Since being named CEO of CHIME three years ago, Russell Branzell has been focused on advancing the organization’s role in the industry — and not just by providing education for members, but by taking the lead with issues that are hindering the journey to digitization. Case in point? The lack of a consistent patient identifier. Last month, CHIME launched a challenge designed to leverage the top minds in the world to come up with a better solution. In this interview, Branzell discusses the game-changing question that Peter Diamandis posed CHIME’s board, his thoughts on the Cybersecurity Act, and the stratospheric rise of the CISO role. He also reflects on Chuck Christian’s term as CHIME Board of Trustees, and talks about why he is exciting about working with Marc Probst, and what attendees can expect at the upcoming CHIME/HIMSS CIO Forum.
- MU changes — “You can be everything from a skeptic to an optimist.”
- Determining “the next step of revolutionary change”
- Keeping on the path to ACOs
- Launching the patient ID challenge
- “What is the biggest problem you need to fix?”
- New Board Chair Marc Probst – “A great leader in our industry.”
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What we didn’t do well was learn from the mistakes along that journey and make course corrections as well as we could to keep us on that true, but we also aren’t so far off that we need to scrap the whole thing
We realized there was not going to be a very strong push, if at all, given the constraints that are there at the federal government to start solving this problem. And maybe it shouldn’t be a federal government solution — maybe it should be in the private sector.
That really got us thinking of a different way than the traditional let’s wait for the next 15 or 20 years for this to be solved in a normal industry maturation process. Let’s create a way to make this happen fast because we need to solve it fast — first and foremost for our patients and the caregivers across this country, but also just the inefficiencies and waste of money that’s going on that’s out there.
That this wasn’t a long-term solution; this was a catalyst to accelerate the industry and to reduce the burdens of exchange in care that are out there today. And this was the most logical way for us to do it.
He has a deep passion to change healthcare. He, like myself, has his own stories of pretty significant family issues, and we both have a pretty strong passion to change healthcare for the better.
Gamble: Hi Russ, thanks as always for taking some time to speak with us.
Branzell: Thank you for having us today.
Gamble: Sure. So we have a lot of things to talk about, but I wanted to start by talking about Meaningful Use. Obviously, some pretty big news came out recently indicating that Meaningful Use is going to be replaced by something better. It’s a little vague right now and I know we’re waiting for more information, but just wanted to your interpretation of the news that’s hit.
Branzell: Well, you can go a lot of different directions and you can be everything from an extreme sceptic to an ultimate optimist. I’m going to probably err more on the optimistic side of this, as I think the government — and in particular HHS, CMS and ONC — has been listening to the feedback that had been given by lots of different constituency groups, whether they’re representing physicians or, in our case, the IT leaders for hospitals and medical groups and physicians themselves. And I think as you look at that, they’ve heard that feedback and they’re looking for some opportunities to improve this.
I think the way it was laid by CMS administrator Andy Slavitt, it really was intended to be, ‘We’ve heard you. We’re going to be moving some programs in some different directions, some alignments and things of that nature, and look at what the next phase of HIT adoption in the country is to help continue to digitize and transform the industry.’ I don’t think it was intended like some maybe in the industry might be projecting it is; that we’re all doom and gloom and this program needs to be shut down tomorrow. I think it was a statement of natural, maybe a little bit more than evolutionary change, maybe the next step of revolutionary change of what should come next after this, as we hopefully fix the things that didn’t go as well, lessons learned in phase 1 and 2, as we probably or possibly roll into phase 3, depending on the organizations that are out there.
But also, this was really formed well over a decade ago. Now that we’re at the point we are, what should be the next major logical steps? And that should be a natural transition to things that maybe we’re not even thinking of to know and revolutionize and digitize the industry, but also care processes. Telemedicine wasn’t even mainstream 10 years ago. How does this all affect telemedicine? It’s just examples like that.
Gamble: Yeah, it certainly seems to make sense moving a little bit away from the regulations that were put into place to get this thing started and allow for the progress we have seen in five years, which really is pretty amazing when you think about it.
Branzell: With the adoption curve that we’ve seen, we have to give credit where credit is due. The stimulus bill that was put in place and the subsequent bill to adopt technology did serve its purpose. We have seen a radical leap forward in the digitization of the industry. Probably what we didn’t do real well was learn from the mistakes along that journey and make course corrections as well as we could to keep us on that true north journey, but we also aren’t so far off that we need to scrap the whole thing; we just need to make the appropriate course adjustments and program changes.
Gamble: Do you see more focus on the payment reform and accountable care and kind of tweaking the program in that regard?
Branzell: Well, I think the real question is what’s the cart and what’s the horse on this, and which should come before the other? I think you have to continue down the path of technology-based digitization and we need to continue down that plan of what those things are to ensure we’ve connected across the industry — things such as exchange and standards and what we’re working on with patient identification to ensure the smooth transition of information and patients throughout the system, so that technology side needs to continue.
At the same time, we need to encourage changes in the overall care process that need to be paired up with other programs such as payment reform to focus more on both individual and population-based health programs to switch us out of the continual fee-for-service model. That won’t change until payment models start changing dramatically. We know that; it’s been said at every conceivable convention and speech given probably for the last five years, that until you see monumental payment reform, you’re not going to see models of care change dramatically, but we are starting to see that occur. We’re seeing people take on risk, we’re seeing people take responsibility for populations, and so we’re starting to see that change a little bit, but until it becomes mainstream, we’re not going to see as much of that occur until payment dramatically changes.
Gamble: Right. And of course the other huge piece of this, as you just briefly touched on, is patient identification. This has really been such a huge focus for CHIME, and a nice segue to talk about the National Patient ID Challenge and where that stands right now.
Branzell: Yeah, we’re very excited about this. As we looked at this almost three or four years ago when we looked at what the stumbling blocks were to everything from exchange to data aggregation for patients to whatever we needed to do, we just knew this was a fundamental issue that needed to be solved at some point. And in working with our federal leaders, our private sector leaders, over the last several years, we realized there was not going to be a very strong push, if at all, given the constraints that are there at the federal government to start solving this problem. And maybe it shouldn’t be a federal government solution — maybe it should be in the private sector.
Working with Peter Diamandis — who was one of our speakers at one of our events last year — he spent some time with our board and spent some time with some of our CIO leaders and asked the question, ‘What are those big problems that you need to fix in your industry that really would be a catalyst for rapid change and revolutionary change to really spur innovation on in a different way than your traditional models?’ And to a person, they all said patient identification. Until we solve that problem, we hinder ourselves at almost every conceivable level of information management and information exchange — and even at the patient care level, we reduce our ability to be successful. And he said, ‘Well, then, why don’t you fix it?’ It was a pretty strong challenge to our board. That’s when we got with them and asked what would a challenge look like, and so now we’re at a great point. We’ve been working now for almost a year on this. We’re at the point right now where we just formally announced and launched the challenge, and that began the process of people working on the solution and organizations working on a solution to start the process. We hope that almost a year later, we will be able to award not only the challenge prize, but more importantly will have made make great strides, if not, solved the patient identification solution challenge and issues we have across our country.
Gamble: And so that conversation with Peter Diamandis — is that how HeroX became involved?
Branzell: It is. If you looked at any of the stuff that’s ever happened out in the macroindustry, they’ve really spurred some amazing technology and innovative changes going on there. That really got us thinking of a different way than the traditional let’s wait for the next 15 or 20 years for this to be solved in a normal industry maturation process. Let’s create a way to make this happen fast because we need to solve it fast — first and foremost for our patients and the caregivers across this country, but also just the inefficiencies and waste of money that’s going on that’s out there.
And so yes, they really did serve as a catalyst for us. It’s a great challenge, and our board took that very seriously and spent a lot of time in deep thought and a lot of time in conversation about ways we can work on this and solve this other than just traditional advocacy in Washington. This really is how this was launched, from an idea now to in full fruition, and we’ve been working on it for months from criteria and all that, but we launched into full concept [on January 19].
Gamble: I know it’s hard to predict what’s going to happen, but would you be surprised if companies and individuals from other industries outside of healthcare get involved?
Branzell: I haven’t seen all the names. I’ve been told that almost 300 individuals and up to some of the largest organizations in the world have put their names in to at least receive the information, if not compete in the challenge that’s there. And many of them are outside the traditional healthcare IT arena. As a matter of fact, I would think a majority of them are probably outside the traditional healthcare IT arena that are there. And again, I don’t want to give any names of a few, but I know because along the way I’ve heard their names, but I will tell you it’s some of the most big and complex problem solvers in the world, and that’s really what we wanted. Those people, whether they are the mom-and-pop shop and a garage that may have the answer and we just don’t know it, to the biggest and most complex intelligence-based organizations out there that solve problems like this on a daily basis. And so, we’re very optimistic that given that the slate of people interested in participating in this and solving this problem, that we will get to a good point through this process.
Gamble: It should be interesting to see. And it does generate excitement when you structure it that way and at some point say, ‘these are the finalists.’ And I think that it’s interesting that CHIME chose to do it that way.
Branzell: I think part of it is we were looking at how we could do this, that this wasn’t a long-term solution; this was a catalyst to accelerate the industry and to reduce the burdens of exchange in care that are out there today. And this was the most logical way for us to do it. They’ve been great partners, so we’re very, very excited about working with them, but more importantly excited about launching this formally.
Gamble: Okay. So with a New Year starting, there are always a lot of new things. You have new Board of Trustees chair, Marc Probst, a name that everybody is familiar with. I wanted to get some words from you about why he was chosen and why you think he’s going to excel at this position.
Branzell: Obviously, Marc is a great leader, not only within CHIME, but within his organization and the industry as a whole. We’re blessed to obviously have an incredible board. Just to get on our board is quite a competitive process where sometimes we have as many as 25, 30 or 40 individuals that have put their name in for just three spots each year. The competitive nature of getting on to the board means we’re going to have really the cream of the crop, the best leaders in the country there. And so it’s both good and bad — you have to pick one to be chair, so that’s even a competitive process in itself, but we’re fortunate that in their last full year on the board, all three from our most senior CIO group, Marc and two others, get to be the officers of the board. One is the chair, one’s the secretary, and one’s treasurer, and all are significant leadership roles.
Marc in particular, obviously, is a great leader in our industry. He’s already proven over the last two years of being on the board really what a great leader he can be to help us drive some of these programs forward. He’s a great spokesman for us. We’ve been blessed as long as I’ve been involved with CHIME now, almost 20 years, to always have great chairs and really great boards, but great chairs that are willing to give personal time to find a balance between their crazy jobs in their organizations and their personal life to somehow give us the amount of time we need to do the things that need to happen across the industry. Marc will be a great, great champion for CHIME out in the industry. He’s already proven that in just some of the interviews and some of the things that have occurred even in the first few weeks of this year. We even put him to task late last year on a few things as well in his new chair role. So we’re very blessed to have Marc in his position.
Gamble: Yeah, and he’s somebody who really seems like he walks the walk when it comes to innovation. I know it’s such a huge priority at Intermountain, and I’m sure that’s a good influence in having somebody who has such a track record with fostering innovation.
Branzell: Yeah, that’s absolutely true. He’s always pushing the envelope. They have their own innovation center. There’s lots of work being done within the Intermountain system to transform care and reduce population health variation. In getting to spend quite a bit of time with him over the last, in particular six weeks, obviously at a board level for the last couple of years, but I’ve gotten to spend a lot more time with him over the last six weeks, and it’s obvious the passion that he has, and not just about technology. Technology, let’s admit it, is fun. It’s fun to work with and use, but most importantly, he has a deep passion to change healthcare. He, like myself, has his own stories of pretty significant family issues, and we both have a pretty strong passion to change healthcare for the better.
Gamble: I look forward to speaking with him and working with him. And who are the other two CIOs you have mentioned before?
Branzell: So, the secretary for this year is Cara Babachicos out of Partners Healthcare. Our treasurer for this year is Neal Ganguly out of JFK, and our chair elect for this year is Liz Johnson, who will become the chair next year. That makes up our officer slate, with Chuck Christian being our past chair who takes over the foundation.