Issue link: https://beckershealthcare.uberflip.com/i/821337
59 CIO / HEALTH IT 30 Answers to 1 Question: What Should CIOs Cut From Their IT Budget Tonight? By Molly Gamble and Emily Rappleye C IOs can't always control how big their IT budget is, so what can they cut when everything seems important? We asked several attendees and vendors at HIMSS17 in Orlando, Fla., this question: Many hospitals are looking for ways to trim costs — if you had to recommend one thing for a CIO to cut from his or her IT budget to- night, what would it be? Here is what they would put on the chopping block. (Responses are lightly edited for length and clarity.) Ed McCallister, Senior Vice President and CIO of UPMC (Pittsburgh): "e one thing would be something we don't nec- essarily do for a living. Manning a data center is not one of UPMC's core competencies. Our core competency is taking care of patients. It's about recognizing what items don't we make a living doing and recognizing the ones we do. If we don't define the future, someone else will." John Kravitz, CIO and Interim Chief Data Officer, Geisinger Health System (Danville, Pa.): "In my opinion, the opportu- nity is to right-size the IT organization by ra- tionalizing the application portfolio, reducing the number of applications, since a consider- able cost is associated with paying vendors for support as well as supporting a diverse infra- structure to host diverse applications. Another consideration is standardizing applications to a singular EHR system if appropriate for much the same reasons as application rationalization." Paul Black, CEO of Allscripts (Chica- go): "ere is not much one can cut from their IT budget tonight unless one is living un- der a rock for a while. I would suggest that the CIOs take a hard look at contracts that have hey maintenance fees for soware licensed and installed in the past, explore ways to re- structure contracts based on the newer pric- ing models prevalent in the market, outsource portions of their IT staff and fill open IT posi- tions with staff augmentation strategies." Francis "FX" X. Campion, MD, CMO, Ayasdi (Palo Alto, Calif.): "ey should think about new ways of doing work. Wheth- er they need to change people [or] the use of data — and that may be improving the skill set of analysts and equipping them with modern tools — is really the key." Adam Klass, Chief Technology Officer, Vigilanz (Minneapolis): "Try to reuse what you have a little bit more. For example, if you've got a disaster recovery infrastructure set up, maybe you could use that environment for things around testing and staging instead of trying to build out new things." Dan Michelson, CEO of Strata Decision Technology (Chicago): "Variation. at is the biggest opportunity — really having produc- tive, collegial, balanced conversations with physi- cians about variation. e average hospital could double its margin just by advancing conversa- tions with physicians in a continuous way around variation. at's a conversation people are reluc- tant to have because they don't know how to have it. ey are in the first inning of a 9-inning game. Physicians need to be able to trust the data, you need to be able to display it in a way that is action- able, you need to do it on continuous basis and lastly it needs to be clinically balanced." Ian McCrae, CEO, Orion Health (Auck- land, New Zealand): "e thing where you are going to get the biggest return is not actually in inpatient automation. What I see today is a lot of money going into automating patient admin- istration systems. I just don't think they are going to get the return on investment. e costs are all incurred in the community." Suzanne Cogan, Vice President of Sales, USA, Orion Health: "I would say really consolidating all the IT systems they have. … [Health systems] grow up with mul- tiple EMRs, multiple analytics systems, a siloed care coordination system here and another one there, and what ends up happening is this spaghetti mess of interfaces between all the sys- tems. We've been seeing a trend in consolidat- ing those, having a centralized platform to ac- quire and aggregate the data, normalize it so it's all curated, and then feed other systems with it." Tina Foster, Vice President of Business Advisor Services, RelayHealth (Atlan- ta): "I'm not sure I would look at cutting any- thing today. If you look at where the majority of costs in the healthcare system come from today, it's in this bucket called unexplained variations in care. …Variations in care across providers, clinicians, operations and workflow leads to a tremendous amount of waste. Because I am an analytics geek, a lot of data is about helping customers understand where those variations are actionable. …When you look at all the key components of the data… that's when you are going to be able to manage variations in care and that's when you are going to be able to cut costs in a high-quality way, as opposed to mak- ing cuts that impact quality on the back end." Todd Rothenhaus, MD, CMO, athen- ahealth (Watertown, Mass.): "Predictive analytics. No. 1. I don't want to say its all smoke and mirrors. Eventually I know that somebody will detect inferences and it will be, 'Mr. Jones exceeds the threshold of 1.5 percent chance of dying next year.' But what I see in all of our cli- ents, everywhere I go and every prospect I ever meet, is data that is staring them in the face that they are not taking action on because they don't have the capacity to do it or they haven't done the hard work of operational delivery. You've got these people who are buying technology in the absence of the ability to implement it or to make the best use of it because there is some- thing lower on Maslow's hierarchy that hasn't been checked off yet. I think predictive analyt- ics is the biggest one. I know it may cure cancer some day, but it isn't going to help the lady get into her Datsun B-210 to get to her diabetes ap- pointment because her sugar is 400." Hemant Goel, President, Spok (Eden Prairie, Minn.): "I have two answers. One is if the CIOs were to go and look at all the ap- plications they have, I bet they would find a lot of overlaps in capabilities. …e second thing is another way of saving costs without having to trim anything. A lot of CIOs do not use the applications to the fullest extent possible. If you go 100 percent into what the application was designed for, you get so much more ben- efit out of it. You won't have to cut anything." Andrew Mellin, MD, CMO, Spok (Springfield, Va.): "Look under the rocks and find the tiny things sucking a lot of cost and time out of your organization. ese little niche solutions that your departments bought or someone's uncle is running... ere is a lot of waste under these rocks they don't even know is happening in their organization. … [ey] don't always have a bottom-line cost you see in the dollars you are paying, but they have a huge cost in terms of getting them integrated, supported and upgraded. When you add up all those costs, it's a lot more than you realize." Paul Bradley, Chief Data Scientist, Zirmed (Chicago): "We definitely see a range with our clients in different HIS systems. Some of the more advanced HIS systems just collect data at a different level of granularity. From a data science perspective, I like the most granular data I can get my hands on. Maybe something not so much to divest in but to re- invest in is an upgraded system. We work with