CHIME John Kravitz, A Look Back / Forward


Bill Russell / John Kravitz

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The Healthcare CIO Look Back / Look Forward series with John Kravitz,
Chief Information Officer Geisinger Health System.


Bill Russell: 00:04 Welcome to this week in health it events where we amplify great ideas with interviews from the floor. My name is bill Russell healthcare CIO coach and creator of this week in health It. A set of podcasts and videos dedicated to developing the next generation of health leaders. We want to thank our founding channel sponsors who make this content possible, health lyrics and VMware. If you want to be a part of our mission to develop health leaders, go to this week, for more information. This episode is sponsored by health lyrics. When I became a CIO, I was really overwhelmed at first and one of the first things I did was to sign a CIO coach to walk with me through the journey. This was someone who had wisdom that can only be gained through years of experience. It was invaluable to my success in the role and I now coach CIOs through health lyrics.

Bill Russell: 00:55 If you want to learn more, visit health or drop me a note [email protected] over the next three weeks. We have a huge treat for you. I’m really excited about it. Uh, I just got back from the chime fall forum in Scottsdale, which was a great event and we caught up with 12 active CIOs from various size health systems and asked them to take a look back at 2019 and I look forward at 2020. Uh, you’re going to hear, what they’re excited to have accomplished last year and what they’re looking forward to accomplish next year. I asked each of them the same eight questions and I think you’re going to be fascinated to hear the similarities and the differences based on where they’re at. Geography and other things. Each of these interviews is about 10 minutes long so you can listen to them really quick and some of you listen at one and a half times speed.

Bill Russell: 01:43 So it’s going to go like that. We’re going to publish one a day with a few news day episodes sprinkled in through the end of November. So check back every day for the next episode and don’t forget to look back to see if you missed any. I love the work that Geisinger Health is doing, uh, with regard to population health around genomics and other things. And, um, I was excited to get the opportunity to sit down with John Kravitz, the a CIO for Geisinger health. Uh, we have a, a wide range in conversation and I really enjoyed it. I hope you enjoy as well. All right,

John Kravitz: 02:16 so here we are, another session from the chime fall forum and we’re here with John Kravitz, the CIO for a Geisinger and a welcome to the show. This is your first time on the show. It is. Thank you. I’d love to have you on more often. Cause I some of the things that Geisinger’s doing is so fascinating to me, especially in the area of population health and, and the articles I’ve read because of your population in Western Pennsylvania, you’re able to do, uh, what would we call it? Generational medicine almost.

John Kravitz: 02:42 We do, we, we actually, uh, we do a lot of genomics medicine. So currently we’ve genetically sequenced over 200,000 patients, people in our area. A lot of that has helped us considerably in that, um, it helps in, in diagnosis certain disease conditions that are not easy to diagnose. Uh, it also helps with prevention or early detection of certain cancerous, uh, diseases that may have, and an examples are for the female population in BRCA one breast cancer or cervical cancer, a BRCA one BRCA two genes that are, have a high prevalence, a very high prevalence of becoming, you know, a certain form of cancer, whether it’s breast or ovarian cancer.

John Kravitz: 03:26 Um, so that’s, that’s, uh, helped a lot of people who did not know they were susceptible to that. Also, prostate and other types of cancers. Uh, so yes, I, I think what’s important though is um, we utilize genetics and genomic data as part of our, um, our environment to support the care of medicine for our patients.

Bill Russell: 03:47 Yeah, I was, I was, uh, have you gotten rid of the waiting room yet?

John Kravitz: 03:51 No, that was dr Feinberg fiber. Your former CEO said, you know, we want to get rid of it. Yeah, we’re actually, we have a plan. And so the plan for that is part of our digital strategy that we are now just about to get board approval to proceed with. Um, and a lot of that will be using technology to support that, that plan to make the patients, uh, focus that the focus all around our customer, whether that’s in our health system as a patient or health plan as a subscriber.

John Kravitz: 04:21 And we do have crossover, not 100%, but about 40% of our health plan subscribers get care in our health system. So for those people, we can really do some phenomenal work and that’s helped a lot.

Bill Russell: 04:33 I am, I am, I’m pulling for you guys, I’m sure for you. I want to see the waiting rooms go, go away. But, uh, I, I want to get to the questions. These were pent up questions I wanted to ask. No problem. Um, so over the last, uh, 12 months, how have you felt that the role of the CIO change in any way?

John Kravitz: 04:52 I am starting to get a feeling, um, at least over the last 12 months that the CIO needs to be part of the C suite. Um, because the strategic direction that the organization’s going has to be enabled by technology to support that. If we don’t have that technology in place, it’s hard to move the organization forward.

John Kravitz: 05:11 And if, if you think about this or talk to any CIO, what in healthcare or other industries can you do without technology? Practically nothing because everything’s embedded with technology, whether it’s IOT devices, medical devices in the and in the facility, electronic health record, every touch point uses technology. So, um, I think then the CIO of the future must be heavily engaged in drive the business forward. Don’t wait, don’t sit back and be told what to do as if you’re in the back office, the back room. That’s not what the CIO needs to do for the future. They need to be part of that group and really drive forward.

Bill Russell: 05:50 Really informing the change? Uh, and you may have touched on one of these already, but uh, what are three priorities that the health system has that health it is going to be asked to support next year?

John Kravitz: 05:59 Well, I’d say I, I did allude on this, on digital strategy is so important for us. Um, and actually part of that digital strategy is bringing together things like a customer relationship management module. Uh, and for us it’s skinning down the it stack, if you will. What I mean by that is minimize the number of applications because we have too many best of breed applications or one off applications that may have a very small number of users. And those applications cost money to support, to keep them compliant, disaster recovery, all those components. Plus, you know, the, the personnel behind it to support them. So one of the things that we need to do is continually look at reducing that application and standardize the on a singular platform where possible. Um, the other thing is, uh, the movement of the cloud. So at this point in time, 28% of our applications are hosted in the cloud, in private clouds, public cloud.

Bill Russell: 06:55 That’s impressive, you’r like the only CIO I know that if I asked that question, you could say 28%. Yeah. So you, so you’re tracking it. This is.

John Kravitz: 07:00 We are tracking it. Yeah. And we, our goal would be to eventually, you know, Eldep enabled applications to be able to be moved to the cloud for security purposes and everything else. Um, we’d be at a point where probably around 70% of our applications would reside in the cloud. I’ll always be those large applications that will have a presence both at the edge and in the cloud. I’ll give you an example. We’re working on a vendor neutral archive for all of our archiving solutions. So things like our radiology PACS solution would be in the archive. But when you look at the volume of those images, your MRIs, your CT scans are so large that it would take so long to pull them down out of the cloud.

John Kravitz: 07:42 It would be prohibitive to our workflow for our clinicians and slow the process down. So we’ll have to have an edge solution as well as a cloud based solution for that. And there’ll be other instances like that that we’ll have to closely engineer them so that we can have maximum performance, low latency and provide the service at the lowest possible cost.

Bill Russell: 08:03 So you guys have a health plan, is it separated?

John Kravitz: 08:06 No, I’m CIO for everything.

Bill Russell: 08:07 CIO for the health plan. That’s great. My parents are on the Geisinger health plan. They rave about it. So it must be a good health plan.

John Kravitz: 08:14 Well they must be in Geisinger Gold cause that’s, that is, that’s really the premium, uh, where they don’t have to, I don’t know if this still run or not, but they, they don’t have to pay out of pocket expenses for anything.

John Kravitz: 08:24 They, yeah, it’s really good for retired people. It’s wonderful.

Bill Russell: 08:29 And they, they came out to California had had an incident and they kept receiving a bill and the people from Geisinger said, don’t worry about right. And they made the phone calls and they got the bill straight.

John Kravitz: 08:39 You actually have coverage for $100,000. Wow. Just through that plan, if you’re traveling, you know, different places, it’s covered.

Bill Russell: 08:46 We’re not trying to do commercial for Geisinger health. Um, so, uh, one initiative that’s going to materially impact the patient experience next year that you,

John Kravitz: 08:55 it’s the digital strategy. Hands down. It’s every touch point where the customer is involved. And again, for us being an integrated delivery network, whether it’s a subscriber or the hospital patient, it’s making it very streamlined and frictionless access to their information. So give you an example. Part of what we want to do as part of our digital strategy is to have a patient identification through facial recognition.

John Kravitz: 09:20 Oh, I don’t want to have to use other biometrics. I’m going to use someone’s face. And as they walk in the building, there’ll be cameras mounted. When they come in the door, we’re going to that zero waiting room. Right. That’s the plan is, is having a device that can, that can function as a kiosk. It’s maybe an iPad or a surface, you know, bolted to a desk. They just walk up, picks up their face and it identifies them and it acknowledges what the appointments are the here for to move them through the process.

New Speaker: 09:47 Actually, as you’re talking about that, I’m reminded of, I walked into a conversation that you and Chad Brisendine we’re having around this and you guys started going back and forth and by the time you were done I was really excited about the future. I mean I’ll, Chad’s a really bright young man.

John Kravitz: 10:00 Um, and he, he comes with a strong technology background. He’s also a very good friend and colleague, so I really appreciate and respect working with him.

Bill Russell: 10:08 Yeah, absolutely. Well, I promise you, you have the chime shirt on. I promise you 10 minutes or less. We got, we’ve got about three minutes here. Okay. What’s one thing you’re going to do to materially impacted clinician experience?

John Kravitz: 10:18 We continuously work with our clinicians. I round with my CMIO and chief nursing information officer as well. Uh, we are very tightly engaged with clinicians. We have teams of nursing, informaticist and physician informaticist as well that are, that all report up through the it pillar and uh, and this group that really is very closely engaged. So we continue to work to improve, uh, components of our EHR and analytics is a big factor for us. We really distinguish ourselves. We’re cause we’re moving everything back.

John Kravitz: 10:49 We were the third Epic customer in the country for 23 years now. We’ve been on Epic, but uh, we’ve had to customize because we didn’t have all the modules that are now available in the foundation system. So we are implementing those to streamline our processes, clean up best of breed and, and really leverage analytics instead of customization within the application. It’s analytics with ETL capability, extract the data, transform the data, reload the data back into the system.

Bill Russell: 11:17 Fantastic. Are you going to get to quarterly updates, do you think or,

John Kravitz: 11:20 Oh yes. Well, right now we do them every six months. We may not go to quarterly only because it, it’d be continuous churn. So the six month interval, we’ve done two of those so far. Just did one this past weekend and put up another new module, grand central from Epic, um, and had good results because we use RTLS to real time location system for our patients and equipment and providers.

John Kravitz: 11:43 So that’s all integrated into our new grand central application. So it’s pretty sweet.

Bill Russell: 11:47 Fantastic. Uh, what’s the thing you’re most proud of that your it team was able to accomplish this year?

John Kravitz: 11:52 I think, uh, we’ve done a good job on the it team within our environment to support our customers with service now platform for service management solution. Um, we’ve, we’ve rolled out a lot of those applications with an ITSP and management, uh, tracking. We have end-to-end automation right to our vendor, which is HP for a lot of this work. Um, and we can acknowledge we have another vendor that does work with, it’s just sport end points. So everything is Barcode, Barcode, Barcode and it’s all seamless workflow all the way through without touching it, making mistakes. And it’s, it’s uh, improved our turnaround time to five days for a new piece of equipment that’s back on the desktop and we replaced.

Bill Russell: 12:30 So it’s streamlined things considerably. Two questions in one minute. Here we go. Um, area 19 you’d like to see the industry, uh, you’d like to see innovation. Uh, you’d like to see more innovation within the industry.

John Kravitz: 12:43 Well, um, analytics are important. Uh, we do a lot with analytics but we also, I think an area of innovation would be most helpful for it would be on voice. So the ability to take physicians, hands off keyboards, still using CDI and clinical assistant coding, uh, with voice recognition, deciphering and separating the voice of the patient versus the physician or the patient, the caregiver and the physician focusing on only in the physician notes. We already do natural language processing that’s been around for a long time. So we create those notes but to make them actionable so they don’t have to go back and change any coding or anything else as part of that process, it would be a game changer.

John Kravitz: 13:24 I know a lot of places I work on it, but they haven’t cracked it yet.

Bill Russell: 13:27 No, no. That will be exciting when we get there. And in the last question, we did a survey of our listeners and they wanted me to ask CIO’s this question, which was what roles do you expect, anticipate you’ll be hiring next year?

John Kravitz: 13:37 Well, um, so our roles in it, we have an enterprise architecture team which helps us out immensely. It’s not just the network architecture or systems architecture, but it’s, they span all areas of the organization. So whenever a new request comes in for a new system or, or customization to a process, the enterprise architect team is very much engaged. I could see that expansion continuing, uh, the deployment supports as well. And our project management team is very important as part of an it governance process too because too much, too many, uh, expenses keep trying to creep into it with requests for new systems. Um, and we are very careful about that and we try to minimize those as much as possible and keep our budgets in check.

Bill Russell: 14:23 John, I appreciate your time. Anyone with that many ribbons on their badge means they’re very busy at this conference.

John Kravitz: 14:27 Well, thank you. It’s pleasure.

Bill Russell: 14:28 I appreciate it.

Bill Russell: 14:30 I hope you enjoy the conversation. Remember to check back often as we are going to drop an episode a day for most of November of 2019 following that, please come back every Friday for more great interviews with influencers and don’t forget every Tuesday we take a look at the news, which impacts health it. If you want to support the fastest growing podcast and the health it space. Here’s a few ways that you can do that. The first share it with a peer, share it with a friend, share it with somebody who’s working right there next to you. Number two, sign up for insights and staff meeting. These are services designed to help you in your career. Number three, interact with our social media content on Twitter and LinkedIn. Number four, post or repost our content. And number five, always send me feedback. [email protected] your insights continue to shape the channel. This show is a production of this week in health it for more great content. You can check out our website at this week, or our YouTube channel. Special thanks to our sponsors, VM-ware and health Lyric’s for choosing to invest in developing the next generation of health leaders. Thanks for listening. That’s all for now.