How physicians, nurses and clinicians are reshaping IT vendor strategies
Health IT vendors do best when they have a deep understanding of the unique needs of their clients: the physicians, nurses and patients whose experience is shaped by the technologies they develop.
Smart companies understand this, and many are making it a priority to fill their leadership positions with top talent drawn directly from hospitals – physicians and nurses, most often, but CIOs and CISOs and other execs as well.
These clinically-experienced professionals are often excited to join these companies and help them conceive, design and implement authentic and effective tools they know work well in the fast-paced environments from which they came.
On the vendor side, these clinicians and technology pros, armed with deep knowledge of the challenges providers grapple with every day – workflow, alert fatigue, UX and design, the patient experience – can help their companies home in on the right ways to develop and deploy that software.
It's a big decision to trade a career on the provider side – especially one that was earned with years of expensive medical school or nurse training – but many who have made the transition say they feel even more empowered to effect positive change across healthcare in roles such as these.
Antoinette Thomas, RN, is chief nursing officer at Oneview Healthcare, which develops an array of digital tools aimed at improving the patient and provider experience, inside and outside the hospital. She joined the company in 2015 (and was promoted this past month to CNO) after a 17-year career as a nurse practitioner specializing in pediatric critical care.
"When I made the decision to leave clinical practice, to come into health IT, it was a huge decision – a personal decision, a professional decision," said Thomas. "My parents were flipping out that I did eight years in school and all this training and then went into technology."
But she "knew inside" that at Oneview she "could help thousands of people, versus one person at a time," she said.
"I was just one of those nurses that grew up in the age of healthcare information technology," Thomas explained. "I knew the value of data. When people ask me, do I miss clinical practice, of course I do. But I'm still being a nurse every single day. And I'm impacting thousands of lives. I just don't use a stethoscope. I just have the privilege of having this amazing platform that someone built, and helping our customers put it in place for patients."
The list of notable clinical and tech leaders who have joined major vendors is long and growing, with professionals bringing a wealth of diverse health system experience to big blue-chip companies.
Judy Murphy, RN, for instance, is another nurse, who made the move: After more than 25 years as a clinical informaticist at Milwaukee-based Aurora Healthcare, she spent three years as chief nursing officer at the Office of the National Coordinator for Health IT – before taking a job with the same title at IBM in 2014.
At Apple, Ricky Bloomfield, MD, signed on as its clinical health and informatics lead in 2016, following years at Duke University School of Medicine, where he served as director of mobile technology strategy and pioneered the integration of Apple HealthKit feeding patient-generated health data into its Epic EHR.
And it's not just clinicians. Rick Bryant joined Symantec as healthcare architect and practice manager after years as CIO at Texas Children's Hospital. Charles Boicey spent years as an informaticist and analytics architect (Riverside County Regional Medical Center, UC Irvine Health, Stony Brook Medicine) before joining Clearsense as chief innovation officer.
Ed Ricks spent a decade as CIO at Beaufort Memorial Hospital and is now director of healthcare at Sirius Computer Solutions. Wes Wright is now CTO at Imprivata after a dozen years spent in various roles – executive director of IS, CIO, CTO – at Scripps, Seattle Children's and Sutter Health, respectively.
In an interview at HIMSS18, John Brindley, VP of Healthcare Services Strategy at Ricoh, who joined the company in 2017 after 17 years as president and CEO of Seton's Austin hospitals (and, before that, leadership positions at Bon Secours DePaul Medical Center, Inova Fairfax Hospital, Medstar and more), raised an interesting point.
As this new age of consumerism continues to shape how healthcare adopts technology – and how companies, many of them otherwise consumer-focused, tailor their products to healthcare – vendors that hire from the provider side can gain valuable insights for how "consumer" satisfaction (those consumers being physicians, nurses and, especially, patients) is experienced in care settings, he said.
"Coming from healthcare, we've been measuring patient satisfaction forever," said Brindley. "One of the challenges, from a non-clinical person, is how do they judge whether they've gotten good care? It was reasonably binary before: You either got better or you didn't. But then we started going to all these relatable aspects. Did your food arrive on time? Did the staff treat you with respect? Did you understand discharge instructions? It's more experiential."
It's not a significant step "from satisfaction to experience," he said. In this competitive landscape, hospitals and medical groups are reimagining themselves. They're doing data aggregation in real time, not sending patient surveys five days later. They're concerned with service recovery.
"Patients have a huge range of places where they can go for their care," said Brindley.
"Then there's CVS, Walmart, Amazon. It doesn't take a whole lot of insight to realize that the times are changing."
And as for clinicians and staff, Brindley explained that his experience as a hospital exec means he can show his Ricoh colleagues not just that healthcare is "rampant with friction," but where that friction exists, and how technology can help alleviate it.
"As a healthcare guy, both as a consumer of healthcare and a leader in the past, I know where all these bottlenecks are," said Brindley. "Those bottlenecks cost money and they invite error. I pay attention to those handoffs: personal handoffs, machine handoffs, facility handoffs. True healthcare should always focus on the patient at the center."
Taking advantage of a 'unicorn' set of skills
At Oneview, Antoinette Thomas is not the only clinician in the company's leadership. Its Chief Medical Officer Seth Bokser, MD, offers insights and perspective to its staff and leadership while also still practicing as clinical associate professor at UCSF and medical director for telehealth at UCSF Medical Center.
Having been on the provider side for 15 years, and having "come out of the electronic health record generation, where we focused on systems that clinicians use, I was really excited about the idea of using technology to provide patients a sort of digital cockpit from which they drive their own care," said Bokser.
But it wasn't just the company's products that appealed to him, it was the people.
"At a place like Oneview the people with whom you're going to work make a big difference, so for me as a company it was important to work for a company where I felt like the other leaders whose skills complemented my own skill set," he explained. "There are other leaders there with strengths in running a business, who come the world of finance, from serial entrepreneurship."
As CMO, Bokser focuses primarily on the design and implementation of various aspects of the Oneview technology, which is used by both patients and providers.
"I have worked on the design and implementation of clinical systems my entire career," he said. "What I have learned as a CMO in company, now that I'm on the industry side, is that I've had to rapidly build skills in many other areas: Overall corporate governance and leadership, sales and marketing, as well as working with the investor community to help them understand our company. It's been a mix of leveraging the skills I've built over the better part of two decades, and now rapidly ascending a learning curve to build the new skills that make a clinician an effective leader of a company."
On the industry side, "there's a lot of smart people, a lot of great ideas and a lot of vision," said Bokser. "And I think the role clinicians like Toni and I can play, and that clinicians leading innovative companies can play, is we can hopefully collaborate with industry and providers to help them understand how that grand vision can actually meet reality."
For her part, Thomas said a typical day at the office is a mixture of leading from the clinical nursing perspective inside the organization, and bringing that perspective to help translate the technology.
"I really consider my primary responsibility to be working with our partners to understand on a deep level what their business problems are and what they're trying to solve," she said.
When she adds her voice to discussions about the design or development or deployment of different technologies, "I always feel that I'm heard," she said. "Maybe my advice isn't always taken, but it's always taken into consideration."
"Toni and I bring to the table, when we work with our product and development teams, decades of experience on the frontlines of clinical care, and our experiences with our own patients," Bokser explained. "And we share with the development teams features and functions and interfaces for our products that we believe will improve the patient experience, lower costs and improve outcomes."
Other clinicians are working for or advising Oneview too. Nurses serve as VP client services, clinical consultants and even regional sales director. Physicians such as Northwestern's Lyle Berkowitz, MD, the well-known clinical informaticist and entrepreneur, is an advisor and sits on the board.
More and more companies are realizing that provider-side insights like the ones they can offer are more valuable than ever, and it seems probable that more and more vendors will be interested in hiring clinically-experienced people to help them tailor their products to a client base that's increasingly discerning.
"Individuals like Seth and I used to be considered 'unicorns" said Thomas. "Now there's a few more of us in industry: people who have the distinct skill sets of clinical care delivery, technology and understanding data patterns."