When you’re being offered a spot on a C-suite that has seen significant turnover, there are really two choices: run, or do some investigating. Rick Allen chose the latter, having a long conversation with the outgoing CIO that enabled him to accept the role with eyes wide open. And even though may have questioned the decision when the CEO stepped down just a few weeks into his tenure, Allen has stayed the course, thanks largely to an IT staff that has remained in place and has bought into the organization’s philosophy. In this interview, he discusses the challenges of moving forward while keeping costs low, how he plans to bring more relevance to IT, and the mentors who showed him “how to be a CIO the right way.”
- About Southern Regional
- Making data “push, not pull”
- Change management — “You struggle with how much the organization can absorb at once.”
- Yellow-lighting projects
- Research before the role to walk in “with your eyes open.”
- Cleaning up a fragmented IT environment
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It’s the whole BI thing — it’s building dashboards, it’s publishing metrics, it’s getting things back out in front of people for them to work from and making it push, not pull. I don’t want people to have to go query information that they need to be able to make a decision.
With a new CEO comes new thoughts and new growth strategies and new alignments, so you’ve got the changes that are coming from there as we’re trying to push things through. So I’ve really got to prioritize. We have things queued up that we haven’t rolled out yet, just because it’s too much to absorb at once.
We had a long talk about what his struggles were and why he left. We really went through all of it end-to-end and had conversations about everything from staff to strategies and plans that he had in place for how he wanted to move forward.
It helps when you’re walking with your eyes open. It would have been much worse to get here and find out the issues that were in place or find out the things that he wasn’t able to accomplish and why he wasn’t able to accomplish them.
Gamble: Hi Rick, thanks so much for taking some time to speak with healthsystemCIO.com.
Allen: No problem. Thanks for having me.
Gamble: Sure. To give our readers and listeners a little background, can you just talk about Southern Regional Medical Center — what you have in terms of hospital beds, ambulatory, things like that?
Allen: We call ourselves a safety net hospital on the south side of Atlanta. We’re just south of the Atlanta airport. We’re a 331-licensed bed hospital with an offsite ambulatory surgery center and offsite imaging center. We’ve got about eight physician practices that are affiliated or actually owned.
Gamble: And then as far as Emory Healthcare, what’s the relationship there?
Allen: It’s a management agreement, so they put a CEO and a CFO here to help run the hospital for us. I spent 12 years in another hospital system here in the Atlanta metro area. In the amount of time that I was there for those 12 years, they had five CIOs here. They had like six CFOs, they had four or five CEOs. So they’ve had a huge churn in the executive staff.
The partnership with Emory gives them some stability. It gives them some continuity. If something happens and one of them leaves for some reason, gets another posting or does something else, there’s at least knowledge transfer for the next person coming in to be able to keep moving. So they also help us with strategy, they help us with marketing, they help us with government relations. From an IT standpoint, I do interface some with the CIO there just to make sure that we’re kind of aligned, we’re working together on population health, we’re feeding into their HIE. So there is some interplay, but we’re not a wholly-owned subsidiary.
Gamble: So you operate pretty independently, it sounds like.
Allen: For the most part, yeah.
Gamble: Who’s the CIO there?
Allen: At Emory? Dee Cantrell.
Gamble: Right. So it’s more meetings with Dee to kind of say here’s where we are on this, and kind of keep each other updated?
Allen: Yeah, they’re a much bigger ship and they have much more process in place than we have, so it’s me learning from them of, ‘here’s what we’re doing,’ so I can kind of help plot a path for here.
Gamble: You’ve been at Southern Regional for how long — a year or so?
Allen: Since September.
Gamble: Oh wow, not even. So in terms of the EHR, you’re using Meditech in the hospital?
Allen: Yeah, Meditech.
Gamble: When you assumed the role last fall, what was going on in terms of the EHR? Was it in the implementation phase or what was the story at that point?
Allen: So they went live in September 2013. It was big bang and it was the first that went live with some big bang process with Meditech. So they cut everything all at once. As I was going through the interview process and then having conversations with directors and executives once I got here, the big thing was they just didn’t have access to information. Reporting was nonexistent; they couldn’t get information back out of the system to be able to make decisions. So my first big push, and the thing I’m still continuing to push on, is providing some type of analytics and getting data out back in front of people. To me that’s not running reports out of Meditech or putting it on their menus to be able to run their own reports; this is truly about building dashboards. It’s the whole BI thing — it’s building dashboards, it’s publishing metrics, it’s getting things back out in front of people for them to work from and making it push, not pull. I don’t want people to have to go query information that they need to be able to make a decision.
Gamble: Right. What is that process like just as far as putting the information people need in front of them, because obviously you have a whole lot to filter from?
Allen: So an easy place to start is ED. Everybody has their own slice they want to see of it. We start with everything from door to discharge or door to admit time, taking the big picture, and then start slicing that up from door to doc and then from doctor to decision to admit or decision to discharge, then we do imaging turnaround times. And we’re pulling all those metrics out of Meditech and then publishing them.
We’re working with Microsoft for publishing and using the power BI tools from Microsoft. We’re putting them up in a nice pretty format and sticking them out, and they’re updated regularly. So every day they know what’s going on; they know what’s going on for the past 24 hours, they know what the past week looks like, the past month looks like and the past year.
Gamble: Okay. You started with ED, is that something that’s been extended to other areas?
Allen: Actually, we’re doing a lot more work now with revenue cycle, looking at outstanding balances, looking at how they’re coming in to the hospital, what services they’re getting. We’re starting to do some work with denials, working through where denials are and how they’re coming in. We’re doing a lot more work upstairs with our business office than we are with on the clinical side right now.
Gamble: I would imagine when you’re a safety net it’s a big focus trying to cut out some of the waste or just stop the leakage.
Allen: If you look at our payer mix, we are about between 75 and 80 percent government payer and self-pay. We truly are as safety net as you’re going to get and still keep the doors open. So we have to run really tight.
Gamble: Right. So that’s a big focus. And I would assume that just in general, looking to optimize the system and get more use out of the EHR system is something that’s a priority.
Allen: And that’s piece 2 that we’ve jumped into. We found that there were modules that while they were put in, there were pieces that weren’t necessarily in use. There wasn’t documentation. While it may have been presented to someone and the decision was made not to use it at the time of go-live, looking back now we see that it should be in use, so we’re pulling documentation on a collections desktop or the denials desktop functionality within Meditech to be able to get those modules built and get it back out in front of the business areas so that they can make better decisions and they can manage their processes a little bit better.
From the clinical side, we’re working a lot on streamlining. We expanded because they did have it in some places, but we’ve expanded the bedside meds verification. We pushed admissions, bedside and ER. Since being here since September — because I came in with a new director of applications at the same time reporting to me — the two of us have really pushed as a team to be able to accomplish quite a bit with the system in just eight or nine months I’ve been here.
Gamble: Now, when you are looking at doing things like optimization and making changes, whether it’s improving workflow or just getting better data in front of people, I imagine that can be tough when you have to decide how much changes do we really need to make or how much tweaking can we do — is that something that you run into?
Allen: You very much have to struggle, especially from the IT side, behind everyone with how much change the organization can absorb at once. With a new CEO coming in — because a new CEO started a month after I did — comes new thoughts and new growth strategies and new alignments, so you’ve got the changes that are coming from there as we’re trying to push things through. So I’ve really got to prioritize. We have things queued up that we haven’t rolled out yet, just because it’s too much for the organization to absorb at once.
Gamble: Yeah, I guess when you’re the new CIO, you have to try to measure how much change is palatable at a time and maybe stagger things a little bit.
Allen: Right. We pushed the IT department to have it built, so we have it built, we have it in our pocket. It’s there and ready. It’s in test or it could be actually for anyone to use, but we have everything there. When I see a window that we can squeeze it into, that’s when we’ll start working to roll it out and do the education, do everything else that has to take place.
Gamble: So for you coming in, knowing there had been a lot of turnover, I imagine that’s something you had to approach pretty carefully because that’s a unique situation talking about a decade or so with that much change.
Allen: I had about an hour and a half conversation with the prior CIO, who was actually from out of town. We had a long talk about what his struggles were and why he left. We really went through all of it end-to-end and had conversations about everything from staff to strategies and plans that he had in place for how he wanted to move forward. So I did a lot of work with him. I also talked with other people that had worked here in the past, because the person about four CIOs back I actually knew pretty well, so I’ve reached out to him also. So I actually did my homework before making a decision to come here.
Gamble: Yeah. Did that kind of change your mind? Or maybe not change your mind, but that was probably tough to hear and to know going in, okay, this is all the challenges that the prior person experienced.
Allen: Well, it helps when you’re walking in with your eyes open. It would have been much worse to get here and find out the issues that were in place or find out the things that he wasn’t able to accomplish and why he wasn’t able to accomplish them; to get here and be slapped with that when you walk in expecting to be able to make change. Once you’ve level-set it, walking in, and you can fully understand what you’re walking into and what it’s going to take to make change, it actually made it a little easier decision for me.
Gamble: Yeah, that’s interesting.
Allen: The other side of it is I was able to learn from what he did from the conversations that we had; to learn from what he did to be able to make different steps. There are things that I’ve been able to do that he was never able to be able to get in the middle of. As part of the go-live, the dictionary builds and a lot of the maintenance was rolled out to the end-user departments, imaging support was an imaging — there were things that were really fragmented. It was a situation that he was put in as he was coming out through the go-live that I actually been able to pull a lot of that maintenance back in the IT where I feel it belongs, and be able to pull the fragmented shadow IT departments back into IT.