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HIT Leader Q&A: ‘Endless possibilities’ spur journey from nurse to CIO and beyond

Editor’s Note: Health Data Management recently named the 2016 Most Powerful Women in Healthcare IT, including Allscripts Analytics Chief Medical Officer Fatima Paruk. This post is one in a series that features insights from some of these women leaders, including Kara Marx Kate Pavlovich and Dr. Carol Steltenkamp.

A fellow honoree from the 2016 Most Powerful Women in Healthcare IT awards reminded me that with recognition comes a responsibility to share knowledge and experience with others. It’s a principle that’s especially true in health care, which is by nature is a collaborative field.

From Sharp Healthcare (San Diego, California, U.S.A.), Vice President Information Technology Applications Kara Marx recently shared some of her insights with us. Here are highlights from that conversation:

Describe your current role and the path you took to get there.

In my current role at Sharp, I manage a team of 200 people who collectively support more than 500 applications that help automate and provide value to our practices. I started out as a nurse, and was introduced to Health IT in 1997 by a physician friend, who was practicing telemedicine. That’s what piqued my interest; I caught the Health IT bug.

I’ve worked with a vendor for many years, worked with consulting firms and most recently focused my career on IT leadership positions, including a chief information officer (CIO) at a hospital in Los Angeles. I came to Sharp because of organization’s reputation for excellence as a large, multi-hospital system.

Why did you choose Health IT as a career?

I see the value that technology brings to the practice of medicine. In 1997, Health IT was expanding fast in clinical areas. I started seeing the potential with telemedicine and how the application of technology could solve so many paper-based challenges. It was quite exciting, to know this was a field with endless possibilities, and I could be part of this evolution. I’ve never looked back. I love my work.

Which of your career achievements are most meaningful to you?

I’d have to say working in the capacity as a CIO in an organization that implemented computerized physician order entry (CPOE) for the first time. To go back and think of the days when CPOE didn’t exist, they were different times; it was a really big change. It was an amazing experience to see that significant transformation occur.

What advice would you give to people who are just starting a career in Health IT?

What is most valuable to me is to network with and learn from others. Health care by nature is extremely collaborative. Make sure you take advantage of that natural sharing that occurs on the medical side, and let’s work to extend that behavior on the technology side. Health IT is so new – it’s impossible to know everything. The best way to stay current, push your creativity and knowledge is to connect with others and share.

What are the biggest barriers to effective population health management today?

For so many years health care has existed to support transactions, incentivized for volume. To move to reimbursement models focused on value is a mental, cultural, technology and workflow shift. There are so many pieces of the care process that need to change. Having everyone on the same page at the same time makes it difficult to jump ahead quickly.

Also, sometimes it’s challenging to define “population health management.” It can mean focusing on disease management, promoting wellness, meeting expectations for ACO payer contracts – there are a lot of variations on the idea.

What are best practices that can help overcome these barriers?

I’ve always been a proponent of good governance, so everyone has the same definitions, goals and objectives. Sharp has done well with population health management, for example with capitated contracts. We’re fulfilling those with tools we already have in place, such as a patient portal, analytics, remote monitoring and telemedicine.

How do you measure success with population health management?

It really depends on the initiative. As an organization, Sharp has various qualitative and quantitative operational metrics. There are required quality metrics from payer contracts, satisfaction metrics we hold ourselves to, growth metrics and more.

Sometimes I think people underestimate what they’re doing. They may be succeeding with population health management, but not giving themselves credit for it. For example, things like managing employee wellness, is a form of population health management. Every healthcare organization is obligated to manage the health of the entire population it serves. In that global sense, our metrics for running the organization are a measure of how successfully we are managing the health of our population.

How are organizations tackling population health management today compared with five years ago?

Compared to five years ago, we’ve seen an increase in patient engagement technology and deployments. Meaningful Use has increased the use of patient portals, but it’s beyond that. More is happening with sensor and remote technology, and things like blue tooth scales, blood pressure cuffs in the home. There has also been a lot of growth in analytics and big data over the past five years. We’re doing more to push that to the point of care to help clinicians improve decision making.

How do you envision population health management changing in the next five years?

I hope that tools will become more consolidated from a workflow perspective, and we can do a better job putting things together in one spot, providing one picture of the patient, to help clinicians to make an impact.

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