Providence's CIO Looks for Humanity in Healthcare Innovation

Cherodeep Goswami wants new technology and ideas that make a difference.

Healthcare experts often talk about new technology as a product or a solution. It’s Cherodeep Goswami’s job to understand the difference.

Goswami is the Chief Information & Digital Officer for Providence, the sprawling health system based in Washington and encompassing seven states through some 52 hospitals (called "ministries") and more than 800 sites of care. It’s his job to figure out what new technologies and services will actually improve care and workflows and which are just shiny new square pegs being wedged into round holes.

Cherodeep Goswami, Chief Information & Digital Officer at Providence. Photo courtesy Providence.

Technology "is a differentiator and an enabler," he says. But it has to be the right technology.

 "How do you leverage technology and actually make something better?" he asks. "Innovation is our mindset, [but] innovation without a purpose is just another hobby."

Meeting Specific Goals

Goswami, who spent more than five years as Chief Information & Digital Officer at the University of Wisconsin Health System and 14 years before that as VP of Information Systems at BJC HealthCare in St. Louis, sees today’s tech trends, from AI to virtual care to digital health, as having the potential to bring humanity back to healthcare. But these new tools have to work for both patients and providers, bringing them face-to-face rather than shunting them onto different pathways.

To that end, Goswami says any new technology has to have at least one of five capabilities:

• Drive better quality patient care and outcomes;
• Drive better fiscal stewardship, whether by generating revenue or managing expenses;
• Improve productivity;
• Address caregiver well-being; or
• Protect assets (cybersecurity).

More importantly, he says, new ideas need to be malleable, or able to fit into whatever environment necessary.

"[We need to] respect the fact that there are laws, regulations and policies that are different between Alaska and [Texas]," he notes. "And equally important are use cases. We may get a lot of frostbite in Alaska in the trauma room; rest assured we're not going to get a lot of frostbite in Lubbock. We may get traumas from snorkeling and scuba diving in Mission Viejo that we may not get in Portland. So understanding that technology serves the needs of those who come into the ministries, and innovating in ways to reduce their wait times, in reducing their length of stay, in improving our margins, that is the innovation part."

It's not an easy task. Goswami points out that innovation doesn’t just mean replacing the old with the new.

"We live in a world today where we still have walk-ins, we still have patients who call, we have patients who e-mail, we have patients who text and we have a generation like my kids who text without vowels or verbs," he says. "We do not have the luxury of saying we're only going to do one way."

Moving Beyond Financial Value

Likewise, Goswami is acutely aware of how innovation and technology affect clinicians and other healthcare staff. That’s why the value of a certain new tool or process isn’t solely financial.

"How about we give the father 15 minutes to have dinner with their kids?" he asks. "How about we give the mother 15 minutes to sit and call their parents?"

And while AI may have the potential to improve workflows and reduce stress and burnout, healthcare leaders need to make sure their clinicians are ready to make the changes necessary to achieve those goals. That means investing in change management, as well as training and upskilling.

"We have to be very cognizant of whose work we are reducing or simplifying or eliminating," he says. "Let's be transparent about it and talk about it, and then talk about an upscaling. By doing that, you take the fear out of the person who's using the technology."

That also means knowing when a new tool or program isn’t working.

"[We have to be brave enough] to pull the plug when the technology doesn’t work," he says. "It says I’m vulnerable and humble, and that I know when to back off."

Technology Doesn’t Always Work

Goswami worries that those skills might be ignored or even lost in training new clinicians. It’s a concern shared by many C-Suite executives: That new doctors and nurses will rely too much on technology and forget how to practice medicine.

"We all get used to machines doing certain things and then we don't know what happens when the machine stops working," he notes. "How can we train our next generation of clinicians on incorporating technology so that you know what to do when something is looking abnormal? You can't blame the machine at that point."

Goswami sees himself as a steward of the health system’s resources, identifying when and where technology can be used to improve care and understanding when it gets in the way. Without clear outcomes for new technology, he says, it’s an expense. And when outcomes aren’t aligned, it’s a waste of time and effort.

"There are many things we do just because that's the way we have done it," he points out. "As an industry, we tend to capture information just in case. And today technology allows us to pivot to say I can capture it just in time. So an average nurse walks over 16,000 steps in a shift. How do I stop making that person walk back and forth and ask, do I even need this information? Can I get it from another place? You know, so on and so forth."

At the end of the day, Goswami says he’s looking for humanity in healthcare. And that means understanding why a new technology works or doesn’t work.

"I always say there's a difference between an output and an outcome," he says. "The amount of time it takes to complete a knee replacement surgery is an output. The amount of time it takes for a person to go back to their lifestyle is an outcome, and we’ve got to measure both."

"How do I bring back quality and dignity to that person who's worked for 50 years and now has 10 years, but a health issue is preventing them from getting on a plane and going hiking or whatever they choose to do?"