Stepping in as the new CIO is never easy, particularly if you’re filling the shoes of a longtime leader who ushered the organization into the digital era. So when Jim Venturella took the helm at WVU Medicine, he knew he had a fine line to walk. He wanted to be patient enough not to push for any changes without first understanding the processes, while still pushing his team to do their best. In this interview, Venturella talks about what it was like to take over for Rich King, why he welcomed the opportunity to lead a system-wide transformation, and the role that having an integrated EHR can have in uniting an organization. He also discusses his roadmap for the Epic changes at WVU Medicine, what he believes are the biggest challenges for today’s CIOs, and why he still “operates as a consultant.”
- WVU Medicine’s journey to integration
- 3 hospitals on Epic, plans for 4 more
- Education through site visits
- Epic everywhere — “I definitely think this is the right strategy.”
- Building buy-in through communication
- Eye on ACOs — “The world is not stopping.”
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We’re going to bring individuals from the three hospitals that do have Epic back to the table to do an optimization of our current design, as well as get input from those facilities so that we hopefully truly have an enterprise model.
We’ve got a great foundation. We’re not going to recreate the wheel, but it gives us an opportunity to improve and optimize what we currently have and then extend it to everybody else.
Knowing that we were going with one core platform for the applications and not having the best-of-breed piecemeal solution was a big positive for me. Because I have seen both sides and I definitely think this is the right strategy to move forward with.
The more and more we talk about it, the more and more we bring people together from around the system, you get more excitement about actually being able to collaborate and work together versus resistance and that siloed thinking.
Gamble: Hi Jim, thank you so much for taking some time to speak with healthsystemCIO.com.
Venturella: No problem.
Gamble: So to give our readers and listeners a little bit of information, can you give us an overview of West Virginia University Health System in terms of number of hospitals, ambulatory, things like that?
Venturella: I can. First, I’ll let you know the new name. We have a new brand that was announced about two months ago now, and so we’re going by the name of WVU Medicine. It replaces the old name.
The health system itself has seven hospitals that are completely owned and we have one new hospital that’s a clinical affiliation. We’re in the early stages of defining what that really means. We have about 1400 beds across the seven facilities. From an ambulatory standpoint, we partner with West Virginia University on their three practice plans, so we support a little over 800 physicians on our platforms, which includes individuals from the practice plans as well as individual physicians who are employed by the health system.
Gamble: And what type of system are you using for that?
Venturella: For three of the hospitals, as well as the majority of the physicians, we’re using the full suite of Epic applications from clinical revenue cycle, inpatient and ambulatory. For the other four, we have a mixture of applications.
Gamble: I guess this is the big question — is there a plan to get everything on Epic eventually?
Venturella: Very soon, actually. That’s by far our biggest initiative right now. I have a number of people from my team going through Epic training to augment the existing Epic analysts that I have. And then in January, we’re going to kick off in enterprise implementation, which will include the four hospitals that do not have Epic yet. We’re also going to bring individuals from the three hospitals that do have Epic back to the table to do an optimization of our current design, as well as get input from those facilities, so that we hopefully truly have an enterprise model that people from all seven facilities feel like they had input into.
Gamble: So in terms of the timeline, you said that’s beginning in January?
Gamble: How long do you think it will take?
Venturella: So we’re also going to be upgrading to the latest version of Epic, so the plan is through next calendar year to get through all the design, build, and test. And then early in 2017, the three hospitals that already have Epic as well as all the physicians who are on Epic will upgrade to the latest code in any of the workflow optimization changes that we decide on next year. Then the other four facilities will be staggered throughout the remainder of 2017. So two years from this point, we’ll have everybody in the health system live on all the Epic suite.
Gamble: So a lot of your focus right now is on training?
Venturella: Yes, as well as assessment. I’ve got people from my team doing site visits to the other hospitals to learn more about their workflows and their current state as we prep to kick it all off in January.
Gamble: So I guess in some ways it’s an advantage having the three hospitals that are on Epic just to get an idea of things like workflows?
Venturella: It really is. Our first hospital went live on Epic about eight years ago. It’s the academic medical center, and they’re pretty advanced. They’re stage 7 hospital, along with all the ambulatory physicians that are at stage 7, so they have been very successful using Epic. But like a lot of places, after you’ve been using it for seven years, you identify ways that you think you can do things better. And through the various upgrades over the years, there’s functionality we haven’t taken full advantage of, so I think we’ve got a great foundation. We’re not going to recreate the wheel, but it gives us an opportunity to improve and optimize what we currently have and then extend it to everybody else.
Gamble: Right. And it sounds like the way this is planned, the hospitals that are on it don’t really have to slow down with their optimization plans and they can kind of keep moving?
Gamble: So you’ve been with the organization since earlier this year?
Venturella: Yes. I started in March.
Gamble: This was an interesting situation to walk into, although I’m sure that can be said for a lot of CIO roles. What were your thoughts knowing that this was going to be a big priority from the get-go?
Venturella: It was actually one of the positive things I looked at coming into the role. I was very happy; I’ve worked with Epic before and I’m a fan of them as an organization. It was a very positive experience, so knowing that was going to be the base and we’re going to be rolling it out to across the system, as well as knowing that we were going with one core platform for the applications and not having the best-of-breed piecemeal solution, was also a big positive for me. Because I have seen both sides and I definitely think this is the right strategy to move forward with.
Gamble: And in talking about a lot of the focus next year in 2016 on getting through the design build, how are you approaching that as far as putting together teams? How does that look from your perspective?
Venturella: We’ve put together a steering group over the whole implementation. I just probably back up and say that our whole system is going through a transformation right now. If we went back a year and a half, West Virginia United Health System, as it was previously named, really acted as just a holding company over the different hospitals. A decision was made last summer and a new strategic plan was put together that really set the direction for us to become an integrated system overall. There are a lot of different things going on within the health system to bring people together and to align them as one single organization across multiple occasions. So I guess either fortunately or unfortunately, this implantation and rolling out Epic is going to force people into that model faster than they may have liked.
But it’s been interesting just in the six months that I’ve been there, the amount of change and progress we’ve made around those thoughts. Things are happening very rapidly and people are coming around, I think, very quickly in buying into the idea and the new vision of the organization, the new brand being put out there starting to unify people. I think the more and more we talk about it, the more and more we bring people together from around the system, you get more excitement about actually being able to collaborate and work together versus resistance and that siloed thinking that I don’t have to do what they’re doing because everything’s fine in my world already.
Gamble: Right. So that would answer a question I had about some of the hospitals being on different systems — this transformation is about working toward that integrated model?
Venturella: Yes. And I think everybody realizes at this point if we’re truly going to act as a system, we really need one common platform that everyone can work with. We had a quality retreat recently with people from all over the health system and to identify what we want to do together as a system and work on quality and patient safety, and as we talked about the positive things, it kept coming up from every work group that we are moving toward a common platform. And one of the biggest barriers people kept coming up with is that we’re not there yet, we don’t have that common platform, so we’re still having to do things multiple times in different systems. At the end of the day, there was a lot of excitement about kicking off this process and that group working together to figure out how Epic will enable what they want to do going forward.
Gamble: When you have those site visits to the hospitals that are already on Epic, are there particular people or groups that you kind of look to for that or how does that work as far as finding the people who can really answer those questions?
Venturella: Well, it’s a lot of discussing that with the individuals there. We’re doing some road trips right now; myself and our chief application officer are going around and talking to the leadership groups at each one of the hospitals and trying to identify who the right people are to be on the different workgroups. After the steering committee, we’ve got a number of different workgroups over the different workflow areas or application areas that are being pulled together right now. And so, we’ve got some of them filled out with people’s names and we’ve got others that we’re still working with the different organizations to identify who are the right people to represent them on those different teams.
Gamble: And then at some point along the way, I’m sure you start to encourage direct communication between people once everyone has their contacts set up?
Venturella: Yes, absolutely. Our project team will be facilitating that over the next two years as we go through the project, and then a lot of these groups will live on after that, and be an overall user group that will help define the future direction collectively going forward.
Gamble: So when you look at things like ACOs and population health, is it a little bit complex as far as how that’s viewed with everything you’re doing with the goal of being integrated or is that something that in the meantime you are looking at?
Venturella: Well, I guess the world is not stopping, so we’re having to do it in the meantime when all of this is going on. I would say fortunately for us in this market, ACOs have been late to the game, so we are a member of one ACO. But we’re still early in the process of that being formed, and from an operational standpoint, we’re still trying to figure out our way through how do we navigate and how do we best achieve the goals of the ACO.
So being on the IT side, we haven’t been hit too hard at this point with requirements and need. We know it’s coming, and so we’re still having to carve out some people from the implementation work to be able to focus on things like that and telehealth and all the analytics. Those are things that aren’t stopping, and we know we need to continue to progress on.
Chapter 2 Coming Soon…