A disciplined approach to innovation results in better outcomes to improve the patient and caregiver experience.
At a time when technology is increasingly transforming healthcare delivery, and some health systems are determined to implement it at lightning speed, Seattle-based Virginia Mason Health System exercises caution at the intersection of IT and innovation. Rather than chasing "all of the shiny objects and new tools," says Ellen Wiegand, the organization's vice president and chief information officer (CIO) of the two-hospital, 562-bed system, has developed a disciplined approach to innovation. The approach is infused into the system's culture, processes, and training—a model that Wiegand says leads to long-term value.
As IT departments across the country grapple with the rapidly changing landscape, Weigand shares a look inside the philosophy that guides Virginia Mason's innovation strategy, a practice that sometimes requires restraint. For example, because data security is paramount, endeavors to move patient information to the cloud have been put on hold.
Wiegand began her career as a project architect at Cerner Corporation, then worked for Capgemini, Catholic Health Initiatives, and a consulting firm before landing in Virginia Mason's IT department a decade ago. She became the organization's CIO in 2018, leading the work of about 200 IT personnel. Wiegand is a participant at the HealthLeaders Innovation Exchange currently in progress in Ojai, California.
HealthLeaders recently spoke to Wiegand about the impact of innovation on IT. Following are excerpts of that conversation, edited for space and clarity.
HealthLeaders: What challenges do you face in your role right now?
Ellen Wiegand: It's a really interesting time because our expectations as an organization and our patients' expectations of technology are growing really fast—faster than we can deliver for the types of proven tools that everybody is looking for. A big challenge is balancing the need for innovation with the need to have safe, effective, proven technology. [Our job is to] help the organization recognize when to take the lead with a new technology and when to watchfully wait and see where the evidence points.
HL: Can you share an example?
Wiegand: We have a robust data warehouse analytics environment, and we receive requests for self-service analytics tools that would require us to move our data out into the cloud. We've had vendors who are really pushing us to do that. At this point, we feel like we just don't have a good, safe way to move all of our clinical data out there, so we've chosen not to do that. At the same time, we are partnering with our vendors to provide on-premise solutions that we can support for the long term that provide a similar level of robust functionality. Sometimes we just have to take a step back and say, "No, now's not the right time," and we can meet some of the needs with some alternate technologies.
HL: What are your primary concerns with the cloud?
Wiegand: The concern is that our patients' health information, which is our most valued asset, is exposed out there in the cloud. We then lose a little control over what security controls are in place for that data. By continuing to host on-premise, we can ensure we have appropriate security controls.
Security is paramount; it's our top priority. Our IT security team is integrated into our development process and involved up front in evaluating new tools [from outside vendors], but also as we're developing our own tools. That's been a key change that's happened over the last couple of years.
HL: How does innovation factor into your processes?
Wiegand: We want to focus our team's work around particular organizational goals and allow them to innovate in that space. We prioritize activities at an organizational level. If we set a goal to improve patient access, then we're all working toward improving patient access, and IT is one member of the team working on that goal. We all work together to generate and implement ideas to improve the patient and team member experience.
We don't have an innovation arm. We view innovation as integral to all of our work. Fostering this culture of innovation is part of our strategic plan, so we're always examining better ways to provide the right care. That causes us to approach our work a little differently and train our team members to have the skills needed to innovate as they think about their own work.
HL: How is that accomplished?
Wiegand: We focus on training our entire workforce to be innovative and built innovation into our Virginia Mason Production System (VMPS). VMPS is our management methodology that's built on the principles of our production system—our Lean. So we train all of our leaders on VMPS and build innovation into that VMPS toolset. We offer training on things like risk-taking, tools for generating creative ideas, and building strong relationships across the organization to connect those dots, as well as setting good targets.
Virginia Mason defines innovation as directed creativity implemented. So we're really not trying to chase all of the shiny objects and new tools available. We're trying to focus on the ones that will bring us the most value and will help us address some of our most critical business and patient care needs.
HL: How does innovation impact the way your department operates?
Wiegand: Our implementation methodology has evolved to support the innovative work going on. Like a lot of IT organizations, we've recognized that having major projects that take a year or 18 months to implement don't meet the needs of our business. So we've transformed the way we implement new technologies, and we've implemented an agile development methodology, which aligns well with our VMPS. We bring together a multidisciplinary teams of IT folks, our informatics staff, our clinical operations staff and, oftentimes, even our patients, to design and implement new systems in a rapid cycle development.
Patient access and population health are [among] our organizational goals. We've combined some of the work of both those teams this year and are implementing a customer relationship management system, or CRM, for patient outreach and to provide better tools for our teams to know their patients in a way that is more robust than an electronic health record could provide. [It includes information such as] preferences, life events, or family members.
This work could not have been done without a concept we call codesign—bringing the patients and our customers into the IT development process as true partners. Our goal is to have them involved from the very beginning to help define requirements and drive design rather than trying to come up with what we think someone would like, deliver a product, and then get feedback. I think most of the big successes we've had have [involved] a codesign process.
HL: Are there any developments on the horizon that you think will have a big impact on IT?
Wiegand: There are so many emerging technologies. We're all thinking about AI and robotic process automation and how we can use some of those tools to provide better care and also to automate some of our business processes. We are exploring that now in areas like the revenue cycle and supply chain. As we dip our toe into AI and process automation, that certainly changes how we are approaching our work as are some of the better integration tools and functionality like FHIR and more APIs that are available into our core systems that will allow us to integrate third-party applications.
Mandy Roth is the innovations editor at HealthLeaders.
Foster a culture of innovation as part of the organization's strategic plan.
Ensure the security team is integrated into IT development processes and involved up front in evaluating new tools.
Train team members to innovate as they think about their work.
Focus on the tools and technologies that will bring the organization the most value and address the most critical business and patient care needs.