Since she started at Summit Health in 1993, Michele Zeigler has witnessed significant change, and learned that the only way to navigate a journey as complex as electronic transformation is to follow a roadmap. In this interview, Zeigler talks about the long-term IT strategic plan her organization recently formulated, which includes new data and IT governance, and how her team is leveraging lean processes to improve not only the selection but also the utilization of new technologies. She also talks about the importance of leadership buy-in, hitting restart on ICD-10, the Summit Health app store she hopes will increase patient engagement, and why volunteering is more than just a hobby.
- About Summit Health
- Meditech HIS, Fuji, GE Centricity
- “We’ve been able to do some really innovative things.”
- Working with Aspen on a long-term strategy
- Lean process improvement
- “We needed to do a better job with our ability to manage and govern data.”
- Voice of the customer
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We are really pleased with our IS governance process and the willingness of senior leadership to invest in more time to help guide and make sure that we’re doing the right projects and we have the right infrastructure and we’re getting the right outcomes.
You need to look at where the new tool can help you as far as improving your processes. So why not look at the lean system and set of tools to help you with those? It provides a common framework for us to use.
We knew we needed to do a better job with reporting and data and our ability to manage and govern data. Because as we’ve done Meaningful Use, we have a lot more electronic real-time information and near-time information that we want to make sure that we’re using wisely.
We learned a lot about data definitions and data accuracy. It was a good process, but we recognized that we really needed some guidance. We needed some guidance at a higher level. We needed some governance and structure.
Gamble: Hi Michele, thank you so much for taking the time to speak with us today.
Zeigler: Thank you for the opportunity.
Gamble: Sure. To give our readers and listeners a little bit of background, can you just talk a little bit about Summit Health in terms of number of hospitals, ambulatory offerings, things like that?
Zeigler: Summit Health is situated in Franklin Country, Pennsylvania. For those that don’t know where that is, we are located in South Central Pennsylvania. We have two hospitals: Chambersburg Hospital and Waynesboro Hospital. We’re right along the Maryland border. We also have a couple of ambulatory locations. We have an ambulatory surgery center. We have a separate cancer treatment center.
We have, at this point in time, about 32 employed practices. And from an IS perspective, we have also what’s called IS contracted services, which we’ve had that for about 10 years. What we do is we provide a cafeteria style list of IS services to affiliated but non-employed physician and physician offices. We do a wide range of IT support and services for them. If they want us to host their system, they don’t have to use any of our ambulatory EHR tools.
We’ve hosted different systems because we have a data center and we do have quite an extensive fiber network that we own throughout the county that we partnered with our local government boroughs. We’re able to actually put in quite a decent infrastructure for us that saved us significant dollars with a wide area networking perspective.
Gamble: And you’ve been with the organization since 1993?
Zeigler: Yes. Not always in this position, but I’ve been with the organization since 1993.
Gamble: Can you just talk a little bit about some of the growth the organization has gone through since that time?
Zeigler: Sure. In 1993 when I started, I started at the Chambersburg Hospital and in that point in time, the two hospitals were separate. I think it was maybe a couple of years later that we started out with our first physician practice. It wasn’t really a strategy; it was just something where a particular physician practice came and asked us to help, and we did.
Later, in probably in 1995 or 1996, Summit Health was formed. The two hospitals came together and said it makes more sense for us to work together than for us to duplicate services, and so Summit Health was formed. Then about two years after that, they did a long-term IT strategic plan, and that created a common Summit IS infrastructure with the first introduction of the CIO role. I was not the first CIO; I was the director of Corporate Applications. I’ve had several roles throughout the facility. And then in 1998, I became the CIO and I’ve been the CIO ever since.
Since that time we’ve had a lot of growth, a lot of learning, a lot of partnership with our end users, a lot of successes, and a lot of lesions learned. We have a pretty robust infrastructure here. Meditech is our hospital HIS, but with that, we have the Fuji PACS system for our radiology. We have GE Centricity for our Cardiology PACS. We have GE QS Perinatal. We have nurse call that’s fully integrated with our cardiac monitors. We’ve been able to do some really innovative things. We’re 100 percent CPOE. We met both Meaningful Use stage 1 and 2 and we did our stage 2 certification back in the end of September.
We have a really good end user partnership. We have good ownership. We have just recently completed a longer term IT strategic planning engagement with Aspen Advisors and have formulated new data governance and new IS governance. We are starting to publish our dashboards and are really pleased with our IS governance process and the willingness of senior leadership to invest in more time to help guide and make sure that we’re doing the right projects and we have the right infrastructure and we’re getting the right outcomes.
About two years ago as an organization, we embarked upon the lean processes which Virginia Mason, and through our new IS governance, we are embedding a lot of the lean tools and techniques. Many of those make so much sense that as you’re looking to implements a new tool in the lab or new Nurse Call, you need to look at your existing processes and then you need to look at where the new tool can help you as far as improving your processes. So why not look at the lean system and set of tools to help you with those? It provides a common framework for us to use. Also, with a lot of our rapid process improvement workshops that we do, there’s always usually an IT element to it. We’ve created a little technology kit for the groups to use so that they can trial things out. They can plan, do, study, act and have maybe a tablet or some different technology tools to trial out in their process before they come to a conclusion.
We’ve also, as part of our IT strategic plan, done some reorganization in the IS department this past year to align some of the sections with what the organization was really requesting. I share with the IS department that in this fiscal year there were only seven positions approved all throughout Summit Health, and three of those were for IS. It tells us that the organization wants to invest in IS in order to help get the value and the efficiency from the tools and everything. One of the members of the new Senior IS Steering Committee said there’s nothing that comes to us anymore that doesn’t have some computer in it or doesn’t need to be interfaced or where we need to have some sort of way of measuring it or doing some analytics against that. So it’s really been a journey for us all here.
Gamble: As far as having that data governance put in place, how did that come about? I’m sure there was a process of coming together and saying, okay, this is what we need and just going to the board. Can you just walk through how that happened? It’s something that I think a lot of organizations could benefit from.
Zeigler: Sure. About three years ago, we went through and started a process. Really what we saw emerging is we knew we needed to do a better job with reporting and data and our ability to manage and govern data. Because as we’ve done Meaningful Use, we have a lot more electronic real-time information and near-time information that we want to make sure that we’re using wisely. We also saw that every single vendor was coming up with their own analytic tool. We saw that with Kronos, we saw that with Lawson, etc. And so we just put the brakes on it, because really what we could have done is ended up with eight different analytic tools. Many times what we need to do is take data from a financial system, and to do hours of care per patient day, you need to take census information out of Meditech and merge it with payroll information or time records. And you need to do it from multiple systems. Then we have external databases that we really didn’t have a good way to bring in and merge with other databases.
So about three years ago, we started a process called the ‘voice of the customer,’ and we went to folks that were real heavy users of reports or the ones that usually asked us for reports that were very difficult for us to do. We included them in a process to select the data analytics tool, and we wound up selecting QuickView. We got approval for staff; so we have four data analysts and we trained them.
We did our first dashboard and we did it with finance because they’re really good partners of ours. Between Finance and IS, we’re probably the primarily report providers. Through this, we learned a lot about data definitions and data accuracy. It was a good process, but we recognized that we really needed some guidance. We needed some guidance at a higher level. We needed some governance and structure. We needed a body that was going to decide, if we’re going to collect readmissions, is it 30 days? Is it three days? We decided to collect it in several different ways, but be very clear on what we’re calling readmissions. Is it a 3-day readmission? Because if I come back within three days, that could tell a story that perhaps there was something in my discharge process that wasn’t effective for me, or the hand-off to the ambulatory setting or physician just didn’t occur timely enough. Those you may want to look at from a different perspective; 30-day readmissions is something where we’re being measured from CMS and other payers.