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"Your IT vision needs to relate to your business: who you want to be and how you want to perform. It’s always in service to that, not just an independent pursuit of gadgetry."
William Winkenwerder, MD, knows hospital management. He learned it many roles: as a physician, an executive in both the defense and private sectors of care provision, and now as CEO of Cureatr, a care coordination and solutions firm. Cureatr provides HIPAA-compliant communications, workflow assistance, analytics, event messaging, and additional tech services to large and well-respected hospital systems like Montefiore, Mount Sinai, and Penn Medicine.
In our C-Suite Q&A with Dr. Winkenwerder, he drew upon his experience to assess the future of third-party health technology providers. He also discussed what hospital executives should keep in mind when navigating the increasingly crowded IT field.
What’s the key piece of advice you would give to a hospital executive trying to parse this new landscape and choose the right technologies?
You need to hire very good chief technology officers and chief information officers, and the newest position is the chief medical information officer, a clinical person who really understands technology well. I think you’ve got to start with smart people who are also good executives, not just people who get overly enamored with technology but who really understand the broader business environment and understand what the big trends are, like at the government level and the insurance level.
At the same time, have a realistic understanding of what it takes to implement this sort of technology in a large organization. It’s not an easy turn. It takes a lot of good management. As someone who has directly overseen CIOs and CTOs, I appreciate the challenge of the job.
The answer to your question is to start with good people and create a vision, which almost always requires support of your board and alignment among your management team. At the end of the day, your IT vision needs to relate to your business, and who you want to be, and how you want to perform. It’s always in service to that, not just an independent pursuit of neat gadgetry.
There are a lot of outside vendors for, say, analytics and communications offerings to hospitals. Some of them are full suites. Some of them are specified. What approach do you see kind of “winning” that: Will we have more collaborations or consolidations?
Well, that’s a great question, and I think there’ll be a little bit of both trends. There is some partnering, but there is definitely early movement afoot to consolidate these different capabilities as they might naturally relate to each other.
Over time—and I mean maybe the next five years—I expect to see consolidation of different kinds of capabilities, whether it’s the alerting capabilities, messaging capabilities, or in-hospital communications… things that might relate to more of what I’d call “static analysis of populations” or even “population health.”
Most of the population health platforms are built off claims information from the insurers. The ideal future solution would have a number of different capabilities that could be pulled together and customized for different customers. I think that’s likely the direction we’re headed. At the same time, I think we’re all taking note that very large players, like Apple and IBM and certainly the EHR companies, are beginning to understand that this whole area is really important, and it will be integrated with the records systems. There’s a lot that’s likely to happen in this area over the next few years.
We talked to Walter Jin of Pager a few days ago, and something he said was that their first move in a new contract is to go in and integrate with all of the other third-party systems a provider or payer was using. It’s a competitive space already, but every company seems to be expanding their reach. Will they be stepping on each other’s toes soon?
They will, and not everyone will survive. The providers and the health plans, or any companies that are accepting financial risk on behalf of a population of patients, are going to be evaluating all of these different technology solutions that there are now.
There are lots of little fish swimming in the sea. Speaking as one with experience from the other side of the fence, having run large organizations, I can tell you that it’s hard when you have dozens or hundreds of organizations approaching you. It’s like, ‘Well, which one of these things works? Who are your customers, and can you scale?’
You want to know all of those things because the last thing you want to do as one of those large organizations is to get connected to somebody that’s not going to be able to execute or perform, or they become such a niche solution that it’s a problem as you try to integrate broader solutions across the organization. Those are some of the decision factors that the chief information officer and the CTO and the CFO face in these different large organizations.
Let’s unpack the notion that healthcare is lagging behind other enterprise industries in tech adoption, and what that actually means.
It is. Some people really like to stand up and criticize the healthcare industry strongly for its slow adoption of information technology. In defense of healthcare, I would say that the complexity of it makes the IT solution set much more difficult. It’s different—it can be very difficult—and I have respect for what it takes to procure and implement and operate the technology.
There are certain challenges in healthcare that you don’t face in other industries: HIPAA and other privacy regulations, clinician and physician adoption, all of that.
The banking industry has done a great job, and they’re an example of an industry that’s transformed. Healthcare is in a transforming phase, but we could be very surprised at where we’ll be in 10 years. I think it’s changing very quickly.
Give us a hypothetical hospital: an ideal scenario where Cureatr’s in there and everything works as it’s supposed to. What is that environment going to look like?
In a hospital like that, you’d have newer, better, more efficient ways to communicate, both with patients and clinicians, even after patients are discharged. You should be making a dent in your medical errors. You should have some incremental impact on patient satisfaction. You should be able to reduce your hospital readmissions. You should have better capability to manage a high-cost, high-risk patient with a chronic disease.
I’d be looking at those kinds of outcomes and an ability to measure those impacts.
There’s something interesting in what you said there: “incremental increase in patient satisfaction.” That’s a relatively modest outlook in a hype-happy field, no?
Saying ‘everything’s going to be perfect…’ is not the case. But I do think that patients notice when clinicians have the information that is needed for their care, and they notice when it’s not there. They notice when there are real delays, when problems crop up or things fall through the gaps.
To the extent that patients experience satisfaction around the experience of a smooth transition of care, hopefully they can say, ‘Oh yeah, that was great. I never had to worry about my information not going with me.’ With all of that, are they more satisfied? Yes. Will that show up in a satisfaction score? It might—maybe if you ask them very specifically about that.
People’s expectations grow. Once they experience something they like, they’ll expect that as the baseline going forward. There’s plenty of opportunity to improve, because still today people experience all kinds of dissatisfactions, with information not getting to where it needs to get. That’s just a chronic problem, and I think it’s a target-rich area to improve healthcare.
How did the Mount Sinai, Montefiore, and Penn Medicine relationships come about, and what sort of advantages do you think you offer to a health system like that?
With those kinds of clients, who are very demanding, they have choices. But I think if you ask them, they’d say they selected Cureatr because, first and foremost, the product works. There are lots of promised solutions on the market today that, maybe in a demo environment, if things are all set up and rigged the right way, it works well. But Cureatr really works, and it’s scalable, so we have tens of thousands of clinicians using it on a regular basis now. I think that’s what’s important to them.
We don’t have to disrupt their installed electronic records system, or their revenue cycling or scheduling system, because we have the ability to integrate with any of those. So I think that makes it much easier for clients to choose.
What made you want to get involved with the company? What stars did you see aligning?
I really appreciated the value of a tool to help with care coordination, because often a missing piece in care coordination is getting timely information to the people who need to know. I look at the customers, who are very satisfied, and I say, ‘Well, my goodness, this is something that’s got a lot of potential.’
In the early years, we’d call it health information technology, but it was not the health information technology of today. I’ve been involved in the early development of electronic health records, and I have always had an interest in adoption of new technologies to improve decision-making, better care for patients, lower costs, and improve quality. Designed the right way and put in the right hands, technology can have a positive impact on healthcare.