bear in their care, at least in Dallas County, and who come to this hospital for care, ironically have some of the best chances of recovery and have some of the best chances of not having to be readmitted than at a lot of other organizations around the country that have more resources or are more affluent.
It especially serves the noble cause of safety-net care, taking care of the most underserved. To see this developing in this environment is wonderful, and that’s one of the reasons that PCCI was spun off as a nonprofit. It is not a for-profit venture. This is more about improving the human condition than it is finding a way to make a dollar.
Gamble: That’s a really good point. Now, with the amount of data that you deal with in the organization, I can imagine that security is really a big priority. I wanted to talk a little bit about what type of strategy you have in place for security and what you’re doing in terms of risk analysis.
Martinez: I’m going to be very vague in answering this, because I don’t think any organization really likes to talk about their security approach. That’s just a way of arming people that want to direct attacks at you. If you disclose how it is that you architect your security, you’re basically giving the blueprint on how to be exploited. But to the spirit of your question, data security is a huge concern for us — certainly for PCCI and the whole emphasis around how it is that we use clinical data, there’s a lot of design and purposeful thought given to how it is that we protect our data, not just because we want regulatory compliance, but because we honor and agree with the covenants of protecting the privacy and confidentiality of our patients.
We approach security in a best practices way. We approach risk management in a best practices way just like a lot of other high-profile organizations in the country. Risk assessments are part of what we do in and out. We have both internal and external risk assessments that have been going on for sometime and will continue to go on. It’s just part of the way the business is run. We continuously look for opportunities to improve and to get better. Our organization, from a security point of view, certainly approaches security in a best practices way. All of what you would expect to find in most organizations in regard to how they prepare a particular or protect for security, we’re certainly one of the organizations that fall into that. I don’t know how to best answer that, but it is a big priority for us. We take it very seriously, and I think we do a good job of it.
It’s not the kind of question that you would answer by saying ‘oh yeah, we’ve got bulletproof security.’ That’s like an invitation for individuals that want to take on a challenge. So I think most organizations are very conservative in the way they respond to questions like this, which is to say, ‘we do what’s prudent. We work very hard at it. We understand it’s a constant threat and we have to continuously be working on making sure that we’re doing a good job of it.’
Gamble: Absolutely. We’ve all seen the stories of breaches. It’s a very scary thing. It’s a very real threat, and you have to take every precaution, especially if it means, like you said, not going into detail about what you’re doing. That’s just being smart.
Gamble: In terms of audits, is this something that your organization has had to deal with, either a HIPAA Omnibus audit or a Meaningful Use audit to this point?
Martinez: I don’t think we’ve had a specific OCR-type audit that’s taken place here — in fact, not one that I’m aware of, but Meaningful Use audits certainly are fairly common. I know that we’ve had some Meaningful Use audits, but that’s normal. I think the majority of the hospitals here in the Dallas area have. I remember I was at CHIME last fall and Pam McNutt and some of the other folks who are CIOs here in the community with me, everybody had gotten letters from the feds that there was going to be a Meaningful Use audit of some sort. We did as well and we’ve responded to it. You design and develop your programs knowing you’re going to be audited. It’s just a matter of maintaining good documentation and being prepared for when they call on you.
Gamble: You didn’t run into any serious roadblocks and, in general, felt that the organization was prepared?
Martinez: Absolutely, and we responded accordingly. I think most organizations, certainly anybody who’s been in a CIO role for any period of time, knows that, first of all, it’s inevitable, and second of all, everything hinges on how good your documentation is and your ability to be able to provide the documentation at that point. So as long as you’re prepared and you know those things, when the time comes it’s just another routine request that you have to fulfill.
Remember, the healthcare industry has been audited for years and years and years. We get audited by state financial agencies, federal financial agencies, regulatory bodies — there’s always some sort of an audit going on. It could be a payer coming in to do an audit. It could be the federal government coming in to do an audit. It could be Medicaid doing an audit. There are so many audits going on. It’s just part of our culture. We know what those requirements are, and as long as you work hard and you’re prepared for it, when the time comes you don’t sweat it.
Gamble: It’s nothing you haven’t been dealing with.
Martinez: Absolutely, no doubt.
Gamble: Are there any other big projects or initiatives on your plate at this time, or anything you’re looking at in the near future? I’m sure there is, but anything big we didn’t touch on?
Martinez: The most notable thing that’s going on at Parkland which you have not touched on, actually, is the fact that we’re building a replacement hospital. Parkland, which is famously recognized, known as, and remembered as the hospital where JFK was brought when he was assassinated, is a hospital that was built in the 1950s. And so several years ago — about five years ago, the taxpayers agreed to support the building of a replacement hospital. So there’s a replacement Parkland Hospital that is being constructed. And in fact, the construction itself is nearly complete. It should be turned over to us later this year and we’ll start occupying it and using it in the beginning of 2015.
It is a very impressive construction project. As far as healthcare construction projects go, I think this is the largest construction project going on in the US right now. It’s close to a 2.5 million square-foot hospital. It nearly doubles the size of Parkland from current to future state, and it’s a very impressive organization being built with a lot of thought towards the emphasis on quality care and optimal conditions for the delivery of care and clinical outcomes.
You’ll have to touch base with me over the course of the next few months and as we move forward toward opening up the hospital and begin to be a little bit more public about what technologies we’re deploying there and how the hospital’s going to run. I think it’s going to be something worth looking into, but that’s a big, big deal right now, and a lot of our attention is directed at opening up the replacement hospital.
Gamble: Sure. Without going into too much detail, which I understand you can’t do, is this something where you’ve been pretty actively involved in the planning just as far as being able to accommodate certain tools, technologies, things like that?
Martinez: Sure, I’ve been extremely involved. Again, this is another one of the reasons that I thought this was a wonderful place to be right now as a professional. I think it’s probably the best CIO job in the country. Many of us would say that about the jobs that we’re in, but I’m certainly uniquely positioned in regard to all the neat stuff that’s going on from PCCI to the new Parkland Hospital but yes.
A lot of the design work predated my arrival from an infrastructure point of view, but a lot of the endpoint solutions that we’re looking at, which revolve around communication, revolve around the patient experience, revolve around how it is that we deliver care, how it is that we reconcile workflows to technology to optimize patient care and the availability of our clinical resources — all of those things are things that I’m involved in, and by extension my team is involved in, that we’re very excited about. Technology tends to change materially once a year; in some cases, every six months. Think about how often consumer handheld devices, phones, smartphones and things like that are replaced. The development in the field of technology is incredibly fast, so we’re only now starting to make actual product selections, because if you made them too early, they would be obsolete by the time you use them.
I certainly have been involved, and by extension my team has been involved, in not only the overall architecture and laying out the infrastructure that’s going to be used, but all of the technologies that are going to ride on that infrastructure that are going to optimize the way our employees work, and optimize the way our patients are processed and taken care of, and, ultimately, the way we deliver our care and the highest degree of clinical outcomes as a result of it. It’ll certainly be very exciting once it’s done. I don’t think there will be another organization like us, but there are a lot of great healthcare organizations around the country and there are a lot of big technology adopters, but we will certainly be numbered amongst them.
Gamble: Definitely. That’s a very cool thing to be part of, and I would think for any CIO that’s really a great opportunity to be part of a construction from the ground up.
Martinez: Absolutely. It’s an amazing opportunity.