At St. Joseph Health, a primary focus across the organization is to give time back to clinicians by improving flow and ease of use. And to the IT department at the 16-hospital system, that has meant transforming the way they interact with care providers, and adopting the mantra of ‘people before tickets,’ according to David Baker. In this interview, he talks some of his team’s key initiatives, including efforts to standardize all of the hospitals to the same version of Meditech, create a platform to facilitate better communication among the staff, and move toward a virtualized environment. Baker also discusses the importance of leadership buy-in with any project, why it’s critical to push the boundaries, and the unique path that took him to his current role.
- “People before tickets”
- StaffHub’s “modern-day intranet” concept
- From 50 to 40K users in 6 weeks
- Selling “Facebook” to the board — “We know it’s a scary word.”
- Power of knowledge sharing
- A softer approach — “You don’t have to use it, but here’s what you could gain from it.”
- Pushing the envelope
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I always say, people before tickets. Get in there and see how we can help our folks proactively rather than reactively.
The knowledge sharing was great. It helped us tremendously. But the biggest thing was to listen to the needs of the business. This has got to be almost sold top-down, board-down.
Just by putting this stuff out there under the premise of ‘you don’t have to use it,’ it starts to sell itself. The most successful products are products that people want to use because they instantly see it’s intuitive
I feel like we’re at a tipping point. We’re moving away from the idea of IT as just glorified email and scheduling, and we’re moving into a world where people expect to forge a relationship through technology to enhance and assist with their day as intuitively as possible.
I think our culture is tolerant and expects failure to an extent, because without that you can’t progress. So remove the boundaries of fear, hire great people and let them get on with it.
Gamble: And is that where you would get ideas for things like UniPrint and solving printing issues — going through focus groups and saying things like, ‘What do you want to see improved?’ Taking that angle?
Baker: Absolutely. We have operational IT managers at the hospitals whose remit is to engage the end user. Our big drive this year is making IT personal and working out how do we get to the customer before the customer calls the service desk. The traditional model was everything centralized, and I think that’s great from a technology standards point of view. In the application layer and the way we serve up the operating system, it’s a great model being centralized, but it’s such a fast-paced business out on the hospital floor. We work every day with what we call sacred encounters — how do we have those special interactions with patients, and how do we make it a dignified and hopefully fantastic experience in sometimes what’s not always a great situation in healthcare and why you’re in the hospital.
For us, it’s about if we can make the docs’ lives easier and the nurses’ lives easier. My mantra is to get in front of those guys, speak to them if they have time, and see how they’re doing and ask, how’s your day? Our best interactions are those personal ones where the nurse would call one of our engineers as they were walking though and rounding and say, ‘Hey, this is really not working for me. Can you help?’ I always say, people before tickets. Get in there and see how we can help our folks proactively rather than reactively.
Gamble: You talked about having a very entrepreneurial spirit there. Another thing I wanted to talk about was the StaffHub initiative and how something like that came about and how it speaks to the way you do things at St. Joseph’s. So if you could first talk a little bit about what it is.
Baker: Yes, do you want me to talk about Staff Hub first or the process around getting behind a project like that?
Gamble: I guess first give a little bit of an overview of what it is for those who aren’t familiar.
Baker: StaffHub is really an interesting space, I think, because collaboration was the recurring theme — hey, we have staff across geographic borders essentially and there are these boundaries. There are these silos. We want to communicate to the company as a whole and bring workers between the regions together that may not have otherwise had the opportunity to engage. So we’re really moving. We’re at a pivotal point where these traditional intranet sites are kind of stale and static. They’re just informational pages — think of it like the Yellow Pages. And we’re moving into this very robust knowledge model where people can share and interact with each other. Think of it like Facebook for business. There are these social networks that are emerging, and we know how powerful they are.
We had several conversations around the cost of supporting the Microsoft licensing that went into our intranet sites, which were essentially a series of built-out SharePoint silos. People use them as a glorified file repository. So we went through the thousand of licenses that we had, there were only 200 regular users on SharePoint across the business that supports 25,000 users. It was pretty minimal. And of those 200, there were probably only about five power users that supported various groups. And so I looked at the savings so we could achieve through moving out that Microsoft stack, and I was looking for progressive company in that community space; that collaboration space. Salesforce just kept reoccurring and being brought up in conversations that we had.
It’s very hard to roll out a product and make people go to it. It needs to be a product that people want to see. We’re still green in the deployment, but we’ve had a really successful deployment around Staff Hub, which is essentially our new intranet. I call it the modern-day intranet. It’s constantly evolving and being updated. At the moment, we have a platform now where users can interact and collaborate on files and conversation, and access regular pieces of information that are critical to them like payroll, accounting menus — all the stuff you take for granted and is sometimes tricky to find in that traditional file transfer print FTP-like site. It’s been really good.
We started off with the deployment saying we’re going to open this up to 50 people to see if it would work in the pilot. It spread within six weeks to just under 4,000 people. It went nuts internally. It was phenomenal to see, because by telling people, ‘you can’t have it yet, it’s not ready,’ but leaving it out open, people just couldn’t help but jump on that. We knew that was going to be pretty successful after that initial release.
Now we understand that people aren’t just going to go there to chat between themselves and waste time; we’re going to drive value and content, and we’re really making it a central resource for staff members to jump in on and find information and application links, as well as applications coded on the platform that are going to help them go about their day and their workflow. It’s interesting. I think we’ve had lots of success with it, but we’re really at a pivotal point where we’re about to take it. I think that’s exciting.
Gamble: Was it a challenge to sell this concept? Especially when you use words like social media, I would think some people associate that with things that are just for fun like Facebook. Was there a challenge to sell this to the board?
Baker: Oh yeah. The savings helped. But the beauty with this is there were so many people that have failed at it. I spoke to lots and lots of people in companies who were gracious enough to take me through all of the pain points they had. So I went in understanding that this wasn’t going to be just an easy ‘turn it on and people use it.’ We had some great collaboration from other companies and some detailed discussions on how it would work and how they thought it would work. The vendor sat pretty closely with us throughout the process as well.
The knowledge sharing was great. It helped us tremendously. But the biggest thing was to listen to the needs of the business. This has got to be almost sold top-down, board-down. Our CEO has been great. Deborah [Proctor] jumped on that and makes regular comments, as does the whole leadership team. People are interested in seeing what their bosses are up to and a little snippet into their day, as well as key information points that they want to put out there.
Once we sold top-down, it helped us gain momentum. I went into a lot of our presidents and leadership council meetings and said, ‘I need to create a profile. Here is where we see the future of social media.’ And we know it’s a scary word for some, and so we went through a really good internal pitch deck and said here’s where we think the benefits are and here’s where we can have you connect with your workforce and colleagues in ways that wouldn’t have connected previously, especially across the geographic boundaries. I said, ‘I need you to put one post out a week. It could be about anything.’ We have pictures of folks on planes and business trips and comments around some of the charity work they’re doing and just general stuff that is somewhat personal and geared with a slant toward the business and what the business would be interested in. So that helps; going top-down, I would say, is huge.
Another thing we do is I’ve now formed in all of my project delivery groups something called an engagement team, and that’s been one of the biggest successes I think from a team perspective that I’ve enjoyed, because historically IT are not great at delivering projects. They’ll get the technology out there, but there’s not a real warm and fuzzy feeling generated around it. People are like, ‘why do I need it?’ They’re just not engaged correctly. So what we did was take a much softer approach with working with marketing communications internally and then really going to publicize and drive campaigns out internally as to what we were deploying, and not say, ‘This is what you’ve got to use,’ but, ‘This is what you could do with these tools, like Box, like Salesforce. And you don’t have to use it, but here’s what you could gain from it.’ Once again, just by putting this stuff out there under the premise of ‘you don’t have to use it,’ it starts to sell itself. The most successful products are products that people want to use because they instantly see it’s intuitive, there’s minimal up time on getting to understand this product, and look at all these benefits I get to see in my workflow through the use of it. It’s pretty interesting.
Gamble: It definitely is. Based on projects like that, it seems like among you and your team there’s an attitude of not being afraid to push the boundaries. How important do you think that is for CIOs now in the industry right now?
Baker: It’s never been more important. It’s that pivotal point I keep referring to. I feel like we’re at a tipping point. We’re moving away from the idea of IT as just glorified email and scheduling, and we’re moving into a world where people expect to forge a relationship through technology to enhance and assist with their day as intuitively as possible. It’s our job to put these new features out and to push the boundaries and not to be left behind. I think the operational efficiencies that we can help with through technology are huge, and folks are expecting it these days.
I think it gives us an edge if we have great tools available to our ultimate customer, the patient, so they’ll be able to see their enriched records and scans and have dialogue with their provider as well as having it be easy to contact them. The days of picking up the phone and trying to find appointment and waiting in an office are fast approaching the end to an extent, because there are so many better ways to take care of that stuff. With telehealth and the other groups we run, there are just some amazing technologies that are changing the game entirely.
Internally, as you mentioned, I think our groups are set up to not be scared to fail. We know that if we’re going to go out with several big-bang initiatives, some of those initiatives won’t always stick. It’s about understanding that you can take failures along the way, and to fail fast and go with the next wind. I think we’re not adverse to that. I think our culture is tolerant and expects failure to an extent, because without that you can’t progress. So remove the boundaries of fear, hire great people and let them get on with it. I think that’s what we’ve been successful at.