There are two areas that have become a passion for Keith Perry. The first is finding a better way for researchers to collaborate (which, in turn, can lead to improved outcomes), and the second is growing the pool of health IT talent that can take the industry to the next level. At St. Jude Children’s Research Hospital, where he has held the CIO since the summer of 2015, Perry is working with his team to achieve those and other goals. In this interview, he talks about how the organization is leveraging data to improve the patient experience, the challenge in redefining workflows to make sure they reflect clinicians’ evolving needs, and what it was like to start a new role after 13 years at MD Anderson.
- St. Jude’s unique model: “No family bears the burden of cost for treatment.”
- Longstanding partnership with Cerner
- Process improvement to redefine workflows
- “We’re challenging the way we’ve been doing things.”
- Turning data into information — “Research is inherent in what we do each day.”
- Leveraging analytics to improve patient experience
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It gives you a sense of accomplishment that, from a technologist perspective, however minuscule and small our part is, we are still providing a needed service to help our clinicians and faculty members to deliver outstanding care, and at the same time are performing the research that’s really driving us toward that next cure.
Technology has advanced, and our knowledge of how we treat diseases has advanced since we’ve implemented Cerner. And so it’s recognizing that, and partnering with our clinical operations to put in place things to step back and challenge the way that we’ve constantly been doing things.
There’s a demand for not only storing that information, which does absolutely nothing but keep it around, but also processing it and making sense of it. That’s where we’re seeing a really big push and leveraging cloud technology and leveraging an existing high performance computing environment.
There’s a lot of waste in our system in terms of patients and family members waiting from appointment to appointment — can we challenge ourselves to do a better job, either with how we schedule on the front end or how we transition them between appointments? And so we’re bringing in technology in to help with that.
We should be doing a better job of how things connect together. That’s really exciting for us because we’re taking that as an opportunity to determine how do we bring systems, processes, and data together and present that to the patients and their loved ones to make their experience just a little bit easier.
Gamble: Hi Keith, thanks so much for taking time to speak with us.
Perry: Not a problem.
Gamble: Can you talk a little bit about St. Jude’s Research Hospital — what you have in terms of hospital beds and the affiliate clinics, and just give some general information about the organization?
Perry: I’d be more than happy to. St. Jude Children’s Research Hospital started in the early sixties as a vision from Danny Thomas, the entertainer, around the notion that no child should die in the dawn of their life. Our mission really stems around that. Our sole focus is on catastrophic childhood diseases; about 80 percent is focused on oncology, although we have pretty large programs around sickle cell and other blood disorders.
From a hospital bed perspective, we’re relatively small. We have less than 100 beds — about 75 — and so the majority of our care is outpatient treatment. What makes us unique is no child, no family bears the burden of cost for getting treatment at St. Jude. We take that very seriously, and we’re funded by the American people.
It’s a holistic vision too. We will pick the families up and we will make sure that they get to Memphis, putting them on an airplane or just ensuring that they’re safely delivered here. We will pick them up at the airport and deliver them to our housing units that have been graciously donated by companies such as Target, the sorority, Tri Delta, and the Ronald McDonald House. Then we provide the treatment and care. We’ll make sure that they’re housed in Memphis during the treatment and then we’ll take them back home with all the medicine and follow-up that’s needed. Again, they don’t bear the brunt of that expense. That’s just a little bit about St. Jude. I can get into more about our research programs which drive us each and every day in terms of finding that next cure as well.
Gamble: That’s a really interesting model with families not having to deal with bills. That’s an amazing thing that the organization is able to provide. When you talk about being a research hospital, I’m sure that the mission is just something that really drives everyone with doing such important work.
Perry: It is, and it’s one that in my career journey that I’ve come to really appreciate having the opportunity to work in a hospital environment and then have the wonderful opportunity of serving the St. Jude mission that you’re grounded in each and every day when you drive into work and into the gates of St. Jude and you see the families and the patients. It gives you a sense of accomplishment that, from a technologist perspective, however miniscule and small our part is, we are still providing a needed service to help our clinicians and faculty members to deliver outstanding care, and at the same time are performing the research that’s really driving us toward that next cure, that next breakthrough.
Gamble: Now, before we get into that a little bit more, just for some background, what type of record system is in place at this point?
Perry: We have a longstanding partnership with Cerner for our electronic medical record system
Gamble: That’s in the hospital. What about the clinics?
Perry: We have Cerner pretty much house-wide. Having been here now a little over a year and a half, I found that one of the challenges you have with a longstanding partnership — and it’s not to diminish the great work that Cerner is doing — is taking a step back and ensuring that we’ve architected and implemented the workflows that are needed to support our mission for tomorrow, not necessarily the mission as it was when it was first implemented. That’s one of our big initiatives: systemically reviewing and putting in place some process improvement or continuous improvement programs to redefine the workflow within Cerner.
Gamble: How is that mostly being done?
Perry: It’s push, pull, drag. I say that tongue in cheek. It’s more a partnership model that we’re building with our clinical operations team, because it’s not a technology problem, per se. It’s a combined technology, workflow, and operational issue, and just getting people to realize that there’s a better way to do things. Technology has advanced, and our knowledge of how we treat diseases has advanced since we’ve implemented Cerner. And so it’s recognizing that, and partnering with our clinical operations to put in place things to step back and challenge the way that we’ve constantly been doing things.
Gamble: So obviously a lot of communication back and forth between IT and clinical.
Perry: That’s correct.
Gamble: Now, in terms of the research goals and really what that entails from an IT perspective, can you talk about how IT is contributing and helping to push forward some of those goals?
Perry: What we’re seeing from a research perspective is this massive amount of information being produced, or a massive amount of data that really hasn’t even been turned into information. And that includes everything from whole genome sequencing to the growth in imaging, whether that’s cellular imaging, diagnostic imaging, or just the explosion of images. There’s a demand for not only storing that information, which does absolutely nothing but keep it around, but also processing it and making sense of it. That’s where we’re seeing a really big push and leveraging cloud technology and leveraging an existing high performance computing environment and continuing to invest in that. But I would just categorize that as just this explosion in data.
Gamble: Being at a research hospital, I imagine it is a really big priority to be able to leverage that data to improve care. Is that one of the major focuses?
Perry: Yes, it is. If you go on our website and look at our tagline, it says, ‘It starts with finding cures and ends with saving children.’ We take those very seriously. Finding cures is really what has driven our mission for so many years in addition to saving children, and so research is inherent in what we do each and every day.
Gamble: Are there specific areas right now that you’re looking at to use analytics for outcomes or is it really more just focused on all these specialties or diseases at this point?
Perry: I’ll break down analytics into a couple of different areas. I talked earlier about clinical operations, and the need to step back and really challenge ourselves — are we providing the best patient experience for our patients and family members? That’s driven by analytics. It’s driven by continuous improvement.
For example, we’ve used data in analytics to understand that there’s a lot of waste in our system in terms of patients and family members waiting from appointment to appointment — can we challenge ourselves to do a better job, either with how we schedule on the front end or how we transition them between appointments? And so we’re bringing in technology in to help with that, in addition to letting analytics drive how we’re doing at measuring and monitoring follow up. That’s one aspect.
The other aspect on the research side is we’re partnering with our research teams in order to drive that next discovery. I can’t really specifically point to one protocol because we’re doing it across the board in all diseases. I will say that one of the areas where we’re shifting and really placing a lot of attention is what we call St. Jude Global. We know that children with catastrophic diseases in developed countries like the United States and the UK have seen a tremendous increase in survival rates, and that’s because of the great work of St. Jude and other pediatric centers across the country. What we also see is that based upon analytics, survival in developing countries is actually abysmal. We’re steering the ship into that and saying that’s not good enough for our mission; and that’s driven by analytics. We’re looking at how do we take the model of St. Jude and help developing countries enjoy some of the survival rates that we’re seeing here.
Gamble: Keeping with that spirit of sharing outcomes and sharing data, how is that done with outside organizations? Is that something that’s fairly common?
Perry: It is. As with any academic center, we have longstanding relationships with other academic and commercial partners to advance research and advance different modes of treatment. We’ve got affiliate clinics that are used to take the knowledge that’s developed here and deliver it without having patients and family members come to Memphis for that level of care. I mean, yes, we’ve got longstanding partnerships outside of St. Jude.
Gamble: Now, from a patient engagement standpoint and also a family engagement standpoint, I had seen that St. Jude has a Patient and Family Experience Office. I wanted to just talk about really what was the impetus for this and what are really the goals that the organization has as far as that engagement?
Perry: That’s a fairly new role for someone in our organization. It really goes back to our strategic planning process that we went through before I joined. That culminated in the release of our strategic plan two years ago — a month before I arrived, a year and a half ago. The impetus was we need to be doing a better job with the experience of our patients and family members. By that, I don’t just mean not just the clinical experience. Once you come in the door, the love and attention that is shown to patients and family members is pretty well-evident. I see it, and I’m with working with the new director of Patient Experience on how do these systems and processes interconnect to improve.
I said earlier about we will pick people up at the airport in Memphis. We will make sure we will put them on a plane in their home state or home city and ensure they arrive in Memphis. We’re paying their travel. We’re picking them up logistically. We’re putting them up in our housing facilities. We’re giving them meal cards. We have patient schedules for different lab tests. We’ve got different events happening to just engage the family members that are spending time with us during their loved ones’ treatment, and looking at how do we start to bring that experience together in a better, more meaningful way?
That’s the goal of that Patient Experience Office. How can we brainstorm? Even though, tongue in cheek, we talk about the Mickey Band experience that you would see at Disney World, we’re not Disney World. We’re a place that’s really focusing on catastrophic diseases, but bringing that same level of attention to detail and customer service. We should be doing a better job of how things connect together. That’s actually really exciting for us because we’re really taking that as an opportunity to determine how do we bring systems, processes, and data together and present that to the patients and their loved ones to make their experience just a little bit easier than it was yesterday.