In the current health system landscape, where organizations just keep growing, Calvert Health System is considered to be quite small. But it’s a “mouse that roars,” according to CIO Ed Grogan, who has spent the past 12 years leading Calvert’s transformation from a small hospital to a dynamic health system. In this interview, he talks about the Maryland eCare initiative and partnerships that have expanded Calvert’s reach and helped improve care for patients across the state. He also discusses the organization’s comprehensive EHR-selection process — and why they ultimately chose Meditech; their work with CRISP, including plans to implement a “Magic button” for physicians; the importance of team chemistry; and his “passion for technology integration.”
- Best-of-breed affiliation strategy
- Staff retention — “Success energizes people.”
- Learning “team chemistry” from Coach K
- Participative meetings
- 21 years with Inova — “I wore a number of hats there.”
- A passion for technology integration
- Riding The mHealth wave
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That clinical collaboration helps improve our care protocols and helps improve the quality of care we can deliver at the local level.
Our philosophy is we want to provide care for those working in the organization so they can care for our patients better.
Having talent is important and retaining the talent is important; it’s vital. But just as important is having good team chemistry, and I think we have that here.
It’s very much a participative approach, and that helps generate esprit de corps, gets folks engaged, generates understanding regarding projects and things, and makes us successful.
I’ve leveraged my education and experience to focus on technology integration, which is one of the passions that I have, and to try to leverage that to help things moving forward.
Gamble: I would think something like that is a great win, especially looking at smaller, independent organizations and the things you can do to ensure your survival and really make an impact. Because I can imagine the challenges with how the industry is right now of being an independent organization. Something like this is a game changer, I would think.
Grogan: Yes. We pay for the service, and how we offset the expense is because we have more diligent care 24/7, we have shorter length of stay. Because we have shorter length of stay, we have fewer lab tests and everything else, so that helps offset the cost. And of course we’re paying for quality, too. But it does basically give the smaller community hospital the ability to not only have the technology, but also to have the clinical collaboration with those at a higher level of care — at the tertiary care center. That clinical collaboration helps improve our care protocols and helps improve the quality of care we can deliver at the local level.
Obviously there are times when we have to transfer out of the ICU or transfer from the ER to a larger, to a higher level of care. But it does help us provide excellent quality at the local level for the things that we do, and it helps maintain our independence, as you were saying. We have sort of a best-of-breed affiliation strategy here at Calvert, where we have the best of breed for ICU telemedicine, critical care affiliation with the University of Maryland. We have some best of breed affiliations for basic cardiology, cardiac surgery, and vascular surgery with MedStar, and GYN oncology best of breed with Mercy. So we have a number of affiliations with MedStar, with the University of Maryland, with Hopkins for breast imaging. We were the first health system to have an extension of Hopkins, Avon Center for Breast Imaging, here. We have that in our new medical arts center.
Again, we have this sort of best of breed strategy where we can still bring in those tertiary resources that come down to our community and serve folks in our community, and then send patients up the road when needed. But we’re able to maintain our independence by pulling in that quality from those other organizations and having that available to residents in our community.
Gamble: Okay, so one of the other topics I wanted to talk about was the recognition Calvert received for being one of the best hospital IT departments. I can imagine that that’s something that’s really validating, and I wanted to talk about your management strategy and any challenges you might run into with holding onto or recruiting good people.
Grogan: We’ve had good retention. I think by having good results at the hospital — strong finances, and certainly number one being quality with all these quality awards and patient safety awards, it really energizes people. They’re seeing that they’re making a difference. When we worked on the ICU telemedicine project and had all these different disciplines involved from IT and telecommunication clinical engineering, it energized them because they saw the fruits of that, the results of that with regard to improved patient outcomes. Having good success from a quality perspective and a care perspective energizes people, and I think helps with retention.
We’re in a community that doesn’t have quite as much turnover than if we were closer into the city, so the residents aren’t quite as transient. I actually came from northern Virginia, which was much more transient, but we have good retention. Yes, occasionally we lose people here and there. They have better opportunities and we applaud them for their career advancement, but we do try to retain people and provide a mechanism for internal advancement.
When I first came to Calvert 12 years ago, I was the only one with a master’s degree. Now we have almost 10 people in IT — that’s about a third of our staff — who have master’s degrees. A lot of folks didn’t have bachelor’s degrees so, again, we promote that. We encourage that, and we have a certification bonus plan. So if you acquire certification, we give a bonus for that, and that’s both on the technical side and on the application side.
We try to have a lot of social functions. In the past, on occasion we’ve done things going out of the community, like when the Montreal Expos moved down and became the Washington Nationals, we went to one of the first baseball games. It was our annual outing. So we would do something like that but we also do a lot of little things — a lot of luncheons, a lot of celebrating staffs’ achievements, their graduations, their certifications, their birthdays. And we try to do a lot of creative things to make it fun, because this is a serious job working in healthcare and dealing with sick patients. Our philosophy is we want to provide care for those working in the organization so they can care for our patients better.
But we do some fun things to lighten things up. I’ll give you an example.
We had a number of ice cream socials last July to celebrate July being ice cream month. In October, one of our managers coordinated a Halloween special and folks got dressed up. I wore a Sylvester cat outfit. They had an interesting activity where they blindfolded everybody and they would sit at this table and you’d put the icing on your cupcake and try to decorate it blindfolded. So funny things like that to get people to laugh, lighten up a little bit, have a good time and relax, and make the environment fun at times. We spend the majority of our time doing real work, but occasionally lighting things up, and it develops a good esprit de corps.
We have excellent team chemistry. I’m a big basketball fan. I used to coach soccer and basketball for my children, and having talent is important and retaining the talent is important; it’s vital. But just as important is having good team chemistry, and I think we have that here. Folks are very collaborative.
I only have one poster in my office and that’s one of those posters on teamwork — all hands in, with different genders, race, etc., everybody working together. Respecting diverse opinions is important. You can’t have an autocratic leadership style and be effective, because you have to look at diverse opinions and let people share their information. When we tend to have team meetings, it’s not so much a project manager doling out work and assigning work and being the center point or the choke point for all information. We have participative meetings where we have the stakeholders, and not only the project manager and applications manager, but also the members of the applications team at those meetings so they understand the context of what we’re working on. It’s very much a participative approach, and that helps generate esprit de corps, gets folks engaged, generates understanding regarding projects and things, and makes us successful.
Gamble: It’s interesting; you said you were a coach, and I always see parallels between being a coach and being a leader. I’ve read some of the sports biographies and it’s really interesting to me how similar it is.
Grogan: I’m a Duke basketball fan, because I did my undergraduate work at Duke. They had a lot of team chemistry this year, even though they had a lot of young players. When you heard some of them speak after they won the championship, they just had excellent team chemistry. That was facilitated by their coach. They’ve got an excellent coach in Coach K, and I think that he helps develop team chemistry.
Gamble: Definitely. I’ve heard that, too. Now, where are you from originally?
Grogan: I lived in northern Virginia most of my life. I’m originally from the Philadelphia area. I was born in New Jersey across the river, but when I was 7 years old I moved to northern Virginia. I’ve been there most of my life. I completed my undergraduate work at Duke — I’ve got a degree in biomedical engineering and also in health policy and public policy studies in two different schools there, and I’ve got a master’s degree in information systems from George Washington. So I leveraged that education and my experience.
I worked for Inova Alexandria Hospital for 21 years. I was with Alexandria Hospital before they merged with Inova, and then for five years after the merger with Inova, and then I came here to Calvert after. I’ve been here 12 years. I wore a number of hats at Alexandria because I was there so long. I was in charge of all the technology areas there; I added them over the years, and I also had some other experience as well. I chaired the environmental care committee for about ten years and I rewrote the hospital’s mass casualty plan. I was there in the command center during 9/11. We were one of two hospitals that received victims from the Pentagon, and I helped coordinate that effort.
At Calvert when we had some BP turnover a number of years ago I took a line of responsibility for some ancillary clinical service areas. I had imagining report to me. I helped set up the center for vascular care that’s in affiliation with MedStar with the Washington Hospital Center. I basically was in charge of imaging. I had imaging report to me being a VP, and used that opportunity to modernize imagine. So we implemented PACS back then and computer radiography, digital radiography, voice recognition for radiologists, dictating and giving their impressions, etc.
I’m also published in some medical textbooks. I used to be an expert a long time ago in medical technology and gave talks around the country in medical schools. In my early career, I started out more on the clinical technology side. I used to be a medical laser expert back in the early 80s. I started in the clinical engineering side early on in my career, and then got involved in telecommunications. I led a project replacing our telecommunications system and telephone system and voice messaging system at Alexandria, and also took over IT when the IT director retired when I was completing my master’s. I finished my master’s degree in IT, and then served in that role for quite a while and then moved across river here to Maryland.
I’ve leveraged my education and experience to focus on technology integration, which is one of the passions that I have, and to try to leverage that to help things moving forward. So I’ve recently been in conversation with a gentlemen from the American College of Clinical Engineering, and I would like to help facilitate further dialogue between CHIME and the ACC to leverage technology in the future. The whole wave of mHealth has just begun. That really is going to involve even more integration between medical devices and information technology and the capture of big data and so forth — the Internet of things (IoT), they talk about. I’m excited about that. I think that we can forge some further collaboration between ACCE and CHIME in that area, and I’d like to help facilitate that.
Gamble: Yeah. There’s certainly a need for it, and I would think that now, more than ever, having your background in clinical engineering is something that you’re definitely able to leverage. Well I think that covers everything I wanted to talk about. I don’t know if there was anything else, but I really appreciate you taking some time to talk about everything you guys are doing at Calvert.
Grogan: We’re really excited about the things we’re doing to help the community and for patient care. The patient is at the center of our mission — it’s why we’re here, and we really get excited about the work we do. We have fun as a team and we’re able to do some really good things. We really enjoy our work, and we’re really excited about it. So it may appear that I’m talking a lot, but I’m passionate about what I do. I enjoy it a lot and enjoy working with the excellent team that we have here.
Gamble: Yeah. It shows through, and I think that that’s something that you really need to have now with so much going on. You have to have that passion for it to be able to keep going back in and doing everything that needs to be done.
Grogan: Yes, that’s for sure.
Gamble: Alright. Well, thanks again. I appreciate it, and I’d really like to get back in touch with you a little bit down the road to see how everything’s going.
Grogan: That’d be great, Kate. And I really enjoyed talking to you today.
Gamble: Thanks, you too, and I’ll be in touch soon.
Grogan: Take care.