July 17, 2024

Vitavo Yage

Best Health Creates a Happy Life

Interview: “Technology is the central nervous system of a healthcare environment” Aaron Miri, SVP and CDIO at Baptist Health, Florida

10 min read

We recently met Aaron Miri, senior vice president and chief digital information officer at Baptist Health in Jacksonville, Florida, to learn about the digital projects in his organisation, his experience at a national level, how technology is being used to support Baptist Health in making healthcare accessible, and more.

On Baptist Health

Aaron explained that Baptist Health serves the entire region, from south of Atlanta to north of Orlando and out towards Tallahassee. “It’s a giant swathe of the country – we are a very large paediatric and adult healthcare organisation with numerous levels of care. We are the preferred regional leader for our market, we’ve been in the Jacksonville area for over 65 years now and we’re growing fast.”

As the inaugural chief digital information officer at Baptist Health for the last three years, Aaron explained that he has been leading the journey to digitise and modernise the system, to take advantage of the latest technologies to benefit patients and providers.

“My role is the first chief digital and information officer for this health system, which is something that is really catching on across the United States. It’s not just about installing the technology and walking away, it’s about looking at how you can really gain adoption, market share, patient satisfaction and care quality and outcomes using technology. I’m looking at whether people are truly using the tech we put in place, and whether they are deriving joy in doing so.”

Experience at national level

Aaron shared some insight into his background and experience, starting with 2016, when he was appointed by the Obama Administration to the Health IT Policy Committee before being re-appointed in 2018 to Health Information Technology and Advisory Committee, or HITAC. Aaron was then elevated by President Trump and President Biden to become the co-chair of the committee. The committee advises the health and human services department on all things health IT, putting together standards and ideas and advancing development in areas such as cyber security, interoperability, public health and patient engagement.

“My projects there were numerous, from helping to construct the requirements and technical specifications for our national superhighway, which we call TEFCA (Trusted Exchange Framework and Common Agreement). I’d compare it to NHS Spine; you can get any information from it. But we had to start from scratch and build the specifications, look at how we could share information, how we could ensure it was secure, and so on. We looked at the NHS as a great example of things that had been done well and took learnings from the NHS experience. We really tried to be comprehensive about that; we wanted to learn as much as possible from our partners too. I’m a big believer in not recreating the wheel.”

Aaron explained that the committee also explores advancements within digital health, such as the progress around telemedicine during the pandemic; bringing together federal agencies to share information with each other and the public; and working with the White House to provide education on areas such as AI, to inform executive orders coming from the president in this space.

“All of these different projects, as a co-chair, member and volunteer for the committee, have been a tremendous highlight of my national work,” Aaron reflected.

At a state level, Aaron also serves on the Florida Cyber Security Advisory Council and has served on numerous other boards, supporting the governor locally across the state to advance digital health and lead efforts on the ground.

Working with CHIME

Aaron discussed his work with The College of Healthcare Information Management Executives (CHIME), an association of healthcare CIOs across the globe. He explained how CHIME seeks to provide an environment of learning, collaboration and partnership, to help the ecosystem navigate things such as the pandemic or AI or cyber security. Aaron has been serving for several years as a member on the board of trustees.

“CHIME brings CIOs together to help guide, teach, learn and network. It’s about putting the patient first. It’s about asking: how can we as CIOs and CDIOs work together and take on each other’s lessons? At any CHIME event you will get CIOs from the USA, UK, Germany, France, so many places; and we are often facing exactly the same challenges.”

Alongside his place on the board, Aaron volunteers by helping to teach CHIME bootcamps, which focus on teaching new CIOs who are rising through the ranks. He is also involved with the public policy committee, building on his experience with the White House to advise CHIME on future directions.

Recently, Aaron continued, CHIME has been working alongside the Florence Nightingale Foundation in the NHS to provide a programme of academies for the scholars, nurses and midwives in the digital health space. “It’s a phenomenal partnership, and I’m very proud of CHIME and the work that we are doing there,” he commented.

Digital focuses at Baptist Health

Moving on to focus on Baptist Health, Aaron explained that the system has undertaken a modernisation programme focusing on clinical systems, including implementation of a new electronic health record. “It was a tremendous planning effort, and it marked the beginnings of our investment into technology. Now, we are doing things with artificial intelligence that are being mentioned on national news and across the globe.” In 2023, CNBC visited Baptist Health to showcase how physicians are using AI software to generate patient consultation summaries, to enable physicians to spend more time interacting with their patients and reduce the admin burden.

Baptist Health is also focusing on using digital tools for patient education around proactive and preventative care, along with investing in its business and supply chain management systems to complement clinical efforts, which is scheduled to go live in 2026.

The work is diverse, Aaron noted, with his scope covering AI, machine learning, analytics and automation, to new technology stacks that will turn hundreds of different legacy systems into one enterprise system. “Essentially, it’s working out how to crack the walnut in a smarter and more effective way.”

Making healthcare inclusive with tech

Aaron said that the marketing department at Baptist Health deserves a lot of credit for the way they have partnered with the digital team to ensure that technologies are inclusive and supportive, from websites to mobile applications to engagement tools such as chatbots. “They’ve been a great help to us in making sure we are not excluding any population – whether that’s disabilities, languages or so on, any of the things you need to consider when you are serving such a huge proportion of people. They have worked with us on harmonising our technology stack to make sure it is as inclusive as possible.”

There can be “clunkiness” in health tech, Aaron acknowledged, because a lot of technology was not designed for the kind of user variety necessitated by healthcare. In some cases, he and his team have worked with vendors to help them understand the breadth of requirements that come with a health system like Baptist Health.

Baptist Health’s brand places emphasis on ensuring that people feel respected and heard, Aaron added, and this applies to technology implementations too. “Our mission is to be by your side the whole time, every step of the way. We want people to feel like we have their backs and that we are thinking about them, including with the technology we bring in; and that needs to be a very thoughtful, planned process. We look at it comprehensively, we are always re-assessing and surveying our patients. We ask how they feel when they engage with us – do interactions feel warm, or do they feel cold and robotic?”

As an example of this, Aaron described how his team is using AI prompts to respond to patient inquiries around things like refilling medications. The AI agent creates a message for the doctor to review and send once they approve. To achieve this, Baptist Health doctors gave 200 hours of time to the digital team to work on prompt engineering with them, ensuring the responses generated by the AI sounded “fair, inviting and warm”.

Aaron emphasised: “They were coming off a long day of seeing patients and then spending another couple of hours with my technical teams to help train the AI agent so it sounds human. We could have easily and quickly created some simple robotic responses, but that’s not delivering great patient experience; as a user it can feel frustrating and annoying. The physicians understood the need to take time on this, so that the technology doesn’t just work, it works well. It’s attention to detail; it’s a culture shift; it’s the right way of using tech. Our practitioners and physicians deserve a lot of credit for helping to drive that culture forward.”

Expanding the digital team

“It’s not too hard to recruit to a beautiful state like Florida – we’re full of sunshine and we have Disney World close by! But in reality, not-for-profit healthcare is always going to be competing with for-profit companies like Microsoft or Amazon.”

Aaron reflected that in his experience, younger generations such as Millennials and Gen Z “tend to want to do something for a purpose. Whilst a pay cheque is of course important in terms of wanting to be paid fairly, receiving higher pay from somewhere like Google may not offer the same intrinsic reward as you do when you help a sick person feel better. Working somewhere like Baptist Health, the technology you implement might help to save someone’s life, and you can see that impact, you can see people leaving the hospital and being able to go home to their loved ones. That’s a different level of reward.”

Healthcare systems should “stay true to what makes them unique,” Aaron suggested. “We’re not a technology company; we’re a healthcare company that does technology well. But we lead with healthcare. That resonates with people when it comes to hiring because they want to stand for something. It’s great to build widgets, but if you can make people better, that’s a return on investment for your time that very few industries can offer.”

Priorities for the future

What are Aaron’s priorities for Baptist Health moving forward?

In the short-term, he said, the system will “continue our quest with digitisation – we want to digitise the entire spectrum and we want to push the envelope with our key partners such as Microsoft, Dell and Epic, looking at different ways of delivering care that haven’t been done before.”

The executive team and board of directors are very focused on patient and public health, Aaron added. “How do we help our communities, the region? How can we give back to our communities with things like preventative screenings? We have a lot of tech that we use well; how can we ensure that people are supported to use it and uplift Jacksonville?”

Aaron emphasised that Baptist Health is a regional health system, located amongst the people it serves in Jacksonville, and rooted in its community. “This is very different from many other leading organisations in this country – we focus on our region. We’re not listening to a corporate headquarters thousands of miles away in another state, taking direction from them. We’re listening to our people, because the needs of the North Florida population are different than the needs in St. Louis, for example. It’s about regional health, and I think that’s where the USA is going in the future; many people gravitate to a region because they want to be taken care of in that location, where the healthcare provider is attuned to their needs. It’s like the NHS in Scotland versus the NHS in England – they’re the same family, but they can be very different, because they have different needs and different focuses. That’s where our near-term focus lies – on our region, its people, processes and technologies.”

Over the next five years, one major priority will be on automation; “smartly and safely” leveraging AI; focusing on cyber security postures and how to defend against emerging threats; and workforce development and ensuring that the workforce is prepared for 2030. “I need to ensure my workforce who have been with us for a while don’t get left behind; that they have a future with us that they feel confident and comfortable with. I also want to create a pipeline for kids coming out of college, so they want to come and work for Baptist Health.”

Aaron also commented on a need to “navigate the headwinds that all of healthcare is facing” such as inflation, wage growth and the rising cost of materials, and working with vendors to minimise the impact of these factors.

“Technology is the central nervous system of a healthcare environment,” Aaron concluded. “If your central nervous system is acting up, then your body doesn’t function properly. I need to make sure that we are optimised to deliver the best possible patient care. As I said earlier, we’re not a tech company, we’re a healthcare company that does tech well. It’s vital that I orient all of our technology solutions to match that alignment.”

… and key predictions

“I think we are going to see an immersion of start-ups that truly understand healthcare workflow, because they came from healthcare,” Aaron predicted, “as opposed to giant tech companies looking to play in the healthcare space. I believe we will see more and more of these real health tech start-ups emerging and starting to dominate over the next few years.”

Also on vendors, Aaron foresees that companies who took advantage of healthcare providers during the pandemic and raised prices significantly to match demand will “lose tremendous market shares. CIOS are tired of being told they are being held hostage and must pay a heightened price. So, I think those two predictions will go together.”

Finally, Aaron shared a consideration for CIOs and people in similar positions, “Continue to better yourself, take advantage of opportunities for learning, and don’t close your mind off. When you don’t acknowledge and embrace the need to grow in your role, that is when your workforce may leave for CIOs who keep pace with the future. So keep an open mind.”

Many thanks to Aaron for taking the time to share his insights with us.

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