Beyond Technology
Baystate CIO Joel Vengco Says His Job Requires Wearing Many Hats
Joel Vengco says healthcare IT now involves much more than technology. Increasingly, the focus is on taking data and transforming it into information — and then knowledge.
And he started with some subtle humor.
“There’s a lot more meetings to go to,” he said with a laugh, choosing that starting point to explain how and especially why this administrative position is now much more about information and operational strategy than it is about hardware and software.
“CIOs today are more strategic in nature; today, there’s so much reliance on technology and on information inside those technologies that the CIO has to be part of the strategic discussion and the envisionment of business as a whole,” he told BusinessWest. “And that’s a different skill set altogether. You really have to understand strategic development, you have to understand the business that you’re in, and you have to understand finance.
“And you have to be more of a people person than I think CIOs were in the past,” he went on, adding quickly that he certainly wasn’t disparaging those who came before him, just referencing how times have changed. “Many of them would sort of hide out in the data center and focus on putting up a server. We’re now forced to be out there, talking to our partners and our users and really helping to lead the use of technology and information for competitive advantage or progression of the business.”
Elaborating, Vengco said the CIO must now wear a number of hats in addition to those that have been traditionally worn. Indeed, while the CIO is still tasked with keeping a health system running from a technology standpoint — what Vengco called “keeping the lights on,” a reference to everything from PCs to operating-room equipment — there is now much more to this job.
“In many ways, I wear an operating hat, a strategic hat, a finance hat, and sometimes I even wear a clinical hat, even though I’m not a clinician,” he said. “And then, you have to wear the innovation hat, because you can’t be stagnant and just look at the technology in front of you; you need to understand and begin to distill all the new technologies that are coming down the pike and correlate them with the current problems and the future state.”
With that mentality, Vengco was one of the key architects of the Baystate Innovation Center, what he described as a cross between an incubator and an accelerator that is taking shape at 1350 Main St. in downtown Springfield (more on that later).
But perhaps the most important line of the job description for today’s healthcare CIO, he said, may be enabling both a specific health system and the community it serves to make more and much better use of the vast amounts of data that modern technology allows people to collect.
Vengco, who came to Baystate in 2012 after work with GE Healthcare, has spent much of his career focusing on information and analytics, or what he called “liberating data,” and transforming it first into information and then knowledge.
“Data is the raw content of systems; it’s the diamond in the rough,” he explained. “You really have to transform it, or massage it, in layman’s terms, to really come up with information from that data. and then, from that information, you can develop knowledge through the delivery of an architecture that really takes that information and makes it actionable for people.
“If you put most of the raw data we have into a computer or an algorithm, it wouldn’t be able to compute anything out of it. In isolation, it may not necessarily make much sense; it’s just data, not information,” he went on. “But once you put it into context, like if you took a lab value and put it in the context of a disease state, or, better yet, you aggregated all of those labs and correlated it with a specific chronic disease state for a cohort of patients, then you have information about diabetes or information about congestive heart failure.”
For this issue, BusinessWest talked at length with Vengco about the evolving and expanding role of the CIO — and about all those hats he and others who take that title are now wearing.
Technically Speaking
Vengco told BusinessWest that, since childhood, he’s been drawn to the healthcare field, and that he attended medical school to essentially appease his parents and become a doctor. But his career path took an abrupt turn during his second year there.
“I was transitioning into my Ph.D. years, and one of my thesis advisors had suggested that I look at doing some work with a health information technology firm, which back then [2001] was pretty novel,” he explained, noting that the firm in question was Boston-based Eclipsys. “The idea was to develop a national data warehouse where I could develop algorithms for disease progression, outcome measurement, develop new clinical decision-support rules in analytics — a lot of the things we’re talking about now in terms of big data, but perhaps it could be done in this corporation.”
He took on that challenge, and in the course of doing so discovered that there was a considerable challenge behind utilizing the data collected by health systems because it was largely unusable, and not “liberated,” a term he would use early and often to describe this phenomenon.
In short order, finding ways to make such data more usable became his career passion.
He left medical school and entered the field of informatics and analytics. He interned at Partners Health Care and later taught at Harvard before landing at Boston Medical Center for his first IT operations job.
“It was at that time that I started to see the value of understanding technology in the context of a journey toward really understanding information,” he noted. “Because, ultimately, my real interest here was to try to figure out how to utilize this information so we could develop new knowledge and new insights. Technology changes so rapidly, but what is a mainstay and the most important element for me is information that we can gather from these systems. It’s like DNA for the human body; this information is the DNA for coordinating and developing quality care for the future.”
From Boston Medical Center, he went to GE Healthcare, where he became vice president of a global business called eHealth, a job he took to better understand what people in other countries were doing in the emerging field of population health.
He took part in projects in the U.K., France, Australia, Canada, and other countries — many of them involving health-information exchanges, care-management systems, collaboration systems, mobile health platforms, and population-health analytics — and took some valuable lessons back to the U.S.
Vengco said he wasn’t looking to leave GE, but always harbored a desire to return to the setting of the health system CIO, preferably in Boston, and in early 2012, Baystate was advertising for one.
“I hadn’t really thought about Springfield or Baystate — I knew of it, but didn’t really know the culture and the footprint of the community,” he said. “When I was recruited to take the interview, I came out here to see what it was about, not really looking to make an adjustment or a move. But I was really surprised with the vision Baystate had and the leadership it had.”
What’s more, he toured the region and came away with the impression that it would be an ideal setting for the innovation center that is now becoming reality.
“I enjoyed my discussions with Baystate, and was deeply moved by the mission they had for the community and healthcare in general,” he said. “It really matches my vision and my hopes — that healthcare needs to be more patient-centered.”
Making IT Happen
Vengco said the work of the IT Department at Baystate has four main pillars:
• Optimization, or making the most of the technology systems that exist today;
• Community engagement, or community collaboration, a realm that includes an initiative known as the Pioneer Valley Information Exchange (PVIX), which essentially creates a single patient record that optimizes the care delivery of all transitions of care across the continuum;
• Analytics, or the liberation of data; and
• An innovation platform, perhaps best represented by the innovation center.
Focusing on all four, plus that aforementioned work to keep the lights on, has become a considerable challenge, said Vengco, noting that he and his staff of roughly 230 are inspired by the breadth and depth of that challenge.
“You really are thinking well beyond the technology that you have to install,” he noted. “It’s an exciting time, but it’s also very daunting; I feel the enormity of the task, and so does my staff.”
And with that, he returned to his thoughts about how IT now extends into the realm of information — both gathering it and liberating it.
“The historic design of the EHRs (electronic health record systems) in the past and somewhat current state is that they take in data, but they don’t necessarily spit it out easily,” he explained. “And data loses its value if you don’t have the ability to liberate it and use it for the delivery of care. And that has been my mission since I started this journey back in 2001.
“There’s so much to be gleaned and to be achieved through the data we have locked in our systems,” he went on. “That’s why liberating that data is the first mission we should all have, because once we have that information in hand, it becomes knowledge and actionable delivery of care.”
Many of the Baystate IT Department’s initiatives have come together in the creation and operation of the PVIX, said Vengco, adding that the broad aim is to create a single patient record that can be used by a host of area care providers.
“Patients are very mobile; they’ll see a specialist, see a primary-care provider, visit the hospital … and those care organizations may not be affiliated with each other and so may not be on the same electronic medical record system,” he explained. “So when a patient goes in for his next visit and the provider wants to see all the meds they’re on and all the allergies they may have, they may not see all that comprehensive data because it may be in other systems dispersed across the community.
“So, today, we have to hope that a patient knows all the meds they take and all the allergies they have, or that the medical group down the street that they just visited will fax that information,” he went on. “But that doesn’t happen consistently, so you wind up treating patients with the information you have, and it might not be enough.”
The PVIX was created to solve that problem, he went on, by creating a comprehensive record that essentially follows the patient.
Founding members of the exchange include Baystate, Mercy Medical Center, Health New England, Riverbend Medical Group, Berkshire Health Systems, Holyoke Medical Center, and many others, said Vengco, adding that some of the challenges moving forward are convincing patients that their information is secure and also convincing providers that sharing such information is the right thing to do at this critical juncture for the healthcare industry.
“There’s still an uncertainty among organizations that care for patients about whether they should be sharing that data with other collaborating providers,” he explained. “And some of that stems from the notion that this data is competitively advantageous — that, if I share this data, you might know enough about me and my market to steal my patients.
“That’s just not where we need to be to care for our patients in the appropriate way,” he continued. “We have to be able to say, ‘for the betterment of patient care, quality of care, and efficient care delivery, we need to be able to exchange this information.’”
Center of Attention
Putting on that aforementioned innovation hat, Vengco stressed the importance of not simply understanding and maintaining the technology of today, but also anticipating the technology of tomorrow and being at the forefront of its development.
This was the impetus for the Baystate Innovation Center, which is still under construction but is in many ways already operating at One Financial Plaza in downtown Springfield.
“We need to make a mind road map, if you will, of what technology needs to look like in the future for your business,” he explained, noting that the innovation center was created, with the help of a $5.5 million state grant, to focus on solving the problems of healthcare today through technology and informatics.
The center’s creation — not to mention its location — brings another layer to a growing regional emphasis on entreprenurship, technology, and economic development, said Vengco, noting that, within a few blocks of each other, the innovation center, Valley Venture Mentors, and Tech Foundry, a facility dedicated to training individuals for careers in IT, are creating enormous momentum for new technology startups and getting established companies to the next stage.
“For those of us in healthcare, the rapid change that has come as a result of reform and the need to change healthcare delivery requires us to continue to innovate,” he said. “And for Baystate, this is an extension of our mission because it enables us to continue to look forward to doing the best that we possibly can to deliver the best possible care to the community through these innovations, while still maintaining our current operations.”
Elaborating, Vengco said innovation center administrators are looking for ventures that are in what he called the “last mile of development.”
“They come in with a solution already in hand, but it really needs a few more tweaks here and there, and that’s where we really come into play,” he noted. “We provide that innovator with the necessary adjustments and development advisement to get them to a usable product or solution.”
And these products and solutions are carefully chosen to meet the objectives of the health system, he noted, adding that organizers are not necessarily looking for the next Google.
“The intention here is to make sure we’re bringing in solutions that will address system objectives,” he told BusinessWest, adding that these include improving quality of care, patient progress, high-value care, and bending the cost curve. “We’re looking for technology that’s relevant to the problems we’re trying to solve. It’s not about making money; it’s about delivering an innovation that’s going to help us achieve our mission in an optimal way.”
He went on to say that he considers Baystate to be a model health system in a model state — Massachusetts is generally considered to be on or well ahead of the curve when it comes to innovations in healthcare — and that the Baystate system, by implementing products and concepts developed at the innovation center, could become an important proving ground moving forward.
“As you look at all of these other organizations, these integrated delivery systems that are being built or are already in place, they’re aspiring to be what I believe Baystate is already beginning to become,” he explained. “And we’re in a state that in many ways is one and a half to two years advanced in terms of policy and reform, and that becomes very attractive for developing solutions when you’re looking at ways to impact care delivery across the country. If you can do it here, it’s likely that it’s going to be impactful elsewhere; it’s a really great environment to do that kind of innovation.”
For the Record
Summing up his thoughts on health IT and where it’s headed, Vengco said it is going to play an increasingly vital role in the delivery of patient care and overall population health.
And carrying out the many and diverse aspects of his department’s mission will become ever more challenging as it extends well beyond technology and optimizing all that it brings to the table.
“My responsibility is to try to engage our leadership and our strategy so we can focus the use of technology and information,” he explained. “That’s the challenge; everyone wants the next technology, but we have to make sure we’re selecting it strategically and that it continues to support our mission.”
George O’Brien can be reached at [email protected]
