As a physician, former CIO and now CMIO, Lynn Witherspoon has operated in the healthcare system from a number of angles. And having lived through Hurricane Katrina, he has a better handle on disaster recovery issues than most. But while Ochsner Health System survived the storm, did that experience leave it at a disadvantage when it comes to qualifying for Meaningful Use dollars, and is the CMIO singularly focused on getting the stimulus money at all costs? To learn about these issues, and tap the wisdom of one wiser than most, healthsystemCIO.com editor Anthony Guerra recently chatted with Witherspoon.
BOLD STATEMENTS
… if you do CPOE and you also deal with the safety features of the med administration on the backside, you get much more bang for the buck than if you just did medication administration or if you just did CPOE. And yet, in the ARRA timetable, those two things are disconnected.
… these are very bright colleagues who’ve thought about this, and I shake my head and wonder, “How did this come out the way it has?”
But really, if you can, try to get a few things done well as opposed to this juggling act of having so many balls in the air all the time.
GUERRA: Some CIOs are frustrated because they’ve done work in areas Stage 1 isn’t focusing — such as electronic medication administration and bedside bar code scanning — and they don’t seem to be getting any credit for that. Methodist Health CIO Pam McNutt touched on this point when I spoke with her. Do you think that’s part of the problem with the way this is being laid out?
WITHERSPOON: Yes. By the way, I enjoyed reading your conversation with Pam very much, and I thought she had some really great insights. I share the concern that this almost looks like they’ve cherry picked a whole lot of things, some of which don’t seem particularly interrelated.
I think the number one thing we’re trying to accomplish with an EHR is clinical communication and the fact that anybody who accesses that record has access to anything anybody else knows about the patient. And yet, in the hospital, instead of saying, ‘We think you ought to be starting with automation of nursing documentation and dealing with physician documentation,’ they’ve said, ‘No, it’s about CPOE.’
And in addition, so much of what we see as success stories marry the front end and the backend. So if you do CPOE and you also deal with the safety features of the med administration on the backside, you get much more bang for the buck than if you just did medication administration or if you just did CPOE. And yet, in the ARRA timetable, those two things are disconnected.
So yes, I relate to that same concern. In some ways, it’s kind of this smorgasbord of stuff – and by the way, we’re supposed to take something out of every single dish on this smorgasbord. But there’s a lot of things that aren’t there that, to me, would make logical sense to have. In some ways, you’re eating the dessert before the appetizer. Interestingly, you know these are very bright colleagues who’ve thought about this, and I shake my head and wonder, “How did this come out the way it has?”
GUERRA: Let’s talk a little bit about the workload CIOs and CMIOs are handling. You mentioned that you’re going to the theater tonight. I know you have a robust social life in the sense that you’re very engaged in different cultural activities. You seem to specifically make time for those things.
WITHERSPOON: You know we try. My wife and I have engaged more recently in reading to each other and trying to find ways to enrich that piece of our lives. I can’t allege that it’s just a New Orleans’ post-Katrina phenomenon, but the pace of change is so hyper-frenetic. In our quality meeting this morning, one of the comments was, ‘Well, if we could focus on four or five things instead of trying to do 25 things all the time, we could really make a huge difference in those select areas.” It’s just overwhelmingly challenging for people who try to keep up that pace.
The other perspective is that, as you move along in your career — and you and I have talked about this a little bit, I know you’re a very happy young father at this point and that’s great, and so I’m a real happy young grandfather — you look back and say, ‘Holy crow, how did all that time get away? Couldn’t I have spent a little more quality time with kids?’ and so on.
Everybody has these feelings I suspect, but particularly in the environment we find ourselves today with healthcare being as challenging as it is and the uncertainties of healthcare reform. In this particular organization, they’re growing at a break-neck pace — we’ve acquired five hospitals in the last five years. That may not be big in some peoples’ worlds but in our world it is. We’re a big clinic and, oh by the way, had one hospital for the first 40 years of our existence, so it’s pretty big deal. Yes, how you find that balance, I think, is a real challenge.
GUERRA: One of the worst or best, depending on your point of view, developments for the executive is the Blackberry, and the expectation that you’ll respond to emails 24 hours a day.
WITHERSPOON: Well, some of my colleagues find themselves able to leave town and leave their Blackberrys in their desk drawer. I confess that I carry mine. I mostly do it not so much having concerns about real time contact, but because I’ll end up with 300 or 400 email messages a day if I don’t do something about them. By the way, getting them off the Blackberry is faster and more efficient than getting them off my desktop, so I can pretty well jettison a lot of stuff that I can tell right from the get-go I’m not interested in. But if I have a personal wish and desire it would be that I could give up on that and leave that sucker in the desk drawer when I leave town. [Laughing]
GUERRA: Here’s the real question. Has it ever gone off in the opera?
WITHERSPOON: Well, first of all, I don’t take my Blackberry to the opera so, no. I was thinking about the airplane however where you have to be careful about turning these things on. I think the best rule for the opera is don’t take your Blackberry to the opera with you. If you’ve got to do it, leave it in the car.
GUERRA: You’re an M.D., you’ve been a CIO and now CMIO. Do you have any general advice on how your colleagues can navigate these waters?
WITHERSPOON: I think you hit on an important issue when you asked about the work-life balance problem. Again, maybe it’s just the perspective of many years and being able to look backward, but the company that you work for, believe it or not, really gets along quite well if you’re not there and it moves along. [Laughing] And I won’t say it doesn’t care, because at some level it kind-of-sort-of does, but it doesn’t care the way you’d wish it cared. At the end of the day, all that sacrifice you made there — and again, it sounds harsh to say it’s not appreciated because at some level it is — but if you have a family, and if you particularly have kids, that needs to be a very significant piece of your interest and concern. It’s not just the traditional, “I’m the male breadwinner, and my job is to bring home a paycheck.” It’s really a much deeper responsibility than that, and I wish I’d figured that out 25 years ago. As I said, you know my wife and I are reading to one another and in my impending old age here, I’m coming to some realizations around those kinds of things. I know that’s advice frequently offered to younger people but really, if you can, you need to take that to heart.
The other thing I was going to say has to do with focus. Again, with the hyper-frenetic pace of things, there’s so much going on. I had a conversation with Joe Bisordi who’s my new CMO here about my concern. I said, “Joe, I’m so used to juggling 50 things all the time and moving everything along on a wavefront, and now I’m really trying very hard to stay focused on a finite number of things that I really want to get done, and I’m concerned with whether that implies I’m now a ‘needs improvement performance’-type because I can’t manage all this.”
But really, if you can, try to get a few things done well as opposed to this juggling act of having so many balls in the air all the time. It’s been my pleasure in this last year, being in the CMIO role, to think about how my colleagues are using the tools we’ve given them. I think a lot about how we help doctors take better care of patients. That’s where I started out 30-odd-plus years ago and got lost, in a way, with the sea of administrative responsibilities and monthly operating reviews and budgets and business systems — all the stuff that comes with the CIO role.
So maybe just those two thoughts that life is short, you need to enjoy the non-work component of it and, at work, pick and choose those things that you really, really want to get done well.
Maybe just one third thought, and that is I’m a continuous learner. I read two or three books every single month. You know that I’m on the road a fair bit of the time learning new things and understanding new things, and I think that has stood me in really stead over the years. My job, of course, began in a more traditional physician practice-focused role and evolved into a CIO and now a somewhat different role with CMIO. It’s always been important to continuously learn. It’s gratifying to stay fresh in your job and bring innovation into the organization.
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