For many critical access hospitals, the future looks bleak. They have the same list of priorities as health systems, but with a fraction of the resources. But Mt. San Rafael is not your typical rural hospital, and Michael Archuleta is not your typical leader. Since taking on the IT Director role four years ago, Archuleta has led the transformation from a paper-based system to a Most Wired hospital. In this interview, he discusses the enormous challenges faced by CAHs, how he’s changing the perception of IT from one of “cost center” to “business partner,” and what it took to implement the organization’s first IT strategic plan. Archuleta also talks about the value of young leaders, how he “sold” cybersecurity to the board, what he hopes to accomplish next, and why he won’t apologize for being an over-communicator.
- Partnerships with MedHost & YourCare Everywhere
- Achieving Most Wired — “Integration was a key concept”
- 30-minute huddles
- “To gain respect, you need to show results.”
- Learning from older leaders — “You always need to educate yourself”
- NetApp CXO Advisory Board
- Education through CHIME
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These groups have been amazing. We’ve been able to develop with them, learn with them, and give our thoughts on how can we improve the overall patient experience.
There are so many things we have going on in the background, it’s absolutely amazing. I’m extremely proud of this team and what we’ve been able to accomplish.
If you can show results and if you can get that recognition, you can really make a difference. And of course, if you’re making a difference with the patient’s life and the patient’s experience with utilizing technology to the fullest, you’ll gain that respect.
If you’re older and you think you can’t learn from a younger individual, in my opinion, you won’t be successful moving forward.
You still need to leverage yourself to the fullest. Get that exposure. Keep up with the trends, try to reach out, and obtain a mentor — a mentor that’s really going to help you and move you in that positive direction of improving yourself to improve the overall organization.
Gamble: When you talk about wearables, that’s not what a lot of people think of with a rural critical access hospital, but it just shows that there is a willingness there to really push the boundaries with technology, especially when it comes to the patients who have to be incorporated more into the whole picture.
Archuleta: Absolutely. Personally, I’m always the individual that likes being the first to try any new product, from being a beta site to trying the new hardware out that’s really going to improve our overall patient experience. In terms of really seeing what we’ve done with technology and leveraging it to the fullest, we’ve been able to partner up with our vendors. Medhost has been an amazing organization to partner up with, and YourCare Everywhere — these groups have been amazing to be part of. We’ve been able to develop with them, learn with them, and give our thoughts on how can we improve the overall patient experience and how are we improving patient experience through technology. So it’s really been a great partnership.
Gamble: You touched a little bit on Most Wired. Obviously that’s really a huge accomplishment for the entire organization. Can you just talk a little bit about what was the biggest challenge there and what it has meant for the organization to have that kind of designation?
Archuleta: Absolutely. Everyone’s aware of what Most Wired is. Most Wired is a nationally known recognition; it is a prestigious award to be given out to any organization. Some of the key concepts were infrastructure, business in administrative management, clinical quality and safety, and clinical integration. Most of the times you can get a little intimidated by those specific concepts, because you’re like, ‘we’re a small critical access hospital and we’ve done some amazing things with technology,’ but how are we really being measured?
From the infrastructure side with centralizing our overall network to improving with VDI, to improving with SSO, to really having everything in a central console to manage the overall network and the infrastructure — that has been huge. Business and administrative management, business intelligence, and our advanced reporting in analytics has been a huge improvement moving forward for Mt. San Rafael. We added all those specific concepts into the actual survey itself for Most Wired, really focusing on clinical quality measures that we were looking at internally here to really be the best we can be. How do we leverage the clinical quality measures within our EMR system to really determine that we’re capturing all these specific quality measures to improve our patient’s life?
Clinical integration is a huge thing. We’re talking about the Interoperability Roadmap for 2016. Sometimes when you look at different organizations, they have several different systems in place, but none of those systems are talking to one another. A big thing here was, how do we create that interoperability within our clinic and our hospital? As I’ve stated, we were one of the first critical access hospitals in state of Colorado to connect to the HIE. And it was pretty impressive, because we’ve been able to leverage some of our data across and get some shared information across all spectrums that are currently enrolled on that HIE portion. How are we utilizing clinical integration? How are we bringing in our ambulatory lab results over into our hospital site, and vice versa? How are we recreating an actual order between our ambulatory EMR to cross over into our inpatient EMR?
Clinical integration has been my number one key. Of course, we continue to improve and we continue to see what needs to be focused on integration wise, but integration is a key concept, and it was one of our key concepts in helping us be successful with this Most Wired survey.
Gamble: With something like that, how did you kind it to the team as something we want to achieve? How was that process from your perspective?
Archuleta: I sat down with my team — I have a morning meeting every morning. We have a 30-minute meeting every day; we huddle up as a team. We discuss issues and items from yesterday and that are ongoing today. I sat down with my team and stated that healthcare’s Most Wired that is a prestigious award. I said, ‘ladies and gentlemen, we have worked extremely hard as a team; as an organization. We need to see how we are getting these specific concepts in place.’ Because, honestly, it’s nice to get recognition, especially for all the hard work that you put into it, because critical access hospitals in rural America are basically left behind at times. Sometimes they’re like, Mt. San Rafael in Trinidad, Colorado? What is that? Where is that? What are they doing?
Once we get this type of recognition, we can really show the amazing things that we are doing as an organization with technology. Honestly, there are so many things we have going on in place in the background. It’s absolutely amazing. I’m extremely proud of this team and what we’ve been able to accomplish as a whole. So having that Most Wired prestigious award is such a huge booster for this overall organization and this team, because it showed that all the hard work was worth it in the end.
Gamble: Yeah. And it’s pretty clear from hearing you speak and hearing your philosophies that communication, obviously, is very important, but then also the whole idea of growing leaders. Is that something that can be a little more challenging when you’re younger? If you have people who are older than you, do you approach that a little bit differently?
Archuleta: I am the youngest director in all of the actual management team here at Mt. San Rafael Hospital. The thing is, though, to gain that respect, you really need to show results. If you can show results and if you can get that recognition, you can really make a difference. And of course, if you’re making a difference with the patient’s life and the patient’s experience with utilizing technology to the fullest, you’ll gain that respect.
As I’ve stated, all my staff members are a lot older than myself. I have an older RN on-staff too who is an amazing individual. It’s been amazing to really see him and try mentoring him to be one of the next leaders, and really trying to get some good concepts and good communication with one another. Because honestly, I learn from other individuals too. It’s amazing when you learn from one another how it makes an overall difference, because they see that they can learn from myself, and I can learn from them as well too. So having that overall concept and really accepting the concept of learning from one another is key. Because if you’re older and you think you can’t learn from a younger individual, in my opinion, you won’t be successful moving forward as a true leader.
Gamble: That’s a good point. It goes back to what you said though before about how age is just a number. What’s really important is having that engagement from the team and having that buy-in; that’s what you need as you go forward with all these plans and projects.
Archuleta: Absolutely, 100 percent.
Gamble: So the last thing I wanted to ask you was about your own continued development and what you’re doing, because we’re in an industry where everything is changing so quickly and there is so much to learn. How do you approach that?
Archuleta: The thing is, being in this position, being in technology, being in healthcare, you always need to learn. You always need to educate yourself. I am constantly Tweeting about the new healthcare trends. I’m always reading The New York Times, reading your publication — you guys do an amazing job in bringing some great information about healthcare IT and some of the amazing things some of these CIOs are doing. It’s a great thing to really leverage other individuals that are currently in your field. And getting mentors, that’s another thing. One of my mentors is still a great friend of mine too. He’s been an absolutely amazing individual, and I’m learning from what he has experienced as a CIO and what he continues to do.
I recently joined the NetApp CXO Advisory Board. That’s such a huge accomplishment, because I can actually collaborate with all these amazing CIOs that are currently a member of this board. I also really try to participate a lot in CHIME sessions. CHIME has been an awesome organization to be a part of, and I really think that in being a director and moving over into a CIO role, you still need to leverage yourself to the fullest. Get that exposure. Keep up with the trends, try to reach out, and obtain a mentor — a mentor that’s really going to help you and move you in that positive direction of improving yourself to improve the overall organization. And if you decide to move on eventually, you’ll have that in-depth knowledge of what it takes to be the next leader of healthcare.
Gamble: Right. A lot of really good stuff there. So I guess I lied, the final thing I wanted to ask you was if you think now back to when you first started there, could you have pictured things going this way, or do you sometimes shake your head just thinking about how much the organization has evolved in eight years?
Archuleta: Honestly, Kate, looking at where I stand today, I’m just like, wow. I’m in utter amazement of what has changed. From Meaningful Use to electronic medical record systems, all the changes happening in healthcare have been absolutely amazing. And it’s been amazing to be part of this actual journey. We’re pretty deep into it, and we’re just going to continue to ride it. We’re going to continue to be the best we can be, and really continue to leverage technology to the fullest. Because in the past, the IT department was your basic tech. Now looking at the new role of the CIO, these individuals are strategists. They’re business thinkers. They’re developers. They’re innovators. They’re really focused on the backbone of the organization. Really seeing the rise of the CIO role, I have loved it since the day it started, and I will continue to try to be the best I can be and continue to improve and really leverage technology to the fullest. I’m super excited of what the future holds.
Gamble: Great. Well, it’s been really interesting to hear about everything you’re working on and everything you’ve been through, and I really look forward to being able to speak with you more down the road.
Archuleta: Absolutely. And honestly, big kudos to your team. You do an amazing job with what you do and I appreciate all the information you push out there. So thank you very much for this opportunity.
Gamble: Sure. Thank you for your time, and I definitely look forward to checking back with you.
Archuleta: Sounds excellent, Kate. Have a great day.