S1E28: Interoperability, BAAs, Integration (ft. Adnan Hamid, CommonSpirit Health)

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Adnan Hamid, VP and Divisional Chief Information Officer for the Southern California Division of CommonSpirit Health, speaks to interoperability, BAAs, and integration.

Transcript:

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Jordan Cooper
We’re here today with Adnan Hamid, the VP and Divisional Chief Information Officer for the Southern California Division of Common Spirit Health. Non thank you for joining us today.

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Adnan Hamid (Guest)
Thanks for having me.

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Jordan Cooper
For our listeners, common spirit health is a health system based in Chicago, IL, with 163 hospitals, 30,000 providers and 20,000 beds. A non represents a Southern California division of Common Spirit Health which includes 18 hospitals, dozens of ambulatory clinics and 25,000 employees that provides care to over 1,000,000 people in Southern California.

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Jordan Cooper
So at night I’d like to kick off our conversation today.

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Jordan Cooper
Ohh I’m an ASK and I’m not sure if this falls in your bailiwick or not, but I know that common spirit recently acquired 5 new hospitals in Utah from Steward Health. I know that obviously Utah is not in Southern California, but perhaps you may be able to speak to general trends in the market that may be affecting you with expansion and kind of new sites, or if that applies at all. I know you said you have many ambulatory clinics. Have you been seeing any kind of expansion and how does that affect?

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Jordan Cooper
Your team.

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Adnan Hamid (Guest)
Right. Yep. That’s the obviously sort of the latest news for common spirit health and we’re really excited in having sort of that part of the country. You know, under US and and able to serve those communities. Yeah, as we look at sort of the overall healthcare landscape.

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Adnan Hamid (Guest)
You know as well not directly impacting Southern California. You know from an IT perspective, we do our best to try to connect a lot of sort of disparate systems and that in itself is a challenge. So what we want to do is do this without disrupting operations of course. And so that’s really the challenge. How do we take a lot of these sort of fragmented systems throughout and kind of put them together. You know we’ve recently have now new leadership.

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Adnan Hamid (Guest)
At the top with our new CIO that joined summer of last year and Daniel Barchi, our new Executive Vice President, CIO, who joined last fall and the goal is to be one common spirit and with that, that means again leveraging the technologies that we have collectively and and and doing the best we can to again.

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Adnan Hamid (Guest)
Not only serving our communities, but what we like to say, restoring the joy of medicine back to our providers. Right. So I think those are the things that we are aiming to do moving forward.

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Jordan Cooper
So a non I’ve heard about an operational transformation initiative and a three-year roadmap. Is that something that you may be able to speak to?

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Jordan Cooper
Umm.

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Jordan Cooper
Mm-hmm.

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Adnan Hamid (Guest)
A very high level. I know our Executive Vice President, Daniel Barchi. You know, he’s setting the vision and not just three years, but ten years. And again, a lot of this is, you know, where we find opportunities to again be on one platform and standardized throughout the enterprise, which of course, as you sort of rattle off the statistics of common spirit, health is not very simple.

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Jordan Cooper
Right.

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Adnan Hamid (Guest)
It’s going to take time to do that.

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Jordan Cooper
Mm-hmm.

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Adnan Hamid (Guest)
We can’t just, you know, do that in in sort of an overnight operations. We really got to be methodical and strategic about how we.

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Jordan Cooper
Hmm.

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Adnan Hamid (Guest)
Look at all out of our systems and forgot those inflection points to get to 1 sort of common spirit and that we’re all kind of utilizing the right platforms and and and leveraging what we’ve got to take care of our patients. So that that really is the trick right now is how do we do that we know.

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Jordan Cooper
So.

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Adnan Hamid (Guest)
A lot of our stakeholders have asked for that. It’s just now how do we do it and do it in a in a responsive manner.

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Jordan Cooper
How are you integrating data from disparate systems systems? I know that within the common spirit family, you’re leveraging Epic Cerner and Meditech EHR’s. Obviously, there’s new entities being brought on board, as I just mentioned earlier, with their own data sources. How what is your data integration strategy and how are you pursuing it?

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Adnan Hamid (Guest)
Great question. You know, again a lot of that is is sort of being evolved from learning from the systems that we have leveraging cloud, of course partners like Google.

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Adnan Hamid (Guest)
And Microsoft and Amazon looking at how we can leverage the sort of the cloud to help us with.

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Adnan Hamid (Guest)
Analyzing the data, collecting the data, and then obviously really more importantly, making sure we operationalize the data so that our providers and operators can use that to take care of our community. So it’s still again an evolving strategy, but I think we’ve got the right people at the table to help us.

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Adnan Hamid (Guest)
Do it.

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Jordan Cooper
What are some of the top priority projects on your plate that you’re using to operationalize your data strategy?

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Adnan Hamid (Guest)
Well, I can just speak to what’s happening in Southern California again, couple major initiatives here is just.

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Adnan Hamid (Guest)
You know, really against standardization of packs, right? So our packs solutions, making sure we’re all on the same sort of imaging systems throughout the division. That will definitely help with making sure that we can support these systems move forward, that they don’t become end of life very soon. And you know at the end they were providing the tools for our providers to take care of patients and then also phones, you know, standardizing on phone systems. Again, these are sort of the sort of what we call.

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Adnan Hamid (Guest)
Bedrock technologies that are key to operations and in our acute care settings. And so I think we just need to make sure that we have a good foundation so that we can build off it. For example, the phones, right. So getting on a a modern.

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Adnan Hamid (Guest)
Phone system allows us to then leverage, you know, mobile phone devices throughout and that you know, again, we are doing the best to.

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Adnan Hamid (Guest)
A. Provide our you know clinicians the the, the latest and greatest tools, but at the same time.

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Adnan Hamid (Guest)
Sort of, and back to restoring the joy of medicine, getting our providers back in front of the patients and having those crucial conversations about their care.

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Jordan Cooper
Mm-hmm.

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Adnan Hamid (Guest)
Versus behind a screen.

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Jordan Cooper
Got it. So it sounds like you’re upgrading from landline to mobile phones and issuing mobile phones to physicians.

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Adnan Hamid (Guest)
No, it’s just a matter of making sure that we’re going from sort of again in analog base to voice. I mean, again, it’s not sort of.

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Adnan Hamid (Guest)
You know the.

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Adnan Hamid (Guest)
Earth shattering or sort of state-of-the-art. It’s just making sure that we’ve got a a technology base that can support sort of mobile infrastructure moving forward.

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Jordan Cooper
Got it. Are there any data harmonization projects that you’re working on?

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Adnan Hamid (Guest)
Specific to something called for you know, but again things that we do work on are population health, right, making sure that we are again utilizing the data that we capture and make and.

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Jordan Cooper
Umm.

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Adnan Hamid (Guest)
And providing that information back to our providers want to make sure that the the lives that we are responsible for, you know we’re able to provide those services and an in network fashion versus having some of these of our community members go out of network which can be costly. So it’s just about making sure that we’re keeping our patients you know within our network and able to serve them the best that we can.

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Jordan Cooper
Our listeners, as you may know are are your peers CIO’s of large health systems across the United States and I think it really helps when we bring particular use cases to life. Would you be willing to speak to an instance or a problem that you’ve solved within the context of that population health use case?

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Adnan Hamid (Guest)
It’s still early. I not sure. I could probably bring one to surface right now, but again, you know in my time here so far with common spirit health, a lot of it is my focus has been of course supporting the sort of the national initiatives such as PAX and Unified Communications. What I’m also doing is.

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Adnan Hamid (Guest)
Installing governance to our division where and one of the challenges as I walked in is the number of, you know, requests outweighed the amount of both funding and resources that were able to work on those requests. So trying to find a good balance so that the request that we do work on are meaningful to the hospitals, but at the same time, we’re able to deliver that work to them in a timely manner so that we can continue to do more work, but right now.

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Adnan Hamid (Guest)
They’re just dealing with as many organizations where, especially in the IT world, the number of requests. That way the number of resources, so that becomes.

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Adnan Hamid (Guest)
We really a source of frustration when we just can’t keep up.

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Adnan Hamid (Guest)
With it.

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Jordan Cooper
So how are you handling that prioritization of help desk requests and how are you structuring the governance in order to accommodate those priorities?

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Adnan Hamid (Guest)
Well, we take a look. What, again, back to when I started. You know, every request has a high or critical priority and that really doesn’t help in a sense of if everything is a high or a critical, then nothing’s really higher critical.

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Adnan Hamid (Guest)
So what I’ve done is working with my team. What we’ve installed is, you know, sort of guiding principles or sort of a scoring prioritization scoring methodology where we take up to 10 business factors will this request.

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Adnan Hamid (Guest)
You know, improve patient care, patient safety.

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Adnan Hamid (Guest)
You know, will it reduce cost, increase revenue and we really asked our business leaders to help score these requests on how.

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Adnan Hamid (Guest)
You know, how close does it align with the sort of the strategic goals of the organization so that we can then prioritize that at a again we can start using it as a data point and trying to prioritize these requests versus others that the site might have.

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Jordan Cooper
Have you ever done a retroactive postmortem, say, on priorities that were tackled by the organization in 2020 or, you know, some prior year, right? So we said that, you know, in, in, in, in 2018, we said that these hundred things were a wish list and of those hundred, we accomplished these 25 and these 25. We actually think that 20 of them actually achieve the ROI we originally wanted.

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Jordan Cooper
Because ever been any sort of retroactive analysis to see how accurate you’re scoring factors are?

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Jordan Cooper
Umm.

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Adnan Hamid (Guest)
Well, again, it’s early in implementation, but that seemed you know is the goal right to get to a point where we can have that moment of reflection to a reinforced that the methodology works and then be if there are opportunities to tweak it, then we get that sort of continuous feedback on how did we do in with the methodology and if there are ways to make it better than we use that information to do so. So yeah, I think we’re not there yet, but.

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Adnan Hamid (Guest)
That is again part of the whole goal is to make sure that again this is a value added process.

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Jordan Cooper
So on the topic of priorities, I like to pivot back to the topic of integrating data in disparate systems and we spoke about leveraging the cloud. You mentioned AWS, Azure and Google Cloud platform. You also mentioned that well, I mentioned a very beginning that there are 163 hospitals of which only 18 are in the Socal division, right. So there’s a whole lot of integration needs to be done across the entire health system at common spirit. Can you speak about how the, what the data strategy is with migrating the cloud? What are some considerations that need to be accounted for?

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Jordan Cooper
Are you trying to move to a single instance? Are you trying to reconcile different EHR? What’s your cloud migration strategy and what are kind of your metrics of success once you go through the migration process?

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Adnan Hamid (Guest)
Well, again, early in our sort of migration strategy. So I won’t be able to speak too high, too much of that where I can speak of is the things that I’ve dealt with in my time here. When it comes to just.

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Adnan Hamid (Guest)
You know, setting up information feeds between our you know, our hospitals and you know our physician medical groups and third party vendors and partners that need some of our data to support our communities.

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Adnan Hamid (Guest)
Umm, you know, obviously the the sometimes the unique challenges are is you know with interoperability you know if we don’t.

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Adnan Hamid (Guest)
Let me back up. You know, when business contracts are formed between, you know, between organizations, healthcare organizations like ours and third parties, a lot of it obviously is focused on sort of the business and the reason to get into that partnership. Sometimes the cost that may not be fully understood are the integration costs of hooking system A to system B.

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Adnan Hamid (Guest)
And sometimes it’s sort of. Unfortunately, expectations may not be set properly, so someone may think that they may be getting data within 90 days of a contract being signed. But after doing some research on what is needed, it could be a little longer. And so that can lead to some frustration on our ability to deliver that exchange of information. So you know, we’re really dealing with is you know, as we look at some of these contracts or some of these requests that are just sitting there where we can’t.

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Adnan Hamid (Guest)
Or we’re we’re, you know, in a sense.

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Jordan Cooper
Sure, what?

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Adnan Hamid (Guest)
Delayed in our ability to exchange this information that that does impact operations, especially partnerships and so just taking a look at that and standardizing on that is a big deal right now.

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Jordan Cooper
Had known what would you say accounts or some of those delays and data exchange?

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Adnan Hamid (Guest)
Just the scope of what is needed. For example, you know one thing. One example is when we switch out radiology groups.

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Adnan Hamid (Guest)
And they, you know, we are all dealing with shortages and and sort of clinical coverage when it comes to imaging.

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Adnan Hamid (Guest)
You know in the past, which has been, you know, sort of as we’ve seen it, right. So even if you change radiology groups to expectation as these radiology groups, for example, would read from your own packs systems.

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Adnan Hamid (Guest)
But what I’ve seeing as a bit of a trend is that these groups have their own sort of radiology information system groups, systems that you have to hook into, and that requires interface feeds and between.

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Adnan Hamid (Guest)
You know, patient demographics, orders and and reports and so that takes time. If we’ve gotta build these kind of interfaces for each radiology group that comes in and goes that in itself takes a lot of effort and planning. And so we’ve got to figure out a way to make it so that I kind of use sort of the gas station analogy, right, so.

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Adnan Hamid (Guest)
You know.

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Adnan Hamid (Guest)
You have a gas station. They’ve got the same setup for any type of car that comes in, right? That takes that fuel, you know. Could you imagine if you had a, you know, a specific gas station for only a specific kind of car that would make it very difficult in trying to support that infrastructure? So, you know, we’ve got to do the same thing for, I think, in my mind, interoperability aware.

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Adnan Hamid (Guest)
System and system B can connect and you as long as all the setups are good, then you know in an infrastructure set then it shouldn’t be too much of a hassle to to really hook up these systems as and as these groups come in and and go. So hopefully that makes it a little bit of clear of the challenge that we have right now because it’s not that way right now.

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Jordan Cooper
Yeah, just to follow up on that, with all these groups coming and going, do you have a electronic master person index or like a provider directory and a patient index strategy?

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Adnan Hamid (Guest)
Yeah, that, that, that would be key, right? So that again with a lot of different systems, we need to have an empi that that makes sense, but again.

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Adnan Hamid (Guest)
Whether we have a specific strategy, you know, not be able to comment on that at the at this point.

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Jordan Cooper
Hmm. OK, so we are approaching the end of this podcast episode. Adnan, we’ve covered a lot of ground. We’ve spoken about integrating data in disparate systems a little bit about cloud strategy and challenges of interoperability. We’ve spoken about the need for standardization of imaging systems, phone systems, standardization, and we alluded to a population health strategy and some governance in terms of just prioritizing the deluge of requests that come into your office would like to provide you with an opportunity to.

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Jordan Cooper
Offer any insights or suggestions to our listeners who may be encountering similar problems in their own organizations today.

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Adnan Hamid (Guest)
Yeah, great question. You know, I think it’s, it can be very overwhelming with the other challenges that are ahead of us. You know I for one kind of think of it sort of inspirate inspiring in the sense of there’s a lot of good work ahead of us. It does take the right people to help work on these problems are very complex problems. Of course, if they were simple, they’ve already been solved. So very fortunate to work with a great group of people that understand.

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Adnan Hamid (Guest)
Where we’re what we’re trying to do.

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Adnan Hamid (Guest)
And it’s it’s really about working with some great people and and solving problems together. It it does take in my mind a village to do these things and I’m just very fortunate to be with an IT organization that that understands that and you know we’re doing our best to, to to solve those really complex questions and be part of a very, very sort of very value based organization that truly, truly is doing its best to take care of the communities that we serve. So.

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Jordan Cooper
This has been a non Hamid the vice president and divisional Chief Information officer for the Southern California Division of Common Spirit Health. Adnan like to thank you for joining us today.

0:18:34.390 –> 0:18:36.580
Adnan Hamid (Guest)
Thank you. Thank you, John. Appreciate the opportunity.