The CIO role hasn’t merely evolved; it’s become “a lot more complicated than it used to be,” says Nader Mherabi, “because it’s multifaceted.” Whereas in the past, the focus was largely on applications and infrastructure — two extremely important concepts — now, CIOs are helping to set the strategy for the organization.
But with that added responsibility comes greater expectations, whether it’s being able to convey the critical role technology plays in patient care, stretch dollars, or command the respect of senior leadership. It is, in some ways, an entirely different set of skills that what was required even a decade ago. To Mherabi, however, it’s a welcome change, particularly when you’re part of an organization that’s moving the needle with digital health and pushing the limits with artificial intelligence.
Recently, healthsystemCIO spoke with Mherabi, who services as CIO and Vice Dean at NYU Langone Health, about the work his team is doing to create “one patient, one record” across the system, what it takes to establish a foundation for digital health, and how leaders can foster innovation. We also talked about the enormous potential (and biggest misconceptions) of AI, his soft spot for applications, and the skills CIOs will need going forward.
Chapter 2
- 10-year digital health journey
- Providing the “same technology experience” in every location
- Optimizing Google search to improve patient experience
- “Innovation is everyone’s business.”
- AI as “another tool” in the clinicians’ arsenal
- NYU Langone’s regional focus
- Evolving CIO role: “You have to be at the table. You can’t be an afterthought.”
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Bold Statements
We also have folks whose job is to ask, ‘What does the patient want?’ We did a lot of market research. We talked to patients, we talked to families, and we talked to our clinicians. We did a lot of work to figure out the areas we want to focus on, and it has paid dividends.
We tell people, ‘Everyone has the power to innovate. Go innovate. Think of better ways to do things.’ But it’s important to create a channel for good ideas. I believe how you foster innovation is more important than actually creating those titles or groups.
It’s not going to replace people. And it’s not just for clinicians and scientists. We think this technology can help other staff and workforce become could be more efficient and add insight into the type of work they’re doing.
Every 12 to 15 months, you have to reinvent your role, and you have to be connected to the institution’s priorities. You have to be at the table with leadership to help shape those priorities.
Gamble: As far as being able to provide digital health services, is that something that was years in the making?
Mherabi: Digital health is something we’ve been working on for the past 10 years. We had to do so much to become paperless. Everything is thought through; whether you go into a hospital or an ambulatory practice, you experience technology the same way. We have palm recognition technology we put in nine years ago. A lot of these foundational things are 10 years in the making. But with patient experience, we’ve had an accelerated focus during the past two years, because the technology allows us to do that. For example, wireless is improving; having 5G would improve it further.
We’ve focused a lot on patient and family experience, from the time they engage with us to the time they come to our facility — even when they’re hospitalized. Our new Kimmel Pavilion provides an awesome experience for patients and families through our MyWall technology, which is featured in each room. It’s a translation endpoint. It’s a telemedicine endpoint. They can order meals. They can watch movies. Kids can play games; it’s great.
But we also have folks whose job is to ask, ‘What does the patient want?’ We did a lot of market research. We talked to patients, we talked to families, and we talked to our clinicians. We did a lot of work to figure out the areas we want to focus on, and it has paid dividends. If you go to our website, you can schedule an appointment online. You can find a specialist. Our public website provides a great experience.
Gamble: That’s so important, because it’s the first thing people see. And you want it to be as easy as possible to navigate, but also to showcase what’s available.
Mherabi: We’ve spent a lot of time optimizing the search engine so that people can find us quickly through Google, and they can match our services to their needs.
Gamble: Let’s talk about innovation. Clearly it’s a priority, but it’s not something that can be forced. Can you talk about how the organization is able to foster innovation in an organic way? What are your thoughts on that?
Mherabi: There are two things. If you notice, NYU Langone doesn’t have anyone with the title of Chief Innovation Officer. We feel that innovation is everyone’s business; making things more efficient is everyone’s job — not one person or one group. You have to empower people to innovate. Everyone has good ideas; you need to create the channels by which people can bring those innovations to focus.
We tell people, ‘Everyone has the power to innovate. Go innovate. Think of better ways to do things.’ But it’s important to create a channel for good ideas. I believe how you foster innovation is more important than actually creating those titles or groups.
If you don’t, people will shut down and say, ‘That’s someone else’s job.’ But that’s our philosophy. If a surgeon sees something that’s important for the OR, or if a nurse sees something on the floor that could done a different way, they have a channel to say it. That’s the philosophy we’ve taken.
Gamble: Right. And it’s not always about tools and gadgets but, like you said, finding better ways to do things.
Mherabi: Some things technology can enable, some can be a method change, and some can be as basic as changing the workflow.
Gamble: Looking ahead to next year and beyond, what are some of your key areas of focus?
Mherabi: Clearly, we’re focused on patient and family experience. We’ll continue to invest in that and work to differentiate ourselves in the market through digital means. We want patients to think of us as being one click away on their phone. We’re marketing to the younger generation as well as the older generation; we want to cover all age groups. We want all patients to be one click away. That’s why we’re pushing apps.
We’re also focused on improving the experience for our clinicians. So we’re doing a lot of work around how they can be more productive and not feel burdened by the EHR. There’s a lot that has to be done operationally through voice and other technologies. We’re thinking about what the exam room of the future will look like.
Another big area is analytics. We’re harnessing the power of predictive analytics and AI to determine how we can improve care. It’s not going to replace people. And it’s not just for clinicians and scientists. We think this technology can help other staff and workforce become could be more efficient and add insight into the type of work they’re doing. It’s exciting. There’s a lot more to come because there’s so much more we can do.
Gamble: I’m sure having the research component is exciting, in terms of being able to see what’s possible with things like AI.
Mherabi: We have an AI group here that is academic, but has more of an operational bend. So we don’t just research things; we implement. We have several models running in real-time to provide insights into specific cases, such as heart failure, so people know what’s going on.
Gamble: When you look at where the industry is going, do you think AI is poised to take off and really start to play a larger role in care as well as operations?
Mherabi: I see AI excelling quite a bit in other areas, but not as much in others. There’s been a lot of hype, and I believe it’s going to take some time to have an impact.
We think AI models can help people do their jobs more effectively and provide valuable insights, because there’s so much data out there. But it’s not going to replace people. It’s not going to replace highly trained clinicians who use their intuition and insight to make decisions. But if it can show you something you might have missed or quickly highlight important points. It’s another tool for you to help you do your job better and not miss anything. For example, in radiology, if it’s able to highlights certain anomalies that you might have missed, that’s great.
In November of 2018, our radiology department de-identified 10,000 MRIs from around the world using AI to help make the process faster. Something like that has a worldwide implication. In many parts of the world, people wait months for MRIs. If we can speed it scans while having the same results, that’s going to improve accessibility.
Gamble: Right. Now, looking at your career, you’re the Vice Dean in addition to being CIO, correct?
Mherabi: That’s my academic title, yes, because I oversee technology for School of Medicine.
Gamble: Okay. So you’ve been with the organization for a while, starting out in applications and integration. Can you talk about how you ended up in the CIO role? Was that something you aspired to?
Mherabi: Yes. Even though I think infrastructure is such an important aspect of what we do and should be a continuing investment, I’m much more of an applications person. How can we help people use technology in different and better ways? My interest has always been in applications. I’ve always thought that if you work with people, listen to them, and present technology in a way that matters, you can make a difference.
But I also wanted to manage. I believe management and leadership are so important. When it comes to strategy matters, I’m a more of a deep thinker. I think a lot about things, but then once I’m done, I push it to the next stage for my team to execute and get it done.
At NYU Langone, we’re all about accountability, but we’re also about research. Do your own work and continuously think things through, but allow people to work with you. When you’re able to get things done and make a difference, it’s positive all around.
This is a great institution. It’s not worldwide or nationwide. We don’t have 50 hospitals, where people constantly have to travel from one state to another. It has a much more regional focus. We’re known internationally and nationally, but the care takes place right here in the community. So it allows us to do things and scale them, which is rewarding, because it’s not too big and it’s not too small. It’s very rewarding to have an intervention and realize people can use it to make a difference. So the organization has been good to me, and I’ve been good to them.
Gamble: I’m sure it’s been interesting to witness the evolution of the organization. Of course, when you’re there every day it’s probably hard to see it, but it’s amazing how far things have come in 15 years.
Mherabi: The institution has grown, whether it’s through the research portfolio, clinical care, or education. It’s been quite rewarding to see the institution become a great health system for the community here in the metropolitan New York area, and to also have recognition nationally and internationally.
Gamble: Right. So, the last thing I want to ask is, when you think about where the industry is headed, what do you consider to be the most important skill sets for CIOs to have?
Mherabi: You continuously have to reinvent your job. Every 12 to 15 months, you have to reinvent your role, and you have to be connected to the institution’s priorities. You have to be at the table with leadership to help shape those priorities. You have to have stature and the respect of people to have that seat at the table. You can’t be an afterthought.
You have to be part of the strategy. And so it’s important to have good communication skills, to understand governance, and to be transparent. You have to be able to communicate across the institution, listen carefully, and be able to explain the strategic importance of technology in improving patient care. Without technology, can you imagine how hard it would be to provide quality care? It’s one of the most important underlying things when it comes to care delivery in today’s world.
As CIO, you have to make sure people understand the importance of technology and digital strategy, both in terms of cost savings and providing a competitive advantage. The job is a lot more complicated than it used to be, because it’s multifaceted. The old way of the CIO was to run the infrastructure and applications; nowadays, you help set the strategy for the organization. You can imagine that when some institutions bet on the wrong technology or didn’t get the technology right, they either went bankrupt or fell far behind.
Gamble: It’s very interesting. There’s much more emphasis now on being able to communicate, whether it’s to members of the board or your own team, and really conveying the importance of technology.
Mherabi: The other thing you have to do is manage costs, because resources in healthcare are so constrained. There are a lot of regulations, and there’s a lot of pressure. You have to find novel ways to stretch your dollars as far as you can. You have to bargain for your money. I always tell people, if we can save 50 cents on each dollar, which could go toward improving patient care.
Gamble: That’s a great point. Well, I think that about covers it. I’m really glad we were able to talk about what you and your team are doing. Thanks so much for taking the time to do this.
Mherabi: Thank you, Kate. It was nice chatting with you.
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