What it Takes to Be a Change Leader: A Conversation with CIO of the Year Ed Kopetsky

Earlier this month, two leading health IT trade associations—the College of Healthcare Information Management Executives (CHIME) and the Healthcare Information and Management Systems Society (HIMSS)—named Ed Kopetsky, CIO of Lucile Packard Children’s Hospital Stanford and Stanford Children’s Health, the 2018 John E. Gall Jr. CIO of the Year award winner.

The award is given annually to a healthcare CIO who has shown significant leadership and commitment to the industry during his or her career. Kopetsky’s career has spanned the sector, from CIO of three prominent healthcare systems to partner in a consulting firm specializing in healthcare IT and process improvement. He joined Stanford Children’s as CIO in 2009, and under his leadership, Stanford Children’s received an array of health IT achievements: the HIMSS Stage 7 Acute Care and Ambulatory Awards; Most Wired recognition from 2015 to the present; honors for having one of the best healthcare IT departments in 2016; and the international HIMSS Davies Award in 2017 for improving patient outcomes and care processes using health IT and analytics.

Kopetsky recently spoke with Healthcare Informatics Managing Editor Rajiv Leventhal to discuss what the award means to him, the keys to his successful CIO leadership, and what’s top-of-mind for healthcare CIOs these days. Below are excerpts from that interview.

First of all, congratulations on this excellent achievement. What does winning this award mean to you as a healthcare IT leader?

I knew I had been nominated and it was a wonderful thing to hear [that I won], but first and foremost, I felt that it was a win for the team I work with here and [a testament] to all our accomplishments. I have been at [Stanford Children's Health] for 10 years and we are a very high-end, quaternary medical center for children, and now we are [moving] out to the community. We have built up a health system, and we want to advance medicine and science for children worldwide. I believe we are doing that here—that’s what this award says.

We have only been a health system for four or five years, and our whole information systems [IS] department has made that happen with patient data, analytics, and using that to improve patient outcomes. It’s a huge honor to get the CIO of the Year Award; it reflects long-term commitment across different venues.

You have been involved in some great health IT accomplishments over the years, spanning across multiple health systems. At Stanford Children's Health, what IT project or projects are you most proud of?

Everything we have done since I got here has really been “leading edge” in every space we went into. First, it was securing our business systems; and that precedes our EHR [electronic health record] conversion and becoming a health system. In just four months, we converted the entire enterprise, both inpatient and ambulatory, in 2014. Just a year later, we were acknowledged with HIMSS Stage 7 [recognition], but we also launched analytics in an academic research teaching environment. That’s a big part of what we do here, and it’s really integrated. We work as partners with the CMIO and the clinical informatics department. You need the analytics—finding the best outcomes and applying that to new approaches.

The best award is probably the HIMSS Davies Award that we won [in 2017], which was the [culmination] of using the EHR and [leveraging] analytics to improve outcomes. And the highlight of all this is that last year we opened a new hospital, which is the highest-acuity children’s hospital in the U.S. We’re very high on technology, and biomedical technology is also integrated and is part of the IS program here. We have enabled our innovation to become preeminent.

We also are an adopter of Lean [management], which I helped the organization launch before applying it. It has been a tremendous shift in culture; we changed the name from IT [information technology] to IS, to emphasize that we are here for patient care. We have this great deployment of Lean culture, and we have service leaders for every major area of our enterprise. I believe I have one of the best IS leadership teams in the U.S. They are “CIO-ready.” The team that I helped build here and that I am part of is what it’s all about—building the next generation of leaders. We have hit the pinnacle.

Can you talk about some of the specific challenges you have encountered with pediatric health IT?

Well, in California, there are privacy rules that prevent parents from seeing adolescent records after the age of 13, so that’s unique. For our high-end inpatient clinical care and for all children’s care, we have different medication management and oncology protocols. With medication management, for instance, our whole systems have to be engineered for weight-based dosing, and that’s not the case for adults.

We are expanding our digital health strategy, and we are trying to involve leading-edge technologies and extension access where we can continuously connect to patients as needed without long-term travel and waiting rooms. Our high-end specialists are very limited in number in the U.S., so an improved digital and virtual care [environment] is where we [want to go].

We did 1,000 virtual video visits last year, which was the first year of our launch. But also for in the home, we have implemented two [apps], which are in the Apple Store: one for glucose monitoring of Type 1 diabetes for children, and another for congenital heart patients, [the latter in which] those patients might need three surgeries over a [shorter] period of time, and we are now getting data so we can see when [care] is needed ahead of time.

As a healthcare CIO in this current environment, what are a few core issues that you are grappling with on a day-to-day basis?

In our environment, and this is true across the U.S., we are challenged with talent, development, and retention—attracting employees to say that this is a great place to be at. That’s a primary role I have and if I fail, it puts everything else at risk, such as leadership, trusted relationships with other organizations, clinicians, executives, and other partners.

I was interviewed after our [EHR conversion] go-live and when asked what the [experience] was like, I said, “Imagine changing the engine on the plane when you are in-flight.” We didn’t shut our hospital down [during the conversion]. Many patients here are at the ICU level, which means you have to be so accurate and reliable to pull this [project] off. And that type of [pressure] is there almost every day, since everything is now so dependent on these systems.

As a CIO for so many years, in the last five years, security has also become a top priority. It is really unfortunate and it’s a tough issue when you are constantly under siege and under attack. Email spam is a great example; it’s a huge problem and you have to hire the best people and be ahead of it. Within CHIME, we started a CISO group to share best practices and exchange knowledge.  As we expand virtual care and digital health [capabilities], and as we go outside our own firewalls and networks, this security issue has to be addressed.

What advice can you offer your CIO colleagues as they continue to navigate the new healthcare?

First and foremost, you have to assume that you are one of the top executives in the company. When these hard issues come up such as physician efficiency, or interoperability that gets stymied, as we got so focused on automating EHRs over the years, fundamentally, it comes down to being a partner with the enterprise. And whether that’s the board, executive management, or the doctors themselves, you need a trusted partner.

The whole is bigger than the parts. When you blend executives’ thoughts with clinicians’ thoughts, and the technology workflows, you can create new solutions and innovate. When it is just about putting in technical capabilities, it never works. I wouldn’t be here without the CMIO, the heads of our patient care systems, or our CTO, and their similar partnerships with their base of doctors, nurses, outpatient care [providers], etc. I could never do this work as just a technology department.  

So, I would ask my peers, are you positioned as “technology-only?” If so, you are at high risk. If you are really a change leader, it has to be about business change and clinical process change. And there is no way to do that alone. I have been here for a long time, and I know many CIOs who got into bad situations—either it wasn’t the right mix, or the organization wasn’t ready to take the next step to make [IT] a strategic asset. You need people to lead change and have partners along with them.