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Healthcare CIO talks innovation in the face of ever-changing regulations

For Arthur Harvey, the role of healthcare CIO is multifaceted, from traffic cop to innovator. He talks about challenges, tech trends and the criticality of governance in this Q&A.

Arthur Harvey's whole career has been health IT. Today, he leads initiatives and technology strategies as CIO at Boston Medical Center, a 567-bed academic healthcare organization.

As a healthcare CIO, Harvey said he believes taking the time to recognize the successes of his IT staff is critical in building a collaborative, innovative team. That kind of a team is necessary in finding the balance between innovation and compliance -- one of the challenges healthcare CIOs face in the midst of rapidly changing regulations.

In this Q&A, Harvey discusses the challenges of making innovative strides in IT, as well as what technologies he believes are valuable and those that aren't.

Editor's note: Responses have been edited for brevity and clarity.

What is the role of a healthcare CIO today?

Arthur Harvey: Primarily, the first thing is coach and leader. The most important thing in healthcare IT is people. They're hard to get, they're hard to train, and they need encouragement, because it tends to be -- not just in healthcare, but everywhere -- somewhat of a thankless task. You get noticed more when you screw up than when you do something right. So, it's building and motivating a team, helping them grow -- that's probably the most important part of the role.

Kind of unique to the CIO role is being a traffic cop. Everyone wants all kinds of cool stuff ... so you spend a lot of time saying, 'Wait a minute, I know the vendor said that, but it isn't true.' It's a lot of time doing that, a lot of time making sure that our work is aligned with the organization's priorities and not just what's the flavor du jour.

What are some of the biggest challenges healthcare CIOs face today?

Arthur Harvey, CIO, Boston Medical CenterArthur Harvey

Harvey: Increasing regulation and the pace of regulation. Change is good ... but the pace of [change] -- you can't keep up. We're spending more of our time complying with those requirements that don't generate innovation and new value and less time innovating.

When I started my career, it was all about blank, empty whiteboards ... and thinking up new and interesting things and how were we going to innovate and go forward. These days, it's more about what do regulations say we have to do this week. That's genuinely the challenge: How do you find time for innovation and to do the things that can actually make your institution better, rather than just compliant?

When you're looking to invest in a technology, what do you look for?

Harvey: Being a technologist by background, I love cool stuff. But the reality is, my job is more about weighing the cost and benefit of the technology we're looking to bring in. In many cases, there's a lot of benefit, but there's also high cost -- not just [financial], it's also risk. I'm approached roughly once every five minutes by a neat, new company that has the latest and greatest, cool, new technology -- a new customer-focused mobile app that's going to make everything great. Except it's going to cost me a ton of money to actually deploy it and integrate it into my highly complex environment and ensure the security of it.

BMC [Boston Medical Center] is a safety-net hospital. I always say that when you look at IT budgets, they're all about risk and functionality. I can give you functionality for a fixed amount of money, but then I've got to take on a lot of risk. In healthcare, we tend to not want any risk. I try and balance that risk and cost versus the benefit. We try and focus on making sure the technology we're providing benefits our core goals we're currently working on.

We're also looking at the real, legitimate problem that all organizations -- particularly ours -- have in vitality of our provider workforce, particularly primary care doctors who are really under the gun. So, what technologies can I use to make their lives better?

Sometimes, it's really simple. We just went and replaced all the printers in our ambulatory areas with better printers. It's not particularly cutting-edge, but it made the doctors' lives better, so it was worth doing. The fact is, when I look at, 'What do we do?' I have to make sure every dollar counts.

How do you introduce new technologies and initiatives at BMC?

The fact is, when I look at, 'What do we do?' I have to make sure every dollar counts.
Arthur HarveyCIO, Boston Medical Center

Harvey: We have to be judicious when we decide we want to be on the cutting edge. We have a governance process that determines what we're working on. If somebody has an idea, whether it's internal from IT or comes to us externally, they'll make a proposal. In the case of something like, 'Hey, I just got a sniff of this. Can you take a look at it?' we have a small amount of resources available to go out and take what I'll call sniff tests on what's out there.

When it gets to a more serious phase and we're thinking we'll do a project, we have a governance structure where a sponsoring part of the organization has a committee that evaluates the idea and makes proposals to IT. We then vet those proposals to have some concept of how big the project is and what types of resources are needed. Then, it goes to our portfolio management committee, which is largely IT. This group is about making the various proposals fit together. This committee evaluates what we can and can't do based on resources and infrastructure -- always with the overriding theme of, 'Does it provide value to one of our stated goals?'

Then, we provide a proposed slate of what we're going to work on for the next quarter. That goes to the IT governance committee, which I sit on as CIO. But it's comprised of hospital executives, and I'm the only IT person who gets a vote. The committee will approve the proposed slate or ask us for more information. IT doesn't control what we're working on, with the exception of certain infrastructure and security things. We do what the business wants us to do. Ultimately, the hospital executives decide what's important and what to do. That's the process for any project that occupies a significant amount of resources. 

What technologies and trends are you paying attention to now?

Harvey: To be fair, I'm pretty skeptical about most of this stuff, because most of the problems in healthcare don't need some super-duper technology to solve them. It isn't that technology can't help, but most of this is really business problems. There's a lot that I'm a little cynical about.

That being said, AI is an important technology whose time is coming. Currently, there are only a few practical applications, but I believe that will grow. Another is blockchain. I think that is the most overhyped thing in healthcare. Everybody makes it sound like it's going to revolutionize things, and, in my opinion, it's not. Although, there will be a few special cases where it's helpful.

From a technology perspective, connected devices ... and the remote use of technology in patients' homes or other settings, I think there's a ton of value there, and I think that's a technology mature enough that it can be put in healthcare and can be successful.

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