If Kathy Ross could offer one piece of advice to fellow CIOs — especially those who are new in the role — it’s this: don’t try to do everything on your own. That might mean finding a mentor, networking with peers, or just reaching out to others going through similar experiences. And in fact, one of the key advantages in being part of an organization like Ascension is the ability to share best practices, something that comes in handy when your team is replacing the acute and ambulatory EHRs at the same time. In this interview, Ross talks about how she balances the roles of CIO at both Sacred Heart Health System and Providence Hospital, the work her team is doing with Optum to give physicians “a clear picture,” and what she believes is the most difficult aspect of the EHR overhaul. She also shares her thoughts on change management, patient engagement, and leadership.
- Clinically-led projects — “We’re being totally transparent and inclusive.”
- Power of executive sponsorship
- “Leadership all the way down is committed.”
- From Allscripts to athenahealth in ambulatory
- Analytics initiative with Optum — “It will give us a clear picture.”
- The CIO’s challenge — “Projects don’t stop.”
LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED
One thing we’re focusing on is involvement; that this is not an IS project, this is a clinically-led implementation. The thing we have done in the past as CIOs is really focused on the technology, and whether we chose to do that or the organization put us in that place, it’s not really seen as collaborative.
We’re doing full workflow analysis to make sure we cover any potential gaps with the new system and make sure that the associates or end users are fully educated, prepared and knowledgeable about what’s going to happen.
The biggest challenge is trying to make sure that we have the clinical information to the caregiver at the site of where they’re delivering care.
We’re very excited about it because we’ve been on disparate systems for so long, and it’s been very, very difficult to try to get a clear picture of what’s going on with a patient. It’s a tool that I don’t think we fully understand yet how valuable it will be.
I’m not sure if that’s going to be the wave of the future yet. I know that managing the delivery of care is a focus — that it’s no longer episodic, but it is really focused on taking care of the patient from birth to death.
Gamble: Change management is a theme that comes up so often with the CIOs we speak with. What do you think is a good way to approach that and prepare users for that change?
Ross: The one thing we’re focusing on is involvement; that this is not an IS project, this is a clinically-led implementation. The thing we have done in the past as CIOs is really focused on the technology, and whether we chose to do that or the organization put us in that place, it’s the same thing — it’s not really seen as collaborative, that it’s being done more to them than with them.
The big thing we’re doing now is being totally transparent and inclusive. We’ve got the organization, from the executive sponsorship down, fully engaged and fully committed to the project, to the success of the project, and to ensuring that we have participation from the end-users, because they’re the ones who really know what we need. We’re doing full workflow analysis to make sure we cover any potential gaps with the new system and make sure that the associates or end users are fully educated, prepared and knowledgeable about what’s going to happen.
We have engagements from all departments, from all physician leadership. The great thing about it — understanding that this is their first month, so I’m sure we’re going to run into challenges — is that the leadership all the way down is committed to the success of this implementation. To me, that is something that has been totally unique to this project, and I think it’s because technology is here to stay and it touches everything in healthcare these days. No longer can people or management in general not be engaged in the technology, and we have great leaders that understand that.
Gamble: As far as getting clinicians involved, did you use certain committees or groups?
Ross: We used leaders, yes. We have what we call a playbook on the different types of roles that need to be involved and different types of subgroups, and so we have two people from the organization called transformational leaders that are working with management to identify the most appropriate people to work with the project.
So it’s very collaborative. We’re no different than other organizations; we’re going to run in and we have run into problems with being short-staffed, but we work with them to figure out what’s the best way. Do we have partial people on different days? It’s totally fluid, if you will. It’s something we work on, but it’s a challenge, and it’s a big commitment.
Gamble: What’s your strategy as far as ambulatory?
Ross: For ambulatory, we’re transitioning over to athenahealth. We’re currently on Allscripts enterprise and we’re moving to athenahealth, which is a hosted solution. The biggest challenge we have is the sharing of the information. Fortunately for both Mobile and Pensacola, we have a community HIE in Pensacola that we have integrated with Allscripts and with McKesson currently so that the information can be viewable from either location. And at Providence we have dbMotion that we use to help share the information. Perhaps the biggest challenge is trying to make sure that we have the clinical information to the caregiver at the site of where they’re delivering care.
Gamble: Right, especially as you’re going through all these periods of change.
Ross: Oh yes, constant change.
Gamble: And that HIE is set up through Ascension?
Ross: No. It started with the Pensacola Chamber, and it’s called Strategic Health Intelligence. Since then, it has gone private, but Sacred Heart has been one of the founding members of the HIE, along with Baptist Health System, in the community. And that’s been going on a while. We have a huge military population in our community, and so it started with a grant to help share data between the Navy and the hospitals within the community. It’s probably been 11 years since they’ve been working with sharing data.
Gamble: Now, obviously so much of the focus is going to be on the big replacement, but in the meantime, looking at things like analytics, what have you done so far or what do you hope to do?
Ross: We currently have a national project that we’re working on with Optum for analytics, and that project kicked off in February. So even though we’re changing out our ambulatory and we’re changing out our inpatient EHR, we’re implementing national analytics capability that we can use at the local level, projects don’t stop.
Gamble: Could you talk a little bit about the initiative with Optum?
Ross: Well, the great thing is it will help us to be able to give a clear picture and within our own walls, do better analytics on our population. We will have all of our Allscripts data and McKesson data, with the go-forward strategy of having all the athenahealth and Cerner data, so that we can do historical reviews. And we’re very excited about it because we’ve been on disparate systems for so long, and it’s been very, very difficult to try to get a clear picture of what’s going on with a patient. It’s a tool that I don’t think we fully understand yet how valuable it will be.
Gamble: Right. And as that starts to get implemented and all that data is put in there, the clinicians can really start to do some of that really interesting work and use that data for all the reasons that they’ve wanted to for so long.
Ross: Absolutely. Right now, we’re in the early world, like how it was when CPOE first started. Analytics in five years is going to change how we actually deliver care.
Gamble: And is there any accountable care organization or anything along those lines in your area?
Ross: We actually participate in the Medicare Shared Savings program. Across all four of our hospitals, we have about a little over 30,000 lines and we are also self-insured for our own associates, which is like an ACO.
Gamble: And what do you see happening with that in the next few years?
Ross: I’m not exactly sure where ACOs are going to land. I know for us it’s been a challenge, and I’m not sure what the future of it is. We, of course, are going to continue to participate, but I’m not sure if that’s going to be the wave of the future yet. I know that managing the delivery of care is a focus — that it’s no longer episodic, but it is really focused, especially within our market, on taking care of the patient from birth to death. It’s not so much episodic, so whether we’re participating in a true ACO, I’m not 100 percent sure, but I know that how we deliver care, we will be doing it more collaboratively and not so episodic.