Healthcare: a fabulous field for the savvy IT pro

A wealth of new and potential developments provides great opportunities for IT pros with the right skills

"Hospital systems are complex and you have to get it right because the smallest changes can make a difference." – Madhunika Sridhar, BluePrint Healthcare IT

By Laurel McKee Ranger
Contributing Editor

Information technology is about to transform the way medicine is practiced in this country, says Peter Waegemann, VP of the mHealth Initiative (www.mobih.org). Waegemann founded the Medical Records Institute (MRI, Boston, MA), served as its CEO for twenty-seven years and has promoted the use of electronic medical record systems since the 1980s.

How will things change? "The healthcare field will use technology and information in new and very different ways," he says. "Treatment will occur 'virtually' in some cases. Doctors won't be the lone caretakers anymore, but will operate more like orchestra conductors, coordinating a team of specialists and nurses."

The Health Information Technology for Economic and Clinical Health (HITECH) Act, passed in 2009 as a subsection of the American Recovery and Reinvestment Act, has enlarged the focus of healthcare IT, adding meaningful use systems to electronic medical records. It has made $22 billion available to hospitals and clinics to use for implementation of such systems.

"In the future, patients will be able to request their personal health information in digital form, empowering them to manage their own health," says Waegemann. "Doctors will be able to find out who else is caring for a patient at any time. This will provide greater continuity of care, so a patient's various medical problems will no longer be addressed in separate medical silos." For example, physicians will be able to determine exactly what medications a patient is taking, look up medications and review scientific evidence at the point of care.

Waegemann feels that iPhone and iPad apps will create a revolution in healthcare. "Within five or ten years doctors will be prescribing on your iPhone, which will tell you what medication to take and what to eat and where to go for additional tests. It will collect your data and send that to your doctor to monitor your health. For example, you will be able to send your symptoms by email along with a photo of your injury, which will ultimately save on visits and be more convenient for everyone. Devices will measure your blood sugar and alert your doctor if it is outside normal limits," says Waegemann.

All these potential developments present marvelous opportunities for IT pros with the right skills. They also pose challenges as concerns with privacy and security increase.

Dr Sujatha Ramanujan: working with a conscience at Carestream Health
Sujatha Ramanujan, PhD is worldwide product line business manager for mammography and pediatrics at Carestream Health (Rochester, NY), a provider of medical, dental and molecular imaging systems and healthcare IT solutions. Ramanujan works in the digital capture area. "We provide the IT package: the algorithms that pick out suspicious areas in a mammogram, for example. It's not diagnostic, but it alerts the radiologist to take a closer look," she says.

Ramanujan works with customers to determine needs and requirements. She's also responsible for developing the business case and ensuring that the product ultimately delivers in financial terms. "And I have to figure out, in this regulatory environment, what kind of clinical studies we can run to demonstrate any claims that will be made. For example, I help with the study designs so we can support claims that our systems help detect cancer," she explains.

A solid understanding of the technology involved is crucial so she can translate customer needs into something technically achievable. "I'm the interface between the customer and the technical team. You have to understand both sides, so it's a job that requires balance."

Ramanujan has a 1989 BSEE, a 1991 MSEE and a 1995 PhD from the University of Michigan. She supported her MS work with a General Electric fellowship and her PhD studies with a National Science Foundation fellowship.

When she got her BS she went to work at General Electric's aerospace division in Syracuse, NY, developing algorithms for LAN radar systems. When she completed her PhD she moved to Eastman Kodak, working in corporate R&D and supervising a team involved in digital cinema and immersive imaging LCD design. She moved up to director of external alliances and venture relations, developing the merger and acquisition strategy for the company's healthcare IT and molecular imaging businesses.

In 2007 the healthcare segment of Eastman Kodak's business was spun off as Carestream Health, and Ramanujan worked for Carestream as a business analyst and marketing manager for healthcare IS, and technical project manager for mammography PACS systems. She was also R&D director for the computer-aided diagnostics business.

Technology was an easy choice for Ramanujan. Her father was a math prof at U Mich, and "I loved math and science and always knew what I wanted to do," she says.

She was working in the research labs at Kodak and got together with the healthcare team. "There was a lot of innovation," she says. "The team was was poised for great growth in the IT area, and I also liked the feeling that what we were doing made a difference in peoples' lives.

"Just recently we got a letter from a lung cancer patient thanking us for our work. I've never seen a scientific team so happy!"

Her prior work in other areas of imaging gives Ramanujan an interesting perspective on her current work. "The IT I work on now is clinically intense. A tremendous amount of math and physiology is involved. You have to learn to interpret a lot that has not been mathematical up to now and translate it into algorithms, and develop mathematical constructs that correlate to clinical findings.

"It requires a huge amount of discipline and also a sense of responsibility. You can't work without a conscience here. If you miss a few pixels someone's cancer may not be detected in time."

Understanding the global markets is another challenge. "You have to change your perspective and be aware of the different cultures," she says.

When she was not on the job, Ramanujan used to be involved in climbing and was a climbing instructor for women. But now that she has small children she pursues the sport less frequently. Instead, she teaches Indian classical dance and volunteers in local soup kitchens.

Charity is an important focus in her life. "I'm concerned about poverty. My family has a tradition of giving to others on your birthday, so I buy dinner for an orphanage in Bangalore, India. Here I work with the Open Door Mission, and also to raise money for breast cancer research."

Diversity and opportunity at Carestream Health
Carestream Health includes both medical and dental businesses. The company hires developers with experience in picture archiving and communications systems (PACS), service technicians who deal with software upgrades, system architects who look at the hardware configuration of hospital and radiologic centers, along with technical implementation specialists and applications consultants who work with the customers and back up the sales team. The company also looks for engineers to develop algorithms to enhance images, and techies with embedded systems programming and interface analysis experience.

"We also need technical implementation specialists and solution architects who look at the whole system and integrate it into the hospital's existing system," says Kevin Duffy, chief HR officer at the company. "We look for people on the development side with experience in radiological information systems and workflow systems and people with digital capture experience. Lean or Six Sigma certifications certainly help."

Duffy emphasizes that the company is a highly diverse organization, with employees from some forty-five countries. "Rochester is the headquarters, but we bring in people from all over the world. We employ people of color and both genders in all areas. We've worked hard to develop a Carestream culture that's open to diversity," Duffy says.

The company is growing. When Carestream was spun off from Eastman Kodak in 2007 it did not actively recruit at first, but now it's starting outreach to universities. New IT recruits are rotated through the organization to get wide exposure in various areas. "We have about twelve employees in that program now," Duffy says. The company has an e-campus with a wide range of technical and management courses and also offers tuition reimbursement.

Ram Krishnan: global IT at GE Healthcare
GE Healthcare (Waukesha, WI) provides imaging devices, anesthesia delivery and healthcare IT solutions and has a life science business that includes drug discovery and biotechnology divisions. As a VP and general manager at GE Healthcare IT (Barrington, IL), Ram Krishnan is responsible for delivering IT solutions that support high-quality and cost-effective care through business, clinical and workflow applications, in settings that range from the physician's office to the integrated delivery network.

Krishnan also has responsibility for the area of the business dedicated to radiology IT, which includes PACS, radiology information systems and business intelligence; he's accountable for global profitable growth, operations and customer satisfaction. He spends more than half his time traveling, working in the field in the U.S., Europe and Asia. He has a staff of six and heads up an organization of close to 900 employees.

Krishnan has a BS in systems engineering from the University of Virginia and is currently in an executive MBA program at the University of Chicago. He interned in the IT department of GE Capital while working on his BS.

He joined GE Healthcare after graduation, working on assignments that ranged from tech support and software development to data center design and global program execution. Then he moved to GE corporate (Fairfield, CT) where he worked in marketing and communications as the eBusiness leader. He was responsible for GE.com, the global GE intranet, and laid the foundation for several global communication infrastructure platforms.

In 2001 Krishnan moved to GE Healthcare as an engineering leader for an operational and clinical performance improvement business. In 2005 he joined the imaging solutions business as services leader, managing the Americas professional services and tech support team. He moved into his VP/GM job in 2008.

"The business I run has $700 million annual sales globally," he notes. "The basic thrust of the business is to take digital images from devices and store them indefinitely, so physicians can compare new images with old ones and use tools to diagnose diseases. We create a 3D image, and our software is focused on digitizing the workflow from initial order through final report. Our solutions include scheduling exams, storing, organizing and displaying the images, and even helping radiologists to create and distribute reports."

As a child growing up in Virginia, Krishnan was heavily influenced by the Indian culture of his family. "You can aim to be a doctor or an engineer; those are your choices," he explains. He went to a science- and technology-focused high school before moving on to U Virginia.

He was drawn to healthcare, "looking to escape corporate IT and be a little more entrepreneurial and customer-focused," he says. "But what keeps me here is the mission and purpose."

It's challenging work. "You have to manage hundreds of IT implementations on a commercial level, repeatedly and predictably. We're a highly regulated business, inspected by the FDA. We have an entire infrastructure built around those regulations."

The challenges Krishnan faces are multiplied by his sense of responsibility and by international regulations as well. "If we screw up, people's lives may be at stake. We're also providing solutions across various markets where healthcare delivery models differ and there are different challenges, so balancing the needs of these markets can be very complex," he says.

In his spare time Krishnan volunteers through the Asian Pacific American Forum at GE, pursues his hobby of photography, and enjoys time with his wife and son.

Madhunika Sridhar: SPAC at BluePrint Healthcare IT
Madhunika Sridhar is a security analyst. She's part of the security, privacy and compliance (SPAC) team at BluePrint Healthcare IT (Cranbury, NJ). The team provides security and compliance analysis and software solutions for hospitals, hospital networks and medical groups.

Sridhar has a background in intrusion detection analysis and vulnerability research and assessment. As a consultant she works directly with clients at their sites.

"We do risk analysis, look for malware and policy breaches, and determine if the system is hackable. Once we identify a problem we recommend appropriate controls. Our assessments are HIPAA and HITECH security focused," says Sridhar.

She has a 2004 BS in software systems from Guru Gobind Singh Indraprastha University (Delhi, India) and a 2006 MSCS from Fairleigh Dickinson University (Teaneck, NJ). After graduation she went to work as an IT consultant with American Tech Solutions (Irvine, CA), training in networking tools and PeopleSoft. The next year she was hired by Niksun Inc (Monmouth Junction, NJ) as a security engineer, serving as acting lead of the certified rules team and point of contact for intrusion detection system issues.

Sridhar grew up in Delhi, where she was writing programs by eighth grade. "After my undergraduate work I wanted to study computer networks. Then I took a course in security and knew that was the field I had to be in. I loved working at the bit and byte level!" Sridhar says.

A major challenge of her work is learning all the various hospital systems. "It's complex and you have to figure it out and get it right because the smallest changes can make a difference."

On the side, Sridhar enjoys Indian classical dance. "I studied that area for sixteen years and have a diploma," she notes.

Opportunity at BluePrint Healthcare
Kimberly Khosia, employee services manager at BluePrint Healthcare IT (Cranbury, NJ), says the company works mostly in security and compliance analysis but also creates software solutions to help hospitals manage beds and patients. BluePrint is small right now, but she expects both the company and its need for techies to grow along with the burgeoning healthcare IT field.

Mohit Pasricha, chief solutions architect at BluePrint, notes future openings will likely be for IT folks trained in network security and familiar with HIPAA regs, and for solutions architects, systems/business analysts, software architects and engineers, DBAs, Web designers and QA engineers on the software side. The company provides training and college course opportunities for employees.

James Cammack: high-tech computer forensics at Highmark
As a security consultant at healthcare insurance company Highmark (Pittsburgh, PA), a Blue Cross Blue Shield affiliate, James Cammack's responsibilities include detection and prevention of malicious use of Highmark's computer assets. Cammack has been working in computer forensics for several years now. "I'm trained in investigative techniques and have assisted the state police," he explains.

Cammack grew up in Harrisburg, PA, and has a 1992 BA in applied psychological theory from Lebanon Valley College (Anvil, PA). But before that he had a career in the Air Force as an assets controller. "I was in for seven years and went all over the world," he says.

In fact, Cammack has been learning computer skills for most of his life. He started on a Commodore 64 and worked on 64s while he was in the military. In the 1990s he joined Pinnacle Health Systems (Harrisburg, PA) and worked there for six years as a network engineer, helping develop the company's inventory management system. He moved on to two years with Network Engineering (Malvern, PA), and came to Highmark in 1998, starting as a desktop technician and moving up to network engineer.

He aced the hardcore courses Highmark offered and became a security consultant, finding that his work involved more and more forensics. That was just fine for him: "I come from the hacking community," he confides with a smile. "But I was a white-hat hacker.

"Now I report to a management team that reports directly to the CISO, and it's my job to examine residuals to determine how black-hat hackers get in. I can remotely connect to a suspicious device, bring it up into the backend and examine it bit by bit to see what's running. I'm able to capture the volatile memory and everything that's running on a virtual disk and then analyze it as if it were on the computer.

"This is pretty slick technology!" he notes. "If the investigation is likely to go to litigation I store the information bit by bit."

Cammack belongs to the High Technology Criminal Investigative Association, where his sponsor is the district attorney for New York City's Manhattan borough. One of his mentors is a forensic analyst who worked on both the Enron and the O. J. Simpson cases.

Cammack sees a lot of exciting opportunity in healthcare. "The healthcare industry has long operated on a 'business as usual' basis. They are very good at claims processing, but I saw opportunity in the forensics area," Cammack says.

Apart from keeping up with the hackers, he faces the challenge of putting across the need to be proactive rather than reactive. "The environment is constantly evolving and information warfare is a whole different beast. Identity theft is a big threat, and we have a responsibility to protect our members' personal healthcare information!"

Cammack has faced other challenges as well. The environment at Highmark is comfortably diverse, but "In my Air Force group I was one of just a few African Americans out of thousands of people. I have always felt that I needed to excel, and sometimes that weighs heavily."

Balancing family and work can be difficult with his compelling, all-consuming career. "I can easily put in fourteen or fifteen hours a day, so I have to be careful not to do it too often."

Fortunately, his family understands his compulsion. "I have a daughter who is ready to go into a Navy ROTC program, and my wife works for the government in hazardous materials."

Not content to limit himself to virtual risks, Cammack likes to relive his Air Force days with a little skydiving in his spare time.

Diversity and opportunity at Highmark
Christine Culp, an employment specialist at Highmark, notes that the HITECH Act of 2009 has put an ever-greater emphasis on the security of systems. "We process more than seventy-nine million health care claims a year, so we have to be sure our systems can handle the volume quickly and in a secure manner," Culp emphasizes.

The company has a significant number of employees involved in healthcare IT and looks for apps developers, tech business analysts and IT project managers. Occasionally it also needs techies with backgrounds in IT security, network security or helpdesk work, but most new hires are apps developers. Mainframe and Web development backgrounds are of course an advantage.

Highmark University helps employees hone their IT skills. The company also offers tuition assistance for other schools, Culp notes.

"Diversity plays a crucial role in our organization," she says. "We feel that in order to understand what our customers want we need to reflect that population.

"We attend community and college job fairs and work with career services and disability services at a variety of colleges and universities, state and private schools. And we post our employment opportunities on diverse job boards."

The company also partners with Inroads, which prepares talented minority youth for leadership roles. Sara Oliver Carter, VP of diversity and inclusion, notes that Highmark "strives to build a culture of inclusion for employees in an environment where people feel valued and respected for their differences and unique contributions. Individual skills, abilities and perspectives are tapped to create business success; when everyone has an opportunity to contribute, the company has the opportunity to succeed."

Highmark sponsors several business resource groups, including the Black Network; Lesbian, Gay, Bisexual, Transgender and Allies; and two new groups, Generation X & Y and Latino/Hispanic.

Alfredo H. Gonzalez manages IS-centric projects at BCBSNC
Alfredo H. Gonzalez is a project delivery manager for Blue Cross and Blue Shield of North Carolina (BCBSNC, Chapel Hill, NC), which provides medical insurance within the state. His group works to deliver IS projects for functions essential to maintaining company computers, and other IS-centric projects.

That includes the computer network, telephone system and more, Gonzalez says. "We also do projects for storage, system monitoring, servers, portfolio management and the helpdesk system. We help maintain and upgrade the computer systems."

IT, he explains, has two main project functions at BCBSNC: corporate and IS. "In IS projects we provide the infrastructure; that's where I work."

Gonzalez' main responsibility is portfolio and resource management. As BCBSNC is a matrixed organization, Gonzalez and other project managers assemble teams of subject matter experts. "I also lead projects myself sometimes," he adds.

Gonzalez was born in Cuba. He came to the U.S. as a toddler when his family escaped the Castro regime. "My parents left everything they owned and came here and started over in North Carolina." Growing up, Gonzalez says, "I liked building things, and computers were exploding!"

Gonzalez has a 1981 BS in industrial engineering from North Carolina State University and is certified as a project management professional (PMP) by the Project Management Institute. Before BCBSNC he worked at Carolina Power and Light (Raleigh, NC), beginning in 1982 as an engineer in fossil ops but moving up to senior IT analyst. In 1996 he joined Walt Disney World (Orlando, FL) as a business solutions specialist and then senior tech specialist in disaster recovery, point of sale replacement and automated ticketing systems.

"I loved working for Disney," he says. "But my family was in North Carolina, so I looked there for companies that meant something to me. BCBSNC was my parents' health insurance provider so I looked into working there. I knew they were helping people and I liked that."

In 2004 he joined BCBSNC as a senior technical project manager, and moved into his current project delivery job in 2006.

In healthcare IT, Gonzalez says, regulations like HIPAA make for a challenging environment. "We have state and federal regulations and also regs from the Blue Cross and Blue Shield association. We have to be able to exchange data with other BCBS member companies, for example. There are uptime and response time requirements, the need to monitor the systems for performance and security, firewalls and internal and external audits to ensure the system is properly protected: all this makes for a complex environment!"

Another issue is healthcare reform. "It's a big unknown, and as of now it has to be implemented by 2013," Gonzalez says. "It's a very fluid environment."

After hours Gonzalez works with several charities including the Jimmy V Foundation for Cancer Research, the Junior Diabetes Resource Foundation and Habitat for Humanity, as well as Be Active North Carolina, dedicated to increasing physical activity levels and promoting healthy lifestyles. On the job he's a founding member of the BCBSNC DiversityIS and the Hispanic and Bilingual Learning Alliance (HABLA) employee networks. HABLA focuses on the range of Hispanic cultures within the company.

Bruce Armsterd: long-term vision in the WebSphere group at HCSC
Bruce Armsterd manages the WebSphere group at Health Care Service Corp (HCSC, Chicago, IL), a health insurance provider of Blue Cross and Blue Shield plans in Illinois, New Mexico, Oklahoma and Texas. He has been in IT for twenty-one years and with the company for four years. "One of the main reasons I joined HCSC is that IT is essential to the company," he says.

WebSphere is Armsterd's main concern on the job. He explains that it's an integrated software-portal-based app that works across platforms. It's used to update portals and websites to improve communication with customers.

Armsterd manages the engineering group that designs and implements the infrastructure to support the company's various apps. "We configure the servers for 24/7 availability while developers publish new applications," Armsterd explains. "Then we help test the apps." He manages a group of twelve techies who work in development, testing and production environments across all apps.

Armsterd started studying CS at college in Illinois, but he left at the beginning of his junior year. That was when Waste Management, the waste collection and disposal company he was interning with, made him an offer he couldn't refuse. He was asked to come in immediately as a systems analyst, installing, updating and maintaining PCs.

"I worked for them from 1992 until 1995 and learned so much on the job," he says. "They got me into Lotus Notes and working with stuff like collaboration software, which was cutting-edge technology at the time."

Next he went to Winston & Strawn, a law firm with an international presence, and became their Notes admin. In 1998 he joined Xpedior (Chicago, IL), an Internet services company, as a senior consultant. He worked with Lotus Notes, migrating large companies from other mail platforms to Lotus.

In 2000 he moved to Aon (Chicago, IL), an underwriting and insurance company that was an Xpedior client. Now he was a senior Notes admin doing a lot of travel. "We had mail servers across the globe and I moved into more of a managerial role with less hands-on work," he explains. In 2006 he moved to HCSC.

For Armsterd, one of the key differences in healthcare IT is the importance of long-term vision. "When we make decisions we're not just looking a year ahead. We're looking at three and five years out as well. You look to make things better down the road."

Armsterd is a member of BDPA and Phi Beta Sigma, a fraternity from his college days. He volunteers to work with kids through both organizations. "I was a judge at BDPA's national high school competition and I was amazed at how skilled the students were!" he says. "Seeing them figure out complex solutions in a few hours was awesome. It's great to show kids that playing video games is fun, but designing them is even more fun!"

Veeneta Lakhani leads enterprise portfolio management at WellPoint
Veeneta Lakhani is staff VP of technology at WellPoint Inc (Indianapolis, IN), which provides health benefits for more than thirty-three million members. Lakhani leads the enterprise portfolio management organization, which aligns IT investments with company priorities and "drives disciplined processes to ensure strong execution and return on investment," she says.

This, she explains, "Includes working to create the best healthcare value in our industry, excelling at day-to-day execution and capitalizing on new opportunities to drive growth." Using data and analytic tools, Lakhani works with her team and senior execs to design the right portfolio of IT investments. She works with cross-functional delivery teams that include IT, finance and other business areas, oversees a department of fifty and has eight direct reports.

She has a 1995 BS in business admin with a minor in CS from Boston University (Boston, MA) and a 2000 MBA from Northwestern University's Kellogg School of Management (Evanston, IL).

Over the course of her career she's worked in the technology consulting group of Andersen Consulting (now Accenture), where she did application design and development, and for consultant McKinsey & Co in its insurance ops and technology practice. In 2009 she moved to WellPoint as a staff VP.

Growing up in Miami, FL, Lakhani was inspired by the potential of Internet technology and its impact on day-to-day processes. Over time her career has taken a broader, more strategic turn toward insurance operations. "Healthcare impacts people's lives as nothing else does," she says. "Regulatory demands are a tremendous challenge to IT. The level of change we're undergoing now is very different. It's important to be very smart about how to be compliant. We spend a lot of time on that," Lakhani says.

As an American with Indian heritage, Lakhani finds that balancing priorities while sustaining her cultural values can be difficult. "I've undertaken an aggressive career path and I have high aspirations. The biggest challenge is to balance those goals with my family values," says Lakhani, who is the mother of two children.

Recently Lakhani was named acting VP of planning and strategy for Lori Beer, EVP at WellPoint. Beer oversees WellPoint's enterprise business services area, which includes the company's IT organization.

D/C

Laurel McKee Ranger is a freelance business writer headquartered in Randolph, NJ.

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