Allana Cummings, CIO, Northeast Georgia Health System
When it comes to major IT projects, two of the most important pillars of success include putting the right team into place and being able to guide a project through a rough patch. Allana Cummings, CIO at Northeast Georgia Health System, has addressed these key issues by embedding clinicians in the IT department and applying a different approach to right projects that seem to be veering off course. In this interview, Cummings talks about the value of a collaborative approach to problem-solving that includes the vendor, the importance of effective communication, having all the right information, and knowing when to take a time-out. She also discusses the application environment at Northeast Georgia, best practices in fostering CPOE adoption, and her organization’s iPhone and iPad empowerment strategy.
Chapter 3
- Working with Merge Healthcare for image exchange
- Moving from a children’s hospital to an adult environment
- Going from single facility to multi-hospital system
- A focus on leadership development
- Going CHCIO
- The paramount skill of project management
- Developing deeper business intelligence
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Bold Statements
Physicians can go out to a portal and be able to pull images from four different organizations, all exchanging images so that we can reduce the amount of radiation exposure that patients have. By having that information readily available, we think that it helps improve the timeliness of care and gives our providers the information that they need.
Our colleagues go through numerous certifications as an ongoing attestation of their competency to do their role in all of the clinical settings. I felt that it was important to demonstrate that same commitment in my technology role.
I think the skill around looking at the dynamics of what it takes to implement process change effectively is the single most important thing we do, because hopefully we’re not just putting technology in. We’re transforming the way we use the technology and the way we can deliver care.
I think having a project management methodology, coupled with a change management strategy and process improvement tools that your organization uses and uses effectively, are what you really need to ensure that you change that paradigm where there is far greater success, hopefully 100% success, with projects
With the way technology is changing, with the rapid needs around being able to take on new components of an EMR strategy, different enhancement tools for efficiency, and visibility to data in the organization, we just continue to have to grow our staff in terms of not only their technical skills, but also their business acumen and their ability to really be more of a consultant within the organization.
Guerra: Let’s talk a little bit about your work with Merge Healthcare, and what you’re doing with images in the HIE-type environment.
Cummings: We actually have been working on a community strategy of developing an exchange—one that we feel is not limited just to data and textual information but actually images as well. We are ready to go live with Merge’s iConnect tool. It’s a strategy of connecting providers in our community so that they can share PACS images in a seamless way. Physicians can go out to a portal and be able to pull images from, right now in our pilot implementation, four different organizations—our medical center and our physician practice as well from the health system—all exchanging images so that we can reduce the amount of radiation exposure that patients have because they may not remember that they had a CT at another facility. By having that information readily available, we think that it helps improve the timeliness of care and gives our providers the information that they need, and it also has a really significant safety implication. When you look at the prioritization of health information exchange, you tend to see people going the route of exchanging data first and we felt—and it was really through the leadership and guidance of our medical community bringing forward this opportunity to say, not only can we exchange the information we need as providers, but we can provide the safety element to patients by being able to eliminate unnecessary exposure to radiation. It’s a little different getting an extra needle stick that, while painful and not necessary, has implications. It’s very different when you talk about folks who have sometimes had three, five, or six CTs within a short window of time. There are more significant implications there, so we’re really excited about taking that from an early pilot and eventually rolling it out throughout our region.
Guerra: That’s a perfect segue to talk about your career a little bit. You came from Children’s Hospital and Medical Center in Omaha. I wonder, does having worked at a children’s hospital make you more sensitive to that overexposure of radiation and these types of things?
Cummings: I think that when you work in a pediatric environment, there is just such a focus on patient and family-centeredness that you hopefully gain a sensitivity that I don’t think there’s anything more precious for us to care for than children. Maybe there is that extra degree of thinking about ways that you can provide safety measures for those little ones that certainly can carry over into an adult environment.
Guerra: So you came over to Georgia in March of 2010?
Cummings: That’s correct.
Guerra: Can you tell us a little bit about that? When we talk about these questions, it’s to help give some insight to your colleagues who may be thinking about changing organizations. I’m wondering why you made the change. Anything you can tell us about making that switch?
Cummings: I had actually worked a significant part of my career in children’s facilities and I’ll always cherish those experiences. I had a situation where my family was looking at where we wanted to live. We had moved from Georgia to the Omaha area, and I have to tell you, I probably was taken back a little bit by winter weather. We had lived in Michigan growing up and I don’t think I remembered snow like I remember it now from the experience in Omaha. We just really had great people in the area—it was a wonderful facility, but we were missing Georgia, to be honest, and I was given an opportunity to be back in the south in a little bit different climate, and there was also an opportunity for growth. The facility that I was at was a single, smaller children’s facility that was doing great work in pediatrics, but I really longed for that opportunity to be able to grow and expand, and was looking at an organization that would have perhaps multiple facilities at some point to be able to have a greater scope of responsibility, and an opportunity to grow professionally. So the location and the opportunity for advancement were really the key drivers.
Guerra: Do you remember, was there was a moment during a particular snowstorm when you said, ‘We have to get out of here’?
Cummings: Some of it was the snowstorms, but other parts of it were 70-mile-per-hour winds—a 110-mile-per-hour sheer wind actually hit in our neighborhood; we didn’t have the damage that some other folks had—and hail that was measured in the size of softballs. It’s a beautiful area, but the weather was just a challenge. I never thought that weather would be a key driver in my decision-making, but it really became a little bit of a challenge. My folks live with me and my dad having to get out and plow snow constantly and such—it’s a lot of work living in that kind of environment. But the people are great, and I can’t say enough good about Children’s in Omaha. They are just a top-notch organization and I feel very blessed to have had the opportunity to work there.
Guerra: I was looking at some of the history of your education that I found online. You have a bachelor’s degree in organizational leadership. I thought that was really interesting. That sounds like something I might have liked to study. Has that been helpful?
Cummings: Absolutely. I actually started in healthcare. My sister was a student at the University of North Carolina and she and I were getting ready to go home for winter break. She stopped by student health thinking that she had a case of strep throat and had an X-ray tech chase us out of the building and catch us to say, ‘You can’t leave.’ We were two college girls going home for winter break. We were definitely heading out and he said, ‘I need you to see the doctor.’ He held her chest X-ray up and she had cancer filling her lungs. She was a Hodgkin’s patient but is fully recovered from that and is actually doing really well as a result of her going to chemotherapy treatments and her visits. One of the nurses told me one day, ‘Allana, you might as well get a job here. You’re here so much.’ That started my career in healthcare.
I started in HIM, working in medical records. I managed a group that filed 35 inches of incoming loose reports per day. So I had dreams and visions of electronic records coming hopefully in my career and future. It was neat to transition from managing the information in a paper environment to getting to be a part of the technology solution. So when I went into that career, I did not have an opportunity to finish my bachelor’s degree. So I finished that later in life and found this great program at Mercer University that was very focused on leadership development. It was phenomenal. All of the courses and seminars that we in healthcare and other business professions take to try and enhance our leadership skills—I actually got an undergraduate degree program in that.
I was also uniquely blessed to be able to go into an executive MBA program, the Ken Blanchard College of Business at Grand Canyon University, which also had a leadership component to it. So I love to study the theory and academic pieces behind leadership and hopefully learn a little bit and be able to apply them.
Guerra: I think some of the things that you’ve told me indicate that, with some of the ways you handle issues. That’s just my observation. So you have a CHCIO certification from CHIME. Tell me about the reasoning behind going for that credential.
Cummings: Sure. I think that anytime that you are in a setting such as the healthcare environment, you see that our colleagues around us go through numerous certifications as an ongoing attestation of their competency to do their role in all of the clinical settings. I felt that it was important to demonstrate that same commitment in my technology role. So when the exam was announced and CHIME brought the program forward, I was eager to help participate as one of the early takers of the test. I think it’s a great tool and something that we should embrace. People will start to pick apart the quality of exams and does it really create a differentiation; but I just ask them to look around their organizations and all of the credentials and degrees that are required to do other roles in the healthcare setting. I think we should hold ourselves to similar standards.
Guerra: You’re also a project management professional. One of the CIOs I interviewed said something interesting. He had given a lot of his staff more responsibility and given them ownership of projects maybe sooner than he would have liked, just because of the workload that’s on everyone. And he said one of the things that he should have done, looking back, is to give them more project management education. I think a few things slipped through the cracks here and there. Tell me about the art of project management and whether it makes sense to you that you really need to make sure someone is up to speed before you give them a project of a certain size?
Cummings: Absolutely. I think that’s wise advice from the individual that shared that with you. In our organization, we have eight certified PMPs. I believe it’s critically important. Probably the single most effective skill that I have as a CIO is my ability to understand project change management and how to work within an organization to basically be an internal consultant around how we can implement change effectively related to our technology. And certainly in serving on a senior leadership role and being able to help peers with that in other areas, I think the skill around looking at the dynamics of what it takes to implement process change effectively is the single most important thing we do, because hopefully we’re not just putting technology in. We’re transforming the way we use the technology and the way we can deliver care. And in order to do that effectively, you have to understand the dynamics of change. There has to be organization to it.
One of the simple things that I’ll share is we have a project management methodology that’s literally just a few pages long. It sets the playbook, so to speak, on what we’re going to go through in a project so that we’re all organized. We all have a common understanding of how we’re going to through this together. We have common tools that we use. We have one tool that is used in 100% of projects and it’s called the decision paper. It’s something as simple as a process to document, when you are evaluating a change, what were all the factors that you considered? What were your assumptions? Why did you not choose option A and felt B was better? Having that documented and understood by the stakeholders involved and having that to go back to as a reference when you get a little closer to go-live and everybody starts to have that moment of ‘how did we get here, why did we do this’; to be able to reflect and bring that back up—just simple things, is critical. I think that sometimes project management can be painted to be more complex than it is. But a simple playbook and standards that everyone’s going to comply with, making sure that your physicians, clinicians, and operational team members understand that, and getting everybody all to work in concert with one another is the recipe for success, I think, with implementations.
You hear the stories about the small percent of projects that actually succeed in many organizations. I think having a project management methodology, coupled with a change management strategy and process improvement tools that your organization uses and uses effectively, are what you really need to ensure that you change that paradigm where there is far greater success, hopefully 100% success, with projects and fewer that truly fail or don’t meet the degree of accomplishment of what you were hoping to get out of it.
Guerra: Before I let you go, I wanted to open it up to you. Are there any other projects you’re working on or issues you’re dealing with or thoughts on any industry trends that you want to touch on? I don’t know if you want to touch briefly on how you’re doing with Meaningful Use, anything like that.
Cummings: I think Meaningful Use has just truly become more integrated into our overall strategy. The key thing that we’ve been focused on are that we’re really trying to advance our use of business intelligence tools. We’ve been creating dashboard views into data that have click-and-drilldown capabilities to expose data that the organization has perhaps never seen, and to do it in a meaningful way where it’s really affecting change. We have very rapid cycle development in bringing these tools forward. We can connect up data from multiple data sets in a matter of days, share the data with the end users, and then work with them to define how they processed the data and how we can create views that really streamline their analytic process. We’ve been using ClickView to do that.
We’re getting ready to make a decision and purchase a health information exchange tool that will integrate with that imaging strategy, so we’re really creating a platform for true clinical integration. I think the other key thing that our leadership team as an organization in particular here in IT at Northeast Georgia is doing is really looking at investing in our staff—in competency and skill development. With the way technology is changing, with the rapid needs around being able to take on new components of an EMR strategy, different enhancement tools for efficiency, and visibility to data in the organization, we just continue to have to grow our staff in terms of not only their technical skills, but also their business acumen and their ability to really be more of a consultant within the organization. We want people to see IT as that internal consultive resource to help us do good things together. Those have been the key things we’ve been focused on.
Guerra: All right, Allana. That’s about all I had for you today. Is there anything else you want to add?
Cummings: No, thank you for the great questions and the time to chat.
Guerra: Thank you so much for your time. I hope to talk to you again soon.
Cummings: Great, thank you.
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