For Cletis Earle, serving as 2018 CHIME Board Chair isn’t just an honor — it’s an opportunity to challenge the status quo. And although there are many ways in which this can be done, he plans to focus on two specific areas. The first is to drive true collaboration by encouraging organizations to share information more effectively. The second is to promote diversity, which he believes will help “create different thoughts, different processes, and different workflows.”
And of course, there’s the work his team is doing at Kaleida Health, where he serves as VP and CIO. Like many organizations, Kaleida has experienced significant growth over the past few years, which comes with challenges. In this interview, Earle speaks about the “Herculean” effort of creating a common patient record across a system, and how digital health can be leveraged to increase efficiency. He also discusses some of CHIME’s key priorities, and what he feels is the biggest benefit of being part of an industry association.
We’re really excited that as this transformation occurs, there’s going to be a synergy that happens allowing our partners — particularly our providers — to have a better level of exposure and connection to their patients around the entire region.
In order for us to move from fee-or-service to a value-based care model, we have to start connecting our entities in a more robust manner.
Many of us already participate with RHIOs and HIEs, but are we really making an assertive effort to collaborate more intimately with competing systems in order to provide the best care for our patients? I would challenge that and say no, not always.
I think that’s going to be the missing link as to why there are some stagnant processes in our industry. We need to mix it up, and we need to really incorporate other ways of thinking in order for us to be successful.
You can ask for help. You can ask for feedback. And you’ll find that many CIOs are always willing to share their experiences and some of the lessons learned.
Gamble: Hi Cletis, thank you so much for taking some time to speak with us.
Earle: Thank you, Kate. It’s always a pleasure.
Gamble: To start off, I want to talk about what’s happening at Kaleida. When we last spoke, you were preparing to open a new Children’s Hospital. What was that experience like?
Earle: I have to tell you, opening a children’s hospital was probably one of the most difficult things I’ve done in my career, because you’re dealing with the most critical and sensitive patient population. And it wasn’t only taxing emotionally; it was extremely complicated from multiple standpoints. We had to pull up two hospitals at the same time in order to address the technology piece. But the team pulled it off without a hitch. We were able to move approximately 125 patients in just over a 12-hour period.
We did an absolutely phenomenal job. It couldn’t have gone more perfectly, and I can’t tell you how proud I am to be part of a team that was able to do that.
Gamble: What are some of the other high priorities right now at Kaleida?
Earle: It’s interesting. Kaleida Health is undergoing a massive amount of growth. We are one of the largest health systems in the Western NY area and we’re the largest employer in the greater Buffalo region, and we’re continuing to expand. Our CEO, Jody Lomeo, and our board, understand that in order to be successful, we have to grow, and we have to continue to represent various areas. We’ve extended down into the Southern Tier of Western NY and are moving into the Pennsylvania region. And so one of our priorities is to continue to collaborate and connect with our affiliates in those extensions as we become one common platform of Great Lakes Health System of Western NY, which Kaleida is part of. We see that extension as becoming more relevant, and so we’re thinking about to create one patient record across the care continuum.
We’re working with our colleagues at ECMC, the University of Buffalo, the practice groups, as well as other facilities around the region, and we just partnered with Eastern Niagara Health System. As this expansion occurs, we’re looking at integration so that we’ll have a better clinical outcome, as well as a better patient experience for the community. We’re really excited that as this transformation occurs, there’s going to be a synergy that happens allowing our partners — particularly our providers — to have a better level of exposure and connection to their patients around the entire region.
Gamble: I want to talk about digital health. We know it’s a high priority for CIOs, but there’s a lot of variance as to where organizations are in this journey. While some are far along, it seems that many organizations are at the point where they’re just starting to define a strategy. Do you think that seems like an accurate reflection?
Earle: Absolutely. Digital health is by far one of the biggest things on our radar. This transformation is imperative. In order for us to move from fee-or-service to a value-based care model, we have to start connecting our entities in a more robust manner. And we believe technology is going to enable us to get that done. Whether it’s from quality efficiencies or financials, that base of technology tools is going to enable our care providers and our businesses to be more efficient. That’s exciting, because I believe we’re going to really require that level of engagement for transparency among institutions. And as we start to report out even more inherently to governmental agencies, the way to get that done is through digital transformation.
Gamble: It’s a bit daunting, but also very excited. Switching gears a bit, let’s talk about your new role as CHIME board chair, which you started in January. Congratulations! I’m sure it’s an honor.
Earle: Thank you so much. It is an absolute honor, not only to be elected into CHIME board, which is a prestigious group of individuals and healthcare IT executives around the world, but to be selected as the board chair. It’s more than an honor. I’m excited to push through some of the initiatives that we’re doing this year.
Gamble: I was talking to Russ Branzell about a couple of months ago, and he said that everybody who comes into the role of CHIME Board Chair wants to make an impact. Are there specific ways that you really hope to make an impact while in this role?
Earle: I’ve been very enthusiastic around collaboration. I think it’s going to be critical for all of us throughout the industry. What does collaboration mean? I’m hoping we can continue to push forward a pathway of how health systems work can in more robust manners together and be in this together, with all the things we’ve talked about, whether it’s security, or the sharing of information. For the most part, we share patients. In order to take better care of them, we have to be able to share clinical information. When a patient chooses to get care outside of our network, we have to work with that organization to get that data transferred back and forth so that we can take care of this patient together. Because we’re all going to be paid eventually depending on how we take care of that patient. That’s a key component of value-based care.
So how do we start doing that right now? How do we get out of the world of competing? By what I call ‘coopetition,’ which means we can compete while also cooperating, because that’s going to be the essential element. Let’s start to do things where we can cooperate with each other and have positive outcomes. Many of us already participate with RHIOs and HIEs, but are we really making an assertive effort to collaborate more intimately with competing systems in order to provide the best care for our patients? I would challenge that and say no, not always. There are some areas that are doing it. We’re doing it in the Western New York-Buffalo area. I think that’s going to be a success for us, and I really want to push that forward. That’s what value-based care is all about — sharing information so that we have better outcomes.
The other thing I’m very passionate about is diversity. I see a huge opportunity for us to improve our posture. Whether it’s through STEM programs or healthcare IT as a whole, we need to look at how we qualify diversity and how we bring that into our environment so that we can start to effect change. Studies have shown that having a diverse workforce is an extremely positive thing — it creates different thoughts, different processes, and different workflows. I want to push that forward and show that having a diverse workforce is a positive to the betterment of our industry. You see different industries pushing this, because they realize that a diverse workforce is a productive workforce. That’s one of the things I want to help foster in health IT.
Gamble: It comes down to the basic idea that if you want to find different ways to solve problems, you have to get opinions from different people.
Earle: Exactly. Whether it’s racial, gender or socioeconomic, diversity is really about having people who bring forward different viewpoints. That’s what you want. You don’t want robots. When you have people coming from all different walks of life that are able to challenge each other and are able to bring that level of spice, or a thought process that is not of the status quo, it helps challenge everybody. And that’s something that helps hold us accountable, whether it’s as a nation or as an organization. I think that’s going to be the missing link as to why there are some stagnant processes in our industry. We need to mix it up, and we need to really incorporate other ways of thinking in order for us to be successful.
Gamble: Right. And as CHIME Board Chair, you become a role model. I think it’s really important thing for others to see that you were able to attain this position, and that there are great opportunities for people from all types of backgrounds.
Earle: I completely agree. That’s why I’m working with Byron Brown, Mayor of Buffalo, to go into city schools and talk to kids about what’s out there. In many cases, it’s a socioeconomic issue. A lot of kids don’t realize that there are opportunities in healthcare IT, and that’s a shame. I’m also working with some female CIOs to speak with young women about the benefits of participating in STEM programs and learning about technology. The problem is that some of the inner-city schools don’t have STEM programs, and that needs to change.
The other component is that our industry, in many cases, pays well. A lot of people don’t realize this, and so we want to communicate that to the potential that exists within our communities. We need to show them that there are great advantages in being part of the healthcare IT workforce. Not only is this fulfilling from a personal standpoint, but it’s helping to build the workforce of the future.
Gamble: Definitely. Now, we have the HIMSS Conference coming up (and of course, the CHIME-HIMSS Spring Forum) coming up, which is a great opportunity for people to collaborate. Can you talk about why this is so important, both for new or aspiring CIOs, and for seasoned leaders?
Earle: Absolutely. To me, the biggest advantage of going to CHIME or HIMSS is being able to communicate with CIOs from all over the country (and even the world), and get their perspective. One of the key takeaways — and I hear this from everybody — is that you realize you’re not alone. Others are having the same experiences you are. I’ve always found this to be refreshing.
We’re all experiencing very similar issues. There’s nothing better than to know that organizations are all facing something similar, in some shape or form. What that does is it helps you level-set. It also helps you set some expectations. You might be thinking, why am I experiencing this? Why am I going through this? And when you go to CHIME or HIMSS, you come to find that others have gone through it as well, and you can ask for help. You can ask for feedback. And you’ll find that many CIOs are always willing to share their experiences and some of the value adds and lessons learned.
That’s one place where CHIME always adds value. I’m extremely excited to be part of that, and to be part of the sessions where we can talk and share numbers. CHIME released an app that enables you to look up members, whether they’re on the Foundation side or the health system side, and get their contact information from the directory. It really is a game-changer, because it allows you to connect with peers, connect with ideas, and to pivot accordingly.
We have some really exciting announcements coming out. One is that we’ve created the CHIME Opioid Task Force to increase awareness and help push forward legislation to address this terrible epidemic. I am extremely honored to be part of an organization that, rather than taking a passive approach, has decided to do something about it. Several CHIME members, including Liz Johnson, are really championing this. They’ve gone to Washington DC and are working hard to provide some guidance.
[Editor’s Note: After this interview was held, CHIME issued a response to the Senate Committee of Finance’s request for policy development around opioid use disorder. In the comments, CHIME offered suggestions on how existing IT systems can be leveraged to improve outcomes — citing examples, and discouraged the imposition of unfunded mandates on physicians.]
Gamble: It’s been very encouraging to see the progress that’s been made. It’s a big problem, and one that really needs resources.
Earle: It is. I really believe that we can do something about this, and I’m excited to be involved. It’s a great time to be part of CHIME.
Gamble: It sounds like you’re already on your way to making an impact. I want to thank you so much for talking to use about what you’re doing at Kaleida, as well as your work with CHIME.
Earle: I appreciate it. Thank you so much, Kate.