With patient engagement such a hot Stage 2 topic, it’s no wonder CIOs are looking to ramp up the pace of their portal rollouts. And Bill Byers, VP/CIO, Western Maryland Health System, is no exception. But, more than that, Byers is also looking to get his staff and community docs up on an EHR as step 1, then facilitate a robust data flow as step 2. All of which he’s doing with an eye to keeping the interface picture manageable to promote scalability, thus also increasing the chances of long-term overall success. To learn more, healthsystemCIO.com recently interviewed Byers for our Podcast series.
- Going down the telemedicine road
- computer-assisted physician documentation
- The value of HIMSS
- Giving back
- Staff-retention talent
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… we don’t want to sacrifice quality to get the speed …
… if I was replacing critical staff every three to four years, well, they’re just getting good at that point and having the benefit of the wisdom that comes from time and experience …
We are in healthcare IT, but we’re in the people business. Our business is to take care of people …
Gamble: Looking a little farther down the road, are there projects that you have your eye on for maybe later this year?
Byers: Yes. We are looking at telemedicine and some virtual presence. We’re actually looking at that for our nursing home first. We’re looking at it also for a diabetes clinic. We’re looking to allow care managers and physicians to evaluate patients from a distance and determine if they need to come to the ED, do they need to be admitted, is there some other, more efficient, way that we can take care of our patients and not inconvenience them. With the diabetes program, in particular, we’re actually looking at devices from Siemens that we can put in their home to have a two-way video chat with them on their TV to help them stay healthy, remain compliant, and keep them from needing more expensive care, so those are a couple of the telemedicine initiatives we’re looking at.
I mentioned earlier we’re looking at integrating patient data across a continuum of care, especially with eClinicalWorks, but even expanding our use of the State of Maryland’s Health Information Exchange, CRISP, looking at how we can get more data to our providers through CRISP is certainly an initiative we’re interested in, also expanding our EMR into the cancer center and to our nursing and rehabilitation facility.
We’re also looking at computer-assisted physician documentation. I gave a demonstration on this at HIMSS. Essentially it allows the physician to dictate their note in real-time using Dragon. It then gets sent to 3M, this is all real-time now, where it’s processed and 3M takes a look at it from more of a coding perspective and it queries the physician, ‘Hey, did you mean this, should you include that?’ It gives them some feedback on making sure the note is complete before they even sign it. So we are internally in discussions to decide if we want to put our hat in the ring to be a Meditech beta for the Nuance 3M Computer-Assisted Physician Documentation.
So those are a couple of projects. I mean, there’s some infrastructure things, such as email encryption, expanding our use of server virtualization, these types of projects, so we’re also taking a look at FY13 and beyond.
Gamble: As far as possibly being the beta site for CAPD, I’m sure that there are some reservations about being a beta site but, overall, you feel like your organization is willing to jump in there and try this and get in on the ground floor?
Byers: Well, you know we’re really looking to try to get the information available as soon as possible. We’re also an eScription customer, so the physician can dictate over the phone, it goes to Boston, it gets turned into text. We then have transcriptionists that edit the document, and then it becomes available in Meditech for the physician to sign. Well, we’re trying to decrease the amount of time it takes to get a signed finished document available in our EMR. Where we have done this with our hospitalists progress notes, the community physicians have come back to us and said, ‘This is tremendous, we love it because the information is available immediately to us.’ They really appreciate that. They’re asking us when we’re going to expand it.
On the flipside, though, there are issues with the quality of documentation coming out of it, and that you don’t have the benefit of that transcriptionist listening to the audio file and editing the document so there can be some errors introduced, not necessarily transcription errors or voice conversion errors, but even just the phraseology can sometimes sound wrong and, if a physician doesn’t catch that when they sign it or before they sign it, that becomes the finished note, and so it puts more of a burden on the physician to edit their own document in real time before signing it, and so that’s been a challenge that we’re working on with Nuance — to see what we can do to improve the quality of those documents, because we don’t want to sacrifice quality to get the speed if you will.
I think Computer-Assisted Physician Documentation may help with that. I also think that when you talk about ICD-10, just because it’s been delayed a year or so doesn’t mean that it’s not going to happen. It’s going to put a lot more of a burden on the physician’s documentation to be more specific and a tool like CAPD, I think, can help with the ICD-10 transition, so we’re looking at it from that perspective as well.
Gamble: That’s smart, and this deadline is probably going to stick so they should be grateful.
Byers: Yeah, I think so. I don’t think it’s up for negotiation now, but we’re looking to build whatever tools we can to aide in that transition, and I do think that CAPD can definitely help with that.
Gamble: Now I wanted to talk a little bit about your activity with things like Maryland HIMSS and actually HIMSS itself. It seems like you’re fairly active in that. Tell me about some of the work you do in that capacity and how that has benefited you?
Byers: Well, until about a year ago I’ve been the beneficiary of HIMSS, I guess you’d say, I’ve been a member of HIMSS I think about seven or eight years now, I’ve had the opportunity to attend probably four or five national conferences, and I’m very fortunate to be a member and now a board member of Maryland HIMSS, which is a very active chapter. We have quarterly education sessions, and they are always just tremendously helpful for me and my staff. I’ve probably been able to bring at least six or eight different staff members, depending upon the topics that they have presented to the Maryland HIMSS education session, and they are always extremely beneficial for us. So, from a HIMSS perspective regarding the sharing of information, I can’t find that anywhere else, and when I was asked to become a board member at large about this time last year, I jumped at the opportunity because I would now like to give back. I’m just now starting that process as a board member, getting my sea legs so to speak, and starting to participate in some different activities at the board level, and I’m excited to give back in any way that I can, because HIMSS has helped, not only me and my profession, but it’s helped the hospital and the health system achieve things that we would not have achieved without the benefit of the sharing of ideas that HIMSS gives to its members.
Gamble: Now we should probably give a little bit of a background just as far as you or your career path. You started as a CIO, officially, last spring at Western Maryland?
Byers: I think it was in March of 2011. Actually, I have 23 years in the industry all at Western Maryland Health System. I started in 1989 as the systems manager at Memorial Hospital and, over time, expanded my role, became director about four or five years ago, and then CIO last year, but all of my experience outside of my college education, my first real job if you will, was at a hospital, so I have 23 years of healthcare experience.
Gamble: That’s really impressive that you’ve been at the same organization for that long. You don’t really see that too much.
Byers: Well, it’s interesting. I just took a look — we have 32.5 FTEs in the IT department, and we are purely IT. We don’t do telecommunications or anything like that and, if you look across those 32.5 FTEs, the average tenure is 15 years here at Western Maryland Health System, so we’re able to attract, I think, some of the best talent in our area, but also retain them, and I’m very proud of that because it’s a big part of what allows us to provide great value to our organization, because if I was replacing critical staff every three to four years, well, they’re just getting good at that point and having the benefit of the wisdom that comes from time and experience, so it’s just amazing to have that luxury here.
Gamble: Right and that’s one of the biggest issues that you hear when you talk to CIOs, is not just recruiting but retaining talent, and if your organization’s able to hold on to people for that long of a period of time, especially now, that’s a really good thing and that’s something to hold on to for sure.
Byers: Well, it is something that we try to work on actively. We talk as a management team here within the department about how to do that and, yes, it’s changing every day. I think we also have the benefit that we’re in Western Maryland. We’re 2.5 hours from Pittsburg, we’re 2+ hours from Washington and Baltimore, so the fact of our location helps us from that perspective as well, but people nowadays are very mobile. They do have options, especially in the healthcare IT field right now, and so we do what we can to treat people the way that they want to be treated.
Gamble: Anything specific you’re doing, as far as offering education? Is there a secret that lets you hold onto them?
Byers: You know, I don’t know what the secret is. I would say two things: that we really try to make our employees understand the value of the work they do, not only to our organization but the patients we serve. We are in healthcare IT, but we’re in the people business. Our business is to take care of people, and I find that personally and professionally rewarding, and I hope my staff feels the same way. I think they do. But the other thing that I try to remember is you’ve got the golden rule that everyone knows, but I think that the rule we should be using is the platinum rule and that is to treat others as they want to be treated, so having a relationship with your team and understanding what it is that really motivates them and makes them want to come to work, I think that’s important as well. I’m very pleased to say that, at least I’d like to think, I have a very good relationship with the team here, and certainly I know the team does with their direct managers, so I think that’s the other part of it as well, just treating people right.
Gamble: Do you think that the fact that you have been with the organization for awhile has helped make your transition to the CIO role smooth?
Byers: You know, Kate, I really hadn’t thought of that in any great detail, but I think you’re right. I think that that continuity of culture from the previous leadership to me has helped. I think that has helped keep things consistent and keep people on board. That’s a very good point.
Gamble: Are you from Maryland originally?
Byers: Yes. Actually, I grew up about 30 miles from where I work now, so I was born and raised in Allegany County in Maryland, so this is my community and it’s the same way with most of our employees. They are, for the most part, born and raised here, and the people that we serve, the customers that we serve, the patients that we serve are all people who we know and have grown up with, so perhaps that adds to it as well.