James Brady, PhD, CHCIO, Chief Information Officer Los Angeles County Department of Health Services
The healthcare sector has been established on the prime principle of providing high-quality, convenient care to patients at cost-effective rates. As the CIO at the Los Angeles County Department of Health Services (LA County DHS), my role is to bolster the quality of healthcare with the efficient use of technology. LA County DHS is an integrated system of providers, clinics, and hospitals striving to facilitate the right care to the right person, at the right place, and at the right time. As the second largest public hospital system in the nation and a safety net health system, we offer care to over 600,000 unique patients, including youth in the juvenile justice system, inmates in county jails, and children foster care, many of whommay lack the ability to pay for their healthcare.
Delivering Cost-Effective Healthcare
Digital transformation is one of our primary initiatives at the LA County DHS, as we seek to facilitate robust digital services at scale. This is being done by leveraging our system-wide Electronic Health Record (EHR). Providing digital capabilities to our clinicians and patients has the promise of improving the timeliness and quality of care. Technology is turning out to be a major game-changer in the healthcare industry. For example, the shift from face-to-face consultation to virtual visits and video conferencing is enabling doctors and clinicians to provide timely care to their patients. Our initiatives also focus on equipping doctors and nurses with clinical and administrative technologies to conduct secure and seamless communications as per the requirements of HIPAA.
Leveraging Cloud to Facilitate Remote Access
One of the prominent challenges in the healthcare sector is data security. The regulations mandated by federal agencies such as the HIPAA make it imperative to protect the health information of patients with the latest security measures. Of equal importance is understanding that the healthcare industry is the primary for cybersecurity threats, ransomware, and data breaches. Not only are we mindful to maintain the privacy and security of our patients’ data, but these emerging cyber threats, particularly thru the increasing numbers of networked medical devices, are causing increased risk to hospital operations and patient safety concerns. Despite the risks involved, more and more healthcare systems are moving their clinical applications and protected health information (PHI) to the cloud. The vendors of EHRs are collaborating with large cloud providers such as AWS, Google, and Microsoft to remote host their EHR data. Healthcare organizations, as well as the vendors, are increasing the focus on data security, thus, alleviating the uneasiness surrounding data breaches.
The regulations mandated by federal agencies such as the HIPAA make it imperative to protect the health information of patients with the latest security measures
The emergence of EHRs has also paved the way for very large amounts ofpatient data in healthcare organizations. With the growth and maturity of artificial intelligence, machine learning, predictive analytics, prescriptive analytics, and genomics, healthcare organizations can now use these data to perform analytics and clinical decision support in new and exciting ways. Because the cloud can provide highly scalable and elastic compute and storage, what was previously not possible or cost effective is now a reality. Cloud providers are partnering with healthcare systems to improve the quality and timeliness of care.
Overcoming the Roadblock of Interoperability
Interoperability is another major challenge in healthcare. Typically, patients have their medical record information stored within their healthcare provider’s EHR and full access to their data is only available from at that health system. If a patient is traveling and presents at another health system’s facility, allowing the clinicians at this facility to see the full longitudinal medical record of the patient can be challenging due to the lack of efficient data exchange capabilities between health systems. Health Information Exchange (HIE) capabilities exist today, but typically only a limited amount of patient data is exchanged. The promising news is that increased regulatory pressure is occurring to help ensure patient data is accessible to all health systems and patients.
Healthcare Should Evolve with Technology
My role as a CIO is evolving with the technological transformation in the healthcare landscape. My primary role is to peer with the executive team and partner with them to help them accomplish their business goals using technology. Along with the increased adoption of cloud, the healthcare industry is experiencing a rise in the use of artificial intelligence (AI) and machine learning (ML). The emerging technologies are empowering healthcare providers to predict and diagnose medical conditions with greater levels of accuracy.
I believe AI and ML can bolster the capabilities of healthcare organizations by harnessing the vast amounts of data, and by performing analysis to derive high value insights. However, there is a need to continue tooptimize and enhance the EHR platform so that it empowers clinicians to do their work more efficiently and with greater insight. Many doctors continue to be challenged with the increased data entry responsibilities on their end now that EHRs have been deployed pervasively.
With increasing numbers of patients and consumers accessing medical information on the Internet, and taking ownership of their own health,the role of doctors in healthcare may soon become more consultative. Patients are more informed when it comes to making healthcare choices today. Because many patients struggle with chronic illnesses and mental health challenges, there is an increased focus on treating the whole person by considering the social determinants of health. This requires both care givers and patients to be more engaged with each other beyond the traditionally brief periods of time experienced with clinic or hospital visits. By striving to empower patients to better manage their own health and care by applying technology advances and new capabilities, healthcare organizations will deliver increased value and experience significantly improved outcomes.
James is the Chief Information Officer for the Los Angeles County Department of Health Services (DHS), the second largest municipal health system in the nation with an integrated system of 19 health centers and four hospitals. DHS annually cares for about 600,000 unique patients, employs over 26,000 staff, and has an annual operating budget of $4.3 billion. James was previously the CIO at Kaiser Permanente Orange County, and the CTO and CISO at Hawaii Health Systems. James holds 7 security certifications, and a PhD from the Nova Southeastern University Graduate School of Computer and Information Sciences.