From Doctor to CIO

Marc Chasin, a physician turned CIO, brings a unique perspective to the technology challenges of St. Luke’s Health System. A look inside his efforts to enhance the approach of his team as they meet the needs of an industry going through a rapid transition.

Marc Chasin got his first Apple computer in 1984. He loved technology, and years later, when he became a physician, he quickly saw opportunities to leverage modern tools. Chasin partnered with his residency program’s IT group and bought Palm Vx handhelds (8 MB RAM, 3.2” grayscale display) to standardize admitting orders.

MARC CHASIN’S GUIDING PRINCIPLES

Engage patients, physicians, clinicians, and frontline staff at every phase
Everyone involved must understand the business of treating people in the system. IT builds strong partnerships with all stakeholders to understand optimization of systems.


Adopt evidence-based and best-practice workflows and standards
IT wants patients to feel safe in all hospital facilities and concentrates on evidence-based practices.


Drive decisions based on what’s best for the overall organization
Operational efficiency and appropriate standardization help the system be fiscally responsible and render the most appropriate care to patients in the most appropriate venue at the most appropriate time.

Later, in private practice, the realities each doctor faces started to sink in. “Doctors have limited time to see numerous patients,” Chasin says. “I realized that to see all of my patients, I needed to find efficiencies. I knew that meant adopting more technology.” The realization led Chasin to develop his own electronic health record (EHR) system, but he learned the value of proper change management when his colleagues balked at the task. Undeterred, Chasin continued his efforts when he discovered that a local health system along the East Coast was implementing an enterprise-wide EHR. Chasin volunteered to help build and develop their application. During the process, the system’s IT leaders offered him a full-time job. Chasin—by then a medical doctor with five years experience—left his practice to become the hospital’s chief medical information officer.

Chasin made his transition during health-care’s evolution into preventative care and the Affordable Care Act. “Big changes were coming in health care, and I knew technology would be the glue to hold it all together,” he says. Today, Chasin is CIO and CMIO at Idaho’s St. Luke’s Health System. He accepted the job in 2010 to drive the adoption of clinical IT with physicians, nurses, and other health professionals. His vision is to combine the traditional IT shop and the clinical IT shop into a single entity. In doing so, he’ll help users understand what happens in the back office and better allocate the system’s resources to benefit each patient.

Bringing smart IT solutions to any modern care environment is a complex and sensitive task, but implementation is especially challenging at St. Luke’s because several of the system’s facilities are in remote and rural locations. The system spans 24,000 square miles and covers seven hospitals, and Chasin has 450 employees in IT that together manage 2.2 petabytes of data and 1,700 applications
each day.

In order to provide the highest level of care—even at its rural facilities—St. Luke’s leaders lobby state officials to ensure broadband is available so they can maintain contact and transfer digital records. Additionally, the hospital has developed a virtual ICU. In Boise, Idaho, technicians use bidirectional audio-video conferencing tools to monitor eighty beds around the state. Chasin has built the system with Philips technology and says implementation has led to a decrease in mortality rates and ICU length of stay.

Outside of IT, the hospital system has 16,000 employees, and outside physicians and clinicians use St. Luke’s facilities on a daily basis. That means Chasin has to navigate challenging device management and security issues in a highly regulated environment. With so many bodies and devices coming in and out, security is top of mind. Chasin and his team do quarterly phishing tests and mock drills to expose
vulnerabilities.

“Technology mirrors people and process. If you have poor processes, and you put tech over that, you’re just going to magnify the inefficient process.”

 To succeed in the environment, Chasin says he has to change the way his colleagues view IT. “We’re taking IT from a back-office department to a health-system resource,” he says. “We are strategic partners that help guide proper choices in best practices, technology, and standardization.” When he came to St. Luke’s, Chasin stepped in to improve employee engagement and to develop competencies and skills that enable the business. Then, he empowered his IT professionals to lead and partner with their assigned stakeholders. Now, those stakeholders bring IT into strategic conversations much earlier. In addition to leading a switch to a system with software creator Epic, IT is implementing an EHR over the entire system. “We’re on a mission to inspire and educate,” Chasin says.

The EHR transition will help St. Luke’s transition from volume to value and become more able to facilitate the next stage in using data to improve overall care. In his implementation of the EHR, Chasin says he’s toiled to make the system as automated and simple as possible. “Clinicians are too often regulated to documentation and hitting the right radio button on a device instead of looking at their patient and building the right face-to-face relationship,” he says. “We’ve tried to remedy that.”

With his early change management lesson in mind, Chasin looks to communicate his strategy as much as possible. “I know what’s critical for a clinician and what’s not,” he says. “I can drive the appropriate
resources to the right place, and when clinicians raise issues, I understand where they’re coming from. I speak both languages, from the clinical to the IT.”

For Chasin, the key to being an effective CIO lies in constant communication. Dialogue is especially important as changes in health care continue. The deadline for ICD-10 (the World Health Organization’s code revision) implementation is coming in October, bringing fundamental changes to how employees code and document. The St. Luke’s IT team has upgraded all technology accordingly and has handed the task to business professionals who must develop their processes to use the technology. “Technology mirrors people and process,” Chasin says. “If you have poor processes, and you put tech over that, you’re just going to magnify the inefficient process.” IT is now working to teach doctors how to document appropriately so coders can capture the proper ICD-10 codes.

In the era of Epic, ICD-10, and meaningful use, health-care IT is more important than ever. For a health system to thrive and serve its population in a meaningful way, physicians and stakeholders must get the most out of technology. At St. Luke’s, Chasin is making sure his team has a seat at the table to help the system realize its vision.