Introducing Jane Aboyoun, CIO, SCO Family of Services

Jane Aboyoun

1. Tell us something about your childhood. What values had been instilled in you that helped you excel later in your life?

My parents are first generation Americans – both their parents were born elsewhere and emigrated to the US.  My mother is in her 80s now and she was amongst the first of her generation to go to college and work full time while raising a family. My mom loved her job as an elementary school teacher, and she taught me that helping others is the key to finding joy in a career.  My father grew up poor and in a foster home, but he managed to earn a full academic scholarship to college.  He went on to have a successful career in sales management.  In my family, education was highly prized and through my parents’ example, I learned that life-long learning and hard work was a way to advance oneself.  I was raised to be independent, to rely on myself, to value being able to support myself, to work hard, to focus, to be proactive and to always say “yes, we can”.  

2. When did you discover your passion for technology?

I found my passion for technology in my first job as a production planner at Nestle Foods.  Production planning is all about efficiency and process.  Computers are essential in delivering that and it was impossible to do my job without them. While studying engineering in college, I had to take a programming class.  Of all the courses that I took, that one was the most challenging for me and I barely passed the course. I vowed to never go near a computer and that stood until I was faced with tracking millions of dollars in WIP (work-in-process) inventory in one of Nestle’s production facilities. To do that, I developed a barcode data collection system to track inventory as it moved around the production floor.  The system was so successful that Corporate noticed and asked me to join their Information Systems team.  I started writing code for an MRP system and all at once, with practical application in real life, it suddenly made sense. My career in IT was launched.

3. What have been some of the biggest challenges in your life and how that has shaped you?

I always wanted to have both a career and have a family, and that is a tough balancing act.  Early in my career, I found working in a global C-suite job and raising young children at the same time to be extremely challenging. I’ve had to create boundaries in order to give 100% to each.  It is much easier now that my children are older, and as a result of my experience, I have huge respect for working parents who are trying to make it all happen. It’s not easy!

4. Tell us something about the social causes that you support.

I am passionate about fighting for equality and equity, protecting the environment, and animal welfare. We have so many challenges at this time in human history and how we navigate the next ten years together will be critical in so many ways.  

5. How would you define success?

What I have learned through my life experience is that success is a journey, rather than an end game, as the world is of course a dynamic place and the bar is always being raised.  Good ideas can come from anywhere and it’s critical to stay flexible and open-minded.  As a leader success is measured by the impact one has on others, and it’s often found in tiny actions that multiply across a team to impact an organization – the butterfly effect at work.  

6. How would you describe your leadership style?

I would liken it to a conductor of an orchestra…having a vision for what could be, selecting the players, empowering the musicians, directing the various piece parts so that together, we achieve an incredible outcome.  The fun part though, is that we are playing jazz music rather than the classics and sometimes the players just need to jam, and trust that we’ve got this, as there isn’t always a playbook for what’s next.

7. Looking back on your journey and knowing what you know now, what is one piece of advice you would have given yourself along the way?

To not lose sight of the big picture. In the rough and tumble of the day-to-day work, it is easy to get distracted and buried in the details.  It takes discipline to stay focused on the end game and keep your eyes above the tree-line.  This is where I feel I provide most value to the team, as in my role, I have the opportunity to see many pieces of the puzzle and how they fit together. I can help bring that insight back to the team, so that we can recalibrate if necessary and link those day-to-day tasks to achieving business objectives.

8. What advice would you give those who want to pursue a career in STEM?

There has never been a better time to pursue a career in STEM.  As I mentioned, the next few decades are critical to the future of the planet.  There are numerous exciting new fields emerging that can help address the issues in the world today.  These solutions are no doubt rooted in science, technology, engineering, and math.  I would encourage those interested to move forward earnestly. I believe the reward would be a satisfying and worthy career that might just change the world!

About Jane Aboyoun –

Jane Aboyoun is the Chief Information Officer at SCO Family of Services, a non-profit agency that helps New Yorkers build a strong foundation for the future. In this role, Jane is responsible for leading SCO’s technology strategy, and managing the agency’s technology services to support business applications, architecture, data, engineering, and computing infrastructure.

As an accomplished CIO / CTO, Jane has spent 20 years in the C-suite in a variety of senior technology leadership roles for global, world-class brands such as Nestlé Foods, KPMG, Estēe Lauder Companies, Walt Disney Company, and the New York Public Library.

Health Information Exchanges in Post-Pandemic Healthcare

Srinivasan Sundararajan

Electronic Health Information Exchange (HIE) allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically – improving the speed, quality, safety, and cost of patient care.

HIE enables electronical movement of clinical information among different healthcare information systems. The goal is to facilitate access to and retrieval of clinical data to provide safer and more timely, efficient, effective, and equitable patient-centered care.

While the importance of HIE is clearly visible, now the important question is how hospitals can collaborate to form an HIE and how the HIE will consolidate data from disparate patient information sources. This brings us to the important discussion of HIE data models.

HIE Data Models 

There are multiple ways in which an HIE can get its data, each influencing the way in which the interoperability goals are achieved, how easily an HIE platform is built and how to sustain in the long run especially if the number of hospitals in the ecosystem increases. The two models are

  • Centralized
  • De-centralized

Centralized HIE Data Model

ehr modernization services with healthcare data

This is a pictorial representation of centralized HIE data model.

As evident, in the centralized model, all the stakeholders send their data to a centralized location and typically a ETL (Extraction, Transformation, and Loading) process ensures that all the data is synced with the centralized server.

Advantages

  • From the query performance perspective, this model is one of the most efficient, because the DBAs have complete control of the data and with the techniques like partitioning, indexing they could ensure that the query can be done in the best possible manner. Since the hardware is fully owned by a single organization (which is the HIE itself), this can be scaled out or scaled up to meet the demands of the business.
  • This model is fairly self-sufficient once the mechanism for the data transfers are established, as the need to connect to individual hospitals are no longer there.
  • Smaller hospitals in the ecosystem need not take the burden of maintaining their data and interoperability needs and can just send their data to the centralized repository.
  • Better scope for performing population predictive and prescriptive analytics as the data resides in one place and easier to create models based on the historical data.

Limitations

  • This model needs to have highest level of security built in, because any breach in the system will compromise the data of entire ecosystem. Also considering that individual hospitals send their data to this model, all the responsibility lies with a single agency (HIE) which is highly prone to lawsuits related to data privacy and confidentiality.
  • There is no control for patients in managing their own records and right to provide consent for data access, even though this information can be collected there is no easy way to implement them.
  • The system is prone to a single point of failure and hence require efforts for high availability of the platform.
  • This model will face scalability challenges as the network grows beyond a point, unless the platform is modernized with latest big data databases, the system will have scalability issues.
  • Lot of coordination required to monitor the individual ETL jobs for their success, failure, and record synchronization details, so this model will have a huge allocation of IT resources and will increase the total cost of ownership.
  • The model of expense sharing between the HIE, data producers, data consumers will be difficult and needs to have a strong governance model.
  • Difficult to match the patient information across hospitals, unless the both the hospitals use deterministic matching attributes like SSN, otherwise it would be difficult to match between patients who have misspelt names, different addresses, etc.
  • This model may suffer data integrity issues when the participant hospitals merge with each other, such that the IT systems of the two hospitals need to take care the internal details of the ETL jobs.

De-centralized HIE Data Model

ehr modernization with health data management platforms

The above is the pictorial representation of decentralized HIE data model.

As evident, in this model individual hospitals, continue to own all their data, however, the centralized database keeps a pointer – MPI (Master Patient Index), which serves as a unifying factor for consolidating data for that patient. While some books also suggest a variant called Hybrid model which combines centralized and decentralized data models, we believe that pure play decentralized model itself is a hybrid (i.e. centralized + decentralized) because there needs to be a centralized repository to keep the master patient index along with all the access rights and related information.

Advantages

  • It is much easier to implement as no huge investment is required from a centralized provider perspective. The HIEs in this model can start low and grow on demand basis
  • Less expensive as no single organization owns all the data, but only a pointer to the data, and the respective hospitals continue to own the data.
  • Much easier to provide patients the control of their own data and patient’s consent can be a key in accessing information from the respective hospitals.
  • No need to worry about broken ETL jobs and the latency between source and destination. All the data is always current.
  • No need to worry about single point of failure, as the individual sub systems will continue to exist even if one link to a particular hospital is broken. Maintaining the high availability of this light-weight platform is much easier than a monolithic large database as part of a centralized data model.
  • A data breach into the centralized repository still will not compromise all the data, as the individual hospitals are likely to have some more additional controls which prevent a free flow for hackers. This also prevents one organization from facing all the legal issues resulting from patient data breach.

Limitations

  • This model will have a query performance problem when it comes to aggregating a patient information across multiple hospitals because each has to be obtained with a separate API call and a facade has to group multiple datasets.
  • Difficult to establish common standards in terms of data formats and APIs across multiple hospitals, this may result in each hospital having their own methods.
  • Bringing all the stakeholders including the patients to agree on a MPI (Master Patient Index) will have governance challenges and needs to be implemented carefully.
  • Providing analytics for a large set of population will have challenges due to the difficulties in consolidating the data.

GAVS Point of View & Role of Blockchain

While no model can be 100% perfect for building an HIE, GAVS’ analysis point to that fact decentralized model of building and operating HIE is better than centralized model.  The COVID pandemic has changed the world and the boundaries of healthcare no longer exist within a smaller geography or neighbourhood as it used to. More the participants and bigger the network size, the better it is for population health improvement initiatives. Also, in high population countries where there are initiatives like national healthcare for all, these larger initiatives cannot be done using a pure play centralized model.

From an implementation perspective, the Healthcare IT world has been curiously watching the role of Blockchain in data interoperability and in the implementation of decentralized HIE. Blockchain which is a distributed database has decentralization built-in as part of its core architecture. It would be easier to implement decentralized HIE using blockchain.

GAVS Reference Implementation Rhodium to cater to Healthcare Data Management and Interoperability has positioned Blockchain as a core mechanism for patient data sharing, we will share more of our thoughts and details of reference implementation in the coming articles in this series.

About the Author –

Srini is the Technology Advisor for GAVS. He is currently focused on Healthcare Data Management Solutions for the post-pandemic Healthcare era, using the combination of Multi Modal databases, Blockchain and Data Mining. The solutions aim at Patient data sharing within Hospitals as well as across Hospitals (Healthcare Interoprability), while bringing more trust and transparency into the healthcare process using patient consent management, credentialing and zero knowledge proofs.