Though running a best-of-breed shop presents some unique challenges for the hospital IT department, Theresa Meadows says the big benefit is being able to give clinicians the exact tools they want. So the answer is no, she doesn’t envy her single-vendor-for-all colleagues. To learn more about how Meadows is melding her Meditech and athenahealth environment, healthsytstemCIO.com recently caught up with the Texas-based executive.
- Words matter — are they “customers”?
- “I have to throw a dollar into the bucket every time I say ‘help desk’“
- Educating the org —the CIO is not the service desk
- The benefits of having been a clinician — “Occasionally, I’ll pull the nurse card”
- From Alabama to Texas (but can you go from NJ to Texas?)
- Going CHIME CHCIO
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I think I use ‘customer’ more because that’s how I think of our teams that we support — they’re our customers and we’re here to support them. We’re a service organization. Without the hospital or without our health plan, we’re really not here. And so they are our customers.
I enjoy interacting with the physicians and hearing their issues firsthand. Can it sometimes be stressful to listen to them complain about things that you can’t resolve? Absolutely, but at least they’re telling you. I worry when you don’t hear anything.
I drive my team nuts because I look at most issues totally from a process standpoint, and then try to apply the technology in that way. It’s very rarely that I go to a discussion where I say, ‘this is the tool you have to use.’
Occasionally I’ll have to say ‘Yes, it was a long time ago, but I was a nurse. I’ve done your job. I’ve worked with physicians. I understand what you’re saying.’ Sometimes you just have to pull that card.
Having that certification through CHIME is one of the best certifications that anybody as a CIO could have. I think it shows that you’ve got dedication and commitment to something, and that you’re interested in learning and progressing and keeping your knowledge current versus just sitting back and waiting for the knowledge to arrive.
Guerra: Let’s talk about some of the terms here. We have the term ‘customer.’ We have the term ‘end-user.’ I interviewed a CIO the other day who said that the organization he worked for decided to stop using the word ‘customer’ and start using the work ‘colleague.’ He couldn’t get comfortable with that, but the reason they did it was because they wanted to differentiate some of the vendor people that were onsite helping the organization from the IT people.
Guerra: Yeah. In his particular organization, the IT team was set up as a separate company. Their only customer is the health system, but they were trying to lift it up and out. So my question to you is, words are important — you use the word ‘customer’ a lot. I think you’re trying to impart to your team the relationship you want created with that, and then we have another term: end-user or customer. I would just like your thoughts around those types of issues and terms and how they relate to actual perception and then the reality of how the relationship forms.
Meadows: I think I use ‘customer’ more because that’s how I think of our teams that we support — they’re our customers and we’re here to support them. We’re a service organization. Without the hospital or without our health plan, we’re really not here. And so they are our customers. I like that terminology. ‘End-user’ to me feels very removed; that you’re not as in touch with what’s going on. ‘Well, they’re just an end-user, someone out that we don’t deal with unless we have to.’ I like the term ‘colleague’ or ‘partner’ because I really think that our customers or our end-users are our partners, and that we’re all part of the same team and we’re trying to make that move going forward.
Terminology is really hard to break. It’s one of the things where that I have to throw like a dollar in the bit bucket every time I say ‘helpdesk’ because I’m old school and I’m used to saying the help desk. But our helpdesk is actually the service desk. I get regularly reprimanded by my team when I call them the helpdesk because really they’re providing a service and they’re doing more than helping people. And so that’s really what we’re trying to propagate. I get in trouble quite a bit on terminology because I waver about what the right thing is to call people or to call things. But I do think ‘partner’ in my mind is the right term if we can get there culturally and get the right terminology in place, because I do think we’re partners in this. We have an obligation to hold up our end of the bargain and they do too, which is use to the technology that they’ve selected in the best way possible, and it’s our goal to support that. It really is a team effort.
Guerra: Do you find that physicians have no problem walking into your office and letting you know what they think?
Meadows: I wish they had that problem. No, they have no problem.
Guerra: They come right in.
Meadows: They absolutely come right in, they call, they email, they text. Any method of communication they can think of, they will do it. We have a very open culture here so they don’t have any problem with walking in and saying ‘Hey, I’ve got a problem with this.’ We had an issue last night and I got one text, two emails, and a phone call about this issue — all from physicians.
It’s just a very interesting culture. I actually enjoy it. I enjoy interacting with the physicians and hearing their issues firsthand. Can it sometimes be stressful to listen to them complain about things that you can’t resolve? Absolutely, but at least they’re telling you. I worry when you don’t hear anything, because that means there are things going on where people don’t trust or don’t want to share. So as long as they’re coming in, I’m comfortable with that. I worry when I don’t hear from them.
Guerra: There are issues that are appropriate for a direct interaction with you, and there are issues that are not.
Guerra: So I’m guessing that quite often, you have physicians contacting you about things that really need to go to the service desk, or something very minor. And you probably either just pass it along, depending on the physician, or you have to do some really delicate, politically correct re-education to tell them ‘You know what, you should just reboot, but next time, don’t.’
Meadows: Yeah, absolutely. You hate to say ‘just reboot’ because they’re like ‘yeah, that’s what all IT people say is reboot.’ But in some instances, that really is the fix. It really is the case. And you know, they are really good with redirection, and some of that has been because they didn’t trust our service desk, and so we’ve kind of worked through that. The calls to me directly have gone down. But there are physicians you can redirect, and there are other physicians that no matter what you say, they’re calling you. You kind of just learn to live with that, and you hope at some point they either retire or they learn how to use the right process. Because the thing that I try to share with them is you can call me, but sometimes your issue will be fixed so much faster if you just went to the service desk, because they would fix it immediately, where if you call me, then I have to call them, and then they fix it. So I try to redirect gently, but sometimes that doesn’t work like I want it to.
Guerra: Right. Do you ever try to say, ‘Here are the kinds of things that you can really contact me on, and maybe these other ones not so much.’
Meadows: I really don’t even try that. I kind of just work with them as they come. Sometimes with some of the doctors, you can joke with them and say ‘hey, why’d you call me,’ but there are others that you just kind of live with it. I try, but people are always going to do what they’re most comfortable with, and that’s fine.
Guerra: They’re the customer, right?
Guerra: Now you mentioned the fact that you were a cardiac nurse before in the interview.
Guerra: So physicians are no strangers to you. You understand these folks and what they’re all about and how they’re unique in their own way and how to deal with them. Having that experience both working with physicians and understanding clinical processes, we see that more and more in the CIO position, people with that experience. It helps you talk the talk, right?
Meadows: Sure. I think it’s so valuable and that I’m really lucky to have that additional skill set because I look at issues in a different way and I drive my team nuts because I look at most issues totally from a process standpoint, and then try to apply the technology in that way. It’s very rarely that I go to a discussion where I say, ‘this is the tool you have to use.’ For technical folks, that drives them crazy because they’ll say ‘why don’t you just tell them to use Meditech for that.’ And so I really try to listen and gather that requirement process and then offer suggestions or solutions on whatever those things are. And I think that’s different because I came from that background in more of a process orientation and workflow, and how does the technology fit in that workflow. I always think, ‘If I had to use this, could I?’ And sometimes the answer is yes, and sometimes it’s no, and sometimes that’s just best we have so you figure out how to make it work.
Meadows: But I do think it helps tremendously. It’s a good credibility to be able to pull sometimes. Occasionally I’ll have to say ‘Yes, it was a long time ago, but I was a nurse. I’ve done your job. I’ve worked with physicians. I understand what you’re saying.’ Sometimes you just have to pull that card. But most of the time, I rarely have to say that because just from my background, people know that. But occasionally I’ll pull the nurse card if I have to.
Guerra: You probably had to pull it more at the beginning, before they knew what you were all about.
Meadows: Absolutely. It’s one of those things where most of the time I’ll say, ‘Is your process X or is your process Y,’ and then they wonder, how would you even know that?
Meadows: So then I can throw it in there as just a little nugget and just keep going. But it is very helpful, especially when you start talking about applications like CPOE, barcode med administration, and physician and nurse documentation, all of those things that are very workflow-oriented and driven. To at least have a picture of what that activity is like and being involved in that activity, it really helps when you’re trying to deploy a piece of software and you understand why things sometimes just don’t work, no matter how much you try.
Guerra: Did you ever actually have someone say, ‘Well you don’t really understand what we deal with,’ and you were able to say ‘I do?’
Meadows: Yes, I’ve had that happen, actually a couple of times. Because I really try not to tell anybody that nurse background story unless I just really have to. But occasionally I have had to say that. And then they’re like, ‘Oh, why didn’t you tell me that before?’
Guerra: Then they think you’re being sneaky not telling them.
Meadows: Yeah, then they think you’re being sneaky. So you can’t win. It’s a no-win situation. But I do think it makes a difference and it does help. Can you be a good healthcare CIO without it? Absolutely, I’ve worked for plenty. But I think it’s just another trick that you have in your bag of things that you pull out when you need it. But it is helpful.
Guerra: Now, I’m sure you detect a slight accent in my voice, and I detect one in yours.
Guerra: Where are you from, originally?
Meadows: I actually am from Alabama originally. I grew up in Alabama, and then have moved several locations including Atlanta. I lived in actually Grand Rapids, Michigan for a while, then back to Alabama, and now in Texas. Even Texas folks say, ‘You’re not from here, are you?’ And I’m like, ‘What gave it away?’ I mean, it’s Texas. But I’m from Alabama originally.
Guerra: Could a CIO who is from New Jersey and worked in a hospital in New Jersey their whole career, go down and be a CIO at your hospital and be successful without moderating maybe some of their cultural, regional proclivity?
Meadows: That is a great question, and the only example that I can use is our CMIO is from New York. He is not a pediatrician. He’s an internist. He was able to come here and pretty much win over everyone with his personality and his abilities. He knows his stuff. If you’d ask me that without Harry being here, I probably would have said, ‘I don’t think anybody from New York City could ever come down here.’ But Harry did it. He is a true New Yorker through and through and has a bit of a New York accent, but he does very well. He does very well with our physicians and is very highly respected. Can it be done? Yes. It’s probably hard, but yeah, I think it can be done. It’s the same as me going to New York City or one of those things. It would probably be hard for me to do that.
Guerra: What about Alabama culture to Texas culture?
Meadows: It’s a lot alike. The cultures are very similar. Certainly the heat is very similar — the weather. You can’t get away from the 100 degree weather coming from Alabama to Texas, that’s for sure. We have a lot of the same values — the same cultural system, very rural communities. I think there’s a lot of synergy and a lot of similarities. The one thing we don’t agree on is football, which is fine.
Guerra: You’re very into college football, right?
Meadows: Absolutely, yeah.
Guerra: Very interesting. I just wanted to ask you one more thing before I let you go, because we’re running out of time. You’re CHIME/CHCIO eligible — you have that certification?
Meadows: I do, yes.
Guerra: Okay, talk to me a little bit about why you went and got that. Obviously CHIME is a very respected, very well-run organization — the healthcare CIO organization. They’ve got this certification that they went through a lot of work to develop and really put a lot of effort into it and quite a few folks have gone through the program. What made you take the time to go ahead and do it?
Meadows: First, being a new CIO. The job I was in before, I was not CIO. I was actually a regional director of our applications. Being new to the CIO role, I wanted to know if I really knew what I was doing. So I think it was a good validation to say, am I in the right role, or am I not in the right role? Two, I think that particular certification, if it doesn’t already, carries a lot of weight. I think it tests your knowledge. It tests what you know about workflow and process, and it’s not all about answering questions that you could read in a book and be able to solve that problem.
I personally think certifications are very important, especially in IT because it does provide some level of credibility. I think having that certification through CHIME is one of the best certifications that anybody as a CIO could have. I think it shows that you’ve got dedication and commitment to something, and that you’re interested in learning and progressing and keeping your knowledge current versus just sitting back and waiting for the knowledge to arrive. I personally would do it again. The thing that I lack is I don’t have three years as a CIO, so I’m in the 2.5 range. As soon as I make that mark, I should be in good shape. But I thought it was really important to get that going and get that on board as quickly as possible.
Guerra: Are you attending the Fall Forum?
Meadows: I will be there, absolutely.
Guerra: I hope to see you there.
Meadows: Yeah, definitely, I’d love to catch up.
Guerra: Very good. That’s about all I had for you, Theresa. Is there anything else you want to add?
Meadows: I just really appreciate the opportunity and thank you very much for taking the time.
Guerra: It’s been a pleasure, and it sounds like you’re having a lot of fun down there. Thanks again for the time.
Meadows: You’re welcome. Thank you.
Guerra: Have a great day.