The IT function has evolved over the last several decades from being a completely operational support expense, to a strategic enabler. Over the last decade, it has further transitioned to provide a potential strategic advantage. The leadership role for that function has similarly evolved from the old Data Processing manager, to MIS Director, to CIO, accordingly. The role has moved away from deep technical and engineering expertise (witness the growing number of Chief Technical Officer or CTO roles), and toward C-Suite strategic contributions. In healthcare, a much more recent strand of this evolution has introduced capabilities, and responsibilities for producing revenue. And by revenue, we are not talking about internal charge-backs for services, but external sources of revenue. One could argue that this is the full maturation of the function to a point where the leader is responsible for contributing directly to items on the corporate dashboard rather than just enabling them. So in what ways is the CIO expected to produce revenue?
- One more obvious area is the provision of IT services to affiliates and partners in the region. The large capital and operational expenditures for IT services can be extended to others who may be less capable, or who may have a financial barrier to providing high-quality, high-availability services. This could take the form of a Consortium, or a separate corporation.
- There are implications here for non-profits regarding how much revenue you can generate before exceeding IRS and bond covenant limits, so make sure that your CFO is fully in the loop.
- Software vendors may have contract clauses prohibiting extending use to other entities, or they may simply want more money to do so. On the other hand, vendors now have a vested interest in the expansion of their software to other entities, and have explicit mechanisms for allowing that. Check your contracts.
- Stark and Anti-Kickback rules are evolving but need to be reviewed here as well.
- Virtual Services is a new and growing area for producing revenue. Since it is almost entirely based on the technology stack, it is an area that may fall to the CIO as leader or Co-leader. E-visits, Telehealth, patient education, social media strategies, etc can combine to produce or enhance a stream of billable activity, increase outreach, and improve access.
- Look at how mobile-friendly your entire mobile technology stack looks before proceeding.
- Get a good handle on the patient experience in general.
- Recent CMS changes have broadened support for virtual services, so they clearly see this as an important strategy going forward.
- Not to be ignored is the category which prevents penalties, or loss of revenue. Chronic disease management, readmission prevention, appointment no-shows, and a host of other areas are increasingly dependent on the extent to which systems, surveillance, and analytics, are functioning optimally, and placing actionable information in the right place at the right time.
- Many states counties and municipalities have grants and other forms of specific funding aimed at areas that may be consistent with your organization’s mission, and IT-centric (eg: underserved access). The same may be true for Payers and Pharma. These sources may not be recurring, but they can often help offset capital needed or fixed expenses.
- Get the Assist. Enhancing the ability of your colleagues to produce revenue should also not be left out of this equation. New or enhanced functionality for claims edits, or prompts for needed clinical documentation, may reduce denials, ensure appropriate levels of billing, or reduce days in A/R. Insights from analytics rather than just reports are another valuable assist.
The CIO is usually already well-versed in reducing expenses and increasing efficiency, and has a good understanding of all parts of healthcare operations. Revenue is a logical frontier to explore.