Joe Bengfort, CIO, UCSF Medical Center and Campus, Chapter 1

Want to know the secret to being CIO at a large academic organization? Fear. “If I wasn’t a little bit worried about being able to deliver what the institution needs, it would mean I’m not paying attention,” says Joe Bengfort. But that, of course, is just part of an equation that also includes a confident knowledge of IT functions, a willingness to engage in the business side, and an ability to apply lean methodologies to situations like consolidating IT departments. In this interview, he talks about UCSF’s clinical enterprise strategy — and the infrastructure required to support it; his team’s “incremental approach” to analytics; the challenge academic organizations face in securing data without stifling creativity; and how he believes the CIO role will continue to evolve.

Chapter 1



* About UCSF Medical Center

* Heavy focus on ACOs

* 3-legged clinical enterprise strategy

* Applying research to the clinical setting “in near real-time”

* 2 years into Lean

* Optimizing Epic “in synchronization” with CPI initiative

* Interoperability challenges



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Bold Statements

We want people to learn more about what it means to be in an EHR environment and what’s required to leverage data and analytics in the process of care. And so we think by working across the three missions of the institution, it puts us in a great position.

It’s trying to move care from a tertiary quaternary focus to a proactive management of health — let’s keep people out of the hospital. However, we have hospitals, and a lot of our research is around these very complex diseases, and so it’s important that we care for patients in that realm as well.

Healthcare, historically, has been a rather inefficient enterprise. There’s a lot of opportunity to improve the processes that not only take out waste, but they reduce the cost of care and ultimately, in fact, improve outcomes.

These implementations are extraordinarily taxing on an organization, so typically when you roll out, you try to roll out in a fairly standard way, and then you have to go in and do a good deal of optimization in the environment.

We have a particular challenge here in terms of interoperability for our ACO partners, so we’re working now to develop strategies on how to accommodate that diversity across the continuum of care.

Gamble:  Hi Joe, thank you so much for taking some time to speak with us today.

Bengfort:  It’s my pleasure. Thanks for the opportunity.

Gamble:  To give our readers and listeners some background, can you just talk a little bit about UCSF Medical Center in terms of what you have for hospitals, clinics, things like that?

Bengfort:  University of California is made up of five different medical centers; I happen to be here at the San Francisco Medical Center. We’re evolving very quickly; we’re probably about a 650-bed hospital system. It’s a tertiary quaternary hospital primarily. We’re part of an academic medical center here. We have a hospital in the Parnassus part of San Francisco and we’ve just built a new hospital over in Mission Bay, close to where the world champion San Francisco Giants play, along with a new children’s hospital, cancer center and women’s hospital. Over the last year, we acquired the Children’s Hospital of Oakland, which is now the Benioff Children’s Hospital of Oakland.

So we’re expanding in that fashion, and we’re currently in the process of getting much more engaged in the accountable care organization-type structure. So whereas we’ve been very much an inpatient and research facility, we are pushing quickly into affiliations with outside parties to establish an accountable care organization and to get more into the proactive management of health — more on the front end of care...