Interview with Mony Weschler, Chief Technology & Innovation Strategist at Montefiore Medical Center

March 8, 2016

Direct Consulting Associates recently had the pleasure of interviewing Mony Weschler, Chief Technology & Innovation Strategist at Montefiore Medical Center.

Please tell us a little bit about yourself.

I am a creative and driven leader with extensive experience (25+ years) spanning the full range of clinical IT and MIS operations in various leading academic healthcare systems and institutions. While specializing in imaging informatics, my subject matter expertise extends to all healthcare and IT including strategy and operations, with clinical expertise in Radiology, Cardiology, Pathology, Perioperative, Perinatal, Surgery, Pediatrics, Nuclear Medicine, Orthopedics, Ophthalmology, Pharmacy, ACO’s, Population Health, Bio-Medical and Innovation.

In the course of my career, I have had the opportunity to establish and solidify Montefiore’s reputation as industry leader for testing and integrating groundbreaking technologies, result in multimillion dollar cost savings by pioneering an innovative cross-training support model, maximize operating room availability and spearheading the clinical use of innovation and mobile solutions.

What fascinating projects are you currently working on?

Mentor to startups at Junto, PilotHealth and BluePrint Health, bringing new innovation and technology to improve healthcare.

3D printing – How to incorporate and expand the usage of 3D printing to improve personalized medicine and outcomes. Imagine printing an airway for an infant or a printed custom hip replacement. How about a printing the before and after for conjoined twins that need to be separated?

Population engagement – communicating with your clinical providers using secure texting and smart Apps. Getting appointment reminders, nutrition guidance from your health system.

Wearables – Advanced activity monitors being handed out in the school systems to help change behavior and tackle pediatric obesity and diabetes with wellness and no drugs.

What is the most challenging aspect of your job?

Changing culture in a system that is resistant to change.

You have over 25 years of experience in HIT. What or who do you attribute your success to?

A love and passion for what I do. No one can escape the healthcare system sooner or later a loved one or ourselves will need care. I am privileged to have made a difference and improved the care and experience of millions of patients.

Did you have a mentor(s)?

Yes, my career began at NYP in 1989 and back then it was called Columbia Presbyterian Medical Center. I was fortunate to have had mentors like the world renowned Dr. Paul Clayton, Dr. Bob Sideli, George Hripcsak, Clair Hill, and other great mentors and friends. What I really enjoy is mentoring others and infecting them with a passion for Healthcare IT.

How has healthcare IT changed since you entered the industry, and where do you see it going?

EPIC was but a thought in Judy’s mind. IBM, 3M and DuPont were in the clinical space mostly with the beginnings of Lab systems. Most large academic medical centers had large programing staffs on hand and were building their own systems on mainframes and AS400’s. There was very little technology and informatics being used in healthcare. In fact, when the first digital imaging modalities like CT’s arrived we printed films to read the studies. Everything was paper and sharing vital information to treat a patient was very difficult.

Today, one can say that technology is completely integrated and integral in how we treat patients. Without technology a system could not properly treat its patients.

With the current pace of innovation and technology we can see the vast improvements in care and outcomes. I see healthcare becoming better and more accessible to everyone. I see great changes similar to the changes in the banking industry experienced. I grew up going with my mother to the gothic bank my children have never been inside a bank. Patients in the near future will have access to virtual visits with their physicians and with the next generation of wearables and implantables your physician will be able to take care of you even before you get sick.

I recently published a piece on the clinical tricorder and how the Star Trek Vision is becoming a reality.

How will the emphasis on patient engagement change healthcare in the future?

We’re already communicating with our patients using SMS text and mobile smartphone technologies. The government has pressured healthcare providers to shift from a fee for service to a fee for performance that makes the system accountable for the health and well-being for the patients it serves. This is a big step in the right direction but it can’t be successful without the patient being engaged and taking care of themselves. Mobile and other technologies allow the provider to help the patient and care giver become engaged in their care. Key communications such as appointment and medication reminders, nutritional guidance, activity coaching and encouragement are essential in improving care and reducing costs. New technologies can monitor patients at home while providing early warnings of decompensation and risks.

How do you incorporate leading-edge healthcare technology systems at Montefiore?

Our innovation process enables me to be a mentor at local accelerators and incubators like Blueprinthealth, PilotHealth and Junto Health. As a member of HIMSS, RSNA, mHealth, MEMS, CES and others I have the opportunity to engage startups early and select the solutions that solve our biggest and most important challenges. Having 25 years of operational and strategic informatics experience I can best champion the new technologies across the Montefiore systems which includes the medical school, acute and ambulatory care, home health, care management, school health and everything in between.

A few years ago you said your challenge was to reliably deliver data to physicians regardless of their physical location in ways that fit and enhance their workflow. Is that still a challenge?

Yes, but it is much better in the last 5 years we really took advantage of mobile devices so today our clinicians have access to Fetal monitoring strips from labor and delivery, cardiac EKG’s, PACS images, EMR data, analytics, communications, collaborative platforms and secure image capture from anywhere. Tele-psychiatry is rolling out, Tele-stroke is next.

What has been the hardest part of pioneering the integrated healthcare delivery network at Montefiore?

It’s always the culture and the ability to take risk. You can’t change and service model if you don’t have the vision and the authority to go in and shake it all up. What makes is most challenging in healthcare is that lives and real people are involved.

What’s the most cutting edge application you’re seeing now? What other innovations might we see in the near future?

TYTOcare this is a device that enables a person to do self-evaluation that captures key vitals and images that enable a clinician to properly diagnose during a virtual visit.

Siri, Amazon Echo, Google Talk, these are just the beginnings of machine learning and what was once known as artificial intelligence. The next big change in how we interact with computers will make the keyboard obsolete and move us into the era of natural language processing where we can communicate with the computer simply by speaking to it. In the clinical world it will allow the clinician to focus once again on the patient and not struggle with the keyboard.

How do you find and develop talented employees at Montefiore?

NY is a great place for talent as the city is home to many universities, prestigious healthcare organizations, financial Mecca. Investing in and growing staff is important but key is partnering with the clinical teams and the knowledge that the systems you support directly impacts on the care that is being delivered to our patients. The best talent like to create and implement new and revolutionary technologies and at Montefiore that’s what we do. Being the parent company to Einstein School of Medicine and the top performing ACO in the country helps as well.

How do you retain top industry talent?

Mentor each staff member, know your people and put them in positions that helps them succeed.

What soft skills do you look for when hiring new talent?

Very soft… Bright, wants to learn, team player, motivated like to ask questions.

What are the most important characteristics an HIT leader needs to be successful?

A leader needs to lead and think out of the box and be willing to take risk. Healthcare is changing at an extraordinary pace the likes of we have never experienced before. IT is critical in the survival of our healthcare systems if a CIO makes the wrong call or no call at all the implications will resonate at the system level.

I have seen IT leadership undergo many phases during my career.

In the 90’s, IT was the dictator; we did things and the business had to do what was mandated. In 2000, after the Y2K nonevent, IT was beaten up and the clinical folks took over; we were servers and did whatever the business asked for even if it was not the right thing to do. Outsource years.

By 2010 CIOs were back at the table but reporting to CFO’s with limited influence there were also many transplants from the financial world and that is not a good fit.

My approach and advice is to always be a true partner with the clinical leadership and to do that you must understand the business you are in. Be a change agent, understand the big challenges and provide the solutions, engage clinical champions and break the mold by introducing new innovation and technology. Only the best and most confident HIT leaders will step into this role. Unfortunately, most fall short and that is a major reason that HIT lags so far behind other industries when it comes to accessibility, ease of use and the inability to share data between systems. There is hope though the population is demanding change and technology is a major change agent. HIT has come a long way in the past 25 years but I’m optimistic that the next 25 will be legendary.