Bryan Bliven isn’t surprised that the pace of attestation to Meaningful Use stage 2 has been somewhat slow. “It’s a different feel and it takes a different type of rigor to manage it,” said Bliven, which is why his organization opted to do a practice run before successfully attesting in the first quarter of 2014. In this interview, he talks about the unique partnership between MU Health and Cerner that enables his team to provide feedback on the solutions they use; his role as executive director of the Tiger Institute; and the approach his team used in attaining HIMSS Stage 7 recognition. Bliven also opens up about what it’s like to be a young CIO, and why he thinks MU Health’s patient portal will be “a game changer.”
- From HIMSS stage 2 to 7 — “We treated it like a project.”
- Quality improvement
- Enabling the staff to “recognize the amount of change we’d taken on.”
- From Cerner to MU Health
- A “different scope of responsibility” as interim CIO
- CHIME Boot Camp – “A great resource on how to approach the role.”
LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED
If there was a gap, we looked at it like, ‘why do you think that they have this as a requirement, and why aren’t we there yet?’ It was some great discussion; it helped us evaluate some of our processes and change them.
We see it as how we do business, and then when people come in and say, ‘Wow, you’re really doing a great job. This is something we’d like to take as a best practice,’ then there’s even more pride in that.
It’s a matter of approaching it from the standpoint that these measures are in here for a reason. It’s to help get benefit broadly, so let’s approach it as such.
I have several industry folks that I talk to on a regular basis to try to educate myself as much as possible. It’s definitely a steep learning curve, and I’m not there yet. I need to keep investing and learning more as I go.
Gamble: I wanted to ask about the HIMSS Stage 7 — what it took to achieve that from a leadership perspective and what something like that means for the organization?
Bliven: We’re HIMSS Stage 7 on both the inpatient side and 46 of our clinics in the outpatient setting, and the ones that have yet to gain that are some of the ones that have been acquired or purchased recently where we’re going through implementing our systems.
The first one to get HIMSS Level 7 was inpatient. At the start of the partnership, we were at about a HIMSS Level 2 solid with some functionality up to HIMSS level 4 that were in place in areas, but it’s really about getting that adoption broadly, and there were large scale IT and clinical projects that we had to get done to be able to qualify. It was a target with the Tiger Institute Board of Governors that if we’re looking at progressing the adoption and use of technology, what outside measures can we use to see how we’re progressing. HIMSS is an industry standard, and that was one of the targets we selected to utilize to advance, and so it gave us some goals to work for.
The organization was bought in. It really was a great project, and we treated it like a project. We had a project manager assigned. We looked at the requirements. We worked with HIMSS. They were great about answering questions — we had a lot of questions about the different measurements on how to get to Stage 7, and we formed a cross-organizational group for the inpatient side.
When you attest and you have your phone call for Stage 6 validation, there are questions you go through. We received that and we wanted to schedule our HIMSS 7 visit, which is an onsite tour. We were able to select the different units that we would have as part of the tour. You can’t obviously go through the entire hospital and spend the amount of time that is required, but we picked our neurosciences unit as one. You’re going to go to radiology, pharmacy, medical records, etc.
We were able to grab people from each of those groups and go through the requirements. If there was a gap, we looked at it like, ‘why do you think that they have this as a requirement, and why aren’t we there yet?’ It was some great discussion; it helped us evaluate some of our processes and change them. For example, getting outside sheets of paper scanned in within a period of time — we were able to put in a process that shortened that time greatly with working with medical records in the floors, and that was just a benefit overall. It just was something that we had not approached outside of HIMSS requirements.
There are things like that where if you approach it as ‘why is this in the measures,’ there’s a reason behind it. ‘Why do we think that? Do we agree with it? Yes, then let’s move forward.’ If we had questions, as I mentioned, HIMSS was great working with us on what does it mean in your barcode scanning percentage in terms of failed scan versus attempted scan? That was one of the measures that we were working with them on, and they were very helpful in what does this mean and what is the interpretation of it. It was a great QI process for us as well, picking out the different areas and moving forward.
By the time that the tour came around and the site visit came around, the floors were excited to show off. From the staff, it was, ‘We’ll show you how we do stuff here. We have a lot of pride in the work that we’ve done. With adoption of technology, it’s not something where you have outside folks come in all the time and say, ‘You’re really advanced in this.’ It just happens over time and we see it as how we do business, and then when people come in and say, ‘Wow, you’re really doing a great job. This is something we’d like to take as a best practice,’ then there’s even more pride in that.
It was great for the organization to really recognize the amount of change that we’d taken on since the beginning of the partnership, and it was the same on the outpatient. We had rolled out an ambulatory EMR project across all our clinics, and we took a similar approach and grabbed folks from the different clinics that we were going to have as part of the tours, engaged them in going through the metrics, and improved certain areas. It allowed us to, for example, implement our vitals monitoring system in the clinic so that it flows directly into the EMR. It’s a matter of approaching it from the standpoint that these measures are in here for a reason. It’s to help get benefit broadly, so let’s approach it as such. Again, by the time we were able to do the tour, the folks in the clinics were ready and they were excited to show off.
Gamble: That’s a really interesting way of looking at it; to say, let’s use the HIMSS Stage 7 criteria to see how we can improve our processes. It makes it a bigger project. Like you said, it’s not just about getting that label — although it is a really nice label to have — but it’s also about how can we improve.
Gamble: It is nice validation, I’m sure, to have that Stage 7 icon.
Bliven: Yeah. We’re very proud of being able to attain that and being able to show off on the site visit.
Gamble: The last area I wanted to talk about was your career starting with how you came into the CIO role there. I know that you started as an interim, and I wanted to talk about what that experience was like and maybe some of the challenges there.
Bliven: I’ve been part of the Tiger Institute really since it was formed. Shortly thereafter, my initial role was director of applications and operations. I managed our project management office and the implementation and support of all of the applications that the health system uses. I had that role for about two and a half years when my predecessor as a CIO moved on to a new role. I was named as interim and had held that title for about eight months before I was named permanent. It was different. It was definitely a different scope of responsibility, picking up a lot of the technology areas where in my previous role I had a counterpart that I would work with and could forget about some of those responsibilities. I had some learning to do to make sure that we were managing that appropriately, meeting with a lot of the physician leaders and clinician leaders around the health system to get acquainted and inform them of the directional strategy that we were working on, get feedback, and try to be a collaborative as possible.
And it was creating our governance committees. We also had a new chief medical information officer at around the same time. Forming a good partnership, working with the chief medical officer and chief of staff and really building out an inclusive, robust clinician-led governance structure was really critical. There are not any IT projects we do a lot that are clinical or operational in nature where technology is an underpinning; creating that transparency about what we’re working on and what the priorities are helps the organization feel comfortable with that style. We definitely want to be transparent and turn the technology over to the organization — how do we want to wield this as a tool, and I think that that really helped to get me comfortable and to help me get introduced to a large number of the leadership folks around the health system.
Gamble: Did you have any hesitancy about being a first time CIO? Did you reach out to anyone for guidance or advice, anything like that?
Bliven: I’m a member of CHIME and I went through the CHIME CIO Boot Camp, and it was a great resource on just how to approach the role. I actually had that in my back pocket, so to speak, prior to accepting the responsibility, so I had an approach. I definitely stay in contact with my predecessor on a regular basis.
I have several industry folks that I talk to on a regular basis to try to educate myself as much as possible. It’s definitely a steep learning curve, and I’m not there yet. I need to keep investing and learning more as I go. I’m still obviously just about a year in and I still have quite a bit to learn and so I’m trying to keep approaching it that way.
Gamble: Your predecessor was Joanne Burns, right?
Gamble: And she’s now with Cerner?
Bliven: Yes, she’s the chief strategy officer at Cerner.
Gamble: Okay. And finally, you’re a CIO who’s on the younger side. While I’m sure there are challenges there, I can imagine there are also some benefits. Do you see it that way?
Bliven: Yeah. I think there are pluses and minuses to everything, and it’s really about how you approach the opportunities. Like I said, I have a lot to learn but I’ve also been in healthcare IT for really 15 years. I worked at the University of Iowa Hospitals and Clinics prior to starting in the field officially. So I’ve had a fairly good amount of experience in that category; I’ve seen a lot of different hospitals, and how leadership has been approached
In a way, I like to think of a communication style in how you approach and work with people. It’s really about building a team, and so I count on my team quite a bit to provide a lot of knowledge and brain trust so that we can keep moving forward. I count on my peers across the hospital leadership a great deal, and I think it’s really about building those relationships and that can help you overcome a lot of your individual weaknesses.
Gamble: Overall, you feel like you’re in the right place at the right time.
Bliven: Yeah. It’s a fantastic place to be. I love the organization. I love our leadership here. We have a great vice chancellor and CEO. They’re really excited about technology, which keeps me definitely excited. There’s a ton going on, obviously, in the industry. It’s a fantastic time to be here. There’s so much to learn and just see how the industry’s reacting to all the different changes, there’s no place else I’d rather be. It’s fantastic.
Gamble: Obviously, you guys are doing a lot of great stuff. We really appreciate you taking the time to speak with us and talk about it. It’s been really interesting, and I definitely hope that we can catch up down the line and talk about everything else you have on your plate.
Bliven: Sure. Like I said, you need to come and visit the care tower. We’ll take you on a tour.
Gamble: I would love to. If I’m in the area, I will definitely call you guys up.
Gamble: All right, thank you so much, and I look forward to speaking with you again.
Bliven: Sure, my pleasure. I’ll talk you later.
Gamble: Thank you.