Episode 9: Visionary Voices with Matt Kull

Larry Kaiser:
Hello, and welcome to this episode of Visionary Voices. Today we’re joined by Matt Kull, EVP and Chief Information and Digital Officer at Inova Health. Recently, from U.S. News & World Report, Inova was rated the number one hospital in Virginia and is Northern Virginia’s leading nonprofit healthcare provider. Matt is a seasoned leader in digital innovation and organizational transformation who has been recognized nationally for his leadership, including the 2022 Ohio CIO of the Year. He’s been voted the Northern Ohio CIO of the Year as well, received the HIMSS Davies Award, and is a newly minted CHIME Board of Trustee.

So we’re excited to have him on the podcast today. Today we’re going to be discussing IT governance and organizational efficiency. Matt, thanks for joining the podcast today.

Matt Kull:
Larry, thanks for having me. It’s great to be here with you.

Larry Kaiser:
Awesome. We’re going to kick things off today with our usual first segment, which we like to call Bandwidth Banter. It’s our fun take on icebreakers and allows us to get to know our guests a little better.

So I’m going to ask you something that used to be a big commercial rivalry for a long time. Are you a Mac or PC guy?

Matt Kull:
Mac, all the way. It only took one blue screen of death during a presentation to make me convert, and I’ll never look back.

Larry Kaiser:
You know, I’m a Mac guy myself. My brother actually opened the very first Apple store on Long Island way back when, and I’ve been sucked into the ecosystem ever since. So I could never get out even if I wanted to.

Matt Kull:
Yeah, it’s tricky, right? My first order of business when I got to Inova was making sure Mac was a designated standard platform. Many people were very happy about that, including myself, so it’s been a long time since I’ve touched a PC.

Larry Kaiser:
That’s awesome. So let’s dive into governance.

Matt Kull:
Often I think governance fails to say no, or to be somewhat realistic about what’s achievable throughout the year, both in the ability to deliver and also the ability for end users and our constituents to consume.

When we look at technology governance, it can’t just be governance around technology itself. It has to start with organizational clinical governance. What is the clinical enterprise governance doing for the organization? From my perspective, it has to start there.

If it starts with “here’s our digital strategy” or “here’s our technical strategy,” I think we’re starting in the wrong place. The question should be: what is our business strategy to deliver care in the best way possible to our communities?

Larry Kaiser:
That’s a very specific way of approaching it, and I can definitely appreciate that. Looking at the recognition that Inova received from the Joint Commission for being the first in the nation to achieve responsible use of health data, do you feel that your governance approach played a key role in that recognition?

Or is it more about the processes that ensure data is captured and used properly for care coordination and other functions?

Matt Kull:
Larry, I think it’s both.

Part of the accreditation is about appropriate use. When you’re using patient data, there are clearly defined reasons for doing so. Either you’re using it for quality improvement to improve outcomes and care, you’re using it for research to improve therapies or identify potential therapies, or you’re using it from a perspective of doing business.

Having a structure around that where the clinical enterprise determines the things we work on and how data gets used is critical. We have a subcommittee for artificial intelligence, data governance, standards, and usage. Coupled with that is a whole structure of procedures.

We make sure things are encrypted. If it’s research, we have appropriate IRBs. If it’s quality work, the data is destroyed at the end of the quality exercise. If we’re partnering, there are minimal use agreements and rights of revocation.

All of those things play into the structure of policy and procedure underneath the governance model. That’s really what the Joint Commission is looking for.

Is the use appropriate? And when you’re using the data, are you using it appropriately?

Larry Kaiser:
That makes sense. Governance clearly plays a role in outlining how data gets used across the organization.

So let me ask you this. For someone like you, or another CIO or CDIO who joins a new organization that doesn’t yet have a strong governance model, what’s the mindset they need to adopt to build one like the model you outlined at Inova?

Matt Kull:
I would say there are three things.

First, the organization has to understand what its priorities are because everything flows from that. If you look at organizations that do structured annual planning or have a three- or five-year vision roadmap, the work we do day to day that isn’t regulatory or safety driven has to tie back to that roadmap.

Otherwise the work becomes distractions from achieving the goals the organization identified as most important. Healthcare has lots of great ideas, but the real question is whether they align with the organizational strategy.

Holding yourself to the discipline of focusing on that and not getting distracted is both the most important thing and the hardest thing to do.

Second, you need a structure for new requests to come into the system. Governance groups need the rigor to go back to the strategic plan and ask whether the idea aligns with it. If it does, you consider it. If it’s a good idea but not aligned, you have to have the fortitude to say “not now.”

But if something emerges that truly should change the plan, then governance needs the ability to revisit the strategy and adjust.

Third, governance teams need to be comfortable with pivots. Things will come up during the year that rise to the top due to market conditions, competitive pressures, reimbursement changes, financial concerns, or new opportunities.

You have to be comfortable saying, what we decided last week was right last week, but today this new opportunity is better.

If you can get those three things right—a solid plan, the discipline to stick to it, and the comfort to adjust when necessary—you have the foundation of strong governance.

Larry Kaiser:
That’s fantastic advice.

You mentioned the rigor required to accept pivots. When those opportunities arise, are there guiding principles you use to determine whether that pivot makes sense?

Matt Kull:
There are fundamental questions you have to ask.

Can we win at this?
Does it advance our mission?
Does it benefit our community?

Is it more than just a good idea? Is it something that will meaningfully move us forward?

You also have to ask about opportunity cost. If we pursue this new initiative, what are we not doing instead?

And then there’s adoption capacity. Delivering technology is only half the battle. Adoption is the other half.

At Inova, every change affects roughly 27,000 people. So we have to ask whether we have enough adoption energy left in the tank.

Sometimes external factors change that calculation as well. For example, during a heavy flu season our hospitals see massive increases in volume. Staff get sick, care demand increases, and suddenly the priority shifts from transformation work to making sure our teams have the space and support they need to take care of patients.

Larry Kaiser:
That balance sounds incredibly difficult.

Matt Kull:
It is. And we also have to remember that nurses experience the most change when new systems roll out because they spend the most time at the bedside.

Managing their capacity for change is critical.

Larry Kaiser:
So the real takeaway here is that governance isn’t just about technology or dollars. It’s about people.

Matt Kull:
Always about the people.

You hear the phrase “people, process, and technology,” but I’d reorder it.

People.
Process optimization.
Technology.

Technology is actually the easiest part.

Larry Kaiser:
Especially in healthcare where staffing shortages are already a major issue.

Matt Kull:
Exactly.

One in four primary care physicians will retire within the next ten years. We’re projected to have about 48,000 unfilled primary care roles by 2032.

At the same time, chronic disease management is increasing because people are living longer. Today we have roughly 46 million Americans between the ages of 60 and 90. Within the next decade that number will grow to about 75 million.

That’s roughly a 45 percent increase in healthcare demand while the provider base is shrinking.

Technology becomes part of the solution, but technology for technology’s sake doesn’t work.

If you take an old business model and layer new technology on top of it, all you’ve really done is make the old business more expensive.

Larry Kaiser:
And as AI continues to evolve—conversational AI, generative AI, agentic AI—it’s only going to get more complex.

Matt Kull:
Yes, but those technologies can help close the gap.

The challenge is we have to move past the “cool pilot project” phase and start treating these tools as infrastructure.

Like plumbing.

They need to be embedded into operations.

Larry Kaiser:
I like that.

Before we wrap up, any final insights you want to share with our listeners around governance?

Matt Kull:
Governance shouldn’t just be about approving or rejecting requests. It should question the norms.

Just because we’ve always done something a certain way doesn’t mean it’s still the right way.

Take patient check-in forms. Many patients fill them out online the night before, yet we still hand them paper forms when they arrive.

Why?

Governance should ask whether workflows still make sense and whether we’ve removed unnecessary steps before applying new technology.

True governance should be a thinking partner, not just a gatekeeper.

Larry Kaiser:
I like it.

Matt, thank you again for joining us today, and to our listeners, thank you for tuning in to this episode of Visionary Voices powered by Optimum Healthcare IT.

Remember, the future of healthcare IT starts with your vision.

We’ll catch you next time.