Physician CIO: 'I Refuse to Fall in Love with Technology'

Fairview Health Services' new CIO, Sameer Badlani, MD, says that change management, people management, and understanding the opportunity are more essential than the technology itself.

"Technology is not everything, says the new chief information officer of Fairview Health Services in Minneapolis. "I refuse to fall in love with technology."  

Sameer Badlani, MD, FACP, brings an interesting background and philosophy to his role; before becoming a CIO, Badlani was first a physician. While his experience as a doctor influences the way he approaches his job, he also believes that focusing on strategy, processes, and problem-solving will lead to greater transformation in healthcare, rather than focusing on the technology itself.

In a recent discussion between Badlani and HealthLeaders, he examines the intersection of IT and innovation, an increasingly significant role for IT leaders, he says.

In part two of this series, From Physician to CIO: How One Man's Journey Reflects IT Transformation, Badlani talks about his career evolution, current responsibilities, and reveals deeper insights into the changing role of information technology leaders and the dynamics that are influencing that transformation.

Badlani's comments have been lightly edited for space and clarity.

HealthLeaders: How do you approach innovation in your role as CIO at Fairview?

Badlani: We don't have a standalone innovation arm. That's partially by design and partially that's what I am pushing for. Typically when you create a completely separate group for innovation, it perpetuates the myth that the other people in operations or information services are there just to do mundane, utility type work. I want everybody in my organization across the board to embrace the spirit of innovation and look for ways to translate innovation into their daily work.

Across Fairview we are implementing Lean methodology as our operating model, and that lends itself very well to agile project management and agile implementations. [Rolling out this model] is an innovation that we are translating across the organization. It gets people comfortable with experimenting, documenting, refining, and using the PDSA (Plan-Do-Study-Act) cycle to do better.

HL: What are the greatest challenges you face in your current role?

Badlani: A big challenge is the technology debt we have accumulated and how to maximize the use of our current technology stack. The second aspect is there are some interesting, intriguing technologies out there that have a lot of promise, like digital assistants, CRM (customer relationship management) [tools], and leveraging artificial intelligence and machine learning appropriately for patient safety, quality, and operational efficiency.

[To move forward, you need to] balance what you need in the present while building for the future. It requires us to think not just of goals for 2020, but we are looking at how you create 18-month or two-year goals. We need a midterm view because typically we all have three- or five-year planning cycles. I honestly find them difficult to stay focused on because technology changes so fast. That's compounded by consumerism in healthcare. People's behavior is not waiting for us to figure out how to implement a technology they are expecting.

HL: How does the explosive growth in technology impact your role?

Technology is not everything. Change Management, people management, and understanding the opportunity plays into the success of any technology out there.

I refuse to fall in love with the technology. I would rather be obsessed with problems because the solution will keep changing based on what is available, what kind of people you have to work with, and what kind of process refinement you have to do.

HL: Where are you focusing your energy?

Badlani: We are focusing on:

1. Data liquidity, which is the notion of getting people access to right kind of analytics.
    
2. Data literacy, which creates a skillset around asking the right question and thinking through what the data tells [us]. We all want to be competitive in using data like Amazon, but healthcare is behind. The first goal is becoming competent in using data. It's not just about having the right set of reports and analytics being generated; it's also about having the ability to ask the right kind of leading and lagging questions, and then follow it by changing standard work.
    
3. Digital transformation. There are two aspects to this. We are focused on making choices today that move us faster on the path of becoming digital to the core. [Digital assistants will change the way providers interact with the electronic health record, and CRM tools will drive better performance and engagement with patients/consumers and employees, he says.] 
   
   Secondly, in partnership with our chief marketing and digital experience officer, we are building a digital studio where we will identify patient personas and document their patient journey. You can take a pregnant mother, [for example, and examine her] experience from the diagnosis of pregnancy to a little beyond the delivery. What kind of interactions does she have with the healthcare system, her PCP, her obstetrician, and other services? That design thinking and documentation of the persona and journey allows us to then create and implement digital and operational processes that support that particular patient's journey. This is in tandem with our service line work, which you will find common at many places. Even for information technology, we are embracing the service line methodology.
    

HL: What innovations on the horizon hold the greatest promise?

Badlani: A lot of work in digital medicine initially focused on creating patient-facing apps. My premise is that those alone do not suffice. You have to become digital at the core and use CRM and mobility first as the way you develop applications.

The digital assistant-type ambient technologies [have the potential to] change our workplace. We also hear a lot about how AI is going to disrupt healthcare. I completely agree, but in my mind, it's not going to be about replacing doctors; it's going to change the way we practice medicine and create more bandwidth for us to focus on tasks that require more attention versus equal attention for every task that gets accumulated throughout the day. It's going to make us smarter workers and provide better access for patients. That's something that I'm really excited about.

HL: Startups are a key element in the innovation culture. How can they best work with organizations like yours?

Badlani: I prefer to work with startups that are less focused on their technology stack and more around the problem they're trying to solve. In my work over the last five years, I've had the privilege of meeting a lot of venture capital, private equity, and startup founders. The good ones showcase that they are in love with the problem, not the solution. When somebody says, "I have artificial intelligence or blockchain and that's going to magically solve [a problem]," that immediately tells me they may not have a deep understanding of what it is that they're trying to solve.

There are a few companies, founders, and VCs (venture capital firms) that take the time to understand the problem—the pain—that is felt by either a provider, a payer or a patient/consumer. They have a laser-like focus. That's a big distinguishing aspect of why they get it. In the end, it doesn't matter if I use a laptop, a desktop, or pen and paper. What matters is that the outcome is better for the consumer and the people providing the care.

The second aspect is I look at how much they employ design thinking in their work. The premise is that whenever you create a new product or workflow, you change the life of the person using that technology. So when you don't have empathy for the user—which is probably chapter one of design thinking—that again tells me that you're probably missing the boat.