Re-tool Wisely!

Gregory R. Wolf, CIO, UMass Medical School

For hundreds of years, medical schools have educated doctors, nurses, biomedical researchers and health professionals in time honored traditions. Today, medical schools form the nucleus of Academic Medical Centers where clinicians, faculty, students and scientists combine efforts to expand knowledge toward the ultimate goal of providing the most comprehensive, innovative and highest-quality patient care. The University of Massachusetts Medical School (UMMS), in Worcester, Massachusetts, along with its primary clinical partner, UMass Memorial Medical Center, is the premiere academic medical center in central Massachusetts. 

“When administrative systems called out for expensive upgrades, we re-organized the Academic Computing group to focus more on instructional technologists” 

When I joined UMass three years ago, it was clear the IT department was not well positioned to support the impressive biomedical research and education powerhouse within the medical school. The school’s technology needs had far outpaced existing IT solutions. Huge genomic data sets clogged the networks. Sophisticated research algorithms required more processing power than our cluster could provide. The explosion of electronic patient records opened up tremendous opportunities, but access to data was limited. What was a CIO to do? 

The first challenge was to figure out how to re-tool the IT department itself. We made an important decision that we would not try to “float all boats” by investing across the board in every possible way. Instead, we set out to build technology ecosystems tailored to the distinct needs of three areas: academics, research and health services. Each of our technology ecosystems would differentiate UMMS from other institutions. Students would become the best physicians possible, due in part to easy access to course material, as well as powerful tools for collaborating. Researchers would accelerate discovery through simpler access to more data, and be able to run more sophisticated analytical tools. Health service professionals would provide more valuable services to a wider variety of patients. 

So if we re-tooled IT to achieve these specific goals, we’d have to make tough choices on what skills to focus on.  At times, our decisions felt counter intuitive. When storage demands taxed our infrastructure team, we hired people with scientific backgrounds. When desktop security concerns escalated, we moved to a more open Bring Your Own Device (BYOD) model. When web designers were in high demand, we trained people in digital marketing. The reasons were simple. IT’s budget could never truly keep up with the demand. Adding gobs of traditional storage without understanding how scientists needed to use it was far less valuable than tailoring a solution for the research ecosystem. When administrative systems called out for expensive upgrades, we re-organized the Academic Computing group to focus more on instructional technologists. 

The upside to specializing the skills within IT has been astounding! Because our web team now is adept at the arts of digital marketing, our phone rings off the hook.  We’ve worked hand-in-hand with the Radiology department to expand its residency program; helped to build a global following for UMMS’ world class Vitiligo research; assisted the Business Development office in a radical expansion of industry partnership. Our data management skills now provide researchers with the key ingredient needed to aggregate clinical and research data. 

I kept three quotes in mind as we gradually re-tooled the IT department over the past three years: 

“Perfect is the enemy of good” 

IT can never implement perfect infrastructures or perfect applications. Don’t invest in having multiple team members with the same skills if you can avoid it. Differentiate. Leverage Cloud services as much as possible to avoid tooling your team with commodity skills. If demand for a resource like storage spikes, you can always leverage the Cloud or partners for elastic capacity. Focus in-house technical skills on unique areas (like how to aggregate genomic and clinical data). 

“One for all and all for one!” 

This model only works if there is a LOT of trust between IT and its constituents. Cooperation between the various IT teams is essential as well. At UMMS, we work hard to set IT priorities directly in partnership with our constituents. To ensure honest feedback, we have “eggs and tomatoes” meetings in which constituents sit on one side of the table, IT folks on the other, and an imaginary basket of eggs and tomatoes in the middle of the table. We ask our constituents to let the eggs and tomatoes fly! Two rules govern these meetings: no one from IT can offer solutions in the room (it’s awfully tempting at times); and IT follows up on all comments. Some issues are resolved quickly. Some new projects are established. And gaps are identified, which make their way to a strong and newly formed IT steering committee for review.

Within IT, we moved to a more open seating arrangement to promote collaboration. Regular manager meetings, hackathons, lunch and learn, and regular department meetings have all helped build the sense of team. 

“If I have seen further, it is because I stood on the shoulders of giants” 

Sir Isaac Newton wrote this to a colleague years ago. It shows that achievements are based not simply by one’s abilities, but by the environment around us. In order to make your constituents see further, you have to lift your shoulders for them to stand upon. The technology we provide can’t simply be a faster email system or niftier web page. It should provide the specific foundation that students, faculty, clinicians, researchers and health professionals can build upon to see further than they could at any other institution. IT can be the giant in this quote. If we can carry just one person to new heights in health care, truly amazing things will follow.