All Articles Leadership Strategy Q-and-A: Ed Marx on innovation, industry changes and advice for CIOs

Q-and-A: Ed Marx on innovation, industry changes and advice for CIOs

7 min read


Ed Marx is the senior vice president and chief information officer at Texas Health Resources in Arlington, Texas. His career in the health care industry spans 24 years, 16 of which have been spent as CIO. Prior to joining Texas Health in 2007, Marx was CIO of University Hospitals Health System of Cleveland. He previously served in a variety of IT leadership roles with health care organizations such as HCA (Tennessee), Parkview Episcopal Medical Center (Colorado) and Poudre Valley Health System (Colorado). Concurrent with his career in health care, he served 15 years in the Army Reserve, first as a combat medic and then as a combat engineer officer.

Congratulations on receiving the John E. Gall Jr. CIO of the Year Award. This award is given for innovative use of technology in health care organizations. What is the most innovative way you have employed technology at Texas Health Resources?

I am profoundly honored and humbled by the award. So many people believed in me before I believed in me. They shaped who I am today, and for this I am grateful. They will be sitting at my table during the awards ceremony. My leadership team will be there as well. They made IT happen at Texas Health. My manager will be there, and he embodies the culture of our organization, which differentiates us from others. One of our docs and nurses will be there. They collaborated with IT and executed well. Also, my bride of 28-plus years will be there. You have no idea how much of me is made by that woman. Without her, we would not be talking right now. So, it is not about me, but really about the folks sitting around that head table.

Innovation has been an area of strength for us. We are blessed to have an abundance of really smart people and a culture that encourages innovation. I have so many examples, but here are two of my favorites:

  • Venous thromboembolism (VTE) kills more people, once admitted to hospitals nationwide, than breast cancer, AIDS and car accidents combined. Some of our team got together and leveraged technology to build an automated calculator that is integrated with our EHR to help us not miss an opportunity to trigger the appropriate care plan. Since we implemented, we have reduced the amount of VTE by 30%. That translates into lives saved!
  • Innovation is fed by collaboration. So, a few years ago, we leveraged a collaboration tool that enables us to engage our clinicians no matter their location. We have 25 hospitals, and trying to bring together physicians to discuss and agree on order sets is a challenging task. So we knew that urinary tract infection (UTI) was the biggest cause of hospital-acquired infections, and one of our IT nurses was particularly passionate about reducing these incidents at Texas Health. So to turn things quickly, she leveraged this collaboration tool, and within days the clinicians agreed on a new protocol and order set. Once implemented, we saw a 29% reduction in UTI. IT makes a difference!

You’ve been a CIO for 16 years and have worked in the health care industry even longer. What are the most important changes you’ve seen in that time? What should CIOs be doing now to keep up with and capitalize on those changes?

The most important change I have seen is the maturation of IT from transactional to transformational. In the past, IT was purely operational. While IT today has operational requirements, it has become a strategic differentiator, both from a competitiveness point of view and as a lever for increasing clinical quality. CIOs are now sitting at the proverbial table and talking about IT from a strategic point of view — how when it is leveraged can dramatically impact business and clinical outcomes.

CIOs really need to focus more on strategy and less on operations. CIOs need to immerse themselves deep into the business and clinical aspects of running health care and well-being and then advising on solutions to the most challenging situations.

The ONC [Office of the National Coordinator for Health IT] has a new national coordinator. What advice would you give her when it comes to federal health IT incentives and deadlines?

I would encourage her to think long term and to pace herself. I am full of ambition, but I also know that to win the race, I need to be intentional. I climb the world’s tallest mountains and do Ironman triathlons. If I tried to run up the summit in one day or go all out in the triathlon, I would reach the halfway point exhausted, with loss of incentive. So I pace myself and keep the vision in mind.

There’s a lot of concern in health care right now about the transition to ICD-10. Do you think it will go smoothly or hit some roadblocks? What are you doing at your organization to get ready?

It will go smoothly. We are doing an immense amount of testing and working closely with partners to ensure success. I am not sure all clinicians understand the gravity of the changes about to happen, so there will be some on-the-spot learning and instruction that will need to take place.

Patient engagement is a meaningful use target and is also gaining more attention as an overall health care goal. How do you think health IT can make patients more involved in and knowledgeable about their care? Do you feel that mobile devices and apps have a positive role to play in reaching this goal?

The future — and I would say present (!) — is all about social and mobile. For any health care organization (ACO, system, hospital, etc.) to be successful, we need to trigger engagement. We have a very robust plan to tackle engagement through social and mobile.

What do you think is the most important technological innovation on the horizon, and how can health care organizations get ready now for it?

Health care is so far behind, so this seems strange to say, but mobile — or what we term “connected” health. So many other industries are far ahead of us. We have such a golden opportunity now to leapfrog over what others have done.

We have had strong success with real-time locating systems, leveraging the technology to enable superior clinical outcomes and patient satisfaction while also impacting the bottom line. There is more opportunity here.

I think we still need to optimize the EHR. Implementing is the easy part! The hard part is enabling workflow and taking all that data and converting it to action.

What advice would you give to up-and-coming health care CIOs?

Several things come to mind:

  • Attend the CHIME Boot Camp. That was the first thing I did. And it made a difference in my life.
  • Second, immerse yourself, deeply, in the world of your clinicians. Spend so much time with them that you have a keen understanding of workflow.
  • Spend more time outside of IT than inside. Don’t insulate yourself.
  • Love on your team. Give them the gift of your time. Spend time with them at the office, but also outside of the office. Be as transparent as possible.
  • Hire slowly, fire quickly. You have to have the right people in the right places or else you are sunk.