Gary Barnes, CIO, Medical Center Health System, Chapter 2

Sometimes it’s all in the approach. When Gary Barnes was making a case for a new EHR system — one that would help achieve the goal of integration across the system — he knew it wouldn’t be an easy sell. So he used a clever analogy, explaining that buying a new system is like building a house — “You don’t want to put your old furniture in it.” In this interview, the 30-year health IT veteran talks about the “tremendous improvement” his organization has seen since creating a combined strategic plan, how the CIO role has evolved through the years, the role CHIME has played in advancing the position, and how he feels about Meaningful Use. He also discusses his team’s plans with analytics, his thoughts on physician engagement, and why he loves teaching.

Chapter 1

Chapter 2

• Recruiting volunteers to drive portal usage
• Restructured capital project committee — “That has been a tremendous improvement.”
• Assessing change readiness
• From IBM to CIO
• Evolution of the role — “It wasn’t the CIO position it is today.”

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Bold Statements

I think one of the key factors is participating with them on the value. They’re patients also for the organization and it’s showing them what we can do for them.

The organizational goals are IT goals. The factor of IT becomes a task within the goal. So if we’re trying to decrease our length of stay or decrease our number of readmissions, one of the tasks that we’re going to do within that is provide the technology to help to reduce those things.

We sit together and look at those and ask, does this project coordinate with the strategic goal of the organization, and how can we put those things together to make sure we get the right outcomes and that the right pieces are all together.

It’s been a tremendous challenge. There’s never been a dull moment. I love what I do, or I wouldn’t be here. I’ve had several other opportunities to do other things and have just elected to be loyal to this organization.

Gamble:  You mentioned Meaningful Use. You said have attested to stage 2 at this point?

Barnes:  Yes, we have. We’re working on our second year of stage 2 now.

Gamble:  What has been maybe the biggest hurdle with that?

Barnes:  The number one thing on stage 2 is getting the patients to actually view their records online, which requires 10 percent of your patients to go out there and look out their patient records. That’s definitely been a challenge of getting them to go out there and do that.

Gamble:  How have you guys approached that? What changes have you maybe made to try to get the numbers up?

Barnes:  We’ve been very creative on that one. Last year when we did it, we actually got high school volunteer students to help us go to all the rooms and help the sign the patients up and show them what information they could get and promoted the value to it. By doing that junior volunteer program, it really helped us get our numbers where we needed to.

Gamble:  That’s a good idea. They’re the ones who know technology so well too.

Barnes:  There you go. Exactly.

Gamble:  What about population health — are you doing anything on that front right now?

Barnes:  We’re actually looking into what we need to do for population health. We use some different databases from SG2 and some other data sources from Advisory Board, but we’re also looking at doing some new stuff with our new system in the future.

Gamble:  Right. One of the other things I wanted to talk about is I know that you’ve given some talks in the past, talking about the concept of showing the value of IT and being able to measure that. I wanted to talk a little bit about your approach to this and maybe if you have any best practices for other CIOs just as far as being able to make that case by showing the value to the entire organization.

Barnes:  One is showing it to your peers on the executive staff. We also do training programs and just keep the board constantly updated on the things that we’re doing so that they’re involved in ways that IT can promote value for the organization. We train them and show them. I think one of the key factors is participating with them on the value. They’re also patients for the organization, and it’s showing them what we can do for them. 

Gamble:  That’s kind of along the lines of another thing I wanted to talk about, which is IT goals and making sure that they’re aligned with the organization. I wanted to get your thoughts on that.

Barnes:  Absolutely. One of the things we used to do is we had a strategic plan for the organization, and then we had a different strategic plan for IT. Anymore, we do not separate those. The organizational goals are IT goals. The factor of IT becomes a task within the goal. So if we’re trying to decrease our length of stay or decrease our number of readmissions, one of the tasks that we’re going to do within that is provide the technology to help to reduce those things. So the number one thing is we do not separate the strategic plans and IT plans. It’s all one.

Gamble:  That’s something that I’m sure could lead to maybe frustrations as the way things were before when you’re seeing certain things planned and then now let’s bring an IT, you could see where there would be some frustrations.

Barnes:  Absolutely. I’m not saying that that don’t happen occasionally, but we have restructured our capital projects committee. Instead of having IT steering committee, a capital project committee, and then a project committee as a whole, we’ve combined all those together. And then we have an executive group that looks at it and will create charters for what we’re trying to accomplish. So the chief strategy officer, the CFO and I sit down and review those to make sure all the documentations there to move forward.

Then we have a committee that involves clinical engineering, regular engineering, IT, administration, and all the other disciplines, and we sit together and look at those and ask, does this project coordinate with the strategic goal of the organization, and how can we put those things together to make sure we get the right outcomes and that the right pieces are all together. Engineering can only handle so many projects at one time. IT can only handle so many things at one time. And the organization as whole can only handle so many changes happening throughout the organization at one time. That’s kind of new within the last year and that has been a tremendous improvement.

Gamble:  I think that awareness too of how much change people can handle at one time or how much an organization can handle it at one time is a big thing too.

Barnes:  Absolutely.

Gamble:  So now you’ve been at the organization since the 80s, right?  Mid 80s?

Barnes:  1985.

Gamble:  1985, okay. And you came from IBM. How did that happen?

Barnes:  I was working for IBM and we came over to sell a new patient accounting system that the hospital I was looking at. And the CFO says, ‘We’re going to do this deal and everything, but I’ve got to find somebody to set up this big department and to manage it.’ I was like, that might be interesting. At that point in time, IBM was restructuring its models, and I thought it was very interesting. So I kind of started communicating with the CFO and we struck up a deal and it’s been 30 years now.

Gamble:  That’s an interesting way to get in. At what point did you become CIO — how was that role created?

Barnes:  Of course we didn’t know even what to call it. It kind of started of as kind of a system analyst position, and then shortly after that, they appointed a person for the IT manager that was a social service director. It was obvious he didn’t have the background or the knowledge to do it. He was just kind of helping to do things. And so it was about eight months later that they promoted me to the IT manager, and then a couple of years later it became the IT director position.

Then in 1992, the CHIME organization came about and started promoting this new position called the CIO which incorporated telecommunications in some of those areas. I went to my boss and said ‘hey, this is something I’d be very interested in doing. I would like to take over the telecommunications arena and be called a CIO.’ And the administrator said, ‘Well, let me think about it for a little bit.’ At that time, I was working for the CEO. He came back and said, ‘I think that’s a good deal. We’ll make you the CIO and give you telecommunications and some other responsibilities.’

Gamble:  It’s really interesting.

Barnes:  I’ve worked three CEOs, four COOs, and two CFOs in my career.

Gamble:  And you were just trying to sell a computer system, right?

Barnes:  Right. That’s how it all started. It’s been a tremendous challenge. There’s never been a dull moment. I love what I do, or I wouldn’t be here. I’ve had several other opportunities to do other things and have just elected to be loyal to this organization.

Gamble:  When would you say that the role started to change to the point where an IT person or IT manager and became more of like this C-suite leader with the seat at the table? When do you think that changed?

Barnes:  Let me think about what year that was. In 1992, it wasn’t the CIO position it is today. That probably changed about 10 years ago and at one point in time, we had a new CFO come in and basically told me, ‘We really don’t need you at the executive table anymore.’ And he told me I didn’t need to go to that, and then a year later, he came back and said, ‘Okay, I understand the importance and need you at the table.’ I think that was about 10 years ago, but in the last 5 years, it is just overwhelming how integral it is to the entire organization.

Chapter 3 Coming Soon…