These days, it’s all about alignment. As organizations face increasing pressure to position themselves for healthcare reform, leaders are finding that this isn’t the time to be on an island. With that in mind, Skaggs Regional Medical Center recently entered into a merger with CoxHealth. But of course, that doesn’t mean the work is done. In fact, it’s only beginning. In this interview, CIO Michael Elley discusses the challenges of adjusting to new workflows, his plans to migrate to Cerner, and the work his team is doing to reduce readmissions. He also talks about the BJC Collaborative, how the organization is using business intelligence to plan for fluctuations in patient volumes, and his career path.
- Migrating to Cerner
- Using analytics to ensure operational efficiency
- Plans to join MHIO & the BJC Collaborative
- Role as VP of support services
- From IT director to strategic leader
- “Righting the ship” at Cox Branson
- Mentoring — creating opportunities for “open, candid dialogue”
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It’s not like a completely new install; largely, the build is there. Where a lot of the work will be is those systems that are new for the whole CoxHealth enterprise — ER, labor and delivery, etc.
It’s the type of deal where we can collaborate and work together to improve health in the communities we’re serving. We’re starting down that path and looking at whether there is information that we could be sharing between the different organizations.
I was very interested in learning more about operations within the healthcare setting, and so coming to Skaggs allowed me to jump into a small organization and really get my hands dirty.
This is an industry where I feel people are truly engaged and involved with the end product, and that makes you feel good when you go home at night.
I’m a big believer in mentoring. The most important thing that anybody can do is establish those informal friendship relationships with individuals who have been there, done that, and with senior leaders who have been successful.
Gamble: Looking at the March 1 deadline, what needs to happen to get you to that point? What are the next steps?
Elley: Right now it’s largely the build and so we’re looking at the Cox build and seeing where there are any variations or modifications that need to be made. Like I said earlier, maybe there are formulary changes or lab changes because we’re just not as large as the parent company, and so there may be changes there that we need to implement down here. I’m not too concerned about hitting that March 1 date because it’s not like a completely new install; largely, the build is there. Where a lot of the work will be is those systems that are new for the whole CoxHealth enterprise — ER, labor and delivery, those sorts of things.
There’s just a tremendous amount of effort right now working with those different departments and working with the technical and the business analysts to understand our environments of care. How do we conduct business? What are our operational procedures within labor and delivery? How do we utilize the current systems and how will we build that so that we make sure we can use the new system in the same fashion or as not to impede our operational efficiencies that we’ve gained?
Gamble: You talked about some of the reasons for wanting to go through with the merger, and we’re finding that a lot of organizations are in the same boat where they want to connect with a larger health system. Now kind of taking that a little bit further, are you involved also in HIEs?
Elley: As an organization, we are just beginning the conversation. The State of Missouri has I’d say two or three large players. One of them — LACIE, the Lewis and Clark Information Exchange — is largely based in the Northern Missouri and Kansas City area, perhaps going into Kansas and Nebraska. The state also has a Missouri Health Connection, and so I think we are getting further and further down the road of looking at the possibility of going the Missouri Health Connection route. But to date, we’re not part of the HIE.
Gamble: Has that health exchange been around for a while, and has it actually been able to show the sustainability that I know a lot of people are looking for before you do all that work?
Elley: I don’t want to get in trouble. But honestly, I’m not sure. I know there has been some turnover and some leadership changes within that organization. However, they’ve established a fantastic board. I used to work for BJC HealthCare, which is based in St. Louis, for about six or seven years. The CIO for BJC, David Weiss, is a part of that board. He’s a very bright individual. And so they’ve kept it running. They’ve signed some large players and they’re in the midst of signing some more very large players within the state. I think Mercy, SSM, and potentially BJC are all looking at signing up, and so we’ll be a part of that, I would foresee, in the future at some point.
One of the driving factors, as we just talked about all the merger and M&A activity, is that four very good-sized organizations — BJC HealthCare, St. Luke’s out of Kansas City, CoxHealth, and Memorial Healthcare in Illinois — have all just signed up for what’s called the BJC Collaborative. All four organizations are largely, for the most part, not competing for business, and so it’s not an M&A type of deal. But it’s the type of deal where we can collaborate and work together to improve health in the communities we’re serving. We’re starting down that path and looking at whether there is information that we could be sharing between the different organizations — are there purchasing advantages if we were to go on together, and those sorts of things. And so I think that the HIE will be a big component of that for those organizations.
Gamble: I would imagine that a few of those are also on Cerner, since its right in their backyard.
Elley: No, actually I think St. Luke’s has just signed with Epic. I think they have also left McKesson. I could be wrong, but I think they have signed and they’re moving toward Epic. BJC has a couple of different EMRs within their mix, and I’m not sure what Memorial is.
Gamble: Okay, so obviously you’ve got a few things on your to-do list in the next year or so, just like everybody else. As far as your own experience and your own background, you’ve been at what is now Cox Branson for about three years or a little less than three years, correct?
Elley: Yeah, a little bit over two and a half year now.
Gamble: And this was your first CIO position?
Elley: That’s correct. I’m the CIO and VP responsible for all the support service areas within the organization, so I look at housekeeping, dietary, biomed, engineering, and those sorts of things. When I was at BJC, I was primarily focused on IT. I was largely in charge of strategic direction and IT for three hospitals at one time, as well as the medical group. But I was very interested in learning more about operations within the healthcare setting, and so coming to Skaggs allowed me to jump into a small organization and really get my hands dirty. The organization was struggling financially, and so there is pretty much a whole new leadership team brought in around 2010. I’ve really worked hard the past two years and have righted the ship — it’s doing well financially, and clinical scores, quality scores, and patient satisfaction scores are all increasing and improving. It’s been a great experience.
Gamble: How long were you at BJC?
Elley: I came to BJC in 2005 and I started just working at Boone Hospital overseeing and directing IT, and then over the next couple of years, added a couple more hospitals in St. Louis and then also the medical group. The medical group, at that time, was about 180 providers. I’m sure it’s well over 200 right now.
It was a great experience. BJC is a very large, not-for-profit organization. When I was there it did over $3.3 billion annually and had 26,000 employees. The IT shop was about 650 to 700 IT staff. It was great organization with a lot of intellectual horsepower, and so I learned quite a bit there.
Before that, I was the Deputy CIO or the Chief Enterprise Architect for the State of Missouri. I only did that for a year — we had turnover. The governor was leaving and a new one was coming in and I was pretty near the top, and so I left because my position got appointed somewhere else. Prior to that, I spent some years in finance. But I know I want to remain the rest of my career in healthcare. My wife’s a nurse and we have other family members in the clinical area. This is an industry where I feel people are truly engaged and involved with the end product, and that makes you feel good when you go home at night.
Gamble: It’s interesting to me that when you started as CIO, that was about a year or so or maybe a little more into HITECH and everything like that, so a pretty interesting time to step into what was actually your first healthcare CIO position. Were there people that you had as mentors? How did you try to assimilate to that role?
Elley: I think largely I was prepared at BJC. In my role there, I was put into several lead positions around Meaningful Use and conducting gap analysis system-wide on where all the hospitals were — what were the deficiencies? Where were we strong? Where do we need to go after more capital to bulk up some of our solutions or our areas to make sure that we met Meaningful Use? Working with a lot of the senior leaders at BJC really prepared me for this role at Cox Branson.
Gamble: You picked an interesting time though to get into the industry, and so I’m sure that although you were certainly prepared for the role, there’s still quite a lot that you’ve absorbed the last couple of years.
Elley: I’m a big believer in mentoring. I think probably the most important thing that anybody can do is establish those informal friendship relationships with individuals who have been there, done that, and with senior leaders who have been successful. I’ve had great opportunities to do that at both BJC and at CoxHealth system. I’ve been afforded the opportunity where whenever I need to balance ideas or have questions or have topics that need to be discussed, I can always go back to those individuals and have some open, candid dialogue.
Gamble: That’s something that’s so valuable, really in all the parts of life. As a parent, I’m constantly asking other people, ‘how do you handle this situation,’ and so I can see how that is really helpful in a position like yours.
Elley: Absolutely. I’m the same way. You often think that you might be struggling in certain aspects of your life — as a parent or as a boss or as a friend. But I think if your heart is in the right place and you’re focused on the right direction, everything will be okay. I’m very much an optimist.
Gamble: That’s a good thing to be. Okay, we’ve talked about a lot of good stuff. This has been really great, so unless there’s anything else that you wanted to touch on, I wanted to thank you for your time.
Elley: Wonderful, I had a good time talking with you and I appreciate the time.
Gamble: All right. Good luck with everything and I hope to talk to you again soon.
Elley: All right, that sounds good. Thanks, Kate.
Gamble: Thank you.