There was a time when Tressa Springmann didn’t think she was well-suited to the CIO role, because she believed customer service, strategic alignment, and communication were just as much a part of the job as the more technical aspects like storage management and virtualization. Fortunately, she stayed the course, and the role has evolved into more of a strategic leader than an IT leader.
In this interview, Springmann talks about the challenges she faced when created a data governance strategy, why having repeatable processes is critical, and why she believes digital health “is a function of the CIO role.” She also talks about the importance of persistence when driving change, how she’s working to balance stability with growth, and why CIOs need to encourage “the messiness around innovation and change.”
- Creating Centers of Excellence – “You can’t do that when you have silos.”
- The rapidly changing value-based care environment
- “It was a lot of hard work, duct tape and bailing wire, and human effort.”
- Keeping an eye on the goal while “learning as you go”
- Data governance – “It’s a forever journey.”
- Importance of persistence
The value-based care environment is changing so quickly. You need to rely on good governance and leadership relationships to keep things very nimble. It’s not like going out and getting a patient accounting system. It’s a highly evolutionary process.
You need to start with the end in mind while also learning as you go. With value-based care, you’re going to have a lot of interim point solutions or activities, but you always need to be mindful of what the long-term investments might be as the tools mature and as the program takes shape.
Persistence was key. And when circumstances occurred where a different maturity in this area might have helped us, it was continuing to put it in front of the organization. A lot of it is just about knowing what needs to happen, and poking the bear until the bear reacts because the timing is right.
You bought the EMR, you stood up different committees, and you brought in the right skills. And then after you went live, you needed a sustaining structure. That same flywheel of activities needs to occur to mature any new initiative that we’re trying to accomplish.
Gamble: Hi Tressa, thank you, as always, for taking some time to speak with us. It’s been a few years since we spoke. I looking forward to hearing about what you’ve been up to. In terms of the EHR environment, you have Cerner in the hospitals and in the physician practices?
Springmann: Yes. That’s our predominant tool, but we have other systems as well. We’re migrating one of our hospitals off of McKesson Paragon onto Cerner, and we have other EMRs in our clinically integrated network along with our physician practices.
Gamble: And the goal is to eventually have a truly integrated system?
Springmann: Over time, we want to create Centers of Excellence across the organization that are appropriate for the communities we serve. This way, we can better inform what specialties we need and where, and we can more effectively offer a complete menu of services those communities. You really can’t do that when you have silos, especially in shared geography, and when you’re dealing with communities that are contiguous.
Gamble: Tell me about the ACO that LifeBridge has in place, and what you’re doing in that area.
Springmann: We two have ACOs. One is at Carroll Hospital Center, and one is the LifeBridge Health ACO. The latter is now in its third year. We saw significant shared savings in both of the first two years — it was all upside. Last year, I believe we were rated 18th in the country. The Carroll ACO is much more mature. They’ve already recouped a lot of the early dollars that were spent on the infrastructure, and so they haven’t had significant financial payouts.
Gamble: Let’s talk about value-based care. Although it’s important to have the right set of tools, there are other factors that are just as (if not more) important. What are your thoughts around what it takes to move toward value-based care?
Springmann: The industry has been evolving so quickly, and the IS organization is very much used to the business saying, ‘here are our requirements. Figure this out or buy something that will help us with this.’ It’s not easy, because the value-based care environment is changing so quickly. You need to rely on good governance and leadership relationships to keep things very nimble. It’s not like going out and getting a patient accounting system. It’s a highly evolutionary process. And I don’t just mean in what we do, but also in how we address a lot of the short-term needs while making an appropriate long-term investment.
I’ll give you an example. For a lot of our value-based care activities, including ACO reporting, the long run is to stand up fully integrated registries with the EMR; and the short run is abstraction. You need to start with the end in mind while also learning as you go. With these value-based care programs, you’re going to have a lot of interim point solutions or activities, but you always need to be mindful of what the long-term investments might be as the tools mature and as the program takes shape.
In the last few years, we were pretty successful, but it was a lot of hard work, duct tape and bailing wire, and human effort. As we were learning, it helped us inform some better investments in registry, EDW, and enterprise care management that we needed to make. Now, we could have gone and bought multimillion dollar solutions that were not necessarily completely market-ready two years ago, and IT would’ve been saddled with a tool that may not have been fit for the program. It’s very iterative and very evolutionary, and it requires a lot of time and attention and interaction between the strategy for your value-based care and how you’re going to execute on the strategy.
Gamble: Right. So it’s not just about having the right processes, but being willing to adjust them as needed. What about the data governance piece?
Springmann: Data governance is extremely important. When I came here four years ago, people didn’t really want to talk about it, because they didn’t understand it. Two years ago, people started to understand it, but it was still very difficult to create the appetite for the hard work it takes to have detailed discussions about metadata, data stewardship, and a line of sight between data acquisition and use. That’s going to be a forever journey and I think we can learn a lot from other industries that have moved forward.
I think a lot of us are struggling with the change management exercise where the reporting skills, analysis, and data acquisition are repurposed, and we have the ability to put tools in the hands of others for their own service line-embedded decision-making, rather than just expecting IS to fulfill a report and request function. It’s a process and it’s very important, but it’s very difficult to implement, for sure.
Gamble: You talked about the challenge of creating an appetite for the hard work required to set up data governance. How were you able to get past that?
Springmann: Persistence was key. And when circumstances occurred where a different maturity in this area might have helped us, it was continuing to put it in front of the organization. A lot of it is just about knowing what needs to happen, and poking the bear until the bear reacts because the timing is right. People spend a lot of money doing the wrong things because they’ve read about it, or their competition is doing it, or they think it’s the right thing to do. In my mind, good leadership is knowing what needs to be done, and making sure you strike when there is organizational readiness to be effective. And sometimes, that means you need to just be persistent and keep at it.
Gamble: Along with making sure the organization is ready, I imagine leaders also need to have a blueprint they can follow to ensure an initiative is successful.
Springmann: Absolutely. With any new area of opportunity, there’s the strategy, followed by identification of the tools. Those tools might be technologies; they might be governance. And then you need to identify the right talent or skills, as well as leave-behind structure. When organizations didn’t have an EMR, the strategy was, we have to do all these things clinically, and so the tactic was, let’s go get an EMR. So you bought the EMR, you stood up different committees, and you brought in the right skills. And then after you went live, you needed a sustaining structure. That same flywheel of activities needs to occur to mature any new initiative that we’re trying to accomplish.
Two years ago, our strategy was around value-based care and population health. Last year, we put into place the governance and made some investments, and this coming year, we’re starting to bring in some new skills and structure. We also identified a strategy that drove new technologies emphasizing the use of telemedicine. So again, there was a strategy, then we implemented governance and tools, and now we’re trying to define a sustainable infrastructure that will enable us to grow our telemedicine program.
The next thing on the hill is digital health. We have a strategy that’s in its infancy. There’s a lot of activity, but there’s no informed strategy. And so it’s this iterative waves — population health, telemedicine, and digital health. That’s where we are right now.
Chapter 2 Coming Soon…