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What Scares Healthcare CIOs

 |  By smace@healthleadersmedia.com  
   October 23, 2012

We now know the extent of the HHS Office of Inspector General (OIG)'s fraud and abuse fishing expedition regarding electronic health records, which came to light in the CHIME Fall CIO Forum in Palm Springs, CA, last week.

According to the American Hospital Association, the OIG letter went to all hospitals that received an incentive payment between Jan. 1, 2011 and March 31, 2012, directed specifically to the CEO's or administrator's office. The letter requests that responses be submitted by this Friday—one week from issuance.

The AHA says OIG will use the information from the survey as part of a report expected out next year. OIG staff informed the AHA that hospitals may take additional time to respond to the survey if needed. In addition, OIG will allow a health system to file a single response for all facilities, where the survey responses would be the same for each entity in the system.

(Health systems that choose to submit a single response for all their facilities should contact Kim Yates at kim.yates@oig.hhs.gov prior to completing the survey, to ensure that OIG properly accounts for their system-level response. AHA urges hospitals that respond to the OIG survey to e-mail a copy of their responses to the association at oigsurvey@aha.org.)

The day before this story unfolded before me at CHIME, I thought I would get into the spirit of the season and started asking some CIOs which part of technology or their job was scary. Little did I know the scare they were receiving in the mail while we were all in Palm Springs.

At any rate, my mini-scare survey elicited a variety of fears and concerns.

Leslie Clonch's response spoke to the fears of all HealthLeaders readers.

"I think the scope of what has to be done, and more importantly, the time frame we have to do it in, the pace at which folks have to be able to digest it and embrace it and use it, adopt it, to drive the benefits that we're all trying to get to—I think that's what's worrisome," says Clonch, vice president and CIO of University Health Care System in Augusta, Ga. "It isn't the complexity of the tasks as much as it's the combination of everything kind of happening at the same time, and being able to juggle all these things in a way that is organized and structured, that's measurable, where we can continue to keep people engaged and informed."

Clonch also had choice words for the concerns raised by cloud computing.

"If everything goes to the cloud, how does that change our liability as healthcare delivery systems with respect to patient security and privacy?" she says. "It holds tremendous promise. We need to figure out a way to take advantage of it in a way that's meaningful. We obviously see benefits in it in terms of our ability to restructure cost, to restructure how we leverage our capital, all those kinds of things, but how do we take advantage of it knowing that we still are fully liable for the information we share outside our borders, and will the regulations and the rules ever catch up with that?"

Jim Albin, vice president and CIO at St. Luke's Episcopal Health System in Houston, says radiation technology in oncology systems is the scariest technology. "Even some of the mundane hardware configurations can cause issues, and you don't realize it," he says.

The only things that ever worry Bill Spooner, FCHIME, CHCIO, in his job is the possibility of a big outage or a security breach. "Those are the things that just scare the hell right out of me," says Spooner, senior vice president and CIO of Sharp Healthcare in San Diego. Knock on wood—he's faced neither during his career.

Spooner says the scariness of healthcare technology pales next to his experience in another industry: the military. "I was in a classified Navy program 40 years ago," he says. "That's probably the scariest."

For Todd Richardson, CHCIO, vice president and CIO of Aspirus, a three-hospital health system in Wausau, Wisc., Twitter is spooky.

"I think I tweeted twice and I was afraid, because I'm not sure what I just did," Richardson says, tongue in cheek. "I'm still trying to understand the reason [for Twitter.] I'm sure there's something out there I don't know about, but I don't know what I don't know."

Sounds like the common journalists' fear of not knowing what you don't know. But in the words of journalist Hunter S. Thompson (author of Fear and Loathing in Las Vegas), when the going gets weird, the weird turn pro. So like the professional I am, I pressed on with my survey.

One other CIO responded that it wasn't technology that scared him, but people.

"They're the most unreliable technology," quips Rod Dykehouse, CIO of Penn State Hershey Medical Center. "For the most part, you can make [machines] work the way they're supposed to. It's how we as people and individuals manage them or not."

I sympathize with Rod. One of my upcoming technology articles is all about how to overcome people's resistance to technology. It's not easy, especially if the technology they're resisting is the wrong technology in the first place. It's up to all of us, me included, to find and tell the stories that lead past the fear and the loathing.

Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.

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