The Grill: Orlando Health CIO Rick Schooler's vision of healthcare IT

Computerworld - With two decades in healthcare IT under his belt, Rick Schooler, vice president and CIO at Orlando Health, is girding for the next big change, as organizations like his begin harnessing the power of analytics to influence how doctors and nurses treat patients. In recognition of his work in using IT to improve healthcare, Schooler was named the 2011 John E. Gall Jr. CIO of the Year by the College of Healthcare Information Management Executives (CHIME) and the Healthcare Information and Management Systems Society (HIMSS). Here, Schooler reflects on how IT has changed, and will continue to change, medical care.

You've spent 21 years putting in systems that automate back-office healthcare functions and deploying technologies that give clinicians better access to patient information. What's next for healthcare IT? We've implemented technology to automate healthcare delivery and payment, and we're now in a reality where the focus will go to using that information to better manage care in real time, to use analytics to understand truly what's going on. We're moving toward a clinically integrated model of care, and the IT platforms that need to be put into place to make that happen are significant and are significantly different than what we put in place in the past.

What is a clinically integrated model of care? The patient's experience in terms of the healthcare continuum becomes seamless, so as a patient transitions through the different levels and venues of healthcare, the information flows through all those venues. In order for this to happen, different players have to come together as a virtual team. We need an information model that really does integrate in ways that in years gone by wasn't possible or wasn't desired.

Computerworld - With two decades in healthcare IT under his belt, Rick Schooler, vice president and CIO at Orlando Health, is girding for the next big change, as organizations like his begin harnessing the power of analytics to influence how doctors and nurses treat patients. In recognition of his work in using IT to improve healthcare, Schooler was named the 2011 John E. Gall Jr. CIO of the Year by the College of Healthcare Information Management Executives (CHIME) and the Healthcare Information and Management Systems Society (HIMSS). Here, Schooler reflects on how IT has changed, and will continue to change, medical care.

You've spent 21 years putting in systems that automate back-office healthcare functions and deploying technologies that give clinicians better access to patient information. What's next for healthcare IT? We've implemented technology to automate healthcare delivery and payment, and we're now in a reality where the focus will go to using that information to better manage care in real time, to use analytics to understand truly what's going on. We're moving toward a clinically integrated model of care, and the IT platforms that need to be put into place to make that happen are significant and are significantly different than what we put in place in the past.

What is a clinically integrated model of care? The patient's experience in terms of the healthcare continuum becomes seamless, so as a patient transitions through the different levels and venues of healthcare, the information flows through all those venues. In order for this to happen, different players have to come together as a virtual team. We need an information model that really does integrate in ways that in years gone by wasn't possible or wasn't desired.

Where does IT add the most value in healthcare today? You have to look at it on different levels. The first level is foundational -- the basic functions: registration, billing, lab systems. That's a level that's just assumed to be there, [but] there are still health systems and providers that do not make use of [those] automation tools. Then you start moving up the value chain, using and exchanging the information that's captured. That's health information exchange, and that allows information to be moved between provider venues. It allows us a more ubiquitous presence of information.

And the layer above that is the ability to mine that data, not only to find out what is causing success or a challenge, but also to learn how to predict and answer the unasked questions: "Let's do some simulation; let's change some variables about care protocols or environmental considerations." So you move out of the realm of capturing data to being able to do true analytics with tools that other industries have been using for a while. That's where the real value comes. That will then enable us to be able to better manage care, to be prompted to do things for our patients that causes them to have better outcomes.

How close are we to achieving that vision? It's already starting. You're going to see a tremendous amount of change to the positive over the next three to five years.

What are the most pressing technological challenges? Information integration between systems is a key challenge. Some of the features and functionality we need to do advanced analytics and information exchange are just now getting to what, in my mind, I call solid. So the IT challenges are still around integration and then being able to take that information and put it in platforms where we can effectively mine it.

Can you elaborate on the idea that the patient's experience is primary in considering your IT strategy? If you look at the patient experience, how easy is it to communicate, to provide or get information, to navigate? These are the logistics. IT can significantly improve that -- or make it worse because of poor use or deployment of technology or lack of it. And then there's the clinical experience: How was I treated, and what was my outcome? We definitely have to consider both. For example, we know it doesn't work when the doctor or nurse has to turn her back to enter information when talking to a patient.

So how do you address that problem? We design workflow and user expectations around technology through trial and error. We have to think about the venue of care. We have to think about how we make use of technology that can accommodate different venues. It's a very complex environment, and what comes out of the box doesn't necessarily meet the needs, so it's understanding how we tailor technologies and what other technologies we put around it to make it work for a particular venue.

What is the most impressive advancement that's happened over the course of your career in IT? I'm someone who believes in the cloud. The cloud embodies the principle that people should be able to use technology as a utility. We're going back to a simple computing device that connects you into an enormous amount of information or computing power. I think we're going to see IT departments change radically because of it. You can now go to the Web and get what you need, for a monthly fee. You don't have to design and build it yourself anymore.

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

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