Currently, Jason Fischer is the Chief Information Officer for PIH Health Hospital, an IDS with 2 acute care facilities, home health, over 20 medical office locations, and a Managed Services organization.
Prior to joining PIH Health, Jason spent 7 years as the Director of Applications and Revenue Cycle at CHOC Children’s. During that time, he led the Information Systems application teams, project management office, development, revenue cycle and hospital coding departments. In addition, he was the executive sponsor for both the ICD 10 and Meaningful Use programs for the health system. Most recently, he was instrumental in the opening of a new patient care tower, tripling the size of the previous patient care facility and bringing in many new ancillary service lines. In addition, he assisted CHOC in achieving HIMSS level 6, a testament to the organizations goals for improving safety, minimizing errors, and prioritizing IT implementations.
Prior to CHOC Children’s, Jason gained broad industry experience as an auditor and management consultant with Ernst & Young LLP and Accenture. During his 10 years, he consulted with many of the leading health care systems in the country.
Jason earned his bachelor’s degree in Accounting and Biology from Syracuse University in New York. He is a lean six sigma green belt and CPA/accounting professional.
If you could have a superpower, what would it be?
The ability to see into the future. With the healthcare IT landscape constantly changing, there are many shifts in resources that we need to consider, both in terms of people and technology, to be as impactful as possible. So if we were able to see into the future that would be great.
What’s the #1 area of focus CIO’s should concentrate on?
In healthcare right now, the number one area of focus is security. With all the breaches that are coming into the healthcare space for patient data and with the increased focus on exploited vulnerability, security is a top priority. We’ve been focusing on everything from laptops to network vulnerabilities from an IT standpoint but the most important and biggest risk for us and any organization are the people. We have what we call a Phishing exercise where we send messages out to the organization on a quarterly basis to see who accepts the messages by launching an attachment or clicking on a web link. This enables us to educate and notify those users thereafter in an effort to reduce continued risk. Because our entry point is our people through email or through other means regardless of how widely deployed our security technology is , any one associate or clinician can pose risk to the organization.
What’s your take on public cloud?
We use the public cloud for a couple of different purposes right now and are working with a few outsourced vendors. I think it’s a great, cost effective model for supporting healthcare IT, however I think that there are some challenges with risk and exposure, potentially HIPAA violations associated with data sharing that may take place outside of our control. The cloud has proven to be cost effective and beneficial from a growth standpoint and the public cloud decreases the need from our data center. But the focus really needs to start with reviewing the risks when we select the vendor. We need to consider if the cost benefit outweigh the risk burden. As one example, our human resources application suite is cloud based along with a few other niche applications.
Do you feel IT still carries the title of a cost center rather than revenue driver?
I don’t see IT necessarily as revenue driver but I also don’t see it as just a cost center. We are 100% a business partner within the PIH Health organization. That’s how this organization sees it and that’s how I see it. We model our strategic plan from the organization’s strategic plan, roadmap and vision, which of course equates to growth, revenue, and quality in the healthcare space. So, while we’re not necessarily a revenue driver we absolutely support, and have enabling technologies to support, those business models and the growth of the organization.
What are you (the CIO) doing to support innovation in the company and its own organization to deliver better solutions?
PIH Health is focused on mobile technologies around telemedicine, analytics and clinical processes. Telehealth is a current initiative we’re starting up for the stroke service line. We have a mobile solution that we are going to deploy here in the next 30 days for our physicians in the in-patient setting to access labs, radiology results and orders all through their mobile phones. For management across the organization, we’ve deployed a mobile application which essentially is an analytics scorecard, where you can view key financial and performance indicators across our two hospitals. We are also focusing on analytics in general. Analytics in the healthcare industry can be improved. In addition to security, we have a huge focus on using all of this data that we’ve aggregated for many years now in a meaningful way to help drive business decisions whether they be in the finance space addressing what we should invest in and where we should grow, or in the quality space around patient disease classifications, whether it be asthmatics or diabetics. We have been collecting data (both clinical and financial) for many years and are now starting to use it to drive business decisions across the enterprise.
The other thing that I think is really exciting for us, you may even experience this in your personal life as well, we started deploying a patient engagement kiosk in our physician practices. Upon arrival, it allows patients to check in without having to wait in line or complete paperwork, or as an option a “pre-visit” check in from a web based platform in the comfort of your own home. The whole purpose of this is to expedite your patient visit so you can spend more time with your care provider as opposed to completing paperwork that you then have to hand over to a person who has to enter that information into the system before you could be seen. Another innovative approach is our interoperability platform. These allow us to share patient data with other facilities so they could have visibility into your problems, your allergies, medicines and so on. Data sharing is another focus in the healthcare industry right now. We are participating in a closed program with seven health systems in the Los Angeles area as well as a major payer to exchange data across our patient base. The purpose is really two-fold and includes increasing the quality of care for all patients whom are part of that population and managing costs.
We run on average about 50 projects through our department at any point in time, and these are not just IT projects. They are organizational initiatives, so we have a lot of examples of things we are doing to advance the business. The whole purpose is creating efficiencies where we can in departments, as well as to determine how we grow and establish ourselves in the community as a care provider that has the highest level of quality and is the most efficient.
We are hearing so much about the internet of things – what does or could the internet of things for your business look like?
The one thing that comes to mind is connectivity of devices, patient monitoring devices or infusion pumps are currently separate from our IT systems. When you start connecting through IoT we’re sending patient data to those devices and they are sending clinical data back to our electronic medical record. We are just beginning to plan for this level of integration and are researching the security concerns to ensure a safe and efficient connection. As an industry, I think we need to get past the security concerns with some safeguards. The vendors we are working with in that space that support those technologies right now are working collaboratively with us and our EMR vendor toward integration.
Are there any hiring challenges?
Yes, every day. The market for healthcare IT specifically, for good talent is challenging. It is really hard to find the right fit with the right skill set. PIH Health has open positions all the time. We try to fill them, but it’s that balance of finding senior-level experience who have niche knowledge of a particular electronic medical record platform or a particular technology. These people are really hard to find because they are sought after so you see salaries increasing as well, which is good for the economy. Our department on-site has about 100 full-time employees. We have an off-site support service in Buena Park and 30-40 full-time employees that we utilize in India, so we have a 24/7 IT support team.
What did you want to grow up to be when you were a kid?
An orthopedic surgeon. I became more interested in the business of healthcare and had a heavy interest in IT. I balanced that out by keeping my focus in healthcare.
What kind of messaging is coming down from the CEO/Key Executives about their partnership with IT? What are they expecting you to look at?
IT is seen as a business partner. We provide shared services to the entire organization. Our senior leaders understand that to achieve our goals around revenue growth and efficiency, technology and a technology team that partners with them is integral. That is why we model our IT strategic plan off of the organization’s plan. We’re in the third year right now of a plan that we’re going to refresh for another three years based on where the organization’s priorities and roadmap take us. From a service line perspective, growth prospective, efficiency and cost perspective, as well strategic advancement, the message is clear that IT needs to be a partner. We’re also looking at the offset of those investments as well. Whether it be in people or other areas where total cost of ownership can be decreased, it is important to constantly evaluate the benefits of any IT investment.
Has the idea of using cloud changed your mindset of using outsourced IT rather than keeping in house?
I don’t think so. As I mentioned earlier when we discussed public cloud, we have our HR suite, we also have a private cloud that we outsource for database support of our EMR platform that services this organization. I’m all for it where it makes sense and where we can show a proven track record. We still have two data centers full of server stacks that must be on-site right now for applications we host on-site. But I do see it as a cost reduction when utilizing larger businesses like our EMR vendors who have larger datacenters that end up costing less. So I fully support it when it makes sense for the business, it’s never an all or nothing decision.
If you won the lottery what would you do?
I would probably still work. I enjoy what I do here at PIH Health, I enjoy the operations side and more so the growth, so I would probably just continue with the status quo.
If you could give guidance to any CIO, IT Manager Director about how they position their careers what would you tell them?
I grew up in IT moving through some of the ranks and had an opportunity at different stages of my career to broaden my horizon and not just be niche focused. For any individual who is interested in growing into a larger management role in IT, I would absolutely suggest creating both breadth and depth to get a good feel for what the department has responsibility for and how it runs. Getting a good feel for what works and what doesn’t is very important. You get to develop your own opinions and your own management style as you grow. I think it’s a lot easier to manage a broader department if you have greater insight into the overall scope of what that department does, so my advice would be rather than being more linear and niche focused, be a little bit broader throughout your career.