After spending 16 years at Trinity Health — which had just merged with Catholic Health East, graduating from being a large organization to a mega system — Kyle Johnson knew it was time for a change. Several hundred miles away, Eastern Maine was looking for a leader with experience in data management and analytics, and a match was made. In this interview, Johnson talks about building a foundation for population health, the organization-wide effort to restructure, EMHS’ homegrown umbrella portal, and her thoughts on the growing M&A trend in healthcare IT. She also talks about what it’s like to go through the merger process as a CIO, and when she knew it was time to move on.
- New roles: CQO & VP of patient engagement
- Leveraging her past experience with population health
- “New leadership can have a big impact.”
- BI steering committee
- Talking data with Gartner
- Geisinger’s employee health plan
- Homegrown umbrella portal
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Back in 2005-2006, folks didn’t even know what they needed analytics, queries, and dashboards for. I was trying to sell the services. Of course today, folks are much more savvy about data and information and what they need it for.
When you get new leadership into the organization, you have to be prepared that it can change the focus for the organization. That’s what it did.
In everything we do here, folks are open and excited to take on the next challenge. I don’t find anybody fighting; they’re just hungry for information and learning.
Those two things look a little bit different underneath the covers, but we’ve tried to make that as seamless and transparent to the patients as we can. And that’s part of the difficulty of having two disparate EMRs.
Gamble: I noticed there were roles of chief quality officer and vice president of Patient Engagement at Eastern Maine that were filled recently.
Johnson: Yes. They actually were filled internally. Those positions were under the office of the Chief Medical Officer, Dr. Rob Thompson, as part of his shared services strategy. Basically, we really didn’t have a clinical function at the corporate office of EMHS, so Rob was really brought in to really create that. Much of that is happening by gathering others from around the system to be part of that function at the EMHS level.
Gamble: Having roles like that seems to speak to what you’re trying to do in the next couple of years in continuing to conform to the new direction of healthcare and how things are changing with the new payment models.
Johnson: That’s absolutely right.
Gamble: You spent several years at Trinity Health — was population health a big focus for you and for the organization?
Johnson: I was at Trinity for 16 years, and the last three years was really spent on the development of population health in the organization. Prior to that, I had really managed all the enterprise-wide applications and all the implementations of those applications, and actually, I had the data warehousing team as well during that time. They asked me to spearhead developing a population health domain as part of our data warehousing function and develop the analytics to go with that. That was pretty fun to do that. I was doing data warehousing when we were data warehouse in search of customers, because back in 2005-2006, folks didn’t even know what they needed analytics, queries, and dashboards for. So in the early years, I was trying to sell the services. Of course today, folks are much more savvy about data and information and what they need it for. So it’s better to be in that place, I feel like, than trying to sell something that people aren’t sure that they need.
Gamble: In developing that analytics strategy, was there anything that that really stands out as like a lesson learned or something that maybe didn’t go the way you thought it would just as far as taking analytics to the point where it is now?
Johnson: I think this would fall in the lessons learned category. We were well down a path. We had picked a solutions partner when I was at Trinity, which was Explorys. So they were a partner, and then we had a new CEO come into the organization, Dr. Rick Gilfillan, and he had lots of experience. He ran the Geisinger Health Plan for a number of years and he ran CMMI, the Center for Medicare and Medicaid Institute, which is part of CMS, for a number of years. He had a lot of health plan and population health experience.
I think the lesson was that when you get new leadership into the organization, you have to be prepared that it can change the focus for the organization. That’s what it did. He really wanted to step back from some of the work we were doing and simplify and start with some basic blocking and tackling and basically just working with claims data and not all the clinical data. We had been down a different path; he came in and in six months’ time, believe it or not, we were no longer using Explorys. This has happened since I’ve left — I think they’re working primarily with CareEvolution on a much smaller scope than what we were after.
It’s interesting what happens when you have leadership changes and how it can change the focus at that level. I don’t know that either way was right or wrong, but definitely, new leadership can have a big impact on things.
Gamble: You said that in coming to Eastern Maine, one of the big drivers was the experience you had with data analytics and warehousing. I’m sure that this is an instance where a leadership change where you became the CIO and you have this experience with data management and data warehousing in a place where there was no formal data warehouse, that was going to change the focus of the IS organization.
Johnson: I think so. In fact, they have a business intelligence steering committee here. I’m part of the group, but was not one of the co-chairs to begin with, and it didn’t really take long before they asked me if I wouldn’t mind being one of the co-chairs. We really like the foundational work that we’re going through right now.
I actually had Gartner come in and really talk about data governance, data quality, and data stewardship, and just all the foundations that they have to do to really have a quality warehouse environment. I think folks just didn’t have the full picture appreciation of all that it’s going to take to really do this work. But, like I said, in everything we do here, folks are open and excited to take on the next challenge. I don’t find anybody fighting; they’re just hungry for information and learning. So that’s really been fun to be part of; helping to teach and guide the organization down this path.
Gamble: I’m sure it is such an interesting thing to be part of; to see an organization like Eastern Maine go through this whole change where you go from a volume-based to value-based care.
Johnson: Yes, and they’re pretty fast on the path here. When I was at Trinity, we were in 26 states across the US and when Trinity had merged with CHE (Catholic Healthcare East), we got a lot more of the East Coast business, and I think they’re further along on the managed care journey. We have a lot more of our population under risk contracts here. We have really seen the declines in our acute care business and surgeries in the hospital — the things that you will expect to decline over time, and we’re having really large increases on the ambulatory side, which is this is all the shift that folks expect to see. It feels like it might be happening here a year or two faster here than other places, so that is interesting. Just managing the changes in reimbursement during this time is pretty challenging.
Gamble: When it comes to dealing with this whole shift, is there either a specific committee or some type of leadership in place to work with the clinics and physicians just on this change and adjusting to it?
Johnson: Absolutely. In fact, Geisinger is our third-party administrator for our employee health plans and we’ve been working closely with them for probably the last four or five years. They actually helped us develop an efficient care model for our offices, and so we’ve been rolling that over the last two years to really make use of the EMR in a more effective way and have all of our care team working at the top of the license. It’s not that the physician does everything; everybody is doing their part and playing the right role in each of our offices to make that much more efficient.
We’re reaping the benefits of that. We have a lot of care management in place as well through the ACO that’s helping to manage patients through the different venues of care, effectively using healthcare resources.
Gamble: Do you have a patient portal set up at this point?
Johnson: We do. We are predominantly using Cerner’s patient portal on the acute care side. We use Centricity on the ambulatory side since that’s the bulk of our footprint, and then we’ve developed a homegrown umbrella portal, if you will, that sits over the top of those two things. For patients at least it looks seamless as they’re signing in, and then if they’re looking at their hospital record, they’re actually in the Cerner portal. If they’re looking at their ambulatory data, they’re on the Centricity site. Those two things look a little bit different underneath the covers, but we’ve tried to make that as seamless and transparent to the patients as we can. And that’s part of the difficulty of having two disparate EMRs — you get into the multiple portal situation, and it’s just really not very good for your patients.
Gamble: It’s challenging enough to get the adoption and the engagement you need on one portal, so that’s just adding a whole other piece to the situation.