Gabriel Perna | August 26, 2020
In the middle of a pandemic, Marc Probst, longtime CIO at Intermountain Healthcare in Salt Lake City, Utah, quietly retired from his role leading the system’s IT operations
“I’d been the CIO at Intermountain for a long time and it was time to let some new blood take a stab at it. And I wanted to give myself a shot at new opportunities. The industry has changed a lot and I’m a believer that you need to honest with yourself and what skills you can bring to an institution. I thought it was time for someone who can bring new skills to Intermountain,” Probst said in an interview with Health Evolution.
Over the course of his career, Probst oversaw the development of the health system’s powerful digital health infrastructure, including the creation of its virtual hospital and various specialty telehealth programs. Probst, who won the HIMSS CIO of the Year earlier this year, joined ELLKAY, a company that offers interoperability solutions, as its new CIO in August.
Health Evolution spoke with Probst about how COVID disrupted innovation in the industry and opened up the siloes between IT and operations, why true interoperability is still far off from reality, and why CEOs should continue investing in information technology while their budgets have been tightened in 2020.
Health Evolution: You were at Intermountain for 30 years. Now you’re working for a health IT company. What’s the biggest change you’ve had to get used to?
Marc Probst: The scale for one thing. ELLKAY is a little bit smaller. My team is a little bit smaller. I had about 1,100 people on my team at Intermountain. I’m not sure I have anyone working for me at ELLKAY. The big difference is scale and how we’re helping. We’re not dealing with the day-to-day issues that providers deal with. It’s a difference in complexity. I’m not getting texts at 3 a.m. that some system is down, or some interface is down, or that we have a central security breach. These are the things that go with a huge job like the CIO of Intermountain. Instead, I’m getting to deal with a lot more people in the industry, discussing what they need from us and I enjoy that a lot.
Health Evolution: How has COVID disrupted innovation in health care?
Probst: A burning platform gets people’s attention. COVID is the perfect example of a burning platform, and that’s been the case for our whole country and certainly our industry. This wasn’t an industry where you could stop everything and shift everything we were doing into the home. We could shift a lot of it to the home. You could connect physicians to telehealth, but you still had to take care of people in a care setting. People get hospitalized, they go to an ICU. Like grocery stores need people to stock shelves, health care can’t have everyone work at home.
But this burning platform was so multidimensional. Intermountain sent 30,000 people to work at home in five days. We had people working virtually. That created innovation and ideas. Although the innovation is kind of a scattered innovation, not a well thought out innovation. But still, we did it. We innovated quickly. We decided as an industry we needed to adopt digital health. Before COVID, it was like the Jetsons, we were going to get there eventually but no one was investing significantly in it except for a few. But everyone got on board after COVID because it was the only way to connect with our patients. It’s the only way to do contact tracing or have patients stay in their cars before an appointment. This all happened because of that burning platform. It created opportunities and it also created a bit of a mess that we’ll be cleaning up for years.
Health Evolution: What have been the biggest lessons CEOs should understand about innovation from the past few months?
Probst: It was the almost immediate closing of the ranks between operations and IT, they were no longer operating in a silo, they were thrown into the same bucket. They had to work together quickly and make decisions together quickly. The 18 month-cycle needed for an integration—those days are over. We needed these technologies now. Operations people were saying, “We trust you IT people, this is what we need, go take care of it.” A lot of the things that created drag in innovation went away. We were able to work closely to innovate. The lesson is don’t go backward. When we get out of COVID, let’s keep that. I think if we do that, we’ll see continued innovation.
Health Evolution: What advice would you offer to CEOs to sustain innovation post-pandemic?
Probst: There’s no guarantee. To me, the stars are aligning in a way that it won’t go back. All the innovation and the things we’ve done and continue to do through COVID have been terrific. But if you start looking at the bottom line of health systems and hospitals in our industry, they’re getting hammered. That alone is going to create an imperative for organizations to focus on the problem together versus in the fragmented nature that we were pre-COVID.
Health Evolution: Interoperability is a holy grail for health care and you have personally been involved in efforts at the federal level. What developments make you think it’s within reach?
Probst: There’s a lot of work to do. I’m not even sure we are currently within reach. Are we on a trajectory that’s much better? Yeah. We’ve got awareness. We’ve got lots of people using the word. Standards are no longer a four-letter word. They are something people understand we need to have in place to achieve interoperability. There are good things happening. FHIR (Fast Healthcare Interoperability Resources) is a nice standard. It doesn’t achieve semantic interoperability, but it drives us toward the discussion where we can find commonality to achieve semantic interoperability.
FHIR is a big step. The federal government is doing a fair amount of work around patient ID. Five years ago, I’d go to Washington D.C. and that was a non-starter. Now it’s being brought up as something that’s important. It will take some work to get us over the end zone, but again we’re on the right trajectory. To get semantic interoperability, it’s going to take a national, and ultimately international, effort and focus. Early on, people saw it as a technical problem. But they didn’t see the benefits from a financial or a lifesaving perspective. And now the industry overall, the people in federal government, are seeing it has those benefits.
Health Evolution: We’ve seen the innovation acceleration in 2020 and also know that there is a lot of work still to do. Why do CEOs need to keep investing in IT, particularly when their budgets have been tightened by the pandemic?
Probst: It’s become pretty apparent how much more efficient we can be by using some of the tools we’ve deployed during COVID. We’ve been talking about telehealth for five years and it’s had very slow uptake, pre-COVID and then an immediate boom when COVID hit. We’re not going to keep using telemedicine with everybody. But people are learning the kinds of interactions that are perfect for telehealth. They’re leaning which interactions are better for the patient and better for providers. We can stick with those and continue to innovate.
We all knew we had inefficiencies in health care, the problem was getting everyone on the same page about how to solve that. Now that we’ve seen we can do that, health care will continue to innovate. It’s not like the problems didn’t financially exist before, we were just making money and were charging way too much. Our patients couldn’t afford to use it. We had some pressure around costs. Now we’re seeing there are pretty creative ways to use technology to [solve that problem]. Anyone that doesn’t continue to innovate around the right technologies, will get acquired, merge or go away. It’s the only way we’re going to be able to do the work in the long run. The long run being 10 years.