When Kristin Darby first considered the CIO position at Cancer Treatment Centers of America, she was intrigued by idea of being able to dip deep into cancer research and leverage technology to improve outcomes. But what really drew her in was the organization’s focus on patient-centered care and its commitment to innovation. Just over a year in, Darby is long past the getting her feet wet stage. As part of CTCA’s ultimate goal of personalizing cancer care, her team is rebuilding the analytics platform to more effectively harness data, and is utilizing the portal to educate and empower patients. In this interview, she talks about these projects, as well as how rounding has dramatically increased staff engagement, and how she manages the juggling act of being a CIO with two young children.
- Patient engagement & entertainment platform
- Personalized treatment
- Rebuilding analytics — “It requires a heavy IT investment.”
- Using consultants
- Staff engagement — “It’s incredibly important to me.”
- Rounding & face-to-face talks to “feel the pulse of the facility.”
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We want to make sure patients understand that through the science and the technology options that we have available, we can bring them into that care team in a way that truly does empower them to contribute positively to their outcomes.
It requires a heavy information technology investment and analytics to be able to deliver this to physicians at the bedside at a point that really provides them the information in a consumable manner.
We want to ensure we have an architecture that’s very nimble and can adopt as there continue to be new discoveries. What we’re reacting to today maybe different two years from now, and we want to make sure we have an architecture that enables us to shift as quickly as the science and the business demands.
As a leader, one of the things that I value most is having a team that loves what they do; that wakes up and cannot wait to get to work because they’re working on things that are so challenging, inspiring, and really give them purpose.
When you start to understand different patient journeys and understand our care provider process, you can then start to understand the connections between the work that you perform and provide, and how that connects to the overall service offering within the healthcare industry.
Darby: One of the other things we’re in the process of doing is deepening our understanding. We’ve spent the last few months of reflecting on what does a patient value, and it’s recognizing that everyone has different preferences. Some demographic groups might prefer that personal one-on-one interaction, where millennials, for example, might prefer more of an electronic communication that’s not as much a one-on-one interaction. We want to make sure our patients are receiving a personalized interaction based on their preferences. And so as we start to deepen our understanding around that, one of the things we’re in the process of doing is implementing a new patient engagement and entertainment platform that will enable us to continue our journey around maximizing patient engagement but also enabling the personalized medicine journey that we’re on to start to resonate in a way that can be personalized for patients.
Basically what we’re looking to do is when a patient comes to our facility, whether they’re in an infusion room, in an inpatient room, or in the cafeteria on their own personal smartphone or iPad, that they have access to our platform, and this will also extend to the home as our model continues to evolve. The idea is patients go to one place for everything, one interface. And through that, everything from entertainment options, which they’re often looking for during treatment, but also the things such as engagement and empowerment. So for example, how do I understand that today, the lab results tell me a patient might be feeling a particular way — maybe they’re cold or fatigued because their lab values tell us that those are side effects of their current condition. How can I then interface to a patient and say, ‘If you are feeling XYZ way, would you perhaps want to understand why and make these two adjustments to your behaviors today in ways that perhaps influence how you feel in a positive way?’ Part of it is making those things easily available, but also customizing them to that particular patient, and making sure it’s time sensitive. So that’s part of the goal we’re looking at.
In addition to that, as we continue to modify our approach to the medicine that is being prescribed or the treatment path that is being prescribed to our patients on their cancer journey, we continue to focus heavily on providing personalized treatment options to our patients, and that’s based on the discoveries around the human genome. As those start to get understood related to specific types of cancer tumors, we’re taking those learnings and incorporating them into the treatment path that our providers are following to better understand what the best options are for that patient as we start to operationalize this.
And this is a developing area, so what was relevant six months ago is different today. We know more, and it continues to evolve pretty rapidly. So we’re taking those learnings and trying to pull the net in and synthesize the data in a rapid way that can be consumed by our physicians very quickly, but enabling them to provide those specific personalized options that are best for that patient. We want to also take that into the patient engagement platform. And so as these treatment options continue to be personalized, we want to make sure that the behaviors that a patient can engage in that are also based on their personalized make-up based on the ultimate makeup of the tumors that they’re being treated for, that that information is being brought into that platform.
Our goal is to enable patients to do as much as they can as part of their care plan, because it will maximize their engagement and it gives them the hope and the commitment that they are empowered to be part of that team. That’s very important for the psyche of any individual, to know that they can contribute positively. It gives power back into a disease that feels very disempowering when you’re diagnosed and you hear those words, ‘you have cancer.’ We want to make sure patients understand that through the science and the technology options that we have available to us, we can bring them into that care team in a way that truly does empower them to contribute positively to their outcomes.
Gamble: That’s pretty amazing when you talk about individualizing these treatments and using information that even in a couple of months can be outdated. That’s a really sophisticated level of analytics you’re talking about.
Darby: It is. One of the things we embarked on in December of last year — we’re in the beginning of the build stage — is actually rebuilding our analytic platform and data foundation capabilities within the organization to really make sure we’re continuing to evolve to be cutting edge, because this is a developing area and it’s very exciting at this time. The hope is we’re shifting the dynamic over the next few years that you when you hear the words ‘you have cancer,’ does this become a manageable chronic illness? That’s really the vision and the hope versus something where you’re in the battle for your life.
As we continue to learn more and more, we’re on the right path. We’re not there yet, but I think there’s an incredible amount of work being done in this area. It’s an exciting time, but it requires a heavy information technology investment and analytics to be able to deliver this to physicians at the bedside at a point that really provides them the information in a consumable manner that affects each patient particularly in a way that the appropriate options are available for them based on their disease type.
Gamble: Right. As far as rebuilding the platform, that’s something that started back in December — where is that right now as far as what else needs to be done to keep moving things along at such a quick pace?
Darby: So we’re doing things on our existing platform right now and then in parallel, we’re building a new platform. On the new platform, we finished our design phase and we’re actually in the build phase now. Our goal is to have some interim deliverables throughout that process — we probably have about nine months left to complete that process. In the interim, we’re leveraging the existing platform that we have, which is working well for us, but we want to continue to optimize the technology and resources to stay as cutting edge as we can. Especially as this is such an evolving area, we want to ensure we have an architecture that’s very nimble and can adopt as there continue to be new discoveries. What we’re reacting to today maybe different two years from now, and we want to make sure we have an architecture that enables us to shift as quickly as the science and the business demands to ensure that options that could be available to our patients are available immediately when they’re discoverable and can be brought to an operational availability.
Gamble: Did you use outside help or a consultant or anything like that just as far as everything it was going to take to rebuild this platform?
Darby: Absolutely. From a strategic perspective and design perspective, it’s absolutely being driven in house, but we have brought in outside partners that have subject matter expertise in particular areas to ensure that we’ve got the best expertise contributing to building this out. And so with each step that might be different partners that we leverage, but we recognize that often the talent to design something and build something is very different than the talent that operationalizes it and supports it daily. And so we’re bringing in those different experts throughout that process to ensure we’re building it with the optimal potential to service the patients of Cancer Treatment Centers of America.
Gamble: Okay. So you said a lot of the IT was based in Goodyear. What is the approximate size of your IT staff?
Darby: 225 stakeholders.
Gamble: From everything you’ve talked about, it seems like it’s a great opportunity for the staff because you’re talking about really changing the care of cancer patients. I want to talk about your strategy as far as just keeping the staff engaged because it’s certainly very interesting subject matter, but I can imagine that there are unique challenges in dealing with this particular type of data.
Darby: Absolutely. Employee engagement is something that’s incredibly important to me personally. As a leader, one of the things that I value most is having a team that loves what they do; that wakes up and cannot wait to get to work because they’re working on things that are so challenging, inspiring, and really give them purpose; that can’t wait to get here, or when they’re at home at night, they find themselves thinking about problems and how to solve them and they have that connection.
One of the things that I probably started about 10 years ago in the healthcare industry was that while innovation is very important to me, it was the recognition that working for a healthcare provider in an IT department, you can become very separated from the healthcare setting; working in an IT department and administrative office that’s not next to the clinical setting could be no different than working for a bank or working for a financial services company. Those of use that work in healthcare, I think have an extremely amazing opportunity to truly connect to a larger mission, which is enabling people to fight disease and fight illness in a way that contributes oftentimes to many people living longer lives.
I think sometimes that connection between an individual’s job and that larger mission of really providing good in the healthcare industry and taking care of people and nurturing them and really using technology enablement in a way that positively affects clinical outcome to allow people to live longer and happier lives — I think that connection oftentimes is not understood. I think it’s a travesty, frankly, because it’s so much rewarding to have that connection.
One of the things I started many years ago and instilled here at CTCA when I arrived is that clinical connection is essential to me, and so I require that my IT teams round in the clinical areas. It’s a minimal amount of time per month, but everybody has to get out of their offices and their cubes and go connect with the nursing staff, go connect with the physicians, go talk to the individuals in lab or imaging and understand what their challenges are, what their needs are. Get to know them personally and understand also how the technology is used to provide care to the patients.
In addition to that, one of the benefits that I think is unique about CTCA that I haven’t encountered as much at other provider facilities I’ve worked with, is the ability and the encouragement to connect to patients directly. And so here, one of the things you’ll find is our IT team members will go over the cafeteria and just sit down with patients — it’s a very family oriented culture — and understand what does the patient journey look like. Everyone has a different journey, but the more you talk to patients, the more you start to understand. How do they process the diagnosis? What would it feel like the pick a provider? What was important for them? What types of things work well when they show up for treatment? What types of things would they change? What services do we provide that are the most soluble to them, and maybe what services do we provide that we think are valuable that maybe they don’t notice or they don’t utilize? It’s having those discussions to understand what is it like from an emotional perspective or social perspective to deal with a disease and a disease that you continue going through treatment.
I think when you start to understand different patient journeys and understand our care provider process, you can then start to understand the connections between the work that you perform and provide, and how that connects to the overall service offering within the healthcare industry. How are you actually contributing to that overall picture? How do you impact that patient and the family, the caregiver that’s sitting there at the end? Once you start to understand that, that’s when I believe many of the innovation opportunity starts to appear. Most of the great ideas I get is when I’m walking around either talking to a patient or talking to one of our clinical stakeholders in the clinical areas and you see things. We as technologists see things in different ways than a nurse does. We understand that certain problems can be solved very quickly with technology, where they might just think ‘this is the way it is because we’ve always done it this way.’ But when you’re out in that environment, you can actually feel the pulse of the facility. You understand and feel the emotion of the patient and you start to understand what’s valued and what isn’t, and I think if you don’t start there and have that connection, people oftentimes find themselves lacking engagement in their jobs.
One of the things that I heavily impress on individuals is the importance of doing that rounding. I think initially it’s forced, because many people don’t feel comfortable in a clinical environment. But we have enough clinicians on our teams and healthcare areas that you can have people round with someone that is comfortable in our end on the team, or somebody’s that worked in a different clinical support area. And as they build that comfort level, you find that you no longer have to make it a requirement. I can’t go over to our cafeteria at the hospital here without seeing at least 20 of my stakeholders in the cafeteria. When I started, I didn’t see any. And it’s because they’re comfortable going there now and they can just go sit down with the patient, or they find it a welcoming atmosphere because they’re comfortable there.
The result of that is in one year, I’ve been here 14 months now, but we just got our one year engagement surveys, and I’ve increased highly engaged 16 points in one year. So it’s dramatic results and part of it is that connection of meaning for individuals and the purpose of their role in that overall delivery and the impact of what they’re making on a patient’s journeys when they’re fighting this cancer disease.