To most insiders, Epic’s installation in the ambulatory facilities of an organization with a different inpatient system augurs ill for the incumbent. But according to CIO Joan McFaul, that’s not necessarily the case. She said Epic and Cerner are coexisting peacefully, at least for now. To learn more about what the future might hold for Glens Falls’ application environment, and to hear about McFaul’s other projects at the health system, healthsystemCIO.com recently caught up with the New York state CIO.
- A CIO’s soft skills
- Providing more than one good option
- McFaul’s career path — in, out, and back into healthcare
- Getting IT staff out onto the floors
- Managing CIO stresses
- Leveraging a masters in philosophy
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We tried to pull in the very best vendors and give the organization an opportunity to understand that there are some options. ‘We can go this way or we can go that way — what do you think?’ I think if you give people one good option and one bad option, it doesn’t take them long to figure out what you’re doing.
Sometimes you just have to say, ‘no, we can’t.’ But if there are solutions, then we’d like to present them, and I think we do. I think most IT departments try to provide solutions. That’s what we’re in the business to do.
The care and the quality of the care often are directly related to information that resides in the electronic medical record. And so that’s a pretty compelling model to attract people to healthcare. You can look in some other industries like manufacturing, which has a lot of IT embedded in their actual processes, but in healthcare, the IT is embedded in the processes and in the workflows.
Our team does a great job of trying to stay connected with the patient side of the business. There really is not much that we do that isn’t patient focused — maybe HR systems, but everything we do touches the patient in some way or another, and so I think people appreciate that and they care about that.
I think CIOs and all of IT personnel are working under extreme circumstances these days, and it’s taking a toll. People are stressed and they have so much on their plates that it’s difficult to keep everything focused and moving forward.
Guerra: In your description of your session with Matthew, you talk about highlighting the soft skills required to deal with these rollouts and things like that, and develop that good relationship with the users and the customers. Tell me a little bit more about what you mean by ‘soft skills?’
McFaul: I think especially when you’re communicating with very smart, talented people, which a lot of healthcare professional are just really smart and very talented, most of them care very deeply about what they do and they’re passionate about what they do in their work with people. Many of them are focused on people. So I think when we talk about soft skills from a leadership perspective, it’s the ability to have empathy. I think there needs to be good communication — the ability to communicate effectively. I think there needs to be a certain amount of business — not really soft skills, but a little bit of the ability to understand the business that you’re in, and whoever you’re trying to communicate with, to understand their business as well. Even though it’s all healthcare, understanding what radiologists face versus what nurses on the floors face; having that kind of expansive understanding of healthcare is very helpful as well.
Guerra: In your bullet points, one of the things that caught my eye and really resonated with me was understanding the value of providing more than one good option. Just give me an example or a scenario where that may come in handy.
McFaul: Well, we could talk about what happened on the physician practice side. We tried to pull in the very best vendors and give the organization an opportunity to understand that there are some options we have here. ‘We can go this way or we can go that way — what do you think?’ I think if you give people one good option and one bad option, it doesn’t take them long to figure out what you’re doing. So I think you want to try to give people good options — good ways to be able to solve problems. And so whenever possible, we try to always have a plan A and a plan B.
Guerra: Could you take that to sort of a micro level where a physician or someone comes into your office and they’re upset about something. You want to be able to, instead of saying no, say, ‘Well, here’s what we can do that may help solve your problem.’ They may not even realize that there are certain solutions out there other than the one they’re demanding that may be impractical for you.
McFaul: Yeah, I think that’s a really good point. To just say no to somebody doesn’t work. Well, I wouldn’t say that. Sometimes you just have to say, ‘no, we can’t.’ But if there are solutions, then we’d like to present them, and I think we do. I think most IT departments try to provide solutions. That’s what we’re in the business to do. So yeah, I think it’s very common to have those kinds of conversations, not only with physicians, but with all of the staff or customers.
Guerra: I was looking at your LinkedIn page and your career path is a little interesting. You were at MetroHealth System for nine years and then it looks like you were out of healthcare for about three years. You were at Case Western Reserve University, and then you got back in at Glens Falls. So is that sort of how it went—in for a long time, out for a little bit, and then back in?
McFaul: Pretty much, yeah. MetroHealth is an affiliate of Case Western Reserve so all of the medical staff at MetroHealth are faculty at Case. But I had some interesting opportunities that came up and so I went back and forth a little bit between Metro and Case, largely in a role where I was serving in a leadership role and implementing some big systems. That just sort of worked out where I went back and forth for a little bit. The opportunity of serving as a CIO was pretty attractive, and so that’s what brought me here to Glens Falls. But I had been a director, an executive director, and an AVP in my most recent roles at both Metro and Case.
Guerra: Was there any dynamic that you missed about healthcare?
McFaul: Oh yeah, I think higher education is great. I used to kid that there’s doctors in both, right? But the thing with healthcare that is so compelling is how these systems today — these EMRs and other systems — actually integrate with patient care. The care and the quality of the care often are directly related to information that resides in the electronic medical record. And so that’s a pretty compelling model to attract people I think to healthcare. You can look in some other industries like manufacturing, which has a lot of IT embedded in their actual processes, but here in healthcare, the IT is embedded in the processes and in the workflows, and so it just is a different animal then even higher education.
You can make an argument that some of the student systems are kind of embedded, but it’s different. It’s not as day to day. It’s not as life affecting. Here in healthcare you can adversely affect or positively, hopefully always positively, but if you’re not carefully you can adversely affect the care of a patient. That does kind of bring your stress level up a little bit but it’s amazing that you can have that kind of effect using an IT system in someone’s life. I think a lot of what was behind Meaningful Use and all that kind of stuff is recognizing how powerful these systems can be.
Guerra: Do you like to get out on to the floor and get your teams out into the hospital floors to keep that strong connection that they are actually working on things that directly affect patient care?
McFaul: Yes, and a lot of the people who work on the EMR side of the business, because we also have business systems and so forth, but a lot of people who work on the EMR side of the business understand that. They’re clinical. A lot of them have a clinical background, and so they get it. They understand that. And we’ve been working more and more — we have our clinical analyst do rotations where they’re on call for the physicians in the hospital. So a physician, if he or she is struggling, can call the clinical analyst and they’ll come up and help them. So it’s kind of an elbow support program.
We have some of that that continues, even on the billing side, that affects peoples’ lives as well, and our team does a great job of trying to stay connected with the patient side of the business. There really is not much that we do that isn’t patient focused — maybe HR systems, but everything we do touches the patient in some way or another, and so I think people appreciate that and they care about that.
Guerra: Is there anything else you want to touch on? I just have one more question I’m going to ask you but before I do that is there anything else that you want to touch on today?
McFaul: I think the world of healthcare IT in the last two years or three years has become much more stressful for people, and it’s not just the IT folks. It’s the whole organization and I think that’s because there are these incredible projects that need to be completed under very tight timelines. There’s a lot of change that’s being forced on people, and change is hard. And we get that. Being in IT for so many years, you understand that you’re always a change agent and how difficult that is. So I think CIOs and all of IT personnel are working under extreme circumstances these days, and it’s taking a toll. People are stressed and they have so much on their plates that it’s difficult to keep everything focused and moving forward. I just mention that because I would imagine — although I guess I’ll find out more when I go to CHIME this year — that most organizations are feeling the kind of stress that I’m sensing out there.
Guerra: Well, I’ll definitely look for you at CHIME because I’ll be over at the conference too. The best advice that I’ve heard on that dynamic, which is certainly something I’m hearing from everyone, was from John Glaser, who is now heading up Siemens. And he said his best advice was to remember, it’s a marathon not a sprint. This is going to be going on for a long time, so you have to pace yourself. You have to keep a work life balance that’s livable because if you go all out you’re going to burn out, because it’s not going to end any time soon.
McFaul: Yeah, I think that’s great advice, and I think it’s easier said than done — right now it is, with ICD-10 coming down and continuing changes with Meaningful Use. These are big changes and they mean constant change for the organization and it’s not easy. Now I’m not saying it’s the wrong thing to do. There are certainly minds greater than mine that are out there making these decisions. It’s just that it is a lot for the organizations, and the pace of change — and I’m talking specifically for healthcare right now—is very dramatic and very intense, so I’ll try and remember John Glaser’s wisdom.
Guerra: Well, you’ve given me a nice segue to my last question because I usually try and find something interesting on everyone I interview and yours was pretty easy. It was right there. You have an interesting educational background. One that I remember was Randy McCleese, a CIO colleague of yours, had a degree in geology. You have a master’s, I believe, in philosophy, correct?
McFaul: That’s right.
Guerra: That’s no joke. I did a little undergraduate philosophy before I switched to anthropology but a master’s in philosophy is no joke. I think you do have a great mind.
McFaul: All right, sold.
Guerra: That’s right. So tell me a little bit about how someone does a master’s in philosophy and then gets into IT.
McFaul: It’s interesting; a lot of it is timing. I started off in college not knowing what I wanted to do and I ended up studying philosophy and loved it. I loved the challenges and the discipline and the thought processes and just the scope of what you get exposed to and what these great minds had to contribute to the human race. I really enjoyed studying it. When I was done with my master’s, it was either go for a PhD, which was not as easy to do as one might think, or get a job. And so I got a job, and when I first started, IT wasn’t as integrated. It was mostly billing stuff and they were just starting to look at automating some of the more difficult areas like EMRs and just creating database for patients. PCs were really becoming integrated and networks were expanding. So I just got in on the ground floor and it was just happenstance. I told somebody one time that I had two interviews. One was for this IT job in a social services agency and the other one was to head up a dry cleaning chain, and so I could have been a dry cleaning queen. I could have been, but it didn’t work out that way.
Guerra: Right, a dry cleaning mogul.
McFaul: Yeah, which would have been even more interesting having a philosophy degree and being a dry cleaning queen. But there are a lot of great dry cleaners out there.
Guerra: No doubt.
McFaul: And I appreciate them.
Guerra: Yes, when they do a good job.
McFaul: Yes, absolutely.
Guerra: All right, Joan. I want to thank you so much for your time today.
McFaul: Thank you, Anthony, and I will look to see you at CHIME.
Guerra: Sounds good. Thank you. You have a wonderful day.
McFaul: You do as well.