It’s such a subtle change that many people may not have even noticed it. But when HIMSS changed its mission statement from “transforming health through IT” to “transforming health through information and technology,” it was a testimony to how far the industry has come. As technology has evolved, patients have become consumers, connectivity has been the essential puzzle piece, and the CIO has become “a critical partner in how care is delivered.” For Hal Wolf, who started as CEO of HIMSS last fall, it’s been a thrill to watch it all unfold.
In this interview, he shares his thoughts on the transformation we’ve seen in consumer engagement, why digital health should be the “cornerstone” of any strategy, what healthcare can learn from the automobile industry, and what it’s going to take to improve cybersecuity. Wolf also talks about how mergers are impacting both organizations and leaders, how the CIO role has changed (and will continue to change), and what HIMSS is doing to better serve its members.
- His first months as HIMSS CEO
- Shifting toward consumer-based care
- Digital health — “It’s going to allow us to deliver to the expectations and needs of the market.”
- Portals & the learning curve
- Auto industry’s approach to consumerism
- “I absolutely see the product experience hitting healthcare.”
- Designing hospitals in Europe to create a “warmer environment.”
- Hospital M&A – “What are the drivers?”
You can see technology becoming a critical part of how we connect clinicians, patients, and applications. And it’s developing into an ecosystem which really does have the patient/consumer/citizen in the middle. It’s amazing. You see the health model and the medical model really being brought together, and the piece that’s connecting them is data.
How do we build digital health into our fundamental delivery system, and how do we think about it not just as one size fits all, but in terms of segmentation? This ties back to consumerism. Each patient is different, and we have to deliver care in different ways based upon those segmentations, especially in terms of digital health.
We’ve started to use extenders, and we’ve started to create digital health strategies. We’re in a cycle, and that’s what innovation is all about. We’re in a cycle of learning. We’re in a cycle of improving. And if we can, we need to learn how to fail fast — to be able to look at something that’s not working, and change it.
It’s a huge change. It’s change management that’s running into innovation, which is running into new delivery capabilities. And so yes, I absolutely see the product experience hitting healthcare.
Gamble: Hi Hal, thank you so much for taking some time to speak with us. We really appreciate it.
Wolf: Absolutely. My pleasure.
Gamble: You started your role as CEO of HIMSS about six months ago. What was your main focus when you started?
Wolf: To me, the key was getting to know the organization and the people in it. I felt it was really important to spend the first two to three months flying around the world, meeting with every employee and creating opportunities to have one-on-ones, because you can never really understand an organization if you look at it solely from the point of view of the board. I’ve had the honor and the privilege of serving on the board and supporting it from an advisory standpoint in combination for four years, but getting face-to-face time with the departments and the individuals and understanding their viewpoints has been critical. In every organization I’ve been in, I’ve wanted to know what keeps people up at night. I want to know what they’re happy with, and what they’d like to see improve. Hearing that from the employee base has been invaluable.
Gamble: As you know, health system leaders have so many priorities on their plates. One that we’re hearing a lot about is consumer engagement. I want to get your thoughts on how dramatically this landscape has changed in the last couple of years, and what you think we’ll see going forward.
Wolf: Consumer engagement has been through a really interesting transformation. I spent some time earlier in my career in the entertainment industry, where products and services are developed with a focus on the individual. What I noticed is that healthcare, from a functional and an operational standpoint, was originally set up — and is still set up, in many cases — around the function of the institution, as opposed to viewpoint of the customer, the citizen, and the patient. I use those three terms because individuals wear all three caps simultaneously. As a citizen, I have expectations depending on where I am globally about what a system is going to do for me. As a patient, I have needs from a care standpoint. And as a consumer, I have expectations in the marketplace. Are my needs being met?
I’ve seen an incredible attention shift in the last 10 years — and even more so in the last five — in what we call a consumer-based approach, where we’re thinking about integrated care and integrated communications from the point of view of the patient. And you can see institutions changing. You can see technology becoming a critical part of how we connect clinicians, patients, and applications. And it’s developing into an ecosystem which really does have the patient/consumer/citizen in the middle. It’s amazing. You see the health model and the medical model being brought together, and the piece that’s connecting them is data, which is being turned into information.
You see applications being developed to support it, and you see strategies being created to support it. It’s quite a change.
Gamble: And along those lines, we’re hearing so much about digital health and how it’s playing a bigger role in the CIO’s strategy. Based on your experience — particularly at Chartis, where you were Director of Information and Digital Health Strategy — what are you seeing in terms of this evolution?
Wolf: Actually, it started for me when I was at Kaiser Permanente, where there was a lot of thought around the use of information and the extension of digital health. I saw it more when I was at Chartis Group, which is a consulting organization working with systems across the United States and overseas. Now we’re seeing that for healthcare systems, digital health is about using information not only to improve internal services and operations, but to extend beyond the walls of the clinic and the hospital to create unique partnerships.
It goes back to the connectivity model. If hospital systems or practices today are not thinking about digital health; if they’re not already engaged in understanding the consumer’s expectations of connectivity, and if they don’t have a digital health strategy that they have already begun or are deeply embedded with, I really worry about their ability to survive in the next 5-10 years. There will always be beds that need to be filled, but you need to look at the basic economics of healthcare — the number of physicians and nurse practitioners that are going to be available, and the use of extenders that digital health allows. It’s going to allow us to deliver to the expectations and needs of the market.
I’ve spoken in the past, as many others have, about the silver tsunami. We have a huge number of people who are reaching retirement age. They’re going to live longer, and they’re are going to carry chronic disease with them. What I think every system is working with is, how do we build digital health into our fundamental delivery system, and how do we think about it not just as one size fits all, but in terms of segmentation? This ties back to consumerism. Each patient is different, and we have to deliver care in different ways based upon those segmentations, especially in terms of digital health.
Because when physicians are doing a face-to-face encounter, they speak differently to a child than they would a parent. They speak differently to an older adult than they would a caregiver.
When we think about how we use applications and how we use connectivity, we have to reprogram that. Of course, we can get smarter through machine learning and AI (artificial intelligence), but you still have to know the audience. That’s part of this journey. We need to give it great consideration, because digital health is the cornerstone of where the market is going.
Gamble: That’s a great point about the different segmentations. I think that was one of the issues people had with portals — they didn’t work with every patient population. But on the other hand, you could argue that they served as a stepping stone to what we’re seeing now.
Wolf: I think you’re right in both cases. With the initial portals, it was about understanding how we can connect outside of the walls. That was the first step. But if we look at what has happened to our phones over the last 5 years, we see this acceleration of understanding and learning and a flood of applications and capabilities. It’s a learning curve. It’s a great learning curve. And now we’ve started to use extenders, and we’ve started to create digital health strategies. We’re in a cycle, and that’s what innovation is all about. We’re in a cycle of learning. We’re in a cycle of improving. And if we can, we need to learn how to fail fast — to be able to look at something that’s not working, and change it. Keep going. Not everything will be perfect day one. It’s an acceleration that’s occurring inside healthcare overall, and it’s being driving by these factors.
Gamble: Very interesting. Keeping with the theme of innovation, you wrote a piece a little while ago about how the automotive industry has started to view vehicles not just as transportation, but as consumer products experiences, which is a huge shift. Do you think healthcare is moving in that direction?
Wolf: Absolutely. The automotive industry’s attitude towards consumerism has changed; they’re delivering the product in a much different way than in the past. They understand that they have to create an environment that matches the expectations of the consumer and of the product experience. In healthcare, we’re beginning to do the same thing.
Last year, I attended a large hospital conference in Vienna where I had the opportunity to spend time with architects who are designing new hospitals. When they look at design, it’s not a function of, ‘here is the OR. Here is the maternity ward.’ They’re creating environments on a physical level that have a different feel, whether it’s a children’s ward, cardiovascular, or women’s services. They’re creating an environment that is warmer and a flow that is dramatically improved.
One example is Odense University Hospital in Denmark, which is being redesigned. They’re thinking about things like, ‘how are we going to use drones in the hospital? How are we going to use sensors? How are we going to be able to follow the individual all the way back in their home with connectivity, and what does that environment feel like?’ And this is all in the very early, fundamental stage — it’s not at the stage where you’re looking at applications, connectivity, and how the family is going to be connected. It’s a rebirth, and it’s all driven by data. It’s driven by the use of information, which comes back to the CIO’s role. It’s a huge change. It’s change management that’s running into innovation, which is running into new delivery capabilities. And so yes, I absolutely see the product experience hitting healthcare.
Gamble: It’s very exciting. Now, as we look at all the changes in healthcare, one of the biggest is the trend with mergers, and even mega-mergers. We’re seeing this all over the country, and some believe it will continue. Do you think that’s the case? And how do you think it will impact the way care is practiced?
Wolf: It certainly seems to be a trend, in every industry. The fact that healthcare is going from fragmented to consolidated is a natural state. The question then becomes, what are the drivers that sit behind it? Any driving trend is going to be built upon economics. If you think about hospitals acquiring hospitals, that makes sense. That’s a normal merger. What we’re starting to see in the mega trends is providers and payers coming together. We’re seeing an integration of services to create horizontally-based and vertically-based companies that didn’t exist before.
If you go back to the beginning of Obamacare, we started to see more primary care practices align with hospitals. Now we’re seeing these acquisitions beginning to occur on the payer side — you can see the integration starting to take place.
One example is Kaiser, which is an organization that provides both healthcare and insurance, and views at it as a total structure. I think we’ll continue to see those trends, especially if we continue to emphasize value-based care. Because it fundamentally puts the focus in the right place, which is on the efficient delivery of care, with a value-based outcome. Many have made the argument that this is best delivered through integrated models, and so that’s what I think we’ll continue to see.