Transformation is word that tends to be misused, but in the case of Hospital Sisters Health System, it’s an accurate description of what’s happened over the past few years — as the organization completely changed its operating model — and what will continue to happen. One of the key leaders in this transformation is Kevin Groskreutz, who took on the role of Division CIO as HSHS was starting on the journey to becoming a cohesive health system. In this interview, he talks about the “constant conversation” needed to facilitate successful change management, the ever-changing role of IT in enabling change, how HSHS makes its multi-CIO model work, and the organization’s three-year plan. Groskreutz also talks about his own career path, how MU is changing the game, and what it’s like to get 14,000 people to start thinking as one.
Chapter 1
- HSHS’ transition from independent model to managing 14 hospitals
- Enabling IT to “engage a new business model.”
- Overseeing ancillary systems & telehealth
- System CIO Ray Gensinger — “He brings a lot of energy to the organization”
- Hospitals on Meditech & Epic
- “We’re discussing a single EHR strategy.”
- Telehealth & remote monitoring — “Preliminary results have been very positive”
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Bold Statements
It’s been a journey trying to get 14,000 roughly colleagues to start thinking differently and start acting differently in how we are going to interact and engage patients and providers in a more cohesive manner.
As we align ourselves with more physician practices, it creates a sense of acknowledgment and understanding of the clinician practice versus somebody with strictly an IT background that is more technology-centric and focused. It brings a new dimension to the organization.
We’re discussing a single EHR strategy. With a large health system, you can imagine managing four main core EMR platforms increases your cost of ownership and doesn’t really allow for consistency of operation across the enterprise.
There have been a couple of stories where the patient is having abnormal results and the care providers have reached out before the episode of care that became critical so that they could do some proactive monitoring, which makes a huge impact on that individual’s life.
Gamble: Hi Kevin, thank you so much for taking the time to speak with us today.
Groskreutz: Thank you.
Gamble: To get things started, can you just talk a little bit first about Hospital Sisters Health System and then about your division, just giving an overview?
Groskreutz: Hospital Sisters Health System is a multi-state health system founded in Springfield, Illinois. There are sites across two states. It’s a 14-hospital system right now and also is comprised of a medical group practice now as well, which is a fairly new endeavor historically.
Hospital Sisters Health System used to be more of a holding company and we used to operate hospitals independently. Even in the western Wisconsin market, the two hospitals, St. Joseph’s Hospital and Sacred Heart Hospital used to kind of compete for services. Now we have been having transforming the organization over the last four or five years into more of an operating company so that we’re coordinating care and coordinating services so that we don’t have competing services over our patients in the market and much more of a joint effort across the enterprise. There’s a total of more than 3,000 beds across state of Illinois and Wisconsin, to give you an idea of the size. It’s a little over $2 billion annual revenue organization.
Gamble: Okay. So this has been a process over the last four or five years of going from that independent model to actually managing these hospitals?
Groskreutz: Correct. It’s been a journey trying to get 14,000 roughly colleagues to start thinking differently and start acting differently in how we are going to interact and engage patients and providers in a more cohesive manner. It’s been fun. It’s been rewarding and it’s been lots of changes, which really impacts IT as we try to enable IT to help engage that new business model. It’s created a lot of opportunities for different system design and how we approach patients and care in the two states.
Gamble: Yeah, that’s really interesting, I’m sure there’s a lot of good stuff there. So you’re the Division CIO of the Western Wisconsin Division, that’s correct?
Groskreutz: Correct. In our organizational structure, as I said earlier, we used to be more independently operated and so as we realigned ourselves, we’ve restructured. Right now we have four divisions. It’s gone from five to four — we had six at one time. So as we’ve tried to position ourselves to what was most operationally effective, we created four divisions. I have three other counterparts that are divisional CIOs as well. We are the local executive in a medical market within the organization that interact with IT. All of IT for the health system is one large IT group. So we have responsibility across the enterprise for different product lines, but also for market operations and executive interaction with IT as they need IT services for each division. So in Western Wisconsin we have two hospitals currently, St. Joseph’s in Chippewa Falls, and Sacred Heart Hospital in Eau Claire, Wisconsin.
Gamble: So there’s one CIO of Hospital Sisters Health System and the other four work with that CIO?
Groskreutz: Correct. We had just brought on board Dr. Ray Gensinger. He’s a physician by background and has been in the informatics role for a while. He worked over in Fairview and now has taken the system lead for all of the health system.
Gamble: How does that relationship work? I imagine that you’re in contact pretty often, but is this something where you have meetings set up at certain times or it is a little bit more of an independent relationship?
Groskreutz: Our senior IT management team meets weekly to really talk about our strategy, our progress towards that strategy, and any potential obstacles or issues that need more attention, or roadblocks, so we can work on those. It’s a single cohesive strategy across the health system. Now each divisional CIO, myself including, I have system responsibility for ancillary systems, meaning basically any “ology” if you will — lab, radiology, oncology, surgery, etc just to name a few, along with telehealth, across the entire health system. So that’s my product line. I support all those applications across all 14 hospitals.
And then as far as the other division CIOs, we have one that is in charge of Meditech platform, one that’s responsible for the Epic platform. Our med group is using AllScripts. And then we have another division CIO that is responsible for all of the business applications for the health system. We’ve really structured the organization with market focus as more of a liaison interaction for the various markets. So we have an on-site presence there, and then we all have enterprise responsibilities broken down by various functions of IT.
Gamble: Okay, that makes sense. Now you said the new CIO has a clinician background. I’m sure is an interesting thing to have and is really beneficial.
Groskreutz: It really is. Dr. Gensinger brings a lot of energy to the organization. And as we align ourselves with more physician practices, it creates a sense of acknowledgment and understanding of the clinician practice versus somebody with strictly an IT background that is more technology-centric and focused. It brings a new dimension to the organization, which is great.
Gamble: As far as the two hospitals in your division, what clinical systems are they on right now?
Groskreutz: Currently, we are using Meditech as our core EMR. We do have a medical group practice that is using EMDS as an EMR for their practice, and we have plans there to transition them over to Epic right now. We are having some challenges with the current vendor there and being able to prepare for ICD-10. We are working on migrating them over to a new platform.
Gamble: What version of Meditech are the hospitals on?
Groskreutz: We are on version 5.6.6.
Gamble: You mentioned that some of the hospitals in HSHS are on Epic right now?
Groskreutz: Correct. We have four hospitals in Eastern Wisconsin market: St. Mary’s Hospital in Green Bay, St. Vincent’s Hospital in Green Bay, St. Nicholas Hospital in Sheboygan, and our newest edition to the organization, St. Clare Hospital in Oconto Falls, Wisconsin, are all on the Epic platform.
Gamble: Do you think it’s something where the organization is looking to do that with all the hospitals, or is it just not even really in your sites right now?
Groskreutz: We’re discussing a single EHR strategy. With a large health system, you can imagine managing four main core EMR platforms increases your cost of ownership, as you have different support expertise inside of IT, and doesn’t really allow for consistency of operation across the enterprise. We’re looking at the strategy to see if it makes sense, and what the potential timing of that may be.
Gamble: As far as some of the other projects on your plate, you mentioned telehealth before. What are you doing in this area or what do you plan to do?
Groskreutz: Currently, we have I think a couple pilot programs put together because they’re really market specific type applications. In Western Wisconsin, we are actually using telehealth for behavioral health counseling and psychiatry, and so we have a service piloting that. In the state of Illinois we have a telestroke program that is a partnership between not just Hospital Sisters Health System — although the St. John’s Hospital in Springfield, Illinois, is really the core driver of that — but other health partners in that market that are collaborating together to have a telestroke program. So there are remote workstations. We’re using a technology by InTouch so that ED providers can share that patient’s image and vitals with the neurologists in St. John’s in Springfield, and just really help determine if the patient is having a stroke, and then implementing a stroke protocol, or if it’s not a stroke, taking a different course of action. It started out with 16. I believe they’re down to 13 health systems participating across the state of Illinois.
And then across both states, we are using cardiology remote monitoring in a lot of our locations as well, with patients wearing a medical device and transmitting the data back to the application so that the care providers can monitor the patient’s progress.
Gamble: That’s starting to ramp up in a lot of places. What type of results have you seen with it so far? I know that there are some concerns, but is it something that’s been a positive so far?
Groskreutz: So far clinically, the data is really new, so we don’t have a lot of or longevity in the data to make or draw a lot of conclusions, but the preliminary results have been all very positive. There have been a couple of stories where the patient is having abnormal results and the care providers have reached out before the episode of care that became critical so that they could do some proactive monitoring, which makes a huge impact on that individual’s life. We expect to see a lot of positive results from that. Just initially, they appear to be well worth the effort and investment in improving the patient’s lives.
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