Springhill Medical Center has history of doing things differently. In fact, its founder, Dr. Gerald Wallace said he wanted an organization that would “rewrite the traditional and make the most advanced a common occurrence.” The organization has done just that, becoming the first hospital in the state to achieve Stage 7, and doing so with an entirely outsourced IT department. In this interview, CIO Mark Kilborn explains how he engages Allscripts as any CIO would despite the arrangement (and in fact, is “a very difficult customer”). He also discusses the benefits of being a vendor showcase, how the organization leverages its high-level IT adoption to recruit clinicians, and the “drive” that has made Springhill so successful.
- About Springhill MC — “It is a competitive market.”
- Being a showcase for Allscripts
- Working with developers to “maximize efficiency”
- HIMSS Stage 7 — “You have to have all hands on deck.”
- Shared best practices
- Convincing docs to go electronic — “That’s a tough pill to swallow.”
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Anybody that’s done alpha or beta work knows that what you’re trying to do there is get some influence on the design of the product, and working with the vendor to get some input. And that’s been a tremendous benefit for us here.
We actually have developers sitting side-by-side here at our hospital finding out what works and what doesn’t work — and not trying to custom-fit the solution just to fit our hospital, because we’re working with them to help them develop a product.
You’re talking about a significant change in the workflow, particularly in the clinical area with the barcode. So being able to reach out across the country to so many accounts that we showcased for has been invaluable.
Everything we have done in Springhill is not necessarily based on momentum, but driven by reaching the best outcomes. Everything we do here is quality-driven. We don’t do anything just because somebody says we need to do it. We do it because we know it’s the right thing to do and because that’s what we need to do.
Kilborn: Springhill Medical Center is located in Mobile, Alabama. It’s a 252-bed community hospital. We are a private, for-profit hospital — the only for-profit hospital owned solely by a woman in the US, Celia Wallace. We’re a full service hospital serving Southwest Alabama and the greater gulf coast. We offer a full array of surgical services including outpatient, inpatient, open heart and robotics. We’re the only hospital in town with board-certified ER physicians. We’ve been in business 40 years.
Gamble: So that’s obviously a pretty different model, being a for-profit with a single owner. I can imagine that’s interesting from a leadership perspective and what that means for you.
Kilborn: It is. And also, I think if you were to look at the layout of the competitors here in Mobile market, we’ve got nine hospitals serving two counties managed by five separate healthcare providers, and we’re the only for-profit in the group, and that puts us in a very competitive situation. We don’t have the benefit of grants and foundations and charities. We also have to pay taxes, and our competitors don’t. So we’re in a very, very tough market, and to be as successful as this hospital is, I think, is testament to great leadership, and most certainly a very caring, knowledgeable and dedicated staff.
Gamble: Right. So even more so than for other organizations, budget and staying within a budget really has to be top of mind, I would imagine.
Kilborn: Oh yes. People think that in healthcare we’re making money hand over fist, and that’s just not the case, certainly not in a for-profit business. You might have to spend two million dollars just to redo a parking lot — that’s a chunk of change, or a million and a half to put a new air conditioner on top of the building. It’s one thing after another. It is a competitive market, and it takes excellent fiscal stewardship, which is something that this hospital does a remarkable job of.
Gamble: So now in terms of the application environment, what EHR systems do you have?
Kilborn: We are actually a showcase for Allscripts Corporation for Sunrise Clinical Manager. We rolled their product out in November of 2004. We use a host of best of breeds for some of our other applications that Allscripts doesn’t provide. We use Sectra PACS, Sunquest Lab, and McKesson Material Management, those type of things. But the core of our system is centered around Allscripts. And with that solution, Springhill became the 200th healthcare organization in the country back in January to reach HIMSS stage 7. We were the first hospital in the state of Alabama to reach HIMSS stage 7, and the first hospital worldwide using Allscripts SCM to reach HIMSS stage 7, and that was done just six months after reaching stage 6. In other words, the solution at Springhill is well-tuned.
Gamble: Can you talk a little bit about what that means being a showcase — what it means for your role and how it affects your strategy?
Kilborn: Being a showcase for any vendor is certainly a challenge because vendors mostly want to bring as many customers in to see us as they possibly can. And we like to be on the cutting edge. Like I said, we are a for-profit organization, and to stay competitive, we have to stay ahead of the game, and that means we need to have the best that we can afford, again taking that fiscal stewardship into account.
One of the huge benefits for us is that Allscripts works closely with us in helping make sure that we’re maximizing the power of the product, if you will — the dynamics of it. We’ve done some beta work for them, and anybody that’s done alpha or beta work knows that what you’re trying to do there is get some influence on the design of the product, and working with the vendor to get some input. And that’s been a tremendous benefit for us here.
Allscripts does a wonderful job of sending their developers out to the customer to find out what the customer needs. We’re working on a project with them right now, and we actually have developers sitting side-by-side here at our hospital finding out what works and what doesn’t work — and not trying to custom-fit the solution just to fit our hospital, because we’re working with them to help them develop a product or a solution — sometimes enhanced solutions — that are going out to the marketplace. But having their developers take the time to come out of the lab and out of the office and sit down in the real world is priceless. So Allscripts helps us maximize the efficiency of the machine.
In doing so many site visits over the years, we have built some wonderful relationships with healthcare providers from across the nation and Canada. Even as far away as Singapore. What a prospect sees here at Springhill I believe is a much more mature solution than what you will see in a traditional demo. Ours has been deployed for 11 years and is very mature. With the purchase of Sunrise Clinical Manager, they’ll tell you 90-plus percent of the ingenuity will come out of your own head because of how dynamic the solution is. We’ve had 11 years to fine-tune it, so it has a nice polished look when they come to Springhill. They see a solution that we’re seeing improved outcomes with all across the board, both clinically and financially.
Gamble: With some of those users, do you find that they keep in touch more once they start really using the product?
Kilborn: They do, but where it really helps is we have had the product for 11 years, but by no way are we the only ones that know how to skin a cat. A lot of times, somebody else has already tackled this, so we use their client connect as well as our own relationship with them to reach out to other folks and find out how are you doing this?
Two of the most challenging things in qualifying for stage 7 was the deployment of barcoding for breast-feeding and blood transfusions. Those are two difficult solutions to get in place. You’re talking about a significant change in the workflow, particularly in the clinical area with the barcode. So being able to reach out across the country to so many accounts that we showcased for has been invaluable to us. Like I said, there’s several ways to skin a cat and somebody’s already done it.
Gamble: How did you work through those challenges with the barcoding in stage 7?
Kilborn: Actually, it was the vendor. We use Sunquest, and they worked very closely with us. When you’re working towards stage 7, you have to have all hands on deck, and I have say that Allscripts, the IT staff here, and Sunquest worked closely to bring a solution into place. It was just a great partnership between vendors and the client.
We managed to pull it off in about a month and a half. It was a tremendous work effort by the lab getting that set up. There’s not a whole lot of IT involvement in rolling out the blood transfusion barcoding. That’s mostly a work effort that originates in the lab, and the workflow is affected tremendously up on the floors where they actually will have to do the validation of the barcoding.
Gamble: In terms of the decision to go after stage 7 so quickly after reaching stage 6, was that something where you kind of didn’t want to lose momentum or what was the thinking there because that’s a quick turnaround?
Kilborn: I can tell you, I’ve been to Springhill 15 years, and there’s never been a lack in momentum here, so that certainly wasn’t the driving force. The president of this hospital, Jeff St. Clair, made the decision back in 2003 when I think something like 2.5 percent of hospitals were using the EHR. He saw the value of the EHR and how it was going to change the landscape for healthcare. Making that decision early on to ask our doctors, again, in this competitive market place, to put down their pens and pencils and say, ‘throw that chart away, we have a new way for you to do it’ — that was quite a bold move. Everything we have done in Springhill is not necessarily based on momentum, but driven by reaching the best outcomes. Everything we do here is quality-driven. We don’t do anything just because somebody says we need to do it. We do it because we know it’s the right thing to do and because that’s what we need to do. The hospital realized technology’s place in the future a long time ago, and that’s why I was so attracted to work here at Springhill. They understand that technology compliments the quality care they are known for at SMC, and it is a tremendous marketing tool with your referring physicians. If you can make life simpler for your referring physicians and help them improve patient outcomes and their operations, then everybody’s going to do well.
In terms of the technology in trying to maximize the potential of the solution here and Mr. St. Clair recognizing that back in 2003, we got quite a jump on the competition. In fact, many were singing our death song when we deployed, because as you might very well expect, there was some pushback. You have guys that have been doing something for 40 years in the twilight of their career, and then you tell them, ‘We want you to change the way you’ve been doing everything for the last 40 years’ — that’s a tough pill to swallow.
And so the effort to reach stage 7 was driven by improving outcomes both for ourselves, certainly from a business perspective, but the number one reason is to improve our clinical outcomes and to build on our relationship with our referring physicians.