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HIT Leader Q&A: The evolution of embedding excellence in health care

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.

Few people in the industry have achieved as much as Carol Steltenkamp, M.D., MBA, FAAP, FHIMSS. She is the chief medical information officer at UK HealthCare, which is the hospitals and clinics of the University of Kentucky (Lexington, Kentucky, U.S.A.), serves as chair for the HIMSS International Board of Directors, and is a professor of pediatrics at the UK College of Medicine.

Even with all of these responsibilities, she still finds time to see pediatric patients. Her passion for helping others is inspiring, as is the advice she shared in a recent interview. Highlights from that conversation appear below.

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

When I was a practicing pediatrician, I had done some work on the administration side and realized I had a gap in knowledge around the business aspects of medicine. I went back and worked on my MBA part time in the late 1990s. That was the first time I was really exposed to Health IT and the decision sciences, and it was fascinating.

Why did you choose Health IT as a career?

I have a passion for using Health IT to improve health care, which I recognized as an opportunity when I got my MBA. I’ve been blessed to have many opportunities as part of the UK HealthCare system and have been exposed to different aspects as Health IT was evolving. For example, when UK became the regional extension center for most of Kentucky, I was the primary investigator for the branch and could see how it all came together.

Which of your career achievements are most meaningful to you?

Having the opportunity to act locally, but to then go throughout the Commonwealth of Kentucky to help implement electronic medical records (EMRs) and take them to the next level through my work at HIMSS. To be able to see this work from an international perspective and effect real change is meaningful.

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

This really isn’t different than advice for any other industry, but I think it’s important to push yourself, get outside your comfort zone and accept new challenges. In any career, some of it is timing, some of it is luck, and a lot of it is hard work and passion for the opportunities you get.

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

Coordinating the data. Medicine to date has been very episodic. As a primary care physician, I still see patients and experience that. We still need to get data, information and knowledge flowing across the care continuum. From a practicality standpoint, interoperability is still a huge challenge. Using my organization as an example, we are a large academic medical center and see some of the most complex medical cases from across the Commonwealth of Kentucky.

For example, the endocrinologist at UK trying to coordinate care for diabetic patients needs to share information with primary care docs for the most effective care. Or if we get victims from a car crash on Interstate 75 that runs from Detroit to Florida, we might have their identities but not their medical histories. If we don’t have interoperability with referring providers and hospitals, that’s a challenge. Population health is a hot topic, but you can’t do it optimally unless you have interoperability.

What are the best practices that can help overcome these barriers?

One of the major keys will be getting the patients involved. We live in a consumer-driven world for most things, and health care should be looking to do the same. Early on, I used to describe it to folks this way: When you go to the bank and make a deposit in one branch, wouldn’t you be livid if that deposit was not reflected at another branch you visit the next day? As consumers, why don’t we hold Health IT accountable to those same standards? That’s the oddity. Once consumers start requiring information to be available across the continuum, the providers have to be responsive. Health IT has to become the facilitator for care and not a barrier.

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

Five years ago, pop health was something that only researchers did. Now, thinking about population health is really making its way into acute episodic care. The term is not a research term anymore. Providers need to work in concert with patients and payers to be successful. When we are completely aligned in our goals, we will have taken a good first step in the process.

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

We’re evolving. It’s like any project that is just starting to move into the action phases. We know the next phases will revolve around quality and be about embedding excellence into clinical practice. For years, as a practicing physician, I could see that Health IT and Quality were two paths that were starting to merge. They are intersecting now and need to work in concert with one another to facilitate – not hinder – better health care.

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