Rick Follett, CIO, Good Samaritan Health System, Chapter 3

With the exception of the rare CIO who has called one organization home, most have spent time in consulting. It was a path Rick Follett took, but the move wasn’t permanent, because he learned that “when you’re a CIO, you’re an owner. When you’re a consultant, you’re more of an advisor. In this interview, Follett talks about the lessons he learned in holding different IT positions and what it was like to come full circle with Good Samaritan. He also discusses the challenge of continuing along with the current strategy while the organization is in talks to affiliate with a larger system, his plans with population health and data analytics, and why getting buy-in can be much easier with clinicians than IT staff.

Chapter 1

Chapter 2

Chapter 3

• Career path twists and turns
• From Good Sam to consulting and back
• “When you’re a CIO, you’re an owner.”
• Benefits of CHIME — “As we help each other, we improve the profession.”
• The pace of MU
• “It’s still the number one thing on the minds of CIOs.”

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Bold Statements

When you are a CIO, you are an owner. When you are a consultant, you are more of an advisor, and there are times when, as an advisor, you’d like to get a little bit more involved.

It’s not just the stimulus program, but really how do we best utilize this new technology that we’re now buying and implementing so that we and our doctors can use it well and achieve high adoption rates.

Having that experience showed me when you can scale up, and what are the additional things you might be able to do or be required to do just as a result of your size.

I think the pace at which we’re pursuing this is really challenging our ability to move everything forward safely. That is still the number one thing on the minds of CIOs who are adopting and promoting this technology.

Gamble:  I want to switch gears a little bit and talk about your career path. From looking at LinkedIn, I can see there some interesting turns that you’ve taken. To start off, you’ve been CIO at Good Samaritan since 2011, correct?

Follett:  Yes.

Gamble:  But you were at the organization several years prior?

Follett:  I was here for about eight years starting in 1998. I started as a director of IT, and ultimately, as we kept advancing automation, it became clear to me that we were buying in a best-of-breed strategy, and I didn’t think that that was going to be something that we as a community hospital could sustain, and even afford, in the years to come. So we went through a strategic planning exercise that resulted in a change of strategy to purchase an integrated system. Logically for us, it came down to two choices, in part because McKesson had a fairly new system then called Paragon that was scaling up to meet the needs of larger hospitals, and we were already a large McKesson customer with many of their best of breed products, and so it became a pretty easy choice to convert to the Paragon system.

In the process of doing that, we also decided it was a good time to outsource the IS department to McKesson. As result of that, my position was eliminated, and I went on to do some independent consulting. That consulting led me to another large regional hospital that had purchased an Epic system for use in the ambulatory environment. They were making a selection at that time to use Epic throughout the acute care side as well. I was brought in as a consultant to help determine how they could use their ambulatory Epic system with other community physicians who could then perhaps take advantage of the relaxation of Stark Laws that allowed for hospitals to donate some technology to physician practices. So within that program, we were designing an offering of the Epic ambulatory system to be used in the physicians’ practice for a small fee that was qualified for the Stark exception. That project was successful.

Ultimately, I went onboard to work for that organization as a fulltime employee in order to achieve the buy-in from the board for the stimulus. It’s not actually called stimulus — it’s more of a subsidy that they would offer to those practices who joined. We brought the project live, and I moved on.

Gamble:  I imagine it was really interesting going from the director role to consulting and being in the same environment, but having that different role. I imagine that was an interesting perspective for you.

Follett:  It really was. I think the difference between the two is when you are a CIO, you are an owner. When you are a consultant, you are more of an advisor, and there are times when, as an advisor, you’d like to get a little bit more involved. It may be true that your scope is limited as a consultant, and the benefit there is you can devote your time to solving the problem at hand, but the downside is there may be other low-hanging fruit that you’d like to also participate in picking, and you may just not be able to do that because it’s not your role.

I think both worlds are very interesting and intriguing for what they offer. My personal preference has been to be an owner and to have more accountability for a broader array of responsibilities than the simple project you might have. Not all of them are simple, but you may be focused on a particular solution as a consultant.

Gamble:  You eventually came back to Good Samaritan. How did that happen as far as coming into that CIO role?

Follett:  There was a point in time where, as the stimulus program — ARRA and HITECH Act — was enacted, it became clear that the outsourcing agreement with McKesson needed to be supplemented with some consulting staff, and ultimately, a fulltime CIO at the hospital to lead us through the whole EHR adoption curve. It’s not just the stimulus program, but really how do we best utilize this new technology that we’re now buying and implementing so that we and our doctors can use it well and achieve high adoption rates as well as good outcomes and benefits from the system. As I said before, I really preferred being an owner, and this was an opportunity to come back to my own community and take a lead in something that’s really close to me.

Gamble:  Right. And obviously you were so familiar with the organization and seemed like it was a good fit, right?

Follett:  It was a perfectly good fit, yes.

Gamble:  How do you think having been not just consultant but also having worked in different settings and different types of hospital settings has helped shaped your current role now?

Follett:  I’ve been through a pretty wide array of settings. My first healthcare experience was at an academic medical center, so I learned the ways of governance and how you interact with the various entities within an academic medical center. That was a great education, and it prepared me well for my transition to Good Samaritan, working in a smaller community hospital where scale and resources become more acute and it’s important there to sort out what your priorities really are and keep them in the right order.

From there, going to a large community health system that was not an academic medical center — having that experience also showed me when you can scale up, and what are the additional things you might be able to do or be required to do just as a result of your size. So that range of experience I think has really rounded out my career and enabled me to be as effective as I can be. Even though I’m in a smaller setting today, I’m very comfortable at large settings as well, but there are some challenges here that you might not see in a larger organization that I find very intriguing.

Gamble:  I noticed that you’re a part of CHIME. Are you in touch with a good number of CIOs at organizations maybe similar to yours to exchange ideas and best practices and things like that?

Follett:  Yes. Over the years, that’s been really one of the big benefits of CHIME. Not only are they a world class organization for healthcare management leadership, they’re also just a great group of people who will help you in any way they can. I think as we help each other, we improve the profession of healthcare IT management.

Gamble:  I don’t know if there’s anything else you wanted to touch on, but we’ve covered really what I wanted to ask. I wanted to close out by asking you about where the industry is headed today with Meaningful Use and whether you think that the industry is on the right path. I know it’s a big question.

Follett:  It is a big question, but it’s one that I think most healthcare CIOs have given plenty of thought to. I honestly believe we’re heading in the right direction. The pace at which we are pursuing it through the stimulus and the Meaningful Use programs is probably a little bit too brisk for many of us, especially since we are reliant on our vendors for producing the products that we need to achieve these additional features and functions.

Those mature products may be well-positioned to deliver on those. For example, a smaller community hospital may be using a less robust system, and therefore is really dependent on the maturing of the system they are using. Even after the vendor delivers the feature function, we have to upgrade to adopt it, and no matter the size of your setting, adopting it often involves changing the workflow. And you want to do it as cautiously and safely as you can so that you don’t introduce new errors into the system, but rather you make an improvement every step along the way.

I think the pace at which we’re pursuing this is really challenging our ability to move everything forward safely. That is still the number one thing on the minds of CIOs who are adopting and promoting this technology, but it’s been probably one of the bigger parts of the challenges to be able to get it done in a timely manner to meet the deadline, yet to do so safely.

Gamble:  That covers everything I wanted to talk about. I want to thank you so much for your time. I’ve enjoyed hearing about the work you’re doing as well as your thoughts on the industry.

Follett:  You’re quite welcome. It’s my pleasure.

Gamble:  Thank you, and I hope to follow up with you again down the road.

Follett:  I would welcome that, Kate. Thank you very much.

Gamble:  All right, thank you.