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Over thirty years experience in Information Technology for Healthcare, the last eighteen years as a Chief Information Officer, Podesta has worked for Academic Medical Centers, Health Systems and Community Hospitals. He is currently the CIO for University of California Irvine Health. Previous to this engagement Podesta was SVP & CIO of Fletcher Allen Healthcare, a large academic medical center and health system in Burlington, VT.
Other positions included SVP & CIO at Caritas Christi Health Care, now Steward Health in eastern MA, CIO at Berkshire Health Systems, Pittsfield, MA, Director of IS and Interim CIO for Baystate Health Systems in Springfield, MA. And prior to that, leadership positions at St Vincent Hospital, Worcester, MA; UMASS/Memorial, Worcester, MA and Magee-Women’s Hospital, Pittsburgh, PA.
Over the years, Podesta has made numerous presentations at national conferences and is quoted widely in healthcare publications on a variety of IT topics including Epic’s Community Connect Program.
What did you want to grow up to be when you were a kid?
I was interested in being a major-league baseball player or being in a band, and I currently play spoons for bands so I kind of made it. Maybe not with a real instrument but it’s fun, you can check out my YouTube account to learn more -just type in Chuck Podesta Spoons.
What innovative projects are you the CIO focusing on this year to support the vison and mission of UC Irvine Health?
We’re currently working on a huge strategic project with UC San Diego, we’re changing our electronic health records from all scripts base to the Epic system. UC San Diego has already migrated to this system and will be hosting us, which is saving us a lot of money being we won’t have to build a system from scratch. We’re doing it as a collaboration with UCSD so from a strategy perspective we’ll have two independent academic medical centers on a single instance of that electronic health record. Patients that we both serve will be in a single database so when physicians access that information they could see patient data from anywhere in the UCSD or UCI network. We’re moving to population value based care and strategically working together on joint programs serving areas that may be underserviced from a standpoint of health. Having a single electronic record between the two organizations really supports that effort both in Orange County and in San Diego.
We go live in November with this big project but parallel to that we’re looking at a single support model from an IT perspective between San Diego and UCI because if we have a single instance of the electronic health record we don’t really need two IT teams supporting it separately. We’re going through a process looking at where we can share and centralize resources with the implementation. It’s pretty exciting, we’ll be the first two academic medical centers on the same instance of electronic health record in the United States when we go live. It’s never been done before. We’re making the single support model scalable so other UCs could potentially take advantage of that as well to reduce costs. It’s more about IT following strategy, making sure you create the IT components to follow your business strategy and being a key partner throughout the process.
What’s your take on Public Cloud and how have you as the CIO improved academic healthcare workflows due to cloud technology?
I just had a keynote speaking engagement on a panel at a recent cloud conference. If you look outside of healthcare, yes everyone is moving to the cloud. The issue with healthcare has always been with the Protected Health Information (PHI) and as CIOs we have been nervous about moving that information to a cloud based system with the risk of having a breach. That’s always been in the back of our minds with the thought of how fast you really should move to the cloud. Some of the technologies we use aren’t architected for the cloud, which is another reason we’ve been slow to adopt, but now it’s starting to rapidly move in that direction.
When we first started working on a recent analytics project, we had a large new data warehouse on premise that we just recently moved to the cloud. With HIPAA protection in place the savings are tremendous because now you’re able to scale up or down and easily add more storage when its needed, making it a lot less expensive. We’re seeing huge benefits from that right now so what I think you’ll see is more and more movement going forward. Every time we look at a new
application we always look to see if we can run it from the cloud, either private cloud or public cloud. Now with all the security protection public cloud vendors are all moving in that direction, getting into the healthcare side of the business.
With our Epic project, both UCSD and UCI are having Epic host us on their private cloud at their large datacenter headquarters in Wisconsin. Electronic health will technically be in the cloud. If you talk to 100 CIOs you’ll get 50% that express wanting to move to the cloud and the other 50% that aren’t ready to move, I think we are at a crossroads. It’s about timing, a few of us should try it; as we get a year or two down the road and see the savings without breaches the fear will be eliminated and others will get more comfortable.
What innovative projects are you the CIO focusing on this year to support the vison and mission of UC Irvine Health?
We’re working with a start-up company doing quite a bit on the analytics side. We’re building what we like to call an ecosystem with a new data warehouse. We like to call it an ecosystem because it’s a living, breathing entity instead of thinking of it as a being a black box that receives information from all various sources like electronic health records or lab systems, mapping it to some data warehouse that you must update once a day for reporting. That worked in the past with Microsoft SQL but we’re moving into a more native format wherever it comes from whether it be social media, IoTs sensor information, and again the electronic health record, tracking the data in real time and being able to use it right away. This way you don’t have a bunch of people mapping the information, you’ve created a self-service environment. We now have dashboard graphics to display as data is refreshing in real time on a second by second basics, so they could start to use the data for research or operations. That’s why we call it an ecosystem because what is looks like right now is different from what it looks like 30 seconds from now based on the data that its ingesting.
We’re starting to do a lot of subscriptions with social media, it’s amazing what’s out there. Just from turning your location services on it’s unbelievable with the amount of information being sent to the cloud. We could look at patients and see how they are using applications and how they prefer to collaborate, email vs. text messaging. If you’re going after a specific demographic with a message you could now see how you should target them based on the analytics.
With these analytics, we’re trying to create a personal experience designed to target a personal persona based on the data as a corporation group. Design an experience for patients without having to ask, we just know from the data insights. Part of how you get reimbursed is based on the patient experience. You’re going to see a lot of Chief Experience Officers coming in to drive that experience into the healthcare space. We want patients to have a satisfying experience when they’re spending time to visit our facilitates.
What are your specific hiring challenges if any?
It’s a very competitive area, Epic is one of the leading electronic healthcare systems along with Cerner, they probably take up 80% of market share between the two of them. Once you get on that specific platform it’s hard to find talented professionals with those specialized skills and once they get the certifications in the product they become highly marketed, so consulting companies are recruiting your best employees. You need to get creative with some strategies, our UCI
undergraduate and graduate school is filled with smart engineers, as well as excellent students with math, science and even English majors. When you hire millennials right out of college and get them certified on Epic they get up to speed quickly because you’re trying to hire the best and brightest. I’ve had success managing and measuring success during my tenure at the University of Vermont where we would hire two or three millennials per year. Managing them is different. They produce very productive work but have a work hard, play hard attitude so actually work better and faster without a deadline. They enjoy completing projects so they could move on to the next thing, rather than waiting until the last minute when a deadline is provided. New graduates are also compensated at a lower pay scale so you may lose them after a few years as their pay scale goes up, if you manage them well they work very well. Don’t get me wrong you also need to recruit employees with more experience, you should just leverage millennials as a strategic way to recruit.
What kind of messaging is coming down from key executives about their partnership with IT?
With the Epic implementation, our joint collaboration has been huge, we have 700 people across the organization working on this project. I just did a big presentation to our executive team addressing where we are on progress and the benefits in each of the areas whether it be revenue cycle or clinical, they are all looking for efficiencies within their area based on the new electronic health record. This is making nurses and physicians more productive while the revenue cycle is calculating charges we may be currenting losing so getting up in revenue by utilizing technology to empower the business going forward is key. Right now, we have a bunch of different systems but Epic will provide us with a single system that integrates efficiencies so everyone can really see where the information is flowing. That’s what they’re looking for right now. Our collaboration with UCSD is huge for us as they’ve been live on the system for a while now so they’re educating us on how they are using it best.
If you won the lottery, what would you do?
I would start a foundation, build a school somewhere either in the United States in a poverty-stricken area or outside of the United States. That’s something I’ve been thinking about anyway. I’m passionate about running marathons that support charities, so I’m at a stage in my life where I want to give back. I’ve been blessed with a wonderful family and life so I would definitely want to start a foundation that would give back in some way.
Has the idea of using cloud changed your mindset of outsourcing IT?
We still mainly handle IT inhouse but outsourcing, which we now refer to more as managed services has its place for certain things if you can get creative around that. I think outsourcing to other countries will slow down more, especially in healthcare. You really need to look at your core competencies and consider what you need to accomplish for them. We are outsourcing our datacenter to the cloud and letting those experts manage it as it’s not our core competency so I look at that as smart outsourcing.
If you could give guidance to any CIO about how they position their careers what would you tell them?
It’s interesting because it depends what they actually want to accomplish. Do they want to be a CIO or VP from an Operational standpoint? There is a place for both and depending on your work style you need to sit down and consider how you prefer managing and leading. Ask yourself the question, am I tactical and results driven when leading people day to day or do I like to sit back and look at what should be happening a year from now and take more of a strategic standpoint. Then you need to consider what both entail. I’ve seen employees get promoted to a VP or Director role and do extremely well there because they are hands on and could still patriciate in strategy but really excel in the day to day operations. I would say that role is 30% strategic and 70% technical from an operational standpoint. I’ve seen employees excel in these roles and get promoted to CIO and get lost, finding it hard to make that leap and start thinking in a unique way. You need to be introspective about yourself and really consider if you want that change because both roles are very important so if you excel as a Director or VP you could be very successful staying in that role rather than taking the leap. When I was in that role and interested in becoming a CIO I got a mentor who I asked to coach me in understanding the differences of the roles, so if you are ready for that leap there are defendable ways to achieve that but my initial advice would be to consider what role you would be more successful in as they are both very important.