Exclusive Interview with Mass General Brigham CIO Adam Landman: Addressing Two Core Contradictions in Hospital Digital Transformation and Solving Data Silos

With the gradual maturation of big data technology in China after 2010, healthcare informatization entered a period of explosive growth.

Driven by factors such as policy, demand, technology, and environment, along with industry-wide exploration, the construction of medical digitalization has become increasingly comprehensive. In the development of smart hospitals, medical consortia, close-knit medical communities, and private hospitals, smart healthcare products have flourished, intensifying industry competition to a fever pitch. The new generation of medical management information market is ushering in an incremental market worth no less than RMB 40 billion, making its development more diversified.

However, the basic digitization of hospitals does not mean that they have completed their digital transformation.

Due to disparate data acquisition systems and the lack of interfaces between them, numerous data silos have formed across different departments. Data sharing and business collaboration remain insufficient among hospitals, various clinical services, and operational stages. Data analytics and intelligent applications have not yet been fully realized, and it remains evident that certain medical data have not been consolidated into standardized, generalizable, and applicable medical datasets.

How can we resolve the problem of information silos across different departments to enable sharing of patient medical information throughout all stages of the healthcare process? How should hospitals plan their IT infrastructure development before implementation? Which details are critical? How can medical errors be prevented and patient safety enhanced during the use of digital health products? How can we ensure accurate and consistent data flow when selecting different health information software solutions?

VCBeat Exclusively Interviews Dr. Landman, Chief Information Officer of Mass General Brigham, and Attempts to Organize and Summarize the Valuable Insights Shared by Dr. Landman.Address the above questions from the perspective of digital infrastructure development in overseas healthcare institutions, so as to provide reference insights for the development of medical informatization in China.

Dr. Adam Landman, Chief Information Officer of Mass General Brigham

As Chief Information Officer of Mass General Brigham, Chief Information and Digital Innovation Operations Officer of Brigham and Women’s Hospital, Associate Professor of Emergency Medicine at Harvard Medical School, and Attending Physician in the Department of Emergency Medicine at Brigham and Women’s Hospital, Dr. Landman has extensive experience in the design, development, and implementation of health information technology and digital health solutions.

Currently, Dr. Landman oversees the development and delivery of technical solutions for all hospitals and clinics under Mass General Brigham. While promoting multi-departmental collaboration within hospital systems, he designs future digital development strategies to meet the clinical frontline’s demand for new digital capabilities. He has provided numerous solutions to address potential challenges arising in the course of healthcare informatization development.

“Hospital management information systems are highly complex; their defined scope not only encompasses the entire workflow of hospital administration and services but also supports the most critical clinical processes in medical practice. Achieving system completeness cannot be accomplished overnight. A holistic approach is required, addressing individual issues one by one.”Dr. Landman said.

Regarding the issue of information silos across different departments, Dr. Landman suggests that improvements could be made through three approaches:

First, all medical institutions utilize a unified electronic system. Based on this unified electronic system, medical institutions can leverage a shared database to facilitate data sharing both within and across institutions.

Second, establish relevant standards for data exchange and sharing, such as HL7 and FHIR (Fast Healthcare Interoperability Resources). Once these standards are established, it is necessary to ensure that product vendors certify that their products support or comply with the aforementioned standards, thereby enabling information interoperability on this basis.

Third, grant patients ownership of their personal electronic medical records. This would enable patients to carry their personal electronic medical records when seeking care at different hospitals or from different healthcare providers. From the patient’s perspective, this further facilitates information interoperability among different departments.

After addressing the issue of information silos at a systemic level by establishing frameworks and setting standards, it is still necessary to provide specific solutions for data transmission errors or inconsistencies among different software applications currently in use.

Dr. Landman proposed two solutions.

First, select a single system within the medical informatics infrastructure (such as the electronic medical record system) to promote data interoperability, enabling seamless data sharing and exchange among various departments within the hospital. Second, provide customized solutions tailored to the needs of different departments.

Meanwhile, Dr. Landman also highlighted potential challenges that may arise during the practical implementation of the two solutions.

The challenge with the first solution lies in its potential inapplicability across all departments. The challenge with the second solution is that, after customization, healthcare institutions or health IT vendors must integrate disparate solutions and perform unified updates. On one hand, due to the high complexity of integration, achieving full integration may be difficult. On the other hand, employing different solutions necessitates ensuring continuous software updates, which increases the difficulty of software operations and maintenance to some extent.

Dr. Landman proposed a balanced solution to this issue.Prioritize a unified architecture within the enterprise health information system; if the usage requirements of other departments are not met, then develop customized solutions for specific areas or departments.

Having resolved the challenge of data unification, how should hospitals plan their IT infrastructure development at the outset? What key details warrant particular attention?In response, Dr. Landman offered the following recommendations:

In the informatization construction of hospitals, the planning and development of infrastructure are crucial.If the infrastructure is not properly planned and established during the initial phase of hospital informatization, the hospital will incur substantial costs for subsequent rectification and renovation.

First, during the preliminary planning phase of hospital information technology (IT) infrastructure development, it is essential to determine which technologies each department will require and their specific application scenarios (e.g., the placement of infrastructure such as Ethernet networks and power supplies). This step is critical for establishing the foundational architecture of the hospital’s IT system, thereby ensuring the effective deployment and utilization of subsequent technologies.

Secondly, the digitalization of future hospitals will inevitably evolve toward more complex and diversified systems. Therefore, when planning hospital information technology construction, it is essential to consider future development trends and formulate corresponding plans accordingly.

For example, future hospitals will inevitably adopt an increasing number of wireless and mobile devices. Therefore, it is essential to fully consider the deployment of wireless networks and mobile data networks when planning hospital information technology infrastructure. These networks will significantly influence the utilization of wireless and mobile devices within hospitals in the future.

Hospital Management Information Systems are complex systems whose defined business scope not only encompasses the entire workflow of hospital management and services but also supports the most critical clinical processes in medical disciplines. With policy support, informatization must continue to play a foundational role in providing support and assurance.

In the future, as data becomes further unified, healthcare information systems will gradually enter a phase of open integration and collaborative sharing. Prior to this, both healthcare institutions and enterprises must recognize that informatization development should be demand-driven and problem-oriented. Business expansion is meaningful only when it aligns with actual needs. While moderate foresight can yield technological dividends, excessive advancement may prove counterproductive.

Dr. Landman’s insights on healthcare IT infrastructure development provide a more tangible reference for future initiatives in China. A clear takeaway is that, amidst current trends, “standardization” and “unification” should be the key principles guiding data center and infrastructure construction, with infrastructure planning serving as the foundation for digital transformation in healthcare. Only on the basis of standardized infrastructure can big data fully realize its incremental value and achieve dynamic extension across various specialized domains to a certain extent.

Mass General Brigham, located in Massachusetts, USA, is a comprehensive academic medical system integrating clinical treatment, patient care, medical education, and scientific research, and is also one of the leading medical research institutions in the United States. Leveraging its clinical practice and innovation capabilities, its affiliated medical institutions rank among the top in the United States and globally.

It is reported that Mass General Brigham comprises 16 affiliated institutions, integrating world-renowned academic medical centers, community and specialty hospitals, health insurance plans, physician networks, community health centers, home care, and long-term care services into a comprehensive healthcare system. Several of its affiliated institutions serve as primary teaching hospitals for Harvard Medical School, including Massachusetts General Hospital, Brigham and Women’s Hospital, Mass Eye and Ear, McLean Hospital, and Spaulding Rehabilitation.

Over the past 25 years, Mass General Brigham has collaborated with healthcare institutions in more than 40 countries and regions, accumulating extensive experience in designing or reimagining integrated healthcare systems, constructing new hospitals (incorporating the latest therapies and medical technologies), enhancing hospital clinical service line products or research projects, building or improving existing clinical service lines, and formulating future outpatient service strategies.