Bill Lewkowski, Executive VP & CIO, Metro Health, Chapter 1

Most leaders would like to think their organization is well-positioned for the future. But when your health system had the foresight to bring in futurists more than a decade ago to design a campus around the concept of patient-centric care, there’s no doubt about it. In this interview, Bill Lewkowski discusses the vision his team has and how they’re working to make it a reality, from building a clinical integrated network to viewing analytics as a core strategy. He also talks about the challenge of keeping the team focused during a pending acquisition (which eventually fell through), his plans bold plans with Epic, the cutting-edge work they’ve done with virtualization, and why it all comes down to having the right people.

Chapter 1

• About Metro Health
• New campus to enable consumer-centric care
• Epic in hospitals & practices
• MyMetro portal
• Clinically integrated network — “Our strategy is one of integration”
• Centralizing reporting & analytics
• “Guiding principles” for success with Great Lakes Health Connect

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Bold Statements

We saw the consumer being the center of the world even back then, and that’s what’s happened. So with everything we did, we wanted to make sure that the experience and the perspective absolutely have the consumer in the center.

We look at the business intelligence and analytics as the heart of all that we’re doing so that we can become much more data-driven and do a better job around all that we do with better analysis.

We had some guiding principles that have paid off down the road. One of those was that we would not take grant money or governmental money. This needed to be self-sustainable.

We don’t look at the HIE as the one source. We can connect directly with other Epic organizations and we can connect up with other networks like Surescripts. We can use some of the other emerging interoperable technology, so it all comes together to provide you a really good way of getting information. 

Gamble:  Hi Bill, thank you so much for taking the time to speak with us today.

Lewkowski:  My pleasure.

Gamble:  So to get some background information for our readers and listeners, can you just talk a little bit about MetroHealth — what you have in terms of bed size, ambulatory care, that kind of thing?

Lewkowski:  MetroHealth is located in Grand Rapids, Michigan, in western Michigan. We are a health system; although we have a single hospital, we are a much larger organization around ambulatory and primary care. So we have a primary and secondary care network. We have about 20 different ambulatory sites around the West Michigan area. But we do have an acute care hospital and in fact, we moved into a new hospital and campus about eight years ago. It’s about a 200-acre campus on the suburbs of Grand Rapids, and not only does it have a new state-of-the-art hospital, but it has about 25 other buildings on our campus, all based around providing different types of care and health and even some retail and commercial types of things. So it’s a campus that is a destination for not only healthcare, but a place within our community here.

Gamble:  Okay. And you said that it was about eight years ago?

Lewkowski:  Yeah, it’ll be eight years this September. It’s hard to believe, but that’s when we went live in the new hospital. And we continue to build on our campus, so we may have about 25 buildings now. The ultimate plan is to have somewhere around 35 to 40.

Gamble:  That’s really interesting to me because that seems like pretty forward thinking to have that idea. It’s becoming so big now, that whole idea of treating the whole patient and it seems like you guys are ahead of the curve on that one.

Lewkowski:  So the way we did this is although we went live here eight years ago, we began planning for that about five years even before that. So if you look back around 14 or 15 years ago, we knew we had to move from our old campus. We were landlocked, the city kind of grew up around us, and we needed more space for a lot of things. We made the decision we needed to move, but also, when we did that, the board put together a visioning committee that had board members and senior leaders and physicians and community members, and we brought in some healthcare futurists who really helped us see the future. We saw the consumer being the center of the world even back then, and indeed, that’s what’s happened. So with everything we did, we wanted to make sure that the experience and the perspective absolutely have the consumer in the center.

Gamble:  Right. I imagine that’s been pretty well received from the patient point of view?

Lewkowski:  It has, and it continues to evolve. So as healthcare, especially now with value-based, accountable care and so on, as we expand, it really has fit into our strategy with other additional care providers all around the patient. So the idea of population health and having the consumer in the middle not only is a part of our campus, but it’s a part of our strategy of how we connect, and that’s where we obviously use information technology to help enable all of that.

Gamble:  Right. Now, in terms of the EHR, you’re on Epic, correct?

Lewkowski:  We are on Epic. We made the decision for Epic back in the 2003 and 2004, and began implementing in 2005, and we’ve been live on Epic for a number of years. We’re on all of their applications and just continue to expand that as the center or basically the center of our EHR.

Gamble:  Okay. And I imagine that that goes beyond the hospital. Is it also being used in the clinics?

Lewkowski:  Yes, not only the clinics of our employed medical group, but we extend Epic out to other affiliated physician practices and partners, and they run on our instance of Epic here, so we really have an integrated EMR with many of our providers, almost the majority of our providers so that we can really have the patient at the center of what we do.

Gamble:  Right. As far as the portal, are you using MyChart?

Lewkowski:  Yes, we’re using MyChart, but also we’ve created a bit of a wrapper around that. We have MyMetro, a portal that includes MyChart, so a patient can go directly into MyChart, or there’s things that we do provide that are supplementary and additional that integrate with MyChart around that and we call it MyMetro.

Gamble:  It sounds like you’re pretty well positioned for what you just touched on before, which is population health. Where do you kind of see things continuing to go as far as moving toward that patient-centered health goal?

Lewkowski:  What we’re really focusing on right now is we’re expanding what we used to call our physician hospital organization (PHO). That is really bringing our affiliated physicians and providers with us together under one umbrella, and so we are more formally expanding that to be a clinically integrated network (CIN), and that continues to expand. So that is kind of like the umbrella of MetroHealth, and indeed, it is all around the patient, it’s all around the populations that we serve. It will expand into other creative ways of contracting and organizing around patients and populations with payers and potentially directly with employers.

Gamble:  So from what you were saying with not only looking into Epic as far back as 2003 and then speaking with healthcare futurists and planning, it seems like it’s definitely kind of an early adopter philosophy at your organization.

Lewkowski:  We knew that back in the early 2000s, our strategy was one of integration; integration meaning that we wanted to bring all of our parts and pieces together around the patient, and we knew we needed to do that digitally or electronically. And so we picked the best solution on the market, which continues to improve and is has become the number one EMR in the market. That’s still the center of our patients, but we’re adding in other parts and pieces, especially around business intelligence and analytics, around that so that we can do a really good job of not only integrating care, but making sure that we improve the value of that care.

Gamble:  Are there any specific initiatives you’re doing right now or looking to do with analytics?

Lewkowski:  I will say that over the last few years, we became a little bit more intentional about business intelligence and analytics. We created a corporate department that does report to me, but it’s a corporate department that has brought together parts and pieces of our own organization that had components of reporting and analytics and so on, and we centralized that.

We have been building out a data warehouse and analytics platform to kind of sit on top of Epic and also integrate back into Epic, and we’re also reaching out across the region here to get more and more information about our patients. One of the ways that we do that is Metro was one of the original founders of Great Lakes Health Connect, which is Michigan’s largest HIE. So we utilized that access to improve and both bring information about our patients inside and also communicate outward with the other providers around the region and across the state.

Those are some of the parts and pieces of what we’re doing. We look at the business intelligence and analytics as really the heart of all that we’re doing so that we can become much more data-driven and do a better job around all that we do with better analysis.

Gamble:  Right. And now as far as the HIE, how has that matured over the years? I know this is something that in a lot of areas has been a challenge, but Michigan seems to have kind of been able to buck the trend.

Lewkowski:  Well, we did something unique back when we started this several years ago. Three of us CIOs in Grand Rapids got together and we formed what at that time was called Michigan Health Connect, and we had some guiding principles that have paid off down the road. One of those was that we would not take grant money or governmental money or funding through grants or temporary funding. This needed to be self-sustainable. That was the model that has continued to this day, and that’s why the HIE has grown but has sustained itself and continues to grow. It does not rely on the mercy of some the grants that run out, where we’ve seen another HIEs fall apart for lack of funding.

The other thing we did was we were intentional about the governance model for the HIE and created a future for it to expand, and indeed, it merged with the other largest HIE within the state of Michigan and now is the number one largest HIE in Michigan but is self-sustainable, which is probably the key to its success.

Gamble:  Yeah. And it seems to me that a good number of the Michigan health systems and hospitals are on Epic, so I imagine that part does make it a little simpler, but I’m sure not every organization is.

Lewkowski:  It does help. Our interoperability; our ability to connect and share information doesn’t rely on one source, so we don’t look at the HIE as the one source. We can connect directly with other Epic organizations and we can connect up with other networks like Surescripts. We can use some of the other emerging interoperable technology, so it all comes together to provide you a really good way of getting information, and it’s going to get better through time. It doesn’t mean it doesn’t have challenges, but it’s getting better that way.

Chapter 2