David Lundal, VP/Regional CIO, Dean Health System & SSM Health Care, Chapter 3

Whether it’s termed customer or colleague satisfaction, David Lundal is focused on not only ensuring those he serves have the technology they need to deliver superior patient care, but are happy to call IT when they need help with it. Specifically, the massive and complex organizations he calls home are well along the road of implementing just about everything Epic has to sell, in just about all their entities. To learn more about both his organization and how it’s working to have IT seen as sound service provider, healthsystemCIO.com recently caught up with the long-time IT professional.

Chapter 1

Chapter 2

Chapter 3

• Health plan experience and the brave new world of accountable care
• On project management
• Working with joint-venture facilities
• Living up to Epic’s expectations

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BOLD STATEMENTS

One of the other big things we’re doing now is business intelligence. So we’re working on a shared system where our EMR data will be matched with claims data to start to really get very good at population health, managing gaps in care, doing predictive analytics, trying to really fine tune how we do things.

… we didn’t own the project; the consultants were running it and that’s never a good thing.

I think how they do it is appropriate because they’re big projects and people get nervous. You’ve got to keep going. You’ve got to get live.

Guerra: So are you still doing stuff with Dean Health Plan? I see it was on your LinkedIn profile, it said 9 months. So that was a short stint?

Lundal: Yes, that was a short stint with Dean Health Plan. They were in the midst of a very, very large project called Project Armor. It had kind of gone off the tracks a little bit to a lot. I was asked to assist in the re-planning of that. Then for a short time, while they were looking for a new vice president of IT, I took the reigns there for a little bit just to keep things going while the project was going until we could find a new person there.

Guerra: Has the time on the health plan side benefitted you in your current work, just getting an understanding of what goes on in that side of the business?

Lundal: Yes, it’s always helpful to know. I’m always trying to learn more about health care. That was very beneficial, and I think it will even be more beneficial as we move down the path of accountable care.

So right now we have the electronic health record fully deployed and we have attested to Meaningful Use and are high up on the EHR adoption scale, and so we have all of that, and we’re going to continue to optimize that and continue to do Meaningful Use, which is just going to get harder and harder. One of the other big things we’re doing now is business intelligence. So we’re working on a shared system where our EMR data will be matched with claims data to start to really get very good at population health, managing gaps in care, doing predictive analytics, trying to really fine tune how we do things. So the whole process of paying claims, of what’s in there, of managing the risk that health plans do, the knowledge of that is helpful to me. I’m far from an expert; obviously a short stint like that is not going to do that for me, but it does help.

Guerra: You’ve talked about being brought over there because a project had gone off the tracks. Certainly, one of the biggest skill sets for a CIO is project management. So when you were exposed to that and you had to do that work, did you pick up any new lessons in terms of project management?

Lundal: I think it just reaffirmed some things that I already knew, so that was very helpful. A couple other things about that, (1) there were a lot of consultants there, in fact, more consultants than internal employees. So from my history, what I took from that was that we didn’t own the project; the consultants were running it and that’s never a good thing. Also (2), from doing an Epic implementation on the provider side, it’s a massive project in many ways. I’ll parallel to that the fact that we were building some hospitals at the same time as well. When I compare implementing an electronic health record with building a hospital, they’re very similar.

The Epic implementation is just as big, if not bigger. When you’re dealing with big, big projects, the organization needs to be in a position to support that. On the health plan side, doing what they were doing in my estimation was the biggest thing they’ve ever done. That is something that, going into a project, you need to understand the scale and scope of what you’re doing, is it just we’re putting in a software project or is it we’re transforming our business and everyone really needs to be engaged in this? We can’t just go on the course of our normal business with everything else as if you’ve got this side project going on. No, this is transforming the whole business.

Those are a couple of things that it reaffirmed for me and are definitely now firmly implanted in my psyche.

Guerra: Have you experienced that with the different facilities and different ownership structures that you need a different approach based on who your main point of contact is going to be at the facility level?

Lundal: We try and keep a very consistent approach with everyone. So starting from the foundation of Integrated Health Technologies being a shared service organization for all SSM Healthcare, the things we do there with the colleague satisfaction survey with how we bring people together to get their opinions, whether that be for a selection of a new software program or the design of a new software program. We have what we call functional quality teams where we bring people together across the health systems to help us really plan and let them drive a lot of it and, at the very minimum, have their voice be heard. We may not end up doing what everyone wants, but there’s a platform for their voice to be heard.

So we have some lessons there and then, foundationally, WIITTS is at this cross-section of Dean Health System and SSM Healthcare Wisconsin. Those are two different organizations. You have a multi-specialty physician-owned business and a 130-year-old Catholic health system. St. Mary’s just celebrated 100 years here in Madison. Different, different cultures, and so we have to do things in a way that bring the organization together, but do it differently because we have different customer bases. So we learn to do things so that people know we value what their business is, their issues are very important to us. So bringing in independent physicians or affiliated hospital physicians was very natural for us.

Guerra: Did you ever feel squeezed between what you’d promised Epic and what you were able to deliver, in terms of change from your organization?

Lundal: It’s been a few years, Anthony. Our St. Mary’s Hospital in Madison went live in 2008. The clinic started going live in 2003. We have been on our own implementing the clinics. You do the first couple with Epic then you do them yourself. The hospitals, they were very involved at St. Mary’s Madison in 2008. We’ve rolled out five other hospitals since then where they were minimally involved. We own the projects.

So it’s been a long time since I felt that pressure. My memory does tell me that they are very aggressive in that, and I think rightfully so. I think how they do it is appropriate because they’re big projects and people get nervous. You’ve got to keep going. You’ve got to get live. You’ve got to keep people on the path because there’s so many distractions. You could get to a point where you never get live. I think that aggressiveness is appropriate, but it’s been a long time since we felt it.

Guerra: You mentioned the dynamic about the Epic folks coming in and they know their stuff about their product but they may not know the healthcare environment. So we talked about that a little bit. Your other CIO colleagues reinforced the fact that they’ve got their recipe. They know what they’re doing, but you can’t just sit back and be a passive participant in the project. So there’s a balance there. Can you talk about that a little bit?

Lundal: You need to make sure you’ve got a good implementation team, and you’ve drawn that implementation team from the business. If we had people on our team that didn’t know the business, we would be in trouble. It’s also very important that the, whatever it is, be it a hospital or a clinic, they have this high in their priority list. This is a big project, and they need to know that when the meetings are set out, the schedule is done, here’s where we need input, here’s everyone that needs to have input on these things, they need to be there, they’re present and they’re actively participating in the project. If you miss that, then I think you run the risk of having some trouble.

You need to make sure you get physician input as well. We have three very active medical informatics directors part time that are critical and really, on any of our implementations, having that connection point to the physicians to get that input I think is key as well.

Chapter 4