There is a growing sentiment that when the Meaningful Use criteria were established, small organizations—which are often short on resources—were not the top priority. Even forward-thinking organizations like KishHealth, an Illinois-based health system that has been running an EMR for more than a decade, are spinning their wheels to meet the requirements. But CIO Heath Bell hasn’t let that hamper his plans. In fact, he has big dreams for his (relatively) small organization that include consolidating from three EMR systems to one, facilitating data sharing both within and outside the health system, entering the realm of owned physician practices, and of course, meeting those Meaningful Use requirements.
- Moving forward while staying flexible
- Tackling ICD-10
- The pressures of producing quality measures
- Staff management and motivation
- The art of saying no
- Not just CIO, VP of revenue cycle too!
- The importance of being available
As an industry, we’re going to have to find a way to become a little more nimble and react appropriately. I think that has a number of organizations scared right now, and rightfully so, because you also are facing an uncertainty associated with the costs of all of this, and finding a way navigate that and remain successful for the organization is going to be a challenge.
I think that’s one of our biggest challenges right now—everybody needs their projects done yesterday, and we’ve only got so many people to go around. And at what point do you say no to someone?
We have limited items in relation to iPads and mobile devices right now. And a lot of that is primary functionality that isn’t well-supported in the Meditech arena yet. Placing orders and things like that are very difficult on those devices and the current interfaces that we have.
We’re a very open organization. We share data with our employees, we share it with our physicians, and we share it with our community at large. We don’t hide behind the names or the titles or the secrecy of administration or any of that stuff as I’ve seen at some other organizations.
There are concerns, certainly, that I bring to the table: Are we doing this too fast and am I going to be able to keep up? But in the end, it is about patient care. It’s about the patient’s experience, and ultimately, the welfare of our individual nation’s health.
Guerra: One of the quotes you had in a release brought a question to mind. You said you chose Medicity because the technology has enabled you to pursue your health system’s goals while giving you the ability to connect with regional HIE initiatives as they take shape. Now what that made me think of is that so much of what CIOs have to do right now, especially for Meaningful Use and ICD-10, is to move forward with maybe less clarity then than they would like. The FAQs are coming out on Meaningful Use and changing in your directional a little bit to the left, a little bit to the right. But you can’t wait for every little detail to be in place. Do you find that that’s the kind of environment you’re working in, and does that make your job a little more difficult than it used to be?
Bell: Absolutely. There’s so much uncertainty lately, and you’re constantly having to adjust. But being in the technology field to begin with, you kind of enjoy the challenges of last-minute deadlines and things like that—at least in the way that I came up through the ranks, that worked for me. Would I love to have absolute clarity to say that over the next five years I need to have implemented every one of these particular pieces, and if so, I’ll get all of this back, etc.? Absolutely.
But I think that with the changing environment—healthcare reform looming on top of the HITECH Act, on top of all of the other pressures that are coming, I don’t think we’re going to get that clarity anymore. And I do think that as an industry, we’re going to have to find a way to become a little more nimble and react appropriately. I think that has a number of organizations scared right now, and rightfully so, because you also are facing an uncertainty associated with the costs of all of this, and finding a way navigate that and remain successful for the organization is going to be a challenge. So far we’ve been able to weather it pretty well, but yeah, I absolutely think that there’s a lot of uncertainty. But I also think that it’s never going to return to a more certain world.
Guerra: In terms of ICD-10, do you have a plan in place?
Bell: We do. We have started with our coding departments at both of our respective hospitals and they’ve already started establishing training plans, and they’ve started sending people out for additional training. We’re trying to bring the physicians into a new documentation models. So we’ve laid out a plan that should take us through the next two years to make sure that were going to meet all those requirements. It’s not going to be an easy task or something simple by any means, and it just adds to the layers of things we have to deal with.
Guerra: All right, I have a few more questions, but I wanted to see at this point if there’s anything you want to talk about—any main challenges on your plate that you’re dealing with.
Bell: Well I think the one that we haven’t hit so far in relation to this has been the initiatives towards quality. We’ve been dealing a lot with the Meaningful Use requirements, but at the same time we have to worry about value-based purchasing. We have to worry about the core measure outcomes and quality reporting on the national level and transparency. So that has also created a lot of work and extra effort for our IT departments, because we needed to be able to get better data out of our systems and do mining. So it’s kind of hitting us from every aspect right now, and I think that just creates additional pressures for CIOs and other leaders in the industry to find a way that navigate this and balance to resources. I think that’s one of our biggest challenges right now—everybody needs their projects done yesterday, and we’ve only got so many people to go around. And at what point do you say no to someone? I’ve been working in the industry long enough to know that this isn’t new, because there’s always been a lot of pressures on people, but the deadlines associated with them lately just seem to be tighter and tighter. So it’s been a challenge for us.
Guerra: Tell me a little bit more about getting quality data, and from your position as the CIO, what are some the activities that you’re engaged in to try to get that done.
Bell: Well it’s interesting, I’m actually probably in a unique position compared to some of colleagues, and I’m excited about it, but it also does require a lot of my time. We’ve started what we call a quality steering committee here. It’s a very a small group of executives—myself, our CMO, our CNO, and our director of nurses sit together on a daily basis and we walk through items that are going on within the facility, we talk about the challenges that we’re hitting, and then identify problems or start to trend information forward. And within this, I’m getting a different perspective in relation to the clinical care and quality initiatives that are going on, and it’s bringing clarity to me to be able to go back and say, ‘Okay, our solutions should be able to deliver this in order for the clinicians to meet the challenges that they’re after.’ I’ve found it to be very enlightening and very rewarding so far. It’s out of my normal world, but at the same time it helps me to go back and make better decisions on the ultimate solutions that we’re selecting.
And we’re trying to be very nimble with this, we’re trying also be able to deliver what we’ll meet today, and then hopefully by tomorrow we’re already be digesting data that’s coming out of something that we discussed this morning. So those quick turnaround time that I mentioned earlier are becoming even more so in this particular committee, because it’s one of those models where we want to deal with the quality issues that come up immediately. We don’t want to have to wait and then trend the data six months later and say, ‘Oh wait, we should have changed that process.’ We’re trying to do it in real-time now.
Guerra: You mentioned the stresses that are on the IT departments. Tell me about how you’ve found it in managing the staff and keeping people from getting burned out. Have you seen some turnover?
Bell: So far, I’ve been lucky there. I have a great team in the IT department; they have been very dedicated to the organization and to our initiatives as a whole. In relation to some of the things that we’re doing, we’re trying to be as flexible as possible with schedules. We’ve actually started letting people work from home one day a week, and we make sure that we have a good team environment as well. We still try and bring some fun into the environment occasionally, whether that is through departmental parties, little outings here, etc. We’re trying to manage that work-life balance associated with the individual team. Like I said, I’ve been lucky. I haven’t had any turnover associated with any of my major analyst positions, or even the helpdesk, for that matter. The last turnover we had was two years ago, and that was an individual that actually left the organization to move out of state. And that was for a family issue that had nothing to do with not being happy in their current role.
And we’ve been growing. We’ve been adding staff every year, and so the staff do feel supported with us trying to make sure that we’re equally balancing the demands that we put on them with the number of resources that we have spread to around, so it’s been good.
Guerra: That’s good. What about saying no—you talked about having to say no. Have you mastered that art when it comes to the physicians asking for things like they want to use their iPad or something like that?
Bell: I don’t think I’ll ever master the art, but do I utilize it? Occasionally, I do. We have limited items in relation to iPads and mobile devices right now. And a lot of that is primary functionality that isn’t well-supported in the Meditech arena yet. Placing orders and things like that are very difficult on those devices and the current interfaces that we have to use for them. So we’re looking at some solutions that may change that going forward, but right now we are going back to them and saying, ‘Just give us a little more time.’ It’s worked so far, but I’ll tell you, the patience is staring to wear thin with the physicians, and they would like to see us move a little bit faster on some of those things. I’ve actually ended up saying no more often on the more administrative side of the house, whether it’s accounting materials management or the revenue cycle side of things, more than I have on the clinical side.
Guerra: All right. Forgive me if I got bad information, but are you also the VP of revenue cycle?
Bell: I am.
Guerra: Tell me about that, because I don’t see that very often.
Bell: Right place, right time I guess would be the right answer for that.
Guerra: Or wrong, depending on how you look at it.
Bell: I guess it depends on who listens to this. Several years ago with my previous role, I was hoping to make some changes in processes with the revenue cycle department at the facility I was at, and right after working with those departments very closely, the directors over that area left. And they started to realign just to give me a little more responsibility, and I picked up revenue cycle in that organization. When I came here, I was just over the IT telecom areas—the standard CIO role. And then about two years ago, we started looking at equity amongst all of our individual executives, and they wanted to do some realignment, and so I picked up the revenue cycle group. So I do oversee patient access, patient accounts, and revenue cycle now for both facilities as well as the HIM departments at both facilities. So, yeah, I have a wide net that is cast that I have to deal with on a daily basis.
Guerra: It keeps you busy?
Bell: A little bit.
Guerra: One of the things I noticed when I was scouring the Internet for information was that everyone on the hospital executive staff has all their e-mail and phone number right on the website, and I thought that was interesting because this morning I was looking for a CIO’s information, and on the hospital’s website, I couldn’t even find the executive’s names at all.
Bell: Oh yeah.
Guerra: So you have varying degrees. You are completely transparent—here’s my name, here’s my e-mail, here’s my phone number. Some don’t have names, and some have names but no contact information. Is that part of a philosophy of the hospital—to be available?
Bell: It is actually one of our strategic goals as part of our overall plan. We are a community-based facility; we believe in being out in the community, and we believe that we should be approachable. And it is a philosophy. We’re a very open organization. We share data with our employees, we share it with our physicians, and we share it with our community at large. We don’t hide behind the names or the titles or the secrecy of administration or any of that stuff as I’ve seen at some other organizations. And I’ll tell you, from a rewarding standpoint, and it’s a very good organization to work with. People know all of the administrators here, more than just their picture on the orientation slides. We get out, we talk with the staff, and we make sure that we’re available to the community as well. So yeah, we want to make sure that patients, employees, physicians alike can all get to us at any time.
Guerra: Now I hope I haven’t outed you in the sense that after this interview is published, you get a million pitches from vendors who can now find your e-mail.
Bell: Well the one thing is that I get a lot of e-mails from vendors and I selectively filter.
Guerra: You may have to change your address and put it in digit at the end of it.
Bell: Yeah, exactly. And make sure I don’t post that one.
Guerra: Right. One of the things I did notice—and I could’ve found the wrong profile, but I found a LinkedIn profile of you and you had no connections. I was quite disappointed that you’re not more active on there. Is that correct?
Bell: That is probably correct, yeah.
Guerra: So now what spurred you to create a profile and yet not reach out? And I’m sure people have pinged you with connection requests.
Bell: They have. I started up a LinkedIn profile just to get a little familiar with the site and kind of see what was out there, but I have not reached out and created a nice set of networks with people out there. It’s just been a personal choice at this time.
Guerra: You’re busy enough
Bell: I am, and when I get away from work, I don’t do as much scouring of the Internet and playing with things as some of the others do.
Guerra: What do like to do?
Bell: I have two kids. I have two boys and they are active, and so I spend time with them and my family, and we try to get away from the computers occasionally and do something else.
Guerra: How old are your sons?
Bell: I have a 15-year old and an 11-year old.
Guerra: Okay, so you can relax, because I have two sons. I have a 2-year old and a 3-month old, and I can’t relax.
Bell: Yes exactly.
Guerra: There is absolutely nothing relaxing about that.
Bell: It gets better.
Guerra: Okay, good. I believe I did notice that you are somewhat active with CHIME, at least you do go to the annual meetings. Are you any more active than that?
Bell: I try to be. I’m also on the awards committee, so I’ve done that. I’ve done the boot camp. I try to participate online as well with the focus groups and/or scenarios, etc. I think it’s a great organization, and I would like to be a little more active in it as time permits, but right now we’re all kind of pulled in different directions.
Guerra: How long have you been in the industry? You said you’ve been around a while.
Bell: I have. I actually started in healthcare in the early 1990s when I was putting myself through school and was working kind of part-time here and there in different departments. But I started healthcare IT in 1994 and have risen through the ranks. I actually started with night shift operations and now I’m a CIO.
Guerra: It has been good to you?
Bell: Yeah, it’s been a great ride. I still look forward in many more years, though.
Guerra: Heath, is there anything else you want to add? That was a wonderful interview, and I think we covered everything I wanted to talk about.
Bell: I guess I would just like to say in closing that I find a lot reward out of my individual position, and although I have challenges and all of us are going to face a number of challenges in our industry, I also think it’s an exciting time. I know a number of us have been waiting a long time to see integration and actual true collaboration of care. There are concerns, certainly, that I bring to the table: Are we doing this too fast and am I going to be able to keep up? But in the end, it is about patient care. It’s about the patient’s experience, and ultimately, the welfare of our individual nation’s health, and so and I think it’s a great and exciting time for us to be in healthcare. And I look forward to many more years here, and hopefully making things better across the board for everyone.
Guerra: All right, Heath. I want to thank you so much for your time today, and hopefully we’ll get to speak again soon.
Bell: Certainly. It has been a pleasure, thank you.