There are four new ways to be a CIO in today's disruptive healthcare environment. They're not mutually exclusive, but different ways to think about the role depending on the task at hand and the context of the work. In an earlier post, I discussed the "Frugal Modernizer," an archetype of the CIO that focuses on developing a new funding model that takes a smarter approach to modernizing existing technology through continued and preventative maintenance. Here, we take a deeper look into the "The Integrator," who creates an enterprise IT structure that enables all the intriguing possibilities of plug-and-play.
Today’s healthcare environment is more modular than it's ever been. There are:
- More suppliers – more products and services focused on solving specific consumer needs, and fewer suppliers who try for a comprehensive product or service that addresses multiple needs.
- No single owners – success depends on stitching suppliers together across the marketplace to create the comprehensive suites of products and services that consumers want.
- More opportunities – each supplier aspires to delight its customers with the one or two things that it does best. Thus, each supplier can delight, and therefore potentially capture, customers for its collaborators, creating more opportunity for all.
Look at what's happened, for example, in the travel industry. After the Internet made everyone their own travel agent, various apps and websites started competing to make travel planning easier. They combine air, hotel and car rental, allow travelers to book "experiences" along with their Airbnb room, and invite them to purchase travel insurance for their adventure. They allow consumers to snap together personalized itineraries like puzzle pieces.
Healthcare is becoming modular in a similar way, but to take full advantage of this transformation, organizations need to transform themselves. This transformation requires a different type of leader: the Integrator CIO. This CIO creates the technological fabric across an entire organization to connect suppliers as effectively as other industries do.
Organizations Can No Longer Operate As Do-It-Yourself Shops
Healthcare organizations often self-develop, and when they do use external vendors, they frequently demand extensive customization. "Integration" means basic data exchange and not much more. And even getting that degree of integration to work presents challenges like:
- Effort duplication – both sides create data to exchange, check the data once exchanged, and fix data exchange errors. All that is before the data makes it to the end user.
- Extreme delays – data shared between organizations is often old and outdated.
- Exasperated consumers – once data is exchanged, its users inevitably find errors and all too often it's their job to track down whose fault it is and try to get the problem fixed.
- Unbreakable bonds – custom data feeds are complex to design, complex and costly to implement, and require continual maintenance. Once they are working, the organization may feel like a prisoner of its vendors and/or partners, because even one change entails possibly having to go through the whole painful process again.
Creating the Modular Environment with the Integration Fabric
Outside of healthcare, "integration" means something different. The components "snap together" regardless of vendor, creating a smooth experience for users that goes way beyond basic data exchange to create a new product with each combination of components. The Integrator CIO strives to give the healthcare organization that level of integration by creating an "integration fabric": a technical environment where vendors and partners can connect–or when necessary, disconnect–simply, easily, and consistently. The “integration fabric" has five layers:
- Legal – agreements that enable partnering across the ecosystem. An industry example is The Sequoia Project, whose Carequality framework reduces the legal complexity of exchanging personal health data.
- Access – baseline technical integration to provide software as a Service, infrastructure access, and cross-partner monitoring, so consumers are not the first to experience outages. Most companies have internal, integrated command centers; however, they do not have cross-ecosystem integrated command centers. Functioning a bit like an air traffic control tower, cross-ecosystem command centers constantly manage decisions about incoming and outgoing flights based on the steady flow of incoming information made available to them – all without worrying too heavily about what surrounding airports are doing. But, air traffic control towers do responsively and proactively communicate with each other around the globe as necessary to prevent passenger headaches. For example, airports communicate on how to best keep passengers from being stranded on their journey when flights are canceled due to an unexpected blizzard.
- Information – data exchange standards that guarantee information security and veracity, and form the baseline for required analytics. This fabric is based on more traditional application programming interfaces (APIs) and information bus concepts. An industry example is Fast Healthcare Interoperability Resources (FHIR), which combines information standards and APIs.
- Workflow – standard and consistent application integration across all partners are necessary so that one partner can initiate actions and hand off to another, with the guarantee that the work will be completed. EHRs and practice management systems sometimes have this type of integration, but a true workflow fabric will go beyond these two systems to encompass every vendor and partner.
- Experience – consistent, magnet experience for every type of user across the ecosystem. The consumer should not know, or care, which partner is providing a service. Calling into a call center should be exactly as effective as doing a task on a mobile app or through a portal, with the same information and options available.
Are you the Integrator? Have you created the fabric across the organization that allows it to integrate new business capabilities effectively?