Skip Rollins, CIO & CISO, Freeman Health System, Chapter 1

When it comes to partnering with vendors, there’s one thing a CIO needs to keep in mind: if it isn’t working, you must be willing to walk away. Skip Rollins has done just that, but he’s also been involved with co-development projects that have been very successful for both parties. The key, he says, is putting trust in each other. In this interview, the CIO of Freeman Health System talks about the pros and cons of partnerships, along with the major decision his team faces in selecting a core EHR vendor, one that he believes can’t be made in a vacuum, and can’t be rushed.

Rollins also opens up about his past experience in consulting and why he decided to return to the CIO world, how his organization is dealing with recruiting challenges, and why he believes continuous learning is a critical component of the health IT leader’s role.

Chapter 1

• Freeman’s 3-hospital system: “We see ourselves as a cornerstone of the community.”
• Working in a multiple-vendor environment
• EHR selection process — “We’ve done a thorough vetting of the market.”
• Setting a goal for end of 2017
• “Knee-jerk reaction decisions rarely turn out well.”
• Patient flow initiative with TeleTracking — “It’s all about maximizing our resources.”

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Bold Statements

We see ourselves as a cornerstone of the community, and that’s not always the same when you get into larger metropolitan health systems where everybody has a little piece of territory staked out.

We’ve done a thorough vetting of the market. We’ve done cost analysis for the three big players and have looked at both 5- and 10-year TCOs to make sure that we understood the full impact of doing business with any of them. We’ve analyzed the numbers. And honestly, we’re struggling

Knee-jerk reaction decisions very rarely turn out well. You’re much better off to vet it and understand the implications in the long term. And it’s frustrating for folks when you’re deliberate about your decision-making, but the prudent thing to do is to make sure that you understand everything around you before you make an important decision

We wanted to make it so that the departments were owning the schedules, and if there were changes to be made, they were made with the department and we were simply the people that pushed the button to make the alert.

Gamble:  Hi Skip, thanks for joining us today. I think the best place to start is by providing some information about Freeman Health System — what you have in terms of hospitals, clinics, and where you’re located.

Rollins:  Freeman Health System is a community health system. We’re located in Southwest Missouri, in an area that generally is called the Four State Area because Arkansas, Oklahoma, Kansas and Missouri all come together in a very close vicinity. We pull customers from all four areas. We’re a three-hospital health system with just under 500 beds. We’re a regional health system. We draw customers from generally about 50 to 60 miles around us. Freeman has been open and been in this area since the 1920s, and they like to say that they’ve never shut their doors. It’s what I would consider to be a very typical community health system.

Gamble:  As far as being a locally-owned organization, what does that mean from your perspective?

Rollins:  Profitability is always important, but it’s not as important as being a good steward of the community. And Freeman is the largest employer in Joplin. Therefore, we see ourselves as a cornerstone of the community, and that’s not always the same when you get into larger metropolitan health systems where everybody has a little piece of territory staked out. We see ourselves as the healthcare provider for a large geographical area and actually a pretty large population of patients.

Gamble:  Now being in that Four State Area where you have patients from other states, how does that work? Do you have partnerships with other organizations?

Rollins:  I wouldn’t say partnerships as much as I’d say working relationships, because we exchange patients with several of the health systems — one is Springfield, which is to the east of us, and we also do a lot of patient exchanges with Children’s in Kansas City, and we do a lot with Integris in Oklahoma. We don’t do much to the south of us, but we are entering into partnerships where we can be referrals for each other. We exchange patients when it makes sense geographically, or if it’s a specialty that one or the other of us may not have, it’s not unusual at all to see patients move in between the facilities.

Gamble:  Okay, but Freeman doesn’t have any formal affiliations.

Rollins:  We don’t.

Gamble:  And in terms of the EHR environment, are you using Meditech in the hospitals?

Rollins:  We are, yes. In fact, I just left a meeting where we talking about our EMR. We actually have five that we have to deal with. We’re on Meditech in the hospitals, and we use GE Centricity in our clinics — Freeman has a very large population, just under 70 clinics now in the Four State Area. And we have a third one, Avatar, in our behavioral health. We have a wide variety of systems, and that’s the reason why our number one initiative from an organizational perspective as it relates to technology is to get to a single EMR.

Gamble:  Right. And what phase of the discussions are you in now? Is it pretty early in the game?

Rollins:  No, I would say it’s late in the game. We’ve done a thorough vetting of the market. We’ve done cost analysis for the three big players and have looked at both 5- and 10-year TCOs to make sure that we understood the full impact of doing business with any of them. We’ve analyzed the numbers. And honestly, we’re struggling with some of the numbers because of their size, but we continue to have ongoing discussions with all three of the vendors. With Meditech being the incumbent, we continue to have very strong negotiations or discussions with them, but the tool they are indicating would be best for us is very, very new, and it’s still not widely deployed in the market. And so we’re a little pensive about getting onboard with that tool.

Gamble:  That’s understandable. And I don’t know if you can even answer this, but we’re starting to see more hosting models. Is that something Freeman would look into, as far as being hosted by another organization, or is it something you’d rather stay away from?

Rollins:  We certainly have talked about it, but we feel that Freeman is a little too large and a little too diverse in the specialties and our needs from the systems to exist and be happy in that environment. We know there’s health systems our size that do it, but we feel that because of the kind of things that we need to do here, we might be encumbered if we were on a system piggybacking off someone else’s build.

Gamble:  Right. So I guess the big questions is at what point do you hope to move to a decision?  It’s never an easy one.

Rollins:  No, it’s not. Freeman is a fiscally very conservative company. It’s the reason why Freeman has made it for the period of time they have. They don’t make decisions like this in a vacuum. They certainly don’t rush into decisions that are nine figures when you look at them. So I would say our goal is to get a decision made before the end of this calendar year or very early next calendar year. But it will only be made when we’ve completely and thoroughly vetted all of our options and made sure that we understood all the implications of the decisions.

Gamble:  Right. That certainly seems like a sound approach not being up against what are sometimes unrealistic deadlines.

Rollins:  From my perspective, Kate, I’ve been in IT business a long time, and knee-jerk reaction decisions very rarely turn out well. You’re much better off to vet it and understand the implications in the long term. And it’s frustrating for folks when you’re deliberate about your decision-making, but the prudent thing to do is to make sure that you understand everything around you before you make an important decision like this.

Gamble:  Okay. So you have Meditech in the hospitals at this point — are there different versions?

Rollins:  No, it’s just one. We’re all in the same instance of software — 6.08, which is the predecessor version to the 6.1 portfolio. And all three hospitals are on the same software.

Gamble:  Okay. Now, looking at some of the other things you’re working on, I want to talk about some of the initiatives Freeman has in place for improving patient flow and throughout the organization. In terms of the primary goal, I imagine that as a community hospital it’s always a goal to make sure you’re getting the most out of the resources that you have and trying to make things as efficient as possible. Was that the mindset going into this project?

Rollins:  Absolutely. It’s all about maximization of our resources. Patient management and patient flow is important because we can’t afford to have people sitting around in the room all day waiting to get discharged when we have people in the ER waiting to go into that room. And managing that flow, making sure we’re efficient when we move the patient around, and making sure that everyone is aware of the need to be efficient is super important for us, because we run a very high census. We need to make sure that the folks that need to be in the hospital are in the hospital and the ones that are ready to go home have gone home.

Gamble:  Right. So the work you did with TeleTracking was partly focused on automating that switchboard process and making it easier to manage call schedules and things like that.

Rollins:  Yes. That’s been a great win for us in IT. We have worked very hard to make sure that we’re not an encumbrance, but an enabler. The process that was in place before we partnered with TeleTracking was very manual. It was time-consuming. It took a long time sometimes to be able to make sure we contacted all the people. They had to check the schedule and make sure there was no changes, and so it was very labor-intensive, leading up to making the phone call to notify the particular team that needed to be brought in or for any other things that they might be called about.

We wanted to make it so that the departments were owning the schedules, and if there were changes to be made, they were made with the department and we were simply the people that pushed the button to make the alert. We didn’t want to have to figure out who would switch shifts with who, and who was on this week or who was out of town. We just wanted to be able to make sure that the right people got contacted. So we sat down with the stakeholders in the hospital and we explained to them what we were trying to do, and everyone thought it was a good idea. So we executed with TeleTracking and it’s turned out to be a very good thing.

Chapter 2