This is Aranow's second time working with us, having previously served as a senior director from 2012-2015. Before returning to Advisory Board in 2019, Aranow was the CEO of Edaris Health. Aranow has had a long career in academic medical centers. For 15 years, she was the VP and CIO of Boston Medical Center. For nine years prior to that, she held various executive positions within Brigham and Women's Hospital and Partner's Healthcare. Earlier in her career, she also held numerous positions of increasing responsibility in the group health claims and actuarial departments of The New England (now MetLife). For six years, she served as a governor's appointee to the Massachusetts Healthcare IT Council.
Question: In 2020, what do you think will be the dominating theme for health IT?
Meg Aranow: I think 2020 will bring continued progress on the complementary themes of empowering the two primary actors in the health care ecosystem: clinicians and patients.
For clinicians, design and tools that better support user interface and workflow will help the ongoing efforts to return technology to a supportive role—rather than a dominant consideration—in the clinician-patient interaction. For example, we can look for the evolving maturation of natural language speech integration and the simplification of documentation requirements on the data acquisition side, and the use of analytics to narrow the decision-making burden of diagnosis and treatment.
For patients, I think we will see increased adoption of and reliance on remote monitoring, distance visits, and the use of consumer devices for both data acquisition and guided interactions with health care providers.
Q: Which technology do you see finally delivering on its promise for hospitals and health systems in 2020? Which technology is still overhyped?
Aranow: I think the last remaining reservations about cloud computing will be laid to rest in 2020. Its adoption in health care has been deliberate and thoughtful with virtually no unintended consequences reported. The need to continue to do more with less (or flat budgets), increasing computing demands, and a more competitive labor market have set the stage for the final push to the cloud.
I also think virtual reality is still overhyped. It may yet find its lane, but for the moment it is still a solution in search of a problem to solve. There is a natural fit for simulation and other forms of training and education, but its contribution in direct care is still unproven.
Q: What technology issues should be keeping CEOs up at night?
Aranow: The fear of threats and the ensuing risk management have rightfully earned privacy and security concerns a spot on board agendas, and for that reason, both will demand CEOs' attention and resources. Their No. 1 job will be to establish a cogent plan that supports a response that is proportionate to the likely threats. Security budgets will need to be created for the marathon effort. It is likely that this is not a zero-sum exercise—security expenses will be additive and ongoing.
Another challenge with a significant IT role is telehealth. I would categorize this as a care delivery challenge rather than a technology challenge, but telehealth should be on the CEO's agenda and IT leadership should be aligned.
Q: Say you're a CIO today and your CEO hands you a blank check to do your job—what's the first thing you do?
Aranow: Focus on two things: Computing infrastructure and human infrastructure.
It is hard to overstate the importance of investing in the fundamentals of all technology deliverables—the reliable hosting, delivery networks, and the people who make it all work.
We start 2020 with one of the tightest labor markets in memory, making retention a hot-button issue for the traditionally "non-sexy" health care IT industry. As other infrastructure expenses are reduced, CIOs might consider moving the money into underfunded retention efforts, like training, work-from-anywhere tools, and salary.
Q: How do you see the role of a health system CIO evolving alongside the emerging Chief Transformation/Innovation/Digital Officers?
Aranow: The CIO title was first envisioned in the 1980's—it elevated the role of technology by elevating the status of a technologist. In those days, there was no one else in the executive suite that had any knowledge of technology. Today, everyone in the executive suite is tech savvy. Today's CIO needs to understand how to bring complementary knowledge and value to his or her specific executive team. Though no one size fits all, our CIO friends should likely consider:
- The deep-rooted technology issues such as infrastructure, networking, interoperability, and computing power;
- Emerging fields such as AI and machine learning; and
- Health care horizon issues such as telehealth and the IoT.