Any CIO worth his or her salt knows the importance of getting physicians engaged; the big question is how to do it. In his three years at Thibodaux Regional, Bernie Clement has learned that there is no easy solution, but if you want to get clinicians on board with change, you have to seek input when designing processes and implementing systems, be transparent, and be patient — eventually they’ll see “the light at the end of the tunnel.” In this interview, Clement talks about how his relationship with Meditech has improved, the work his team is doing with analytics, and why some vendors just “get it.” He also discusses his career path, the most challenging — and rewarding — aspects of being a CIO, and why you’re only as good as the organization you work for.
- Director of strategic planning — “It was nice to use the other side of my brain”
- The CIO’s toolkit
- Taking a job closer to home
- Getting — and staying — lean
- From the oil industry to health IT
- Applying project management skills
- Toughest part about being a CIO
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You have to be pretty adept at not only project planning, but also program planning and portfolio planning. I think a lot of hospitals would be surprised if they really looked at their CIOs.
They really have it nailed. When you look at their cost per discharge, it’s very low, and it’s not because they skimp on things — it’s because they’ve really leaned out their processes, and they’ve dedicated themselves to that.
There was also something else that pulled me toward healthcare; the opportunity to really be able to impact patient care was pretty intriguing to me.
The pace of change moves so quickly, and we’re asked to do things so quickly. And it’s not because the hospital necessarily is changing priorities; it’s because regulations are changing so much.
Gamble: Before arriving at Thibodaux you were at East Jefferson General Hospital, correct?
Clement: That’s correct.
Gamble: I had seen in LinkedIn that you were CIO there, and then you were Director of Strategic Planning.
Gamble: What did that position entail?
Clement: The hospital at East Jefferson was in the midst of creating a new strategic plan, and so I assisted in creating that plan with the executive team and the board and the medical staff. And then I assisted in turning that plan into something that was more operational where we could have a more precise plan of how to accomplish those strategic objectives, and then how to establish a system of accountability and coordination where we could be able to move the dial. It was pretty interesting stuff. It was nice to use the other side of my brain for a little while. I have an MBA; my undergrad is actually in business, but my career path took me to IS, and it was nice to be able to do something a little different for a little while.
Gamble: I’m sure being able to get some more of that business experience is a big benefit for you now in the CIO role.
Clement: Right, and the unique thing that a lot of CIOs and IS people have in their toolkit is that they’re looking beyond their department. Most of what they’re doing is process-based, and so they’re getting a good taste of the hospital and all the various workflows within the hospital, but it’s so complex what you’re doing that you have to be pretty adept at not only project planning, but really program planning and portfolio planning. I think a lot of hospitals would be surprised if they really looked at their CIOs. The skillset that many of CIOs out there have can really help their organization in many ways beyond IS.
Gamble: Definitely. Now, how did you arrive at Thibodaux? Was it something where you were looking for a change, and did you have any hesitations about it?
Clement: I wasn’t really looking for a change. The situation really presented itself. I’m from the Thibodaux area — Thibodaux is not exactly a metropolis. I know some of the people that work here in Thibodaux, and I have some relationships through our kids playing sports together and whatnot. I had relationships already established here at the hospital when the opportunity arose.
I think what really intrigued me was adding two hours back to my day. I have two young boys, and I’m excited about the opportunity to spend more time watching them grow up. They’re pretty active and those two hours allow me to be able to dedicate a little more time to family. As I’m sure you know, most IS people in healthcare work long hours as it is, and so to tack two more hours on to that really limits what you can do during the week. So it was nice really from a lifestyle perspective too to be able to get closer to home.
Gamble: That’s absolutely huge. Was it laid out as far as some of the things that you were going to be working on? Was there a three- or five-year plan, something like that?
Clement: There was a five-year plan that was underway. They may have been in year two — perhaps year three, but I had a pretty good idea of where they were looking to go. If you look at pretty much all hospitals right now, Meaningful Use, ICD-10 and all these things have laid out the path for most organizations, whether they wanted to go down that path or not. But I had a good idea of where this place needed to go. The CEO, Greg Stock, the vice president of human resources, and the whole executive team did a great job of explaining what was expected here, where they went, where they wanted to go, and the hospital’s goals. They’ve been successful, which really helped me in my decision-making process.
They’ve been able to be a very lean hospital, which is something that intrigued me. I have certifications in Lean Healthcare and Lean Hospitals, and they’ve been doing Six Sigma and Lean really before it was something that was in vogue in healthcare. It really interested me; to get here and to be able to see a place who had figured it out and to see that activity was really something to behold. They really have it nailed. When you look at their cost per discharge, it’s very low, and it’s not because they skimp on things — it’s because they’ve really leaned out their processes, and they’ve dedicated themselves to that.
Gamble: So many organizations are struggling with getting leaner, because the resources just aren’t there.
Clement: You see what’s happening with reimbursements, and for those hospitals that have not gone down that road, it’s really going to be a struggle. It’s going to be a struggle for us. I think for all hospitals, one of the biggest concerns has to be that your reimbursement is shrinking and the regulatory aspects and difficulty of providing care is increasing. Only the people who really dedicate themselves to process improvement are the ones that are going to still be here.
Gamble: Absolutely. I had also seen that earlier in your career you were in the oil industry, and that is interesting to me because we don’t see that a lot. I wanted to know how you got into IT from there.
Clement: As I mentioned before, my undergrad was in business. It was a business degree specifically tuned towards the oil and gas industry. At the start of my career, I was a lease analyst in an oil and gas company in Houston. I really got into IS because I was doing an upgrade project of our and was going to be more of an end user, but ended up liking the IS aspects of it. I adjusted my MBA to focus on IS and ended being the IS lead towards the end of that project, and that just took me on a path to really enjoy IS and what information systems could do to improve an organization.
From there, my next step was to get back home; I was still in oil and gas, but now instead of being on the business side of the oil and gas company, I was in their IS department. I was given great opportunities to learn a lot about Oracle and databases. Unfortunately though, once I moved home, I was seeing a lot of your oil and gas companies consolidating. Many of those companies were moving out of the New Orleans area and back toward Houston, which was a concern because I had finally gotten back home from Texas.
I was not very interested in being forced to migrate there, and was looking around for other options and realized healthcare was a great opportunity for me. One, because you don’t have that potential of a hospital pulling up stakes and moving to a different state. You’re pretty well set there, but there was also something else that pulled me toward healthcare; the opportunity to really be able to impact patient care was pretty intriguing to me.
My initial position in a hospital was being a DBA. That’s one of the things where the more technical you are in IS, really you can span across industries pretty easy. Being an Oracle DBA in an oil and gas company really wasn’t much that different than being an Oracle DBA in a hospital. The hospital had a data warehousing program going, and that’s really what I went in there to do — to help with data warehousing, mainly from a DBA perspective. But as I learned more about the business model and learned more about data warehousing in general, I found myself doing more of an analytics function than a DBA type function for the hospital, and I ended up running their data warehousing program.
In the meantime, I wrapped up my MBA and got my certification in project management. Right about that time, they decided they wanted to replace their entire HIS system at East Jefferson with Cerner. That project with Cerner got off on the wrong foot, and lucky me, having just gotten my project management certification, I was appointed as the project lead to take over and get it back on the right path. I was pretty successful there; we got Cerner deployed. It was difficult. Hurricane Katrina blew through right in the middle of our project, which really made things difficult for us. We had put it aside for a while and get the hospital back into steady state, but we ended up deploying Cerner. About that time, the CIO that we had there in the hospital decided it was time for him to move on. So I became the CIO at East Jefferson. I did that for about three years, and then moved on to director of strategic planning role, and then found myself back here. So it’s been a steady progression, building upon a base of which you know and trying to constantly extend yourself and improve yourself.
Gamble: It’s interesting the things had happened along the way — the Cerner implementation turned out to be a great opportunity for you.
Clement: Yes, I’ve been blessed. I’ve had some great chances to step into roles and had the skillset at the time that I could apply to my employer and be able to get some nice things done.
Gamble: What do you think is the most challenging aspect of being a CIO in today’s industry?
Clement: The rate of change, I believe. IS is seen as something that is very critical and necessary for hospitals to move forward, and that’s great. But on the flipside of it, the pace of change moves so quickly, and we’re asked to do things so quickly. And it’s not because the hospital necessarily is changing priorities; it’s because regulations are changing so much.
We have the two-midnight rule, which that came up last quarter of last year and just came up out of the blue. You’re required to change some processes and address that and address it quickly, or your reimbursement is impacted. I think handling the pace of change becomes pretty difficult, especially in a time where reimbursement is not increasing. You really have to be creative on how you’re going to handle all of that without the ability to really have a huge staff or to grow your staff. You have to have a good network of partners out there to help you keep up with those requests.
Gamble: It’s got to be tough. Then just to round that out, what’s the most rewarding aspect of being a CIO?
Clement: I think for here, it’s being able to see your impact on patient care. Doctors and nurses go into their professions because they know they want to make people better. IS people initially don’t really go in there with those lofty ideas and goals, but it’s nice to feel like you’re having a positive impact, albeit indirect — nowhere near like a physician or nurse, but it’s been nice to know that you can apply what you know and see a positive impact on a person’s health. It’s pretty rewarding.
Gamble: It certainly seems like you’re at the right place.
Clement: It makes all the difference in the world. It’s a fantastic culture. Anyone who would want to come here and work here would be very, very happy. Even though it’s a relatively small town, it’s only an hour away from New Orleans and Baton Rouge. It’s a great place to work.
Gamble: Okay, well I know we’ve covered a lot. I don’t know if there was anything else that you wanted to talk about, but I really want to thank you for your time. You’ve given us some great insights and I really appreciate it.
Clement: Anytime, glad to do it again.
Gamble: Great. I’ll definitely want to check back with you down the road. Things are changing so fast that I’m sure we’ll have more to talk about.
Clement: That is true.
Gamble: Thanks so much, and I’ll be in touch with you soon.
Clement: Great, thank you.