Marc Chasin, MD, VP & CIO, St. Luke’s Health System, Chapter 2

Rolling out Epic across an organization the size of St. Luke’s isn’t a project; it’s a journey that requires an enormous effort to stay on course. It also requires a lot of change, and when that becomes too much, leaders must be willing to hit pause. It’s precisely what CIO Marc Chasin did three years ago, and the result was a more standardized, collaborative approach. In this interview, he talks about how his team is looking to optimize and stabilize its EHR, the federated approach they’ve adopted with data warehousing, and the ultimate goal with patient engagement. Chasin also discusses the application rationalization process, the two types of CIOs we’ll see going forward, and what he hopes to accomplish as a member of CHIME’s Board.

Chapter 1

Chapter 2



* Wearables & IoT — “It’s imperative we start down that path.”

* Multiple layers of patient engagement

* MyStLukes: “A clinical transformation project with IT support.”

* Application rationalization — “Turning them off is easy”

* The “when” not “if” with data breaches

* CHIME Board term — “I want to give back to the organization that has been a resource for me.”

* 2 types of CIOs: technical & transformational



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Bold Statements

Where I see the main gap is not in the capture of information or the technical connections that need to be made; where I see the main gap is the ability to pull out the appropriate patterns that these devices are providing.

What we’re running into now is, as you participate in a risk-based contract, not all of your partners are on the same portal, or even the same electronic health record. We can solve the differences in EHRs with interoperability, but we need to look for a way to consolidate our patient portals.

It’s easy to turn them off. What’s not so easy — and I’m finding it rather difficult and complex — is what do we do with all the data that is inside these records, and once we migrate the data to a centralized repository, how can we serve this up to a clinician or another end user that needs access to the old record.

This individual, I believe, is going to be a disruptor to an organization. They can clearly see the vision of how technology can enable the organization and how we can improve care, how we can make it more efficient, how we can make the patient experience better, and reduce overall cost.

Gamble:  When you look at that patient engagement piece, there’s a lot more interest than ever before in things like wearables. What are your thoughts as far as being able to incorporate that data? Obviously, it’s easier said than done.

Chasin:  I think you’re referring to the Internet of Things. It’s imperative that we start down that path of and incorporating these consumer devices, whether it be the Fitbit or the Apple Watch or sleep monitors. Where I see the main gap is not in the capture of information or the technical connections that need to be made; where I see the main gap is the ability to pull out the appropriate patterns that these devices are providing. There is no way that as a physician, they’re going to sit and sift through 500 lines of pulse capture or the amount of steps that you have walked. We need to ingest that into our data warehouse.

We need to develop some machine-learning capabilities, and have the computer work through and point to areas of concern for the physician or for the care coordinator — or even, if you take a step back, look at a whole entire population that has these wearables and see where there are opportunities to improve care from that perspective.

So I see it in two layers.