Gary Barnes, CIO, Medical Center Health System
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 3
- MU as a catalyst—“It has forced us to go to a whole new level.”
- Analytics & decision support department
- Goal: consistency throughout the organization
- CIO role — “There’s a lot more to the position than IT.”
- Physician engagement — “It’s a give and take.”
- Working on the CHCIO certification process
- “It keeps me learning.”
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Bold Statements
It has forced us to go to a whole new level that we would have never accomplished without Meaningful Use. I don’t think we would have ever got the physicians to adopt and do what they’ve done and get where we are without that being required.
When that data starts coming in and you start trending it, you start seeing where you can make improvements throughout the organization. To me, that’s been exciting where we tie process improvement into analytics.
I think it will continue to grow into embedding more of the clinical components. One of our biggest successes that we have is from the relationship that I have with our CMIO and also our CNO, just being partners in developing better processes for our clinical staff.
We try to make sure they don’t become IT people. We want to keep them in that clinical arena. So we basically require them to go back and work within their respective areas like nursing, respiratory, or pharmacy — go back and work in those areas so they don’t become IT people.
Gamble: I would imagine a lot of that has to do with Meaningful Use.
Barnes: Meaningful Use was kind of the start of it. That’s where you really started getting into some of the more detailed integration within the organization. I would say that’s probably one of the forcing factors of that.
Gamble: When that first came around, what were your initial thoughts on Meaningful Use?
Barnes: It was one of those things where it was, ‘this is not an IT project. Somebody’s going to have to do this.’ And then it was, ‘what are the requirements?’ I guess I knew more about the requirements than anybody else and did my research and background. I dug into those things and said, ‘Okay, here’s what we have to do, and here are the people that need to be assigned to each one of these pieces. That’s what we’re going to do.’ Six months later, nothing was happening and it was, ‘okay, you need to be responsible in making sure it all happens.’ And so it turned, and not necessarily because I was the CIO, but I became responsible to making sure that it was done and holding people accountable for getting it done.
Gamble: That’s very interesting. Now how many years or so we are into it, has your opinion of it changed?
Barnes: I’ve thought about this. That’s one thing about being around for a while, you get to think about things. To me there’s been a lot of negative talk about Meaningful Use, but in my opinion, it has forced us to go to a whole new level that we would have never accomplished without Meaningful Use. I don’t think we would have ever got the physicians to adopt and do what they’ve done and get where we are without that being required. And in turn, there are still some people negatively thinking that it wasn’t a good thing, but bottom line is it’s a three-stage process. One is just making sure you gather the data, start reporting the data, and trending the data before you ever start really getting better outcomes, and the phase we’re starting to move into is that third phase, which I think we’ll start seeing improvements in patient care from some of these things.
Gamble: Right. Really getting into being able to leverage the analytics and improve care on an individual level — that’s pretty exciting stuff.
Barnes: Absolutely. That’s one thing I did a couple of years ago. Our analytics was part of financial accounting and we had some different pieces throughout the organization. I structured a new department under the CIO — I don’t want to say it’s under IT, but under the CIO — called Analytics and Decision Support. I put them in a different location outside of IT so people don’t view them as IT. Because with the people in that group, we have some IT people, but we also have some people from performance improvement and decision support, and we’ve really been able to create our robust analytics department. That’s been one of my exciting things because I like that sort of thing. I have a major in computer science, but also I had a background in mathematics before I got my MBA.
Gamble: What are some of the things that you really hope to see come out of the analytics and decision support department?
Barnes: One of the things we are doing is just getting consistency throughout the organization so when we’re reporting things it all goes through that one department so we give consistent numbers. It’s also really helped us having somebody overview it to improve our processes. Because one of the things you find out from analytics is about inconsistent processes throughout the organization. So when that data starts coming in and you start trending it, you start seeing where you can make improvements throughout the organization. To me, that’s been exciting where we tie process improvement into analytics.
Gamble: That’s interesting, the decision not to put it necessarily under IT because I would imagine it does change the perception thinking analytics is an IT thing.
Barnes: Absolutely. I think a key factor in making it successful was keeping it away from IT and not saying it’s under the IT umbrella. It’s under the CIO position. That’s one thing, I try to view the CIO as not just IT; there’s a lot more to that position if done properly.
Gamble: Right. So now this is kind of like the million dollar question, but how do you think the CIO role will continue to evolve? It’s changed so much just in the past five and ten years.
Barnes: I think it will continue to grow into embedding more of the clinical components. One of our biggest successes that we have is from the relationship that I have with our CMIO and also our CNO, just being partners in developing better processes for our clinical staff.
Because in our breakdown of IT, one of the things that’s changed too from when we did Meaningful Use is the people that are in IT now. We have our core IT people that do hardware and software and all that stuff, but we also have four nurses, a respiratory therapist, two pharmacists, and a physician in the department.
Gamble: Just to make sure that all those perspectives are being factored into the decision making?
Barnes: Absolutely. One thing we do try to do with our staff too is with all of our clinical staff, we try to make sure they don’t become IT people. We want to keep them in that clinical arena. So we basically require them to go back and work within their respective areas like nursing, respiratory, or pharmacy — go back and work in those areas so they don’t become IT people. They use what they’re building in that area.
Gamble: Okay, so kind of a different approach to rounding.
Barnes: Absolutely.
Gamble: Is there anything else that’s surprised you about Meaningful Use? You mentioned physicians and how the trend has been that there’s maybe less resistance to affiliating with hospitals and getting onto EHRs. Is that something that’s surprised you, seeing as how things were years ago?
Barnes: Absolutely. You’ve got to provide value to them. It’s a give and take in everything you do. You’ve got to look at some of their process and say hey, if you could help us out on doing this, we can provide you with what you need.
Gamble: Last thing I wanted to ask you about CHIME, which is now more than 20 years old, and about your involvement in that particular organization how that’s benefitted you?
Barnes: I’ve been very involved. I was on the board of directors for a three-year period back a couple of years back, probably 2008, 2009, 2010, I was on the board of directors. I’ve been very involved over the years. I’ve been working on the CIO certification process, so I’ve been helping with the governance board for that and also doing the testing and creating test questions for CHCIO certifications where every year we get together and write test questions, verify test questions, etc., and making up those. I’ve been involved in that since we started the certification project.
Gamble: I would imagine that for CIOs, either those who are new to the positions or those who were aspiring to the role, that something like getting that education certification is probably more valuable now than it’s ever been.
Barnes: Absolutely. I love doing that because that keeps me learning and keeping up my skill set by doing that. Because to be able to write test questions, you’ve got to learn and you’ve got to take the materials. It gives you a lot of good experience by doing those things.
Gamble: Yeah, it’s interesting. I hear people say that they learn the most when they have to teach.
Barnes: Exactly. I understand now what they mean.
Gamble: I know we’ve covered a lot. I’d covered what I wanted to talk about. I would definitely like to you again because I know there’s more, but I really appreciate your time and perspective.
Barnes: Absolutely. Anytime.
Gamble: Thanks so much, and I hope to maybe catch up with you with CHIME or one of the upcoming events.
Barnes: Okay, sounds good. I appreciate it.
Gamble: Alright, thank you so much.
Barnes: Thank you.
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