Leadership Interview: Kate Kiefert

Kate Kiefert, Colorado health implementation coordinator

As Colorado moves forward with its State Innovation Model (SIM) initiative to create an accountable system of care that integrates behavioral health, primary care and public health, it will need a robust health IT strategy. Kate Kiefert, Colorado health implementation coordinator and state HIT coordinator, discusses what's involved in deploying that strategy and the challenges along the way.


The Ascent: Can you briefly discuss the role health IT will play in Colorado's transformation plan?

Kiefert: Health IT is an integral component of SIM, but it's also an element of other strategic objectives. It can't be siloed. Colorado's SIM encompasses population health, health IT, quality measurement, public/private payer alignment, public health, practice transformation and other areas aimed at integrating physical and behavioral health. Health IT cuts across all health transformation efforts in Colorado. We aren't starting from scratch. The SIM funding will simply accelerate programs that need to happen to support Colorado becoming the healthiest state. We want to continue to add to health IT infrastructure in ways that provide value to providers and the community. SIM is one of multiple initiatives that align with the overall strategy of investing in technology to promote integration of programs and use of data. The goal is improve health across the state, from health information exchanges to public health to corrections and the justice system. We're also supporting expansion of broadband and expanding Colorado's telehealth strategy, in addition to providing practice transformation resources and regional community collaboratives.

The Ascent: What are some of the challenges?

Kiefert: Quality of data is a significant challenge. There's lot of data out there; we need to find ways to make it useful, actionable and available to improve health. We have varying levels of health IT adoption and vastly different maturity levels of health IT systems. Across the state, practices and institutions use EHRs in different ways for clinical workflow. We need to improve the quality of data captured, availability of the data, integration among settings and systems, and aggregation of data for multiple purposes. We're aligning quality measures with population health measures with the intention of sharing the information with providers and other stakeholders. Availability of quality information is imperative, regardless of setting, primary care or public health or behavioral health.

Another challenge is managing communications across all the partners. It's not just connecting the technology. How do we keep everyone connected? As we bring together communities, providers, payers, public health, we need a shared strategy and direction. At the same time, while the community can align to a shared vision and objectives, each entity needs to maintain its own autonomy. Not every small provider will have the same resources, so we need to create a plan--and direct resources and investments--to meet different levels of sophistication. Some may be just beginning, but we need to provide services to get them all on the path to advanced use of health IT.

The Ascent: So the challenge isn't just breaking down silos, but also connecting what remains when the silos are removed?

Kiefert: Yes--it's about integration and collaboration. Solutions aren't going to come from top down or bottom up--they demand cooperation and collaboration among very different entities. As I said, a large part of what we're doing is coordinating and leveraging existing efforts. Everybody is trying to improve care, improve quality and reduce costs. SIM enables us to stitch all this together to make an amazing tapestry.