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.”
- Population health with Emory — “They’re able to access information much easier.”
- Reducing readmissions with paramedicine
- Meditech’s portal functionality — “It doesn’t fit our patient population.”
- From outdated systems to being a Horizon development site
- The mentor that “helped moderate” him
- Being the new CIO — “It’s all about interacting with people. The strategy will come.”
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They’re able to access information much easier than what we can do from here. Because for us to do it, it’s someone sitting down writing reports and working through the data repository in Meditech to write reports. It’s having to hunt and peck to work our way through just because we don’t have that level of expertise on staff.
They’re not meds compliant, they’re not treatment compliant, they’re not following up with their primary care physician on discharge or anything else, because they just can’t. So we send them home, and two weeks later they’re back.
A lot of the reason I stayed for as long as I did was that I learned a lot from him and I had allegiance to him from working with him and trying to get everything from him that I possibly could on how to be a CIO and how to be a CIO the right way.
Don’t be a technology guy, be a people person. If you’re a CIO, you need to be out with the rest of the management team. Don’t lock yourself into the IT department and work in a vacuum. Get out and build relationships. Understand the temperature of the organization — what everybody’s going through and what the pain points are.
For a new CIO coming in, it’s all about interacting with people. The strategy will come, the projects will present themselves, and you’ll be able to prioritize. And sometimes you’re going to guess wrong, but for the most part, you’ll know what the important things are and you’ll know what the organization can handle.
Gamble: You briefly had mentioned population health before, what are you doing there or what are you looking at being able to do on that front?
Allen: I think the first thing is just being able to access the information to understand what the populations look like. We’re feeding all of our information to Emory for them to be able to help us manage and help give us access to information that we can’t necessarily get too easily in the systems that we have. They’re a big Cerner shop and they’ve got the Cerner population management system in place and the Cerner HIE and they’re rolling everything up there, so they’re able to access information much easier than what we can do from here. Because for us to do it, it’s someone sitting down writing reports and working through the data repository in Meditech to write reports. It’s having to hunt and peck to work our way through just because we don’t have that level of expertise on staff, where they have systems and have those in place. The big push is the same big push that everybody has; it’s around CHF. It’s around diabetes. It’s around those things.
We’re also working with the county that we support, Clayton County, with EMS in the county on a paramedicine project where they’re pulling information from their system and we’re pulling information from our systems to get the frequent fliers into the ER — the people that are calling EMS to get transport to the ER and then are doing it regularly — to see if we can work out some way to visit them in their homes and keep them in their homes.
Gamble: Okay. I’ve just seen something on that recently, otherwise I would have never heard the term paramedicine, but that’s obviously something that makes a lot of sense when you’re a hospital like yours and having to reduce the readmissions.
Allen: Right. Our readmission rate is great, and a lot of it is that it’s a very poor market. We’ve got 24 percent of the county residents living below the poverty line. So they’re not meds compliant, they’re not treatment compliant, they’re not following up with their primary care physician on discharge or anything else, because they just can’t. So we send them home, and two weeks later they’re back, four weeks after they’re back. It tends to be turnover because they don’t have the ability to take care of themselves the way that we would like for them to.
So we’re working with Clayton County EMS. I believe they got a grant from Kaiser that they’re going to use to buy the ambulance, and then we’ll have staff and work with them to be able to go out and visit and send social workers and send nurses and send the paramedic out to their houses to help make sure that they’re med compliant and help make sure that they’re eating the way that they should and they’re doing the things that they should.
Gamble: It’s one of those great examples where you can’t treat every patient population the same. When we talk about patient engagement and things like that, there’s just no one-size-fits-all, and that’s a perfect example, having underserved populations.
Allen: Exactly. I’ve been doing a lot of research and looking at personal health records — the ChartSpans and things like that — where you keep all of your information on your phone or on your tablet, so that when you show up, you go to another ER somewhere, they can pull up all of your information and you can send everything to another doctor, but you carry all of your health information with you. It’s great, it’s super cool. Being the technology guy that I come out of, I think it’s super cool technology to be able to put in place. But it doesn’t fit our demographic. It doesn’t fit the people that we’re serving. So while I’d love to put something like that in place and start chasing down it, I just can’t make that a priority.
I met with the Meditech sales reps a few weeks back and they were talking about now with their portal, we can actually import wearable data and have it stored in the patient portal. It’s another one of those great ideas, right? But it doesn’t fit our patient population because they’re just not wearers of FitBits or something.
Gamble: Yeah, exactly. I think that a lot of people are having challenges with some of the patient engagement requirements. Even when it comes down to things like broadband, it’s just not the same everywhere.
Allen: Right. Well, that’s at least the upside of being in the Atlanta metro area. I don’t struggle as much with broadband or wireless coverage or 4G coverag.. I don’t have to fight those battles.
Gamble: Right, just different battles.
Gamble: You talked about being at Gwinnett Medical Center for 12 years. That’s a big chunk of time and I would think you saw a great deal of change.
Allen: Oh, very much so. We were very much a McKesson partner through the whole thing. We were one of the two development sites for the Horizon ERM, the revenue cycle side of the Horizon platform. So we worked with McKesson. We had developers onsite working with us and building. They leased space in a strip mall right across from the hospital and put people there to help make sure that it got built and then got implemented and brought up. We skipped whole generations because we went from running a system that was written in the 70s or 80s to being the development site for their new Horizon revenue cycle side and then bringing up Horizon Clinicals. We took an IT department that was in the 30-person range, including the shadow IT, and we grew it to about 120 people.
And that’s another one. We talked about Ed Marx before and my boss there was Ed Brown. I guess Ed’s one of those good names to have if you’re a CIO. But I learned a lot from him and a lot of the reason I stayed for as long as I did was that I learned a lot from him and I had allegiance to him from working with him and trying to get everything from him that I possibly could on how to be a CIO and how to be a CIO the right way. It just so happened that we got to go through some really fun growth and do some really fun things. You don’t necessarily change out a revenue cycle system that often, but we did. And not only did we change it once, we changed it twice because when McKesson killed the Horizon product, we had to convert back to Star.
So I went through all of that. We converted revenue cycles twice, we converted clinicals once, we brought up all the clinical pieces, and we went from all film to an online PACS system. It was a great learning experience and it opened me up to healthcare in ways that I never would have ever thought. I worked my way through college in healthcare and banking, and in banking, you never had access to the business and understanding the impacts of the business the way that I’ve had since I’ve been in healthcare.
Gamble: Now with all of that change taking place, were there any lessons learned about change management and introducing all this change to an IT department?
Allen: Well, that’s a lot. We talked earlier about learning to phase things through. One of the things that Ed Brown taught me quite a bit was the ability of the organization to absorb change. It’s working around that culture. And because I’m a little more hard-driving type person than what he is, he helped moderate me and make me understand. Just because we have it ready, just because we think it’s neat or it’s something that we know that has to be done, I can’t shove that into the organization and make them do it because they’re just not ready to be there yet.
So we held off on Clinicals. We held off on Horizon Clinicals side until we finished the revenue cycle because we knew that the organization and the IT department both wouldn’t be successful trying to do both projects at the same time. We moved clinical informatics out of IT into nursing to make sure that there was nursing ownership when we started going live with Clinicals. That now has moved back in as part of IT, but through the whole go-live process and the build process, it made sense for nursing ownership.
Gamble: So that’s something else I can imagine is important is being willing to make these tough decisions. I’m sure that’s something that’s interesting to see happen and be part of.
Gamble: So prior to Gwinnett Medical Center, where were you?
Allen: At WellStar, which is another health system here in the Atlanta metro area. WellStar basically owns the northwest chunk of Atlanta. They’ve got five hospitals out that way and they just own that whole section of town. Nobody even tries to play. Gwinnett owns Gwinnett County, which is on the northeast side, and then there’s the middle in between that is up for everybody to fight for. I stayed on the north side, and being here at Southern Regional is my first real foray on the south side of Atlanta.
Gamble: Okay, so much interesting stuff. I guess the last thing I wanted to ask about was having gone through the experience you did at Gwinnett and now at Southern Regional, if there’s any advice you have for people who are new to the CIO role, especially during this time, as far as how to deal with so many priorities? Or just any advice in general you might have that you think would be helpful or would have been helpful for you?
Allen: The things that I would tell people is, one, don’t be a technology guy, be a people person. If you’re a CIO, you need to be out with the rest of the management team. Don’t lock yourself into the IT department and work in a vacuum. Get out and build relationships. Understand the temperature of the organization — what everybody’s going through and what the pain points are.
One of the first things I did coming on board is I set up a meeting with every director in the organization, and I spent an hour with each director walking through what they were doing, what their pain points were, and what they felt I should make my priorities, to try to get that type of information walking in. I think just getting out and working with the departments as opposed to sitting back in IT is huge.
On the other side, don’t forget the IT department. They’ve just got a new boss. You come in as a new CIO, you’re the new person in. They all know each other, none of them know you. You have to get in front of them, you have to spend time with them, and you have to build those relationships also.
So truly for a new CIO coming in, it’s all about interacting with people. The strategy will come, the projects will present themselves, and you’ll be able to prioritize. And sometimes you’re going to guess wrong, but for the most part, you’ll know what the important things are and you’ll know what the organization can handle.
Gamble: It’s really interesting to hear you say that because that’s something that I think has really changed in the past couple of years.
Allen: Very much so.
Gamble: Or at least maybe there’s more awareness.
Allen: I think what you’re finding is you’re getting more and more people into senior IT management roles that don’t see themselves as a strict technologist; that don’t see themselves as a strict programmer. If you think back 10 years, the CIOs and the heads of IT in a lot of organizations were just the PC tech guys from the 80s and 90s that happened to stick around long enough. Now, what you’re finding is you’re getting people into the roles that groom themselves to become a CIO and they understand relationships. They understand communication. They understand all the things that it takes to be successful in the role and have a successful IT department.
Gamble: Yeah, that’s really interesting evolution that’s taken place. Well, I know we’ve covered a lot. That’s basically what I wanted to talk about. I’m sure I could talk to you more, but you’ve got a couple of things going on, so I figure I should let you go.
Allen: No problem, thank you.
Gamble: Well, thanks so much.
Allen: If there are any follow ups or any questions, let me know.
Gamble: I will, and even if not, I’d like to get in touch with you a little down the road and just check in and see how things are going.
Allen: That’d be great.
Gamble: Okay, great. Well, thank you so much, Rick. I’ve enjoyed speaking with you, and I’ll talk to you again.
Allen: All right, sounds good.