CHIME23: Catching Up with Board Chair-Elect Scott MacLean

Despite the fact that Scott MacLean has 25 years of healthcare leadership experience under his belt — or, perhaps because of it — he wasn’t about to treat the role of CHIME Board Chair lightly. In fact, his strategy was to embark on a “listening tour” with current Board members to “learn how they’re thinking about the industry and the organization.” That way, when he starts his term on January 1, 2024, along with fellow Trustees Officers Aaron Miri (Treasurer) and Sheree McFarland (Secretary), MacLean will be able to hit the ground running.

Recently, he spoke with Kate Gamble, Managing Editor of healthsystemCIO, about what he hopes to accomplish during his term, and why he believes the organization holds so much value for leaders. MacLean also talked about what he expects to see at the upcoming Fall Forum, and provided advice on how attendees can get the most from their time.

Key Takeaways

• On the Most Wired survey: We’ve revamped the Digital Health Most Wired survey so that it’s focused not just on your traditional infrastructure and applications, but also what it means to be a digital healthcare organization in the 21^st century.
• On his goals as Board Chair: I want CHIME to continuously evolve our educational offerings, our networking offerings, and our conference programming in ways that help support leaders as they’re faced with tough industry regulations.
• On CHIME BootCamp: The curriculum has evolved as we’ve seen the industry change and the technologies change such that now, I think it’s a must-do now for younger people who want to be CIOs or chief digital information officers.
• On Innovation: Over the last decade and a half, we’ve all been in this great implementation mode, and so, there is a big support burden. The goal, I believe, is to try to put ourselves in a place where we can take advantage of innovations, even if it’s small experiments that can then be leveraged.
• On the AI Hype: I really think it’s something we need to embrace. We need to look at what guidelines might be necessary in one’s own organization administratively or within technical controls, and pay attention to the regulatory environment.

Q&A with Scott MacLean, CIO, MedStar Health

Gamble:  You’re starting a term in January as Chairperson of the CHIME Board of Trustees. Congratulations, by the way. But that election happened more than a year ago, correct?

MacLean:  You probably noticed that we just announced the Board Officers for 2025. The way we do it is, the year you are elected, you are provisional for the December board meeting. Each year, there are three people eligible for offices: the chair, secretary, and treasurer. Four people are elected to the Board, including a CHIME Foundation member. The three non-Foundation members present at the June retreat, and voting takes place in August. I was elected in the summer of 2022, and will start as chair in 2024. This past summer, Tressa Springmann found out that she has been elected to serve as Board Chair in 2025. And so, I’ve been Chair-Elect for a little while.

 

Gamble:  What’s the reasoning behind doing that so far in advance? Is part of it ensuring you have a chance to prepare and to decide where you want to focus?

MacLean:  Yes. And it might seem like it’s a long time, but it goes by very quickly. The organization is moving fast. The industry is moving fast. For that one year as Chair, you have a couple of conferences to preside over and a few board meetings to chair, and there’s a lot of work that needs to be accomplished by the team throughout that time period.

 

Vision as Board Chair

Gamble:  What do you think your vision will be as Board Chair? What do you hope to gain from the experience?

MacLean:  My strategy — and this is what I’ve done in the past with other organizations — is to do a listening tour with all the board members from now into December to learn how they’re thinking about the industry and about the organization. As we start planning for the retreat in summer of 2024, we’re looking at the next iteration of CHIME. I think we’re now on CIO 4.0.

Digital Health Analytics

As things continue to evolve, how does the CIO role change? Of course, most CIOs are now chief digital and information officers, and so, we’re very focused on digital health. We’ve revamped the Digital Health Most Wired survey so that it’s focused not just on your traditional infrastructure and applications, but also what it means to be a digital healthcare organization in the 21^st century.

We’ve opened up the DHA environment. DHA (Digital Health Analytics) is the survey research hub that we utilize to administer the Most Wired survey. It’s about innovation, analytics, and the community. There are lots of opportunities for members to see what others have done and share with each other.

That program has grown significantly. This year, we had 21 Level 10 organizations, which is the most to date. Approximately 40 percent of US acute hospitals participated. That gives us real data about what’s happening out there and how we can help people adopt technology and healthcare.

 

Evolving Education

To your question about what I’d like to see, I want CHIME to continuously evolve our educational offerings, our networking offerings, and our conference programming in ways that help support leaders as they’re faced with tough industry regulations, changes, and rulemaking as the economics of healthcare challenge everyone. People across the board are experiencing burnout and dealing with talent retention; the next wave of leaders needs to be prepared to face these challenges. I want to see us continue on that path and really make progress, such that our membership realizes value, and that we continue to grow. And we’ve already had significant growth in our membership here over the last several years, with about 5,000 members in 58 countries, and 190 foundation partners.

 

Rural healthcare

Gamble:  I imagine some of that includes rural organizations, which unfortunately can get lost in the shuffle. What is CHIME doing, or what does CHIME hope to do, to represent that sector?

MacLean:  We’re definitely looking at that. The CHIME Policy Steering Committee, which I’m part of, includes representatives from rural acute and non-acute care organizations at our weekly calls. And so, we’re attuned to the challenges for some of these organizations with fewer resources. We’re always advocating for more broadband support from the federal government and more cybersecurity support — we all need that, but some organizations just don’t have as many resources as others. We’re always helping to navigate the rulemaking, and the policy team in Washington has done a great job of digesting these huge pieces of legislation or rules, and breaking them down into cheat sheets. That’s really, really helpful.

Obviously, the surge in telehealth helped all organizations, but particularly those in rural areas. We continue to advocate for ways that those organizations can take advantage of regulation and payment given their far-flung situation.

It’s really important for non-acute continuity of care as well. As you know, these organizations were part of the HITECH Act, and so they’re always looking for ways to tie into acute and ambulatory organizations to provide a continuum of care for patients.

 

The Power of Mentoring

Gamble:  Absolutely. So, when I’ve spoken with people about what differentiates CHIME, the most common answers tend to be Boot Camp or mentoring opportunities. They’ve clearly made an impact. Do you think mentoring is more important than ever, given all the changes the industry is facing?

MacLean:  I do. CHIME was designed to be a community of healthcare and information technology executives; I think we’ve been able to maintain that for more than 30 years and create situations where those relationships can happen. And to me, it doesn’t just happen among older and younger CIOs. I’ve benefited a lot from Foundation partnerships and my colleagues working for the vendor community — they see a side of healthcare that I don’t see because they’re out and about a lot more than I am.

CHIME Boot Camp

I attended Boot Camp in 2003; it’s been a very successful program, and it has really evolved. The curriculum has evolved as we’ve seen the industry change and the technologies change such that now, I think it’s a must-do now for younger people who want to be CIOs or chief digital information officers. We’ve been able to use the resources we have to expand the offerings and create an environment where people can learn and grow.

 

Preparing for CHIME23

Gamble:  That’s great. What advice would you offer to CIOs who are planning to attend CHIME — especially those who are new to the organization?

MacLean:  It starts by preparing for the event and taking care of oneself. If you’re headed to CHIME or another event, make sure that you’re well-rested and that you plan your time carefully. If there’s an app, download it. Look at the schedule. It’s designed to have more than you can consume; make sure you decide which events you plan to attend and allot time for travel in between meetings or sessions.

And also, don’t be afraid to talk to people; message them through CHIME to make an appointment. That’s important — if you want to meet one of the well-known CIOs, message them in advance. In most cases, people are pleased to meet with younger people or those who are new to the industry. It’s designed to be a relational organization.

Vendor partnerships

On the other side of the coin, my Foundation colleagues regularly say that it’s not about selling. In fact, that would be a turnoff. It’s more about building a relationship and discovering together what the opportunities might be. I think when you take that approach, it’s more fruitful on both sides. I’ve certainly done business with Foundation members, and it’s not because they confronted me at a CHIME event and sold me. It’s because we got to know each other and figured out what we needed.

 

Leave room for innovation

Gamble:  That’s a really good point, and it’s something that has come up in our interviews. Everyone wants a strong partner. But to make that happen, you have to build the relationship and build trust. That’s really good advice for both sides.

MacLean:  The other thing is that it can be overwhelming for everyone. I think it’s helpful for people on both the provider side and the foundation side to know that we have large systems with large infrastructures, network data centers, telephony, and lots of end-user devices. People have big EHR and revenue cycle platforms, ERP platforms, and now, consumer and analytic platforms. You always want to leave some room for innovation and growth, and try to ratchet down what it takes to support all these things. But over the last decade and a half, we’ve all been in this great implementation mode, and so, there is a big support burden. The goal, I believe, is to try to put ourselves in a place where we can take advantage of innovations, even if it’s small experiments that can then be leveraged.

 

Focus on foundational elements

Gamble:  That segues nicely into my last question, which is around the topics you hope to discuss at CHIME. Everyone wants to talk about the latest tools, but you still need to focus on infrastructure resiliency and things like that. What are your thoughts?

MacLean:  There are always foundational elements that need to run. John Glaser, who was my mentor, used to say, ‘If you can’t run the email system, they’re not going to trust you with CPOE.’ The analogs are the same. Now we say, ‘if you can’t run the EHR, they’re not going to trust you with artificial intelligence.’

We’re going to hear a lot about artificial intelligence and machine learning — ways in which people are applying those tools and the opportunities that exist to apply these tools. I really think it’s something we need to embrace. We need to look at what guidelines might be necessary in one’s own organization administratively or within technical controls, and pay attention to the regulatory environment. We’re advocating for the government to not be too heavy-handed in this, because we do think that there are great opportunities.

But, given the margins in not-for-profit healthcare, we’re likely to get these tools mostly from our foundation partners in various elements that they derive in the EHR revenue cycle and collaboration management space. These big tech companies will provide offerings we can take advantage of that will be curated within the bounds of our HIPAA BAA agreements. I look forward to discovering more about that.