Aaron Miri, CIO, Walnut Hill Medical Center, Chapter 2

When Walnut Hill Medical Center opened its doors in April of 2014, Forbes magazine called it “The hospital Steve Jobs would have built” — not because it was built from the ground-up to support cutting-edge technology, but because Walnut Hill is “founded on the premise that the patient is first,” a mantra that is evident in everything from the “15-5” rule to the design of the rooms. For Aaron Miri, the opportunity to serve as an enabler in improving patient care was too good to pass up. In this interview, he talks about what he’s learned from his mentors, his strategy to incorporate wearable technologies into everyday practice, and the challenge Walnut Hill faces of how to grow meaningfully without losing its core values.

Chapter 1

Chapter 2



* Attesting to MU as a new org

* Prioritization challenges — “It’s keeping up with the demand.”

* Focus on population health & HIEs

* Information blocking — “It’s cost-prohibitive”

* Pros and cons of being new – “There’s something to be said for tried and true practices.”

* Solving the process improvement Rubik’s cube



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Bold Statements

We’re expanding bricks and mortar as well as internally by continuing to add staff and add physicians on staff as well. So how do you accommodate for that? How do you quickly grow meaningfully without losing the most important aspect of Walnut Hill, which is the culture?

We’re really looking at that data in aggregate and saying, okay, the population of folks coming in with diabetes — here’s what the number one indicators are. What can we do to get ahead of this and deal with this in a very programmatic way so we’re not just being reactive, but we’re being proactive?

When I see the marketplace big players that don’t want to talk to each other, I have to ask myself the very fundamental question, ‘Are the people making those decisions really in it for the right reasons?’ Because if you came into healthcare for anything beyond the fact that you want to take care of somebody else, you’re in the wrong industry.

Technology is a wrapper. Technology wraps good process and good people and good clinical care. You don’t look at technology to solve a process gap, and so a lot of times as we’re white-boarding out a problem to solve, it’s asking, ‘what’s the process?

When you want to start a new organization or something brand new, to make sure that you are truly comfortable with the fact that there is no road. You have to build the road.

Gamble:  What are some of the other really big priorities on your plate? I’m sure you have a lot, but just what’s really pressing for you right now?

Miri:  Really pressing for us is a lot of the industry mandated items — ICD-10, Meaningful Use. We are getting ready to do our stage 2 modified rule attestation come January 1. What’s interesting to Walnut Hill — and I give credit to CMS and the ONC for working with us to try to figure this out — is we are a brand new institution, and if you look at the Meaningful Use rules and regulations, it’s a little vague on how a brand new institution that opened its doors in April of 2014 is supposed to navigate all the changes that are coming. You have the proposed rules and you have all these things now with MU3 and, oh wait, modified rules for MU2 — all of those. So we had to quickly figure out what it is we need to do to be accurate, to be succinct, to be in line, and then make sure that the data is there and make sure that our clinicians are properly trained. It’s been a lot of caveats and nuances where I didn’t have the runway to quickly get to speed, and it was again,