One-on-One with Intermountain Healthcare CIO Marc Probst at HIMSS19

Marc Probst has been the CIO of the Salt Lake City, Utah-based Intermountain Healthcare since 2003, and in that time he has been to his fair share of HIMSS conferences, investigating new technologies while also taking sharp notice of how the health IT policy landscape has changed over the years.

This year at HIMSS19 in Orlando, proposed regulations from CMS (the Centers of Medicare & Medicaid Services) and ONC (Office of the National Coordinator for Health IT) have dominated the show discussion. In fact, each HIMSS conference seems to take more and more of a federal policy theme.

At the show this week, Probst, the CIO of the 23-hospital Intermountain Healthcare system, discussed the implications of these proposals, how much information blocking is actually occurring in the real world, while also remarking on the new innovations that are catching his eye. Below are excerpts of the discussion between Probst and Healthcare Innovation.

From a CIO perspective, are you more in support of, or concerned with the proposed rules’ implications?

Anything that encourages data sharing is positive. Anything that helps us move toward the greater use of some of the standards out there is a positive. I’m not a huge believer in data blocking, but the way it’s getting defined now, there is some reality to it. It’s just very complex to share data between different systems. So I am bullish, but I am also always skeptical until we deliver on some of the promise of these rules.

When you say you are not a big believer in information blocking, you mean…?

I’m not a big believer that vendors are intentionally trying not to share data. I do believe there are difficulties in their systems that makes [data sharing] very hard to do, and maybe they’re not as willing to invest all the resources and time that it might take to free up some of that data.

But now with these regulations, they will have to do that, right?

That’s right.

On the provider side, do you see data blocking? Are hospitals withholding patient data for competition purposes? 

I have never seen it happen on the provider side, but I am not naïve enough to believe that it doesn’t happen at all.

The Utah Health Information Network (UHIN) has been a data sharing organization across Utah, and when I got involved with them, working with Jim Turnbull, [CIO] of the University of Utah Health, we both stated that we will not compete on people’s data. There are other ways you can compete—on quality, cost, and access. But we will not hold people’s data hostage to try to compete and hold onto the patient. That has been healthy for both organizations and has set the environment to make data accessible.

The HIMSS platform affords the feds a huge platform to get their message across, and we have seen them take advantage of this in recent years with the MyHealthEData campaign and other initiatives. This year, the proposed regulations take things to a different level in terms of requirements and consequences, don’t you think?

There’s more teeth to it now, but having not studied the rules yes, we will see how they’ll accomplish what the rules are asking for. That’s where my skepticism comes in. There isn’t a single [universal] solution out there. I think we will solve part of the problem, but not the whole problem. As people start to adopt standards like FHIR, opportunities will open up. And the rule certainly encourages that. But I would love us to move quicker.

The health IT community is very much in support of FHIR-based APIs, right?

We have been a proponent of FHIR before FHIR was FHIR. We see it as a positive.

What technologies and innovations are you super excited about this year?

I am super excited about AI [artificial intelligence] and the potential of it. It’s kind of all over the place; it took a certain level of processing and capability that IBM pushed the bounds of when they pushed forward with Watson. That got us the base of technology to build on.

All the technology is in the algorithms; Google, Microsoft, and others have the technology, and these algorithms being built are making it interesting. We are using AI in some limited capability and are really pushing to advance it. I think it has real potential for the industry—an industry that does not have as much discrete data as we would like. All the NLP [natural language processing] capability that is driving AI is really attractive and it will have an impact on healthcare.

How do you feel about blockchain?

If I had $1 million to invest, I would put $300,000 of it into blockchain technology. But do I think it would pay off this year? I do not, particularly in healthcare. But it has a lot of potential.

Intermountain has been moving the needle on virtual care. What are the latest advancements in this area?

Credit our clinicians who are interested in doing it. It’s not so much me as a CIO; we just have to support it. Intermountain is having a lot of success increasing the capability of all our hospitals through virtual care. So, with our neonatal ICU capability, you don’t have to come to Intermountain Primary Children's Hospital anymore for a lot of those cases because we are able to do it virtually. And that is using all different kinds of visual and computer-based technology.

We have been on the front edge of doing that, and it has paid off for us and our patients. We are a huge state with lots of rural areas but from a population standpoint, there are only 3.5 million people. So you generally can’t get that intensity of care out there, but with virtual care, you can. We have a virtual hospital [launched last year] and this isn’t IT pushing something into the organization. This is us working together to come up with a solution. 

What’s most pressing on your CIO mind as we sit here today at HIMSS? What keeps you up at night?

Blocking and tackling; having your EHR available 24/7, 365 days a year. And that’s for every single organization, not just us. Security is a big deal. I think about how to lower the cost, as healthcare costs continue to creep up year to year. What can we do to lower costs? How can we better leverage the cloud?

From a leadership perspective, what advice can you give to fellow CIOs, some of whom might not be in as evolved organizations as yours?

I work for an organization that is sophisticated and likes technology, and you need to continue to push the [limits] on that. My advice for those not as evolved would be to stick with it. Always provide reliable, secure, and fast information systems. The core of what we do isn’t changing. We have pushed innovation; now, we have to push the boundaries on what [more] we can do.