When IT is disruptive, how do IT executives evolve and grow? To find out, and to celebrate the 20th issue of Smart Enterprise, we revisited three executives featured in the past.
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David Guzmán: Transforming Healthcare
When profiled by Smart Enterprise in 2010, David Guzmán was CIO/CTO of Acxiom Corp., a Little Rock, Ark.-based provider of business intelligence and marketing database services. Today, he is CIO of H.D. Smith, a privately held healthcare distributor and services provider based in Springfield, Ill. The new position, he says, gives him a new opportunity to help transform not only a company, but also the country. “Healthcare is such a critical issue for our country that we cannot continue going along the current course trajectory, now approaching 20 percent of GDP,” Guzmán says. “We’ve got to improve the outcomes of patients. Technology is going to play a key role in allowing us to execute this vision of controlling healthcare costs and improving patient outcomes.”
While the bulk of H.D. Smith’s revenue now comes from distributing pharmaceuticals, Guzmán is committed to a vision that will see more than half the company’s revenue coming from IT-enabled healthcare business solutions and services. “Technology is going to enable the personalization of medicine,” he says. “And this will ultimately lead to longer life spans and more productive lives.”
But before H.D. Smith can run, it has to learn to walk. That’s why Guzmán’s first order of business in his new position has been to implement a huge ERP project. It has involved automating the company’s warehouse facility in New York, modernizing its e-commerce platform, and moving large-scale computing resources to the cloud. As part of the strategy, Guzmán recently spearheaded a move of the company’s entire data center into a privately managed external cloud. He expects this to free the IT staff to work on more innovative projects, and to position his company for its transformation into a services provider.
Guzmán is proud to have a seat at the executive table at H.D. Smith, and he says the IT upgrades and changes are crucial to the business. Now, IT can focus on creating new services for the business, instead of just keeping the lights on. This focus will become increasingly important because H.D. Smith serves not just one or two customer segments, as do most traditional pharmaceutical companies, but many. In addition to serving both the retail and institutional markets, H.D. Smith also serves specialty medicine providers, such as disease-specific clinics, and individual patients. In fact, the company’s push into consumer-directed medicine has led to the development of several IT-enabled business services, mainly via a majority acquisition of Triplefin.
To accomplish all its goals, Guzmán has partnered with CSC, the Falls Church, Va.-based provider of business solutions and services. CSC is the same company that provides cloud services to many U.S. federal and state government agencies, including the Department of Homeland Security, NASA and the Maryland State Highway Administration.
Going forward, Guzmán expects IT to allow for more and better personalization of healthcare. And he expects H.D. Smith to be at the forefront of that effort. “Today, medications are mass-produced; they’re not targeted toward the individual,” he says. “Think of genomic recognition, and then combine that with family and personal medical histories. That will allow a much more proactive, personalized treatment that’s going to prolong and enrich our lives.”
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David Blodgett: Getting Agile
When David Blodgett appeared in a 2011 issue of Smart Enterprise, he was then VP of IT and Data Center Operations at Wyndham Worldwide Corp., a Parsippany, N.J.-based hotels and hospitality company. Today he is Senior Director of Global Infrastructure Services at Expedia Inc., the online travel service provider. In making the move, Blodgett has also moved from supporting customers in hotels to helping customers book not only hotels, but also the airplanes, trains and boats that bring them to their destinations.
“ Performance and compliance requirements don’t go away. Nor does the need to be a good financial steward and to maintain operating-environment visibility.”
The transition, Blodgett says, has been an exciting one. His most recent effort involves developing an infrastructure-services framework that is optimized to support Agile software development. “A key focus area for modern infrastructure teams, including my team, is to enable Agile and other time-to-market-focused application delivery methodologies while maintaining environmental stability and control,” Blodgett says. “Performance and compliance requirements don’t go away. Nor does the need to be a good financial steward and to maintain operating-environment visibility.”
A key change for Blodgett, as well as for other IT executives, is the shift toward external cloud services. Internal IT, he says, is no longer the only game in town. In a world where anyone can spin up a Software-as-a-Service contract or their own servers on Amazon, Blodgett and his team must strive to provide not just competitive services, but also services that address the business’s need to rapidly innovate and expand. “To do this in a way that ensures that systems remain stable and highly performing, and remain compliant with a myriad of regulatory and operational requirements, requires extensive use of automation and careful planning,” he says.
Another shift for Blodgett involves the types of skills needed on his team. Expedia has more than 10,000 employees across its dozen or so brands, including Expedia.com, Hotels.com and Hotwire. Because many of these workers are either involved with development services or direct consumers of IT services, Blodgett’s team must have what he calls customer-facing polish. “There was a time when the only way you got anything out of a traditional IT shop was to submit a request form and wait weeks until your service was delivered,” Blodgett says. “But now, in the end-user and developer-driven IT culture, business teams can circumvent IT with external cloud-based engagements. So IT professionals have to have a bit of salesperson in them. They need the ability to manage and deliver a service, versus performing some isolated IT function.”
Of course, IT executives also need expertise with technology. Blodgett’s areas of expertise include virtualization, self-provisioning and cloud management automation. “We’re focused on enabling innovation and speed to market,” he says. “We’re building out internal capabilities that go well beyond the traditional scope of cloud service providers.”
The end goal, Blodgett says, is “allowing developers and business teams to instantiate, on demand, the operating environments they require to innovate and drive the business forward, and to do so economically and with quality.”
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Albert Porco: Healthier Medical Records
Healthcare and IT are recurring themes in Albert Porco’s career. In 2008, when Smart Enterprise first interviewed him, Porco was CIO of Kings County Hospital Center in Brooklyn, N.Y. Today, he is a contract CIO at the Palisades Medical Center in North Bergen, N.J., and an employee of Malvern, Pa.-based Siemens Healthcare. “I view myself as an IT guy who happened to spend 20 years in the healthcare field, rather than a healthcare guy who happens to do IT,” he says today.
While Siemens is Porco’s official employer, he spends his days in the 200-bed community hospital with a view of the New York City skyline. Much of what he oversees is technology from Siemens. Yet Porco is making decisions that will shape the hospital’s future. The medical center is relying on Porco’s expertise in its quest to meet the objectives of the Medicare Electronic Health Record (EHR) Incentive Program — referred to as “Meaningful Use.” The program is intended to spur adoption of certified EHR technology by using Medicare/Medicaid funding as a lever. Eligible providers and hospitals can earn cash incentives by demonstrating their use of certified EHR technology. Then, as the program advances, new standards will be set for how users are meaningfully interacting with EHRs. This level of Meaningful Use must initially be maintained over a 90-day reporting period. Later, it must be maintained for one year. Compliance is important, because hospitals and other medical providers that do not use certified EHR technology in the future could be penalized with reduced Medicare payments.
As Palisades progresses from Meaningful Use Stage 1 to Stage 2, Porco is ensuring that the solutions achieve a high degree of clinical adoption and utilization. One challenge has been finding new ways of using electronic medical records (EMRs) as an incentive for patients to engage with their physicans. That’s a new goal for many hospitals, as well as one that has been written into the Meaningful Use Stage 2 requirements. The problem is, many patients don’t want to look at their EMRs when they’re not sick, Porco explains. And when they are sick, they just want to see the doctor. Adds Porco: “I can’t force people to look at their EMRs.”
“ My job is to tap into the infrastructure and technology, and create a foundation so that we’re ready to make it happen.”
That said, doctors’ offices and hospitals can at least tempt patients to look at their EMRs by bundling these records with other services, such as making appointments and viewing lab results. “If you add that ability to a portal — if one of the features says, ‘Click and look at your medical record’ — well, you might look,” Porco says. “Or you might want to see results of a lab test and take a peek at the rest of the records while you’re there.”
The push to EMRs also affects what Porco’s team does on the back end. That’s because as patients are added, the hospital’s infrastructure requirements expand exponentially. To make sure these resources are always up and available, Porco is depending on virtualized servers, storage resources and desktops. He’s also implementing a bring-your-own-device (BYOD) strategy for employees’ smartphones and computing tablets, a project similar to one he previously managed at Kings County Hospital. As part of the first element of his new strategy, Palisades Medical Center will virtualize its entire technology infrastructure. “We’ve got young physicians coming in who want to bring their own devices, but that only works in a virtualized environment,” Porco says. “We have to be able to meet the demand of the doctor who says, ‘I want to get the electronic medical record on my phone.’”
Another major effort aims to let authorized medical clinicians gain anywhere, anytime access to the center’s medical records. Even for a simple medical procedure such as drawing a patient’s blood sample, everyone in the process — the presiding physician, the phlebotomist who draws the blood and the lab technician — act as essentially independent agents who move around the hospital to perform various services. And because even something as simple as a blood draw can be affected by other factors (such as food or medication given to the patient), Porco and his team intend to use the EMR, and other ancillary systems, to prevent delays or duplicative efforts that can both frustrate patients and present hospitals with large costs. “When you’ve got that kind of dynamic in place, you can’t simply say, ‘We’re going to put two computers and a printer on the nurse’s station, and we’re done,’” Porco says. “You have to go where the work is being performed, the point of care. You need intelligent systems that are managing and optimizing the workflow, and delivering patient care in the most efficient manner.”
Porco is also working on a plan to reinforce the Palisades Medical Center against powerful storms such as 2012’s Hurricane Sandy. The Medical Center sits just 100 feet from the Hudson River, and because of Sandy, it was forced to close for a time. Among Porco’s efforts in this area is a new plan for more robust disaster recovery.
Porco’s main focus, however, remains on helping patients and improving their healthcare experience. “All those things we’ve read about in sci-fiction — like genomic therapies, growing organs with stem cells, and individualized medicine — are becoming more and more of a reality,” Porco says. Hospitals, he adds, must at least consider these types of services and make intelligent decisions about whether they want to offer them, how they can offer them, and how they can partner with others who offer them. “My job,” Porco says, “is to tap into the infrastructure and technology, and create a foundation so that we’re ready to make it happen in any way the hospital decides to proceed.”
Karen J. Bannan is a New York-based writer and editor, and a former Executive Editor of Smart Enterprise.
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