There are several myths floating around in healthcare. One of the most troubling, according to Reid Stephan (VP and CIO at St. Luke’s Health System), is the idea that clinicians are change resistant.
In fact, he believes it’s “lazy” to suggest that’s the case. “They’re overwhelmed. They’re drowning. And so, any added task, even one extra mouse click, can be the extra water that breaks the damn.”
Since EHRs first became part of the vernacular some two decades ago, clinicians have been dealt massive amounts of change, and have handled it quite well.
That’s the good news. The not-so-good news is that change isn’t going to slow down anytime soon, particularly as AI technologies become increasingly pervasive.
As a result, CIOs and other leaders face added pressure to prioritize the needs of frontline workers and make sure technology fits into their workflow. “The AI of the future has to be out of the way and require virtually no training,” he noted.
Reid Stephan
During a recent Keynote Interview, Stephan spoke about the ever-evolving relationship between CIOs and vendor partners, and how it can affect users. He also provided insights on the quest for the “middle truth” when it comes to AI initiatives; the role of EHRs as gatekeepers; and why, now more than ever, no one should settle for “good enough.”
One of the most critical aspects of a successful partnership between IT leaders and vendors is trust, according to Stephan, who commended St. Luke’s relationship with Epic as well as the EMR provider’s “genuine desire to improve healthcare.”
The challenge in working with Epic is that “sometimes we settle for a good enough mindset when excellence is within reach.” For example, if a CIO asks their internal Epic team analyst to see the roadmap, and they’re given a blueprint for Epic itself rather than the organization. “That’s a problem,” he added. “That’s not strategy; it’s vendor alignment dressed up as vision.”
And although his team operates with an Epic-first strategy, both due to the quality of its products and the high cost and complexity of using third-party solutions, Stephen believes leaders owe it to their clinicians to adhere to the highest possible standards.
“What if 80 percent isn’t good enough? Or what if the Epic solution technically checks all the boxes, but the user experience is frustrating, because it doesn’t solve the problem that needs to be solved? We can’t allow functionality to be a substitute for usability.”
What leaders should do, he added, is to raise the bar by asking for a “more modern, intuitive design” from EHR providers. “We need to expect and demand deeper, cleaner, more open integrations when we have to go beyond what Epic can offer,” he said. “We need to expect that our needs – and not just Epic’s roadmap – are guiding what we build, what we buy, and what we adopt.”
Part of the more modern Stephan seeks with EHRs is the ability to incorporate AI capabilities – something he believes is lacking. “Our EHRs are the gatekeepers, and that gate is effectively locked,” he noted, adding that “integration friction” can prove fatal to transformation initiatives. In some cases, EHRs aren’t just “hard to integrate with; they’re actively hostile.”
For that reason, he strongly urged CIOs and other leaders to educate themselves about AI, surround themselves with experts, and don’t hesitate to raise questions – especially when predictions vary so widely. “We’ve gone very quickly from ‘AI hasn’t delivered much’ to ‘it’s going to replace most doctors and teachers,’” he said. “What’s the middle truth? What has to happen over the next decade to certify or add credence to either of those statements?’”
That’s where the questioning comes in, Stephan noted, adding that AI is being marketed as transformative when in reality, it’s basic rule-based logic wrapped in a package, and people are starting to call that out.”
They’re also demanding solutions that require minimal training while offering the benefits that have been promised with AI. “People don’t want tools that look smart. They want tools that are simple,” he said. And “they don’t want AI to take over. They want it to work.”
The same can be said for C-suite executives who are part of the decision-making process around AI initiatives. Rather than focusing on the shiny new toys, his main concern is that the 550 members of the IT department have the tools and training needed to do their jobs effectively. “Do they feel supported and celebrated in the work they do? Do they feel safe? Do they feel like they can take reasonable risks in the work they do and learn from that?”
That’s the main objective, he remarked, adding that the CIO has become, in many ways, “more like a generalized administrator.
“If you’re worrying about cybersecurity or the network or applications at a micro level, you’re not adding value. Quite honestly, you’re probably stepping on team members who are doing good work.”
And, as we’re learning, the last thing anyone needs, whether it’s clinical, IT, or other areas, are barriers.
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