Robin Sarkar, PhD, CIO, Lakeland Regional Health System
When it comes to retaining top talent, many organizations are missing the point, says Robin Sarkar, who believes the key is to focus less on annual performance reviews and more on meaningful dialogue. What that means, says Lakeland Regional’s CIO, is asking questions that focus on where employees want to go and how leadership can help them get there. In this interview, he talks about how this strategy has helped strengthen his team, as well as the work they’re doing to bring data closer to the point of care and push population health forward. Sarkar also talks about why innovation can’t happen without failures, and what it was like coming to healthcare from the business world.
Chapter 2
- Key enablers for technology: leadership support & talent
- “Once in a while, you will stumble.”
- Turning failures into learning experiences
- Working “hand in hand” with clinicians
- Population health & the “cultural change”
- Patient engagement — “We have a lot of catching up to do.”
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Bold Statements
They work with us hand in hand from the design through execution and testing, so it’s not an IT project coming out of a box.
We consider Lakeland Health to be a learning organization, and so it’s really important is to make sure that we learn — not only in smaller groups, but that we translate this learning enterprise-wide so that we can all learn from specific incidents.
Population health moved the focus from healthcare to trying to remain healthy in the community, from working with people within our control to working in the community.
How, through technology and through Healthy Planet, can we locate our high-risk patients who have cardiac challenges or diabetes or other chronic diseases, catch them early, and make sure they continue to stay on the healthy path?
When you look at the way the healthcare industry engages its patients compared to other industries, we still find ourselves needing to run a little faster in terms of how to get patients more involved in their treatment and their health, and how to make medical records as simple for you and me to access as it would be to access your bank record.
Gamble: When you think about the philosophy that Lakeland has when it comes to technologies, the organization seems to be willing to pilot different things. I would think along with that comes not having a fear of failure. What’s your philosophy in that regard?
Sarkar: That’s a great point, because when you try new things, once in a while you will stumble. There are two key enablers for technology at Lakeland. Number one, which I find really unusual and certainly beneficial for a CIO, is strong leadership support. From our CEO, throughout our leadership team, there’s tremendous support of technology around our leadership table. In fact, our CEO Dr. Loren Hamel attends the Epic conferences and attends many technology events. He considers technology a key enabler for healthcare.
The second important enabler for us at Lakeland Health is talent. We do a lot to make sure that we have absolutely the best talent in our in-house IT team to make sure that we can provide the best support for our clinical folks. We do sometimes have setbacks and failures.
One of the ways we try and mitigate it is by ensuring our clinicians are involved. We have an innovative program called 3C where we have 12 or 15 physicians who are involved with us in their respective areas, whether it’s an ED physician, a radiologist, a primary care physician, or surgeons from different areas. They work with us hand in hand from the design through the execution and testing, so it’s not an IT project coming out of a box where, at the end, we take off the shrink wrap and flip the switch. We certainly try to avoid that.
The second thing is we do a lot of piloting. As I mentioned with our initiatives to push information to the point of care, we pilot very carefully before we roll it out. At the same time, I don’t want to say we don’t have failures and learnings. Recently, we did have a radiology project in which we did face some severe road bumps and part of that was due to inadequate change management by our team with the radiologists and clinicians. We’ve learned from that and we expect to do better next time.
Gamble: Right. I would think that being transparent can go a long way toward not making the same mistakes in the future, and also letting people know that is something fails, let’s learn from it.
Sarkar: That is correct. We do consider Lakeland Health to be a learning organization, and so it’s really important is to make sure that we learn — not only in smaller groups, but that we translate this learning enterprise-wide so that we can all learn from specific incidents.
Gamble: Right. Now, you mentioned before that Epic’s population health module is being used as well.
Sarkar: Yes, that is correct. Epic has a population health module called Healthy Planet and while I can’t say we’re early adopters, we are near-early adopters of that module.
Gamble: What type of work are you doing with population health at this point?
Sarkar: In terms of what we’re doing, first I would say that the key challenge Lakeland Health is wrestling with in population health is not so much technological but cultural. We’re a health system with a long history. When people get sick, we make them better, and we’ve been doing this for more than 120 years in our community. Population health moved the focus from healthcare to trying to remain healthy in the community, from working with people within our control — which is through our hospitals and clinics — to working in the community.
This has been a big cultural challenge for Lakeland, and we’re continuing with that challenge. In fact, three years ago, we changed our name from Lakeland HealthCare to Lakeland Health; we want to focus on keeping folks healthy, not just waiting for them to get sick and then trying to work with them to get back to health. This has been the first major cultural challenge for our 4,500 folks in population health.
Gamble: It’s such an interesting time because there’s been such an evolution in recent years in the way patients engage and the role they’ve taken in their care. I imagine that that hasn’t been an easy adjustment.
Sarkar: That’s absolutely correct. One of the big adjustments we’ve had to make as we look at population health is to a certain extent, our healthcare system — like other healthcare systems — is structured vertically. You’re born in a hospital, and you continue life. If you get sick, you come into hospital. You lead a good life, and then at the end, sometimes you need hospice services which Lakeland Health provides.
We have always worked vertically. What we’re now trying to do is look at it horizontally and say, how can we look at a patient throughout the patient’s life? Secondly, how can we start working with our community organizations focused on aging, with our county health departments, and with our mental health organizations so that through preventive health, physical health, and mental health, we can all work together to keep our community folks happy and healthy?
No doubt this is an organizational and cultural challenge, because it’s not possible for a health system to always control what a person does and how he or she leads their life.
Gamble: Right. Now, as far as things like wearables and information patients gather themselves, is your organization looking to incorporate that?
Sarkar: Yes. We have explored it and we have worked with a couple of well-known, reputable organizations to see if we can pilot that. I would say most of our current focus in population health — and we’re in early stages of this, like many other health systems throughout our country — is to try to focus on the high-risk patients. How, through technology and through Healthy Planet, can we locate our high-risk patients who have cardiac challenges or diabetes or other chronic diseases, catch them early, and make sure they continue to stay on the healthy path? Because these patients take up a very high proportion of healthcare costs, whether through us or through insurance.
We’ve explored wearables in our inpatient setting. Of course we have done some work in home care where there are monitors, and we can keep track of some of the patient vitals where they are at home.
One of the interesting areas which we are thinking of — and we haven’t started yet — is in the inpatient area, where instead of a patient being tied up with tubes and connected to multiple machines, they can use wearables. This provides the patient some mobility while ensuring that the nursing staff can keep track of their vitals. But honestly, we’re in early stages of leveraging that technology at this time.
Gamble: I don’t think anybody has gone beyond that, at least not that I know of. Okay, so we’ve already discussed a lot, but is there anything else that you consider a key priority in the next year or so?
Sarkar: I would say one of the priorities we need to look better at is how we engage our patients. When you look at the way the healthcare industry engages its patients compared to other industries, we still find ourselves needing to run a little faster in terms of how to get patients more involved in their treatment and their health, and how to make medical records as simple for you and me to access as it would be to access your bank record or any commerce website.
I would say one of the big challenges for us going forward is certainly the patient engagement area, along with telehealth and video visits, all of which we have started. We’re working on that and we really look forward to accelerating that in the next couple of years, but as a customer of other industries, I do feel we have a lot of catching up to do in this area.
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