For Dana Moore, becoming CIO at Centura Health didn’t exactly happen overnight. In fact, he jokes it may have been the world’s longest job interview. But for Moore, who first served as interim CIO, persistence paid off. Almost eight years later, the organization is thriving. In this interview, Moore talks about Centura’s Meditech journey, his goal to achieve Stage 6 recognition for all 13 hospitals in 2013, and what it’s like to build from the ground-up. He also discusses the health neighborhoods initiative that is transforming the way care is practiced in Colorado and helping Centura position itself for the brave new ACO world, the work his organization is doing with HIEs, how he has benefited from his experience in consulting, and why recruiting isn’t a huge challenge for Centura.
- Rolling out inpatient CPOE & cardiology PACS
- Prioritizing projects —“It’s a very difficult pace to maintain.”
- Maintaining relationships between managers and direct reports
- Using data to secure resources for IT
- Thinking outside the box to recruit & retain quality people
- From consultant to “accidental CIO”
LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED
You have a governance process, you set priorities, and then something changes, and priorities have to shift.
We’re currently making a big investment inside of IT so that we can take that data and show the rest of the organization, ‘here’s how we’re utilizing our resources and these are the limitations we have.’
We’re blessed that we are able to attract new folks when we have the need. But in certain areas, we see the cycle to fill open divisions getting longer and longer and harder and harder, especially when it comes to some of the clinical areas supporting the EMR.
We’ve spent a lot of time and money over the last two and a half years, starting with the leadership team and saying, ‘okay, we all need to be on the same page. We need to have open and honest relationships with each other.’
I knew if I came here, we wouldn’t outsource. We had really great people here — and still do — who believe in the mission of the organization and really saw something exciting that I thought we could do here.
Gamble: Okay, so obviously you have a lot going on. Are there any other kind of major IT projects on your plate for right now or in the near future?
Moore: We’re in the midst of rolling out inpatient CPOE, as matter of fact, in one of our hospitals today that went live last week. And what we’ve seen with that is over 90 percent of all orders being entered electronically — one of our hospitals is at 97 percent and many are at the 95 percent threshold. We’re pretty excited about how that’s going. And as I mentioned, we’re continuing to work on HIMSS stage 7 at our hospitals and as we get them all to stage 6, we’ll move to 7. We’re also rolling out cardiology PACS. We just kicked off that project so other than that and the normal upgrade cycle and continuing to improve, nothing going on here.
Gamble: Right. It sounds like you have a lot of free time.
Moore: Yeah, exactly.
Gamble: With everything you have going on, I imagine one of the challenges is prioritizing projects. That’s a theme that we definitely hear a lot with CIOs, and I just wanted to see if you have any best practices you can share or just anything that you’re struggling with as far as prioritizing.
Moore: I probably echo every CIO you’ve talked to in that you have a governance process, you set priorities, and then something changes, and priorities have to shift. We run a very lean IT organization at Centura. We are roughly 2.1 percent of net operating revenue with a little over 200 FTEs supporting all of these things. At any given time, if you look at our project portfolio, we have 200 to 300 ongoing projects. It’s one to one and a half projects per FTE, and so that becomes very difficult pace to maintain. I sit with the senior executive team. We have a senior executive counsel — I’m a member of that, and certainly we leverage that interaction to help set priorities. I don’t know if winner or loser is the right term, but there’s always somebody that’s happy that their project has been moved to the front, and there’s a person that’s disappointed that their project got pushed out. We have this conversation face to face. With the person that’s disappointed, you spend some time explaining how the organization got there and you make sure you’re able to deliver their project on that new date so that you maintain those relationships and you continue to meet their needs as well. I wish I had the magic answer, but probably like every CIO, I don’t.
One of the things we’re looking at are better tools inside of IT. We spent the last eight or nine years investing in EMRs and PACS systems and all of those things, but we haven’t kept pace with the tools we use inside of IT for project tracking, resource tracking, etc. So we’re currently making a big investment inside of IT so that we can take that data and show the rest of the organization, ‘here’s how we’re utilizing our resources and these are the limitations we have.’ It’s either more money, more people, or extended time to get the projects complete. It’s a balancing act.
Gamble: And along with that comes the issue of having good people on your team and being able to recruit and hold on to talent. That’s another issue we’re hearing a lot of. I don’t know what the market is like in your area, but is this something that’s been a challenge?
Moore: It is. It is a challenge here in the Colorado market. We’re fortunate in that Colorado is a destination state. That’s probably a strong term, but we’re not fighting that barrier to get people to come here. Denver is a metropolitan area, so people are happy to live here. But the challenge we face is that everyone’s competing for the same resources. You can get into a bidding war at times to get that top notch person. And on the technical side, you’re not just limited to healthcare. You’re competing with all the people that use IT systems for some of those top server Microsoft resources.
We’re fortunate in that healthcare is a unique area to go into. We talk about physicians and nurses having a calling, and I see the same thing with our IT resources. We have people that come to healthcare because they say, ‘I can work for XYZ company that produces widgets and do this job and leave at the end of the day, and I don’t have a sense of fulfillment.’ Or, ‘I can come to healthcare and do that and then at the end of the day, what I’m doing is making an impact on somebody’s life.’ We stress that as part of our recruiting. We stress it for retention. We stress it because we don’t want people to lose sight of why we’re here. So what’s really fortunate for us is we have a lot of long tenured people. I have associates that have been here for 40 years.
Moore: I know. It’s wild. I’m fortunate that the two VPs I have in IT have both been here for over 25 years and are still as engaged and excited as they were the first day they started work. So we’re blessed that we have some long tenured people. We’re also blessed that we are able to attract new folks when we have the need. But in certain areas, we see the cycle to fill open divisions getting longer and longer and harder and harder, especially when it comes to some of the clinical areas supporting the EMR.
Gamble: Yeah, I imagine. You mentioned that sometimes it becomes a bidding war, but are there other things you can offer like educational programs or flexible schedules, things like that?
Moore: We certainly do that. We’ve also offered the ability to work from home when needed. We kind of leave each team up to the discretion of the manager. We introduced that a year ago, and that has been very popular. What’s interesting is it was a constant demand. ‘Why don’t we have the ability to work from home?’ So we opened that up, allowing this many days per pay period as an experiment, and the actual usage of the work-from-home option has been less than I would have expected based upon the requests. So that’s kind of an interesting little sidebar. I think it just becomes easier sometimes for people to come to the office where they can interact with their coworkers as needed.
The other thing that we’re working on is what I call working conditions or office space. Probably like a lot of hospital IT departments, it’s a cube farm with lots of cubicles. And so while we’re not doing away with those, we’re making the cubicles a little smaller to free up space, what I call collaboration space. We are patterning after some work Cisco’s done; some things I’ve observed just in traveling, and so we’re putting in tables and comfortable chairs with a little table attached to it where people can just sit down and have an impromptu meeting versus having to book a conference room and go through all the formality of a meeting. It’s more, ‘Okay, why don’t we just walk over here, sit down, and talk through this.’ It’s more comfortable than sitting in a cube but also encourages people to have more face-to-face time with each other.
The other thing we’re looking at that we’re going to be putting in this summer is a treadmill desk or walk stations. So we’re going to put in three of those for people who just need to check email or listen in on a conference call more than really participate. They only go two miles an hour, so no one’s going to be running on them. It allows you to get a little bit of movement and exercise when needed and promote healthy lifestyle as well. Those are the things that we’re looking at — what can we offer that’s a little different. Not only to attract people, but to retain the talented people that we have.
Gamble: Things like that really can go a long way. I’ve seen that in my own experience.
Moore: I agree. What it always comes down to is the relationship that a person has with their coworkers and with their direct manager. And so we’ve spent a lot of time and money over the last two and a half years, starting with the leadership team and saying, ‘okay, we all need to be on the same page. We need to have open and honest relationships with each other.’ And now we’re taking that work that the leadership team has done — managers and above — and applying it to the entire department. At the end of the day, we can put in all the neatest furniture and we can offer all the greatest educational opportunities, but if somebody doesn’t trust the leadership team in the organization, they’re not going to stay. That’s what we’re working on. That’s where we’re spending most of our time.
Gamble: Yeah, it makes so much sense. Transparency is huge. If people are being honest with the staff and you’re telling them what’s going on, it just makes things so much easier and there’s no need to kind of speculate.
Moore: Exactly. Sometimes what you’re sharing is not good news, but if you’re at least open and honest about it and explain why the decision was made, people can respect that and move on.
Gamble: Absolutely. Okay, I’d like to talk a little bit about your career path. You started as CIO there in 2005, but before that, you were interim CIO. Is that correct?
Moore: Yes. I joke that I had the longest job interview of anybody and I’m the accidental CIO. So my background is I went to college, got a degree in accounting, worked for a small public accounting firm for a couple of years, and then got into healthcare. But it was always on the financial side — revenue cycle. I was actually CFO of a couple of small hospitals in Florida, and then went into consulting, and again, I was primarily on the financial side.
In 2001, I was actually engaged by Centura to do some work in their HIM department and then was asked to project manage — from the user side, not necessarily the IT technical side — some work on putting in a new HIM system. I did that work and got a call from the CFO, who had just been promoted to COO and said he was going to outsource IT. This would have been in 2004, so I had various engagements off and on with Centura. And between those, I got a call that he was going to outsource IT. He knew that I had done that project management work and asked if I had any thoughts on it.
So I wrote a little white paper and got a call to meet with the outsourcing company. They asked, would you fly out here because I’d like you to just handle the financial side of this transaction for Centura. So I flew out and met with him. He’s a great guy. The last words he said to me before we walked in the meeting were, ‘you’re not going to be interim CIO. You’re just here to do the financial piece.’ I said, ‘okay, I understand.’ I went into the meeting and they were doing all the introductions with the outsourcing company and the Centura people, and this gentleman from the outsourcing company introduces himself as the interim CIO. And so the person I was working for at the time said, ‘No, we already have one. It’s him.’ And he just points. So I’m looking down the table and everyone’s looking back at me and I’m like, ‘oh, okay.’ That changed in the five minutes we walked down the hall.
And so I became interim CIO at a very difficult time. The department knew that they were going to be outsourced. They were very concerned. We were going through this due diligence with the outsourcing company, trying to make decisions on what our EMR is going to be, and at the same time trying to turn around a failed PACS implementation. So we had a lot of things in the air. And as part of that due diligence, my comment to him was, ‘you’re top-heavy in IT. You have a lot of VPs. You’re spending a lot of unnecessary money, and so therefore, if you do this deal, you’re giving the outsourcing company about $5 million in free revenue because they’re basing it on your current costs.
So we did a reorg in IT. I kept saying to him, ‘You shouldn’t outsource. You’ve got great people. You’re going to regret this.’ And finally he was like, ‘okay, put together a plan.’ So we did. We reorganized the IT department. We reorganized the whole governance process for projects. We moved down the road of making a selection on an EMR, and made that decision. It was right before Christmas. I was walking out of Littleton Hospital, where I am today, with the COO. At that time he’d become interim CEO, and I said to him, ‘You’ve asked me several times if I’d consider moving here. Were you serious?’ And his comment was, ‘I knew I’d win you over.’ And I said, ‘I need to talk to my family, so don’t get too excited.’ I went home and talked to my wife and said, ‘I think I’d like to pursue being CIO for Centura.’ I was traveling a lot, but really what attracted me was that I knew if I came here, we wouldn’t outsource. We had really great people here — and still do — who believe in the mission of the organization and really saw something exciting that I thought we could do here. And it’s been the best decision I’ve ever made in my career.
Chapter 3 Coming Soon…