At first glance, it might seem like Cleveland Clinic Abu Dhabi and University of Mississippi Medical Center have little, if anything, in common. But the two have quite a few similarities, according to David Chou, who served as senior director of IT operations in Abu Dhabi before making the leap to UMMC. Both positions involve working closely with government and other key stakeholders, and both offer significant opportunity for growth. But where his previous role offered the once-in-a-lifetime chance to build a facility from the ground-up, Chou’s new post affords him the opportunity to put an academic medical center on the map — a challenge he gladly accepted. In this interview, he talks about the organization’s rapid electronic journey, how he is fostering innovation, and what it’s like to make a major career change.
- About UMMC
- From manual to digital in 3 years
- Going big bang with Epic & Lawson
- Post-implementation optimization
- From Abu Dubai to Mississippi
- Motivating the staff — “We’re instilling a stronger sense of urgency.”
- Building a hospital from the ground-up
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It was a pretty quick install, in my opinion, for something of this size. It was complete within one year of planning. With that being said, there is obviously a lot of performance improvement and optimization that needs to be done.
The potential for this organization to grow and gain national recognition is on the upswing. There are a lot of things that we can accomplish here to improve for the state and as a whole. That’s what really attracted me to come here.
There is a strong relationship between the royal family and Abu Dhabi and Cleveland Clinic, and so the discussion was, how can we pick up this Cleveland Clinic Ohio model and drop it in Abu Dhabi?
Being able to work closely on a global project and having that strategy and having to staff globally — that’s something very unique. I would say it’s probably a once in a lifetime chance where you get to build something from the ground up.
While the concept and the strategy is great, when it actually gets to the nuts and bolts of working internationally, things just move a little bit differently.
Gamble: Hi David, thank you so much for taking the time to speak with us today.
Chou: No problem.
Gamble: To give our readers and listeners some background, can you just tell us a little bit about the University of Mississippi Medical Center?
Chou: Sure, I would love to. The University of Mississippi Medical Center is the state’s only trauma center and the state’s only children’s hospital, so in terms of where we stand, we play a big role in terms of providing healthcare for the state of Mississippi. We’re the second largest employer in the state.
With that being said, we do have a lot of responsibility to serve the community well and to be part of the governor’s plans. We are growing and expanding internally. As part of the organization, we do have three missions: one is the medical school, another is the research institution, and the third, obviously is the healthcare and the hospital side. To summarize, what it looks like is five health sciences schools, five hospitals and a 450-physician multispecialty practice, in addition to our research center.
Gamble: In terms of the clinical application environment, the system went live on Epic last year, correct?
Chou: We’ve gone through a drastic transformation in terms of systems implementation. We went big bang on Epic sometime in the last year — about 15 months ago. The year before that, we went live on Lawson. So we went from an environment that was fairly manual to a full digital environment. Obviously our goal is to be fully digital, and so we’re trying to get there. We went through two major transformations from a healthcare IT perspective in the past three years.
Gamble: That’s obviously a huge amount of change. At this point, are all of the hospitals on Epic?
Chou: Yes, we have everyone on Epic, including the physicians and all of our clinics as well. Everyone is using Epic. It is pretty much a success story that has not been shared in terms of national recognition.
Gamble: It sounds like that was just an enormous change to go through, especially when you’re talking about an organization of this size and scope. At this point, is the focus on doing post-implementation optimization and just taking things a little bit further?
Chou: We’re definitely looking at ways to optimize. It was a pretty quick install, in my opinion, for something of this size. It was complete within one year of planning. With that being said, there is obviously a lot of performance improvement and optimization that needs to be done. We’re looking at how we operate as an organization and whether it is the most efficient way. With that being said, any shift in operation is going to result in some sort of change in the technology, so that’s where we’re at currently.
Gamble: As far as transitioning of the data, that sounds like something that had to have been a pretty big undertaking. From your perspective coming into the positive recently, were you kind of on the tail end of that as far as moving over all the data? How did that work?
Chou: Fortunately for me, I came in after the install. I’ve been on the ground here for about almost a month. The install was complete about 15 months ago, so that piece has been sent in terms of data migration. And we still have the old system on standby if needed.
Gamble: So you just got there about a month or so ago. What was it that made you interested in the CIO role at UMMC?
Chou: Well, in terms of where I was, I was with Cleveland Clinic Abu Dhabi. They’re doing some great work over there in terms of building a world class hospital internationally. It was a tough choice to leave Cleveland Clinic, obviously, but when I saw the potential here in Mississippi, being the state’s only trauma center and the state’s only children’s hospital, the potential for this organization to grow and gain national recognition is on the upswing. There are a lot of things that we can accomplish here to improve for the state and as a whole. When I saw that potential, that’s what really attracted me to come here. Obviously the first impression of Mississippi is not always the best, but when someone sets foot here, you get a different feel for what’s the potential and what’s really going on in this region.
Gamble: I imagine it’s a pretty significant adjustment and it’s an adjustment period that I’m sure takes some time. Why don’t you talk a little bit about what you’re doing to get accustomed to the CIO role here — what it’s like to step in and lead a staff and get to know them?
Chou: My policy has always been to have an open door policy, and that’s what I’m embracing for this department. It’s a fairly decent size department; we have about 400 staff on board. From an employee morale/employee engagement perspective, I’m trying to bring that higher than it was, and so we’re doing a lot of things to improve morale and employee engagement.
Secondly, things just tend to work a little bit slower in this region. But with the new leaders we have on board — we have a new CEO and senior management has shifted to where everyone is bringing a different perspective from outside of the region — I think we’re instilling a stronger sense of urgency in terms of getting things done a lot quicker. We’re going to be seeing a lot more positive results a lot sooner than what has traditionally happened in the past. We’re trying to speed things up because we’re moving and changing, healthcare is changing, regulatory is changing, and in order for us to compete, we need to step up and change faster than what’s going on in the surrounding areas.
Gamble: You said the CEO is fairly new as well?
Chou: We have a new CEO on board. He started here maybe a few weeks before me. I think the leadership style that’s on board is a shift — it’s a traditional shift, especially given the fact that we’re a state organization. Obviously with any state entity, things just take a little bit longer to move, but I think now we’ve instilled that sense of urgency.
Gamble: That must be pretty interesting from your perspective; you’re coming in as the organization is prepped to move things forward. I imagine it’s a good opportunity to establish yourself and work with the new CEO to create this new environment.
Chou: It is very exciting. This is also a unique opportunity where there is only one CEO over all three streams, meaning the research, the academic and the hospital sides. I think the academic medical center is trying to move toward this consolidated approach, and exciting to see that the University of Mississippi is already there right now. We’re trying to gain some national recognition in terms of some of the things that we’re doing here.
Gamble: Did you have reservations about working for a large academic organization?
Chou: No. I think the environment in Cleveland Clinic in Abu Dhabi was a similar role where it was a joint venture between Cleveland Clinic and the Government of Abu Dhabi. I had a structure where I was working closely with the government officials in Abu Dhabi, which is similar to what I’m doing here in terms of working closely with the state, the governors, and then obviously our stakeholders. We have folks the ground here in charge of the various work streams; it was same thing in Abu Dhabi where I needed to work closely with the on-site CEOs and the executive team, in addition to the folks back in Cleveland. It’s a similar set up to what I have experienced. So in terms of reservations, I would say no. The only reservation was being new to the southern region of the United States. That was the only hesitation.
Gamble: Sure. Moving to a very different area certainly takes an adjustment. As far as the position you had at Cleveland Clinic Abu Dhabi, that was something where there was a new facility opening up. What exactly was your role there and what was the goal?
Chou: The goal was that the Government of Abu Dhabi wanted to have a Cleveland Clinic facility there. Healthcare is not the best in that region, so they’re trying to do everything they can to improve healthcare and improve society in general. There is a strong relationship between the royal family and Abu Dhabi and Cleveland Clinic, and so the discussion was, how can we pick up this Cleveland Clinic Ohio model and drop it in Abu Dhabi?
My role there was senior Director of IT Operations, where I had full responsibilities over all the application suite technology. It was more of a hands-on role and strategic role, especially being a start-up environment. We had about a hundred different applications being installed simultaneously. The goal was to follow the Cleveland Clinic model.
Gamble: That seems like a really unique experience, going to this very different part of the world, while at the same time working in conjunction with the Cleveland Clinic in Ohio. I imagine it was pretty beneficial having this type of role and working with a different government.
Chou: Of course. It helped me tremendously in terms of gaining exposure and understanding how things work globally, and I think it gave me a good grasp of global outsourcing. One of the challenges that we had there was staffing. It’s hard to staff, especially with trying to get North American expertise, so obviously we had an outsource model to where we relied heavily on our partners. And so being able to work closely on a global project and having that strategy and having to staff globally — that’s something very unique. I would say it’s probably a once in a lifetime chance where you get to build something from the ground up.
Gamble: Sure. Was that what appealed to you most — having that opportunity to build from the ground up and not having to deal with an older building and putting in the new technologies, things like that?
Chou: I think that was the appeal for everyone on the ground, and that’s why folks there still love the project now.
Gamble: Did it open close to what was scheduled?
Chou: Unfortunately, no. It’s a 2.3 million square foot building with little under 400 beds, so from that perspective it probably has to be one of the world’s biggest hospitals for a single entity. With construction of that magnitude, there’s always a potential for delay, so there is a slight delay from a construction perspective. When I joined, the original target was to open Q4 2011. I think now there’s an extension of maybe Q4 2014, so approximately a two-year push.
Gamble: And it was being done under the Cleveland Clinic US — is that who was primarily running the building and the implementation, things like that?
Chou: Cleveland Clinic is more of a management layer in terms of oversights. The actual folks running the day-to-day operations are employees of Mubadala Healthcare, which is a sovereign wealth fund entity created by the government. It is a government run project, with Cleveland Clinic as a management layer. Cleveland Clinic does provide a senior management team, along with some of the department chairs and the medical staff. And so we do have some folks there that are actually from Cleveland, Ohio, acting as medical staff and the chairs, just to ensure that the quality is consistent with what we have in the US.
Gamble: That’s an interesting model. What do you think were some of the biggest takeaways or lessons learned from that perspective?
Chou: I would say the vision to try and pick up a facility from the US and drop it internationally is a great concept. But things operate a lot differently internationally, so while the concept and the strategy is great, when it actually gets to the nuts and bolts of working internationally, things just move a little bit differently. Things are just done a lot differently, so without someone having the full international experience, it’s very hard to achieve that in terms of getting to the endpoint.
Chapter 2 Coming Soon…