Healthcare CIO Edward Marx: IT ROI is measured in lives saved

In a life-and-death industry, quality and testing are high on this CIO's priority list.

Edward W. Marx focuses on technology's power to transform the healthcare industry. As senior vice president and CIO at Texas Health Resources in Arlington, Marx has led numerous IT-enabled transformative initiatives aimed at improving patient health. Those projects include using social media to connect with the local community and implementing BI tools to deliver advanced clinical care.

"Everyone agrees there's a financial benefit, but at the end of the day, I know what we're doing is making the difference in someone's life. I can see by leveraging IT you can make a demonstrative difference," he says.

In January, the College of Healthcare Information Management Executives and HIMSS, a nonprofit group focused on healthcare IT, selected Marx as the recipient of the 2013 John E. Gall Jr. CIO of the Year Award.

What do you think earned you recognition as CIO of the Year? My leadership and my transformation methodology and disruption of the status quo. I stress leadership a lot more than technology. I talk to people about wising up and claiming their title, because for most of us, that's senior vice president before chief information officer. So really lean on that senior vice president title. We do a lot of transformation here leveraging technology. And we do a lot of disruption here.

How do you measure IT's value in your organization? We do measure traditional financial ROI, just like any other company. We're very judicious about that.

But what stokes my fire is how do we measure clinical quality and patient safety and how, therefore, do we improve it. We have all these technology tools that we could leverage to improve quality and safety. Our performance is based on the measures of those.

One example: One of the biggest killers of patients that come into American hospitals today is venous thromboembolism, or VTE. So we did some innovation and we reduced the incidence of VTE by 25%. We know because we measure this stuff. In a traditional hospital, if you think a patient is at risk for VTE, you put them on a certain protocol -- elevate their legs or take a particular drug. But in a paper process, you might not realize a patient is at risk.

Because we're automated with electronic health records, we built that into our order set. It's that sort of innovation that really enabled this transformation.

What is your biggest IT initiative right now? We don't have any IT initiatives. We have business initiatives that require IT, and one of those is population health. We're more about well-being, and we want to engage the communities before they need Texas Health. We're engaging our community in many ways, and population health requires a lot of IT.

Another area is patient engagement. That goes back to population health, but it's about mobility and connected health. Not too many people want to come to the hospital, so is there a way to deliver healthcare at a lower cost that's not in the hospital? We call it connected health. You should be able to do a lot more today with your local provider on your smartphone than you do. And we're trying to engage the clinician in the same way. Why go to the hospital if we can give them the data wherever they are so they can take immediate action?

The third area is predictive analytics. We should be able to take this data and make predictions around risks so I could get a call or text from my personal health record that says, "Come in in 30 days for another lab workout" or "Keep exercising."

What's next for your IT department? I think there are three areas. [One is] optimization. We implemented a lot of technology and we did pretty well, but as you get more experience and add new features, you have to make sure you optimize your investment. We come back through with another team after we've been doing it a couple of years and see what more we could be doing or what new features we could take advantage of. Another area is BI. We're going to get to prescriptive analytics, get very customized to the individual. And then the third area is the whole concept of innovation. We have to constantly challenge ourselves on how we can come up with a better way of doing things.

What can IT leaders in other industries learn from you and other healthcare CIOs? Once a year, I take my leadership team and I pick another company and we spend the entire day together. I've done this with Kimberly-Clark, RadioShack, Pier 1, 7-Eleven. And we learn from each other. I think what they can learn from healthcare IT is our focus on quality and testing. If we make a mistake, it can cost someone their life. In other [industries], it might mean cost overruns. So we take extraordinary steps to make sure there's high quality and lots of testing.

What does it take today for IT departments to ensure high customer satisfaction? I have three formulas. You have to have as much eye-to-eye communication as possible. They need to see me rounding with doctors and nurses on the floor, so they know I understand what they're doing. Another way is face to face. You have to know the strategy, where they want to go. And the final is peer to peer. Physician satisfaction is a key indicator to us, and our highest area of satisfaction for the physicians was IT at 94%. We're above 80% overall with everyone, and that's world-class according to Gartner.

What do you do as a CIO to develop leaders? We have a leadership academy. We take eight students a year, they get mentored by me or one of my direct reports and they learn business leadership. We're going to graduate our second class soon. We take advantage of Texas Health University, that's the typical HR-run training program. They do a great job here. And in addition to that, I bring in other organizations to help us because I believe in leadership development so badly that I'm willing to invest. And I push people hard to present. We do a lot of presentations around the country. It improves our brand, it helps our employees and there's nothing like being asked to teach to really solidify it in you as a leader.

Editor's note: An earlier version of this story incorrectly referred to pulmonary thromboembolism as the condition that the EHR initiative helps to reduce. However, the correct term is venous thromboembolism (VTE), or blood clots.

-- Interview by Computerworld contributing writer Mary K. Pratt (marykpratt@verizon.net)

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