Jennifer Laughlin Mueller, CIO, Watertown Regional Medical Center, Chapter 2

If you ask Jennifer Laughlin Mueller how she achieved her career goals, she’ll tell you that it was through hard work, taking advantage of golden opportunities, and being visible. “You say yes to things you might not know anything about,” says Mueller, who has learned a tremendous amount during her 17 years at Watertown. In this interview, she talks about the major changes her organization faces with a recent affiliation to LifePoint Health — and how her team is already leveraging its resources; how physician engagement has evolved from “arm-twisting” to a true partnership; and her vision for state HIEs. Mueller also shares the advice she’d like to give all young women, the attributes she values most in aspiring leaders, and the conversation with a CEO that was a career-defining moment.

Chapter 1

Chapter 2

• Challenge with 5 percent rule
• Early MU adopter — “It served us well participating in it.”
• WISHIN “as a hub and spoke”
• 2-factor authentication for remote users
• “We want to make sure we’re protecting patient information.”
• 17 years at Watertown Regional — “I just kept getting more opportunities.”
• Wearing multiple hats

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The incentives were there to try to get hospitals and physicians to adopt health IT. We had already adopted it back in 1998, so certainly we were not the target demographic for the Meaningful Use program. However, it really served us well participating in it.

Instead of having interfaces directly between our system and all those entities, we’re able to use WISHIN as that hub and spoke. That’s how I describe it. I think WISHIN — and not just them, but any HIE — will be more useful to the providers when it’s embedded into the EMR.

It’s been really great working with LifePoint on this topic because they have so much talent and resources in the whole security and cybersecurity area that it’s really allowing us to shore up our security on our side.

You volunteer for things. You say yes to things that you might not know anything about, but you figure it out. You get the eye of your boss and their boss and the CEO, the board chair, whoever, and that helps.

Gamble:  I imagine having that history put you in a good place for when Meaningful Use started?

Mueller:  Yes, Meaningful Use stage 1, for us, was very easy. We were meeting the measures really without even trying, so that was really good for us. Meaningful Use stage 2 was the same thing — they increased the thresholds on the different criteria and we were meeting them even pretty easy. The one that was a little bit more challenging was needing to have 5 percent of patients send a secure message to providers. That one was a bit more challenging because you’re requiring the patient to take that initiative and send the message. So we had to put people into the clinic waiting rooms and get people to sign up for the portal so that they can send messages. It was the bigger process, but we were able to get there.

With the relaxation of the stage 2 reporting, now we just have to attest that we have the ability to do that, so that’s certainly helpful. But I know in stage 3, at least what I’m seeing is that number jumps up 10 percent, so we have to keep going.

Gamble:  Who did you have going into the clinics? Who was assigned that role?

Mueller:  We had our IT analysts — nurses and IT analysts — and we placed them in our clinics at strategic times. Not all of our clinics, but the ones where the numbers were the lowest.

Gamble:  It’s interesting because you talked about a lot of Stage 1 being about laying a foundation, and it was the foundation that you already seemed to have had in place. It seems like the big change with Stage 2 was that all of a sudden there were factors that are really out of your hands and you’re relying on the patients.

Mueller:  I think with the whole Meaningful Use program, the incentives were there to try to get hospitals and physicians to adopt health information technology. We had already adopted it back in 1998, so certainly we were not the target demographic for the Meaningful Use program. However, it really served us well participating in it, and we will continue to do so.

Gamble:  You mentioned WISHIN — that’s the state HIE?

Mueller:  Yes, WISHIN is the Wisconsin State Health Information Network. We’ve been participating with them for about three or four years now. We were the first hospital in the state to work with them, to begin sending them live patient information to help work through a lot of the bugs. Our system integrator, Terri Ziebell, is a master. She has put in countless hours on this.

We participate with WISHIN certainly with the hopes of allowing patients to be able to get access to their information wherever they are in the state, so if they’re up north on vacation or whatever, those hospitals that participate in WISHIN would be able to query the exchange and be able to access their patient information. I don’t know as of today how many hospitals have signed up, but I heard that hospitals in almost every county are participating in WISHIN, so that dream will certainly, I think, come to fruition at some point in the future.

But right now, what we’re really utilizing WISHIN for is as our hub for our spokes, which includes the reporting for syndromic surveillance, immunization registry and other state lab reporting. Instead of having interfaces directly between our system and all those entities, we’re able to use WISHIN as that hub and spoke. That’s how I describe it. I think WISHIN — and not just them, but any HIE — will be more useful to the providers when it’s embedded into the EMR so that if a patient comes in the ER, the provider is in that patient’s medical record, and they can query the exchange and get that information brought in to them without having to go to a separate system. We’re not there yet, but it’s definitely coming. I’ve heard rumblings of it.

Gamble:  It’s an interesting thing to watch.

Mueller:  Yeah.

Gamble:  And now as far as LifePoint, are they on a different EHR system than you?

Mueller:  There are several different systems that are used throughout their 70-plus hospitals across the country, so there is not one standard.

Gamble:  So that probably works better than knowing that they were on a system and that you’d eventually have to switch to it?

Mueller:  And have to migrate — yes, that would definitely be a big challenge. But it’s been great working with them.

Gamble:  Anything else that we didn’t touch on just as far as priorities on your plate? I know there’s always a lot.

Mueller:  Well, just real quick, one of the other things I was thinking of is security. We are rolling out two-factor authentication for remote users. That’s something we’re doing to shore up who accesses our system and how they access our system. The intrusion protection and vulnerability management and monitoring — those systems are in place because just cybersecurity is such a hot topic right now, and we really want to make sure we’re protecting our patient information.

Gamble:  I would think that with you being with the organization for a while, you’ve seen that evolution of more devices and sites being accessed from different points. I’m sure it’s been a tough thing to adjust to.

Mueller:  Oh, yeah. People have, at minimum, three devices, and right now, our current EMR system isn’t quite tablet-friendly, but it will be. We want to make sure that we have as much security and protection in place as possible before we get there.

Gamble:  Now, with an organization your size, does security fall under your purview or do you have somebody assigned to that?

Mueller:  It does. Seth Hayden he is on our IS Department on the technical side, came to us from a large organization where that was his sole job. It’s been really great working with LifePoint on this topic because they have so much talent and resources in the whole security and cybersecurity area that it’s really allowing us to shore up our security on our side. And so Seth has been working with them directly on that project and those projects.

Gamble:  And that’s obviously an ongoing thing, there’s no security strategy that’s staying static.

Mueller:  Exactly.

Gamble:  I wanted to talk about your career path. We’ve alluded to it that you’ve been with the organization for a while and when did you start there?

Mueller:  I started in February of 1999, so in February I’ll have been here 17 years. I started here as the medical records coordinator back in 1999. My undergraduate degree is in health information management from UW Milwaukee, and so that’s how I started here.

Over the years I’ve had some opportunities that I participated in, and there was retirement, so I was given another title of director of medical records and medical staff services. As the years went on, I just kept getting more opportunities on my plate, and I determined that at some point I would really love to be in hospital administration. I knew I needed an advanced degree for that, so I went back to UW Milwaukee and got my MBA in 2005. The fall of that year, I was fortunate enough to be able to take the position of vice president and chief information officer. I’ve been CIO here at Watertown since 2005.

Gamble:  So it definitely has been a matter of working your way up and getting experience in different areas?

Mueller:  Yes. I’ve worn many different hats over the years.

Gamble:  I think that’s something that maybe gets lost sometimes because people will see a certain goal and want to work toward it, but maybe don’t realize that sometimes by taking on different responsibilities, it’s going to help get you there.

Mueller:  Absolutely. That is exactly what got me there. You volunteer for things. You say yes to things that you might not know anything about, but you figure it out. You get the eye of your boss and their boss and the CEO, the board chair, whoever, and that helps.

I have been responsible for the radiology department — and that’s a department I didn’t know anything about at the time, but in terms of being a leader and empowering people and working as a team, it works. You don’t have to be the line expert in order to lead, so I kept saying yes and taking things on, and today I oversee not only information systems but health information management and coding, and the medical staff office. I’m also the HIPAA privacy officer and the ethics and compliance officer.

Gamble:  You still have a lot of hats.

Mueller:  I still have a lot of hats, yes. They’re all definitely in my wheelhouse now, so that’s good.

Chapter 3