Scott Vachon, Director of IT, Littleton Regional Hospital, Chapter 1

Like any health IT leader, Scott Vachon has quite a few burners going, whether it’s leading his team through a major transition, crafting an effective cybersecurity strategy, or the ever-evolving quest to improve user experience. And although all of these areas are exciting, what he loves most about his role is “creating future leaders.” Vachon, who has had the opportunity to learn from industry icons like Liz Johnson and Tim Stettheimer, is giving back by offering his services to others in hopes of helping them to reach their goals.

In this interview, Vachon talks the key role leadership has played as Littleton Regional has become part of North Country HealthCare, how they’re working toward the goal of providing a “holistic community support system,” why he’ll never be satisfied when it comes to cybersecurity, and what he learned during his time with the US Marines.

Chapter 1

• About Littleton
• Becoming part of North Country HealthCare — “We’re going to be stronger together.”
• Leadership buy-in — “They’ve allowed us to invest in building our team.”
• Keys to a successful transition
• Shrinking the infrastructure & footprint
• Mobility for staff — “We want to offer simplicity.”
• “Defensive and offensive” approach to cybersecurity

LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED

Podcast: Play in new window | Download (Duration: 13:23 — 12.3MB)

Subscribe: Apple Podcasts | Spotify | Android | Pandora | iHeartRadio | Podchaser | Podcast Index | Email | TuneIn | RSS

Bold Statements

We want to offer simplicity. Our goal is always to make sure that the computers and applications disappear into the background and patient care comes to the foreground.

How do we provide a better outcome and a better care delivery system for those patients that are more challenging to keep in the healthcare system? We’re seeing some success right now, and we believe analytics is going to give us greater success moving forward.

We look at it as a holistic community support delivery system. Whether it’s mental health services, recovery services, or traditional healthcare services, they’re all important to the outcomes of our community. And they’re important in terms of us being able to supplement each other and provide the services that any one organization might not be able to.

Our executive leadership sees this as an investment in the business, and an investment in the patients. Instead of looking at it as an expense that doesn’t really have a return, they see it as a definite insurance for patients, and for staff.

Gamble:  Hi Scott, thank you so much for taking some time to speak with healthsystemCIO.com.

Vachon:  It’s great to be here.

Gamble:  To get things started, can you talk about Littleton Regional — what you have in terms of hospital beds, clinics, and where you’re located?

Vachon:  Sure. We’re a 25-bed critical access hospital located in Northern New Hampshire. We have a handful of practices associated with us, and we work with a number of community partners. In addition to that, we’re part of a four-hospital healthcare organization called North Country HealthCare, which also includes a home health and hospice agency. We’re taking care of the population of Northern New Hampshire and some of the folks in Vermont as well.

Gamble:  As far as North Country HealthCare, it looks like that came together fairly recently?

Vachon:  Yes. I think we’re about three years into the affiliation, but the real work has begun in the last year or so, in terms of building the framework for how we’re going to move ahead together, setting out our initiatives, and figuring out how five organizations can work as one.

Gamble:  I imagine that’s not an easy feat. Can you talk about what that has entailed as far as getting different organizations together to build a framework?

Vachon:  The first part was to acknowledge that we’re going to be stronger together, then it was meeting to figure out what are the core projects we want to target, and how can we improve the healthcare outcomes of the patient base in Northern New Hampshire. From there, it was establishing new leadership for the affiliation in terms of care delivery, IT, and patient financial services. All of that has been put in place.

Next, it was establishing the teams and the schedules in which we would work together to build unity and build on our combined strengths for our patient population. I think we’re making good progress on that. We’re establishing the base of trust that is needed to move forward, and I think patients are seeing good outcomes.

Gamble:  At this point, do the hospitals that are part of North Country HealthCare operate somewhat independently? How would you characterize that?

Vachon:  In the beginning, yes, they were somewhat independent. I think we’re all looking forward to being under the North Country HealthCare umbrella and being identified as one organization that’s providing quality services to the patient base. And so the independent identities are still there somewhat, but we really want to be seen as the one premier provider of healthcare in Northern New Hampshire.

Gamble:  You mentioned new leadership for the affiliation. Is there a CIO who sits on top of North Country?

Vachon:  In terms of IT, there is one senior director of IT. He leads and chairs the board and the initiatives for us. The rest of us support his initiatives and help fill in and carry the weight alongside him.

Gamble:  As far as your own team, have you been able to keep most of the core together through the transition?

Vachon:  Yes, and it’s been great. In fact, we’ve added a couple of people to our team recently. The leadership in our hospital in particular is very dynamic and very forward-looking. They’ve allowed us to invest in building our team in an effort to build on better patient care outcomes and to put ourselves — and the organization as a whole — into a better financial position.

Gamble:  I can imagine it’s important to have that stability when you’re going through a transition.

Vachon:  Absolutely. The important part is to communicate, communicate, communicate. Let people know what their role is going to be in the organization, why it’s important that the organization invest in them, and to continue to tell them that their role in building out the future of North Country HealthCare is vital; this is what we have going forward, and this is your part in it.

Gamble:  Right. Now, what type of EHR system do you have in place at Littleton?

Vachon:  We use the McKesson Paragon EHR, and we use eClinicalWorks for our practices.

Gamble:  So the big question is, are there plans for all of the hospitals under North Country to be on the same EHR eventually?

Vachon:  I definitely think that’s part of the plan. In terms of better patient outcomes and better patient care, it has to be done. No decision has been made yet, but we’re looking forward to the process and looking forward to, again, working as one.

Gamble:  Right. What would you say are the biggest initiatives you and your team are focused on right now?

Vachon:  We’re looking at a change in how we do our infrastructure in terms of VMware and hyper-convergence. We’re looking to be more mobile, and have our platforms be able to move to the cloud and back as usage demands. We’re trying to leverage a cloud infrastructure to lower our costs, because obviously if we can lower costs, we can provide patient care at a more affordable rate. We’re trying to shrink the infrastructure, shrink our footprint, and reduce overall cost in terms of capital, and hopefully, operating costs as well.

We’re looking at more mobile desktops, which means virtualizing desktops, reducing our costs for hardware infrastructure in terms of PCs and laptops, and giving our physicians and our support staff the ability to work at any of the organizations that are part of North Country HealthCare. We want to make it easy for them to have their desktop or applications right at their hand, where they need it and when they need it.

Gamble:  Was there a lot of demand for that type of accessibility?

Vachon:  It’s about simplicity. We definitely want to offer simplicity. Our goal is always to make sure that the computers and applications disappear into the background and patient care comes to the foreground.

And so we watch what the rest of the industry is doing. We wait and see when it’s really firmed up and it’s a good direction to go in, and then we make our investment based upon the strategy we have as an organization. We feel pretty confident in the direction we’re going. We aren’t rushing it — it’s certainly planned out, but we’re confident when we make those decisions.

Gamble:  And this process has already started, as far as reducing the infrastructure?

Vachon:  Yes. We’ve been working for a number of years on reducing the amount of equipment that we have in our data centers, which of course saves us on cooling and saves us on electricity. We’re happy to do that because it translates to better cost advantages for patients and for the organization.

Gamble:  What are some of the other priorities on your plate?

Vachon:  Our goal is always to support North Country HealthCare overall and make sure we support initiatives to communicate better. We’re looking at analytics for our CCO and ACO organizations — how do we provide a better outcome and a better care delivery system for those patients that are more challenging to keep in the healthcare system? We’re seeing some success right now, and we believe analytics is going to give us greater success moving forward. It’s really something you have to do, and so we’re excited for the journey.

Gamble:  I imagine a big part of the move to become North Country HealthCare is about having better care coordination and being able to take care of patients outside the hospital walls in a more efficient way.

Vachon:  Absolutely. It’s following them all throughout their lives, throughout the whole care continuum. We’d like to get our community members in as early as possible. We’d like to make sure we’re keeping up with them, and make sure that after they’ve left our facilities, we’re following up and making sure they have the support and the resources they need. We have great community partners that are helping us to do that. It’s exciting to take our partnership that we have with the other hospitals and the FQHCs — home health and hospice, especially — and see how we can provide better outcomes.

Gamble:  When you talk about community partners, are you talking about organizations that are also not necessarily traditional healthcare facilities?

Vachon:  Absolutely. We look at it as a holistic community support delivery system. Whether it’s mental health services, recovery services, or traditional healthcare services, they’re all important to the outcomes of our community. And they’re important in terms of us being able to supplement each other and provide the services that any one organization might not be able to. As a group, we can provide everything that’s needed right in our community locally for our patient base.

Gamble:  Right. Now, as far as the IT teams at the other hospitals, do you communicate with them fairly often? How is that structured?

Vachon:  Yes, we do that through the North Country HealthCare leadership — we’ve got some solid people in there. We meet on a regular basis. Sometimes, we just pick up the phone and call each other. That’s usually the easiest way to get things done. We’re finding the strength that we have inherent in our groups. We’re quickly becoming one team, and with the things we’ve worked on, the outcomes have been tremendous. The turnaround has been great. We have a lot of great people. We’re very lucky to have them locally, and have them working as part of our teams.

Gamble:  Right. Now, what are you doing as far as cybersecurity? Do you reach out to other organizations?

Vachon:  We are heavily invested, and wisely invested, in cybersecurity. We take an approach that is defensive and offensive. We don’t assume we won’t be attacked; we assume we will be attacked. And so we’ve implemented multiple layers of security, whether it’s the computer itself, our backend systems, or the perimeter. We cover most areas, but most importantly, we focus on our staff. We run continuous security training for our staff, with modules they have to complete every month. We can see who has completed it and who hasn’t and provide remediation, and we can also attest on our own to make sure they’ve learned the lessons they need to learn. We’ve had tremendous success with our staff picking up on malware, viruses, phishing scams, whaling scams. You name it, we’ve seen it, and our staff has been great at stopping it.

And so I’d like to say we’re satisfied with what we have, but we’re never really satisfied. The challenge of cybersecurity is as soon as you’ve figured out how to prevent one type of intrusion or attack, a new one comes up. So we’re continuously learning, continuously talking with the security community, and working with federal and state government to make sure our patients and our staff are protected at the highest level.

Gamble:  I’m sure at this point most people understand the importance of it and the implications of going through a breach, but because people have so many priorities on their plate, can it still be a challenge to make sure that there’s enough focus on it?

Vachon:  I think it can, but it’s about talking about it continuously. Every time you meet with the executive team, you have to mention what you’re doing in terms of security, what you’re seeing, and what we have to be aware of. It’s keeping that message front and center for everyone to pay attention to it. I think where we’re lucky is that our executive leadership sees this as an investment in the business, and an investment in the patients. Instead of looking at it as an expense that doesn’t really have a return, they see it as a definite insurance for patients, and for staff. And we’re proud to be out in front of healthcare organizations with what we’re doing. We’re happy to talk about it with our peers to help them get to where we are and talk with them about what we’re missing, what can we do better, what can we do more efficiently in terms of security, and how much should we be investing.

It’s hard to talk about security because you don’t ever want to say too much about what you’re doing. But in the right atmosphere, in the right conversations with people, you can really help the whole industry get themselves in a better place.

Chapter 2