When you’re a military-based health IT leader, one of the biggest challenges is to identify initiatives that align with the overall organizational strategy — and can be completed within a specific timeframe. Not an easy feat, but any means. For Lt. Col. Chani Cordero, who spent three years as CIO with the US Army’s Information Management Division and Medical Education Training Campus, that project involved a concept that hasn’t yet made its mark in healthcare: gamification.
That could soon change, says Cordero, who believes gaming has enormous potential as both a learning tool for medical students and a motivating factor in patient engagement. In this interview, she talks about how she incorporated gamification into her strategy and how it can be so beneficial. Cordero also discusses the military’s ultimate goal of standardizing IT systems, why it’s critical to bring naysayers into discussions, and what she has learned in her time with the Army. [**Please note that the opinions expressed by Lt. Col opinions are her own, and are not endorsed by the Defense Health Agency or the U.S. Army.]
- Military Health System’s reorganization to “determine the best strategy to eliminate duplication.”
- 4 components of the METC
- Getting bogged down in ‘day-to-day’ tasks
- Strategic planning – “I make sure an initiative is nested into the strategy of the organization.”
- Exploring different learning modalities
- Leveraging competition to increase engagement
- “It’s not about a game. It’s about making people change their behaviors.”
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When I look at an initiative, I make sure it’s nested into the strategy of the organization. But I’m also a realist, and so I need to ensure that I have initiatives and goals that support our strategic plan, but also can be done within the timeframe that I’ll be here.
We want to make it engaging for students and bring out that intrinsic value where they aren’t sitting there flipping through 100 pages of PowerPoint secretly wishing they were somewhere else. We want to look at how we can make training more fun, where the student actually wants to do it.
By nature, I’m a healthcare CIO, not an education CIO. And so when I look at initiatives, I’m also thinking about it with my healthcare hat on.
A little bit of competition can make people do something they wouldn’t want to really do. That’s really what gamification is. It’s not about a game; it’s not Candy Crush. It’s about making people change their behaviors.
Gamble: Thank you so much, Lt. Col. Cordero, for taking some time to speak with us today.
Cordero: I appreciate the invitation.
Gamble: I think the best way to get started is with an overview of your role as CIO and Director of Information Management Division for the Medical Education Training Campus.
Cordero: Actually, that’s no longer my title. A couple of months ago, the Defense Health Agency did a reorganization to try to determine the best strategy to eliminate duplication of processes, and so my role was elevated to CIO of what’s called the J7 Education and Training Directorate. Before, I was just CIO of the Medical Education Training Campus; now I’m actually CIO for the entire directorate, which includes the four organizations that fall underneath us.
Gamble: That makes sense. In your role now, what are your prime responsibilities and what are you looking to do?
Cordero: The Education Training Directorate has four large components, with the largest being the Medical Education Training Campus. That’s the Department of Defense’s largest schoolhouse, providing training for enlisted service members and medical technicians. For people in dental technician, lab tech, and x-ray tech roles, it’s essentially an apprenticeship of medical training. We also have a Leadership, Education, Analysis, Development, Sustainment (LEADS) program, which provides training for healthcare executives.
There’s also the Defense Medical Readiness Training Institute — their mission is more focused on combat-related medical training (in areas like trauma care and disaster preparedness), and the Continuing Education Program Office. That organization is responsible for ensuring all of our credentialed providers have the opportunity to continue to receive their CEUs. And lastly, we have the Modeling and Simulation Office. That’s one of our newer organizations we’re standing up. The mission, of course, is on adding more resources for our simulations or augmenting some of the simulation centers we already have.
Gamble: So there’s quite a lot going on.
Cordero: There is. Altogether we have about 84 training programs throughout the directorate, with anywhere from 1,100 to 1,300 faculty members, and students that range from about 6,000 to 7,000 daily. The Medical Education Training Campus graduates about 24,000 students per year. My branch, Information Technology Management, is responsible for the information technology network, multimedia, administration, and all of the tasks that deal with the private sector.
Gamble: You mentioned the reorganization earlier to avoid duplication. I can imagine that’s a big focus, especially when you’re talking about so many different training programs. How are you working to create some level of standardization?
Cordero: Absolutely. That’s what Congress charged us with — why do we have different clinical systems due to different branches of the military? Why does the Air Force have a different way of capturing a piece of medical data that’s different than the Navy and the Army? On my campus, we have all of the clinical systems because my students train on them. Some of those programs are different, but they all do the same type of practice. For example, we have one system that the students use to order medical supplies; and while the Army system may be different than the Air Force system, their prime responsibility is ordering medical supplies. How do we streamline that or standardize that? At my level, I’m only focusing on the training part. I’m not involved in the process of standardizing the actual systems. That would be a different element in a different branch that’s responsible for that.
Gamble: Right. Looking at right now, as well as in the near future, what what would you say takes up most of your focus?
Cordero: Like with most CIOs, we tend to get bogged down in the day-to-day tasks — a system goes down, the network is unstable, cybersecurity, just the everyday tasks of being a CIO. But we’re trying to look at the future, and that’s a little bit different in the public sector compared to the private sector. Especially for someone who is active duty — I’m only going to be in my role for two to three years, maybe four at the most. So when I look at an initiative, I make sure it’s nested into the strategy of the organization. But I’m also a realist, and so I need to ensure that I have initiatives and goals that support our strategic plan, but also can be done within the timeframe that I’ll be here.
Gamble: That’s a really interesting angle. What are some of the things that fit into that category of helping the overall strategy while also being relatively quick wins?
Cordero: It’s about looking at things that can be done within that timeframe. I’ve been here almost three years. It will be three years this summer, and I’m due to rotate into another job. So right now my focus is finishing some of the initiatives we started three years ago. One of our strategic initiatives was exploring intrinsic learning engagement training — how do students learn today — and looking at all of the different modalities.
With the technology advances and the inexpensive cost of virtual reality, we’re looking at different platforms for how we train our students. One program we’re looking at focuses on primary assessment, for example. We’re taking that curriculum and looking at ways in which we can gamify this; ways in which we can ensure that students understand the content. We want to make it engaging for students and bring out that intrinsic value where they aren’t sitting there flipping through 100 pages of PowerPoint secretly wishing they were somewhere else. We want to look at how we can make training more fun, where the student actually wants to do it — they want to compete against their peers. In the meantime, they’re learning the material, even though their mindset might be, ‘I want to beat my friends.’
Gamble: That’s really interesting, and very cutting-edge. I’m sure that for some organizations there’s hesitancy around it, but from what you said, it seems the pros outweigh the cons.
Cordero: Absolutely. The advantage of gaming is that while the upfront cost might be high as far than actually building out the scenario or getting designers and graphic artists onboard, once it’s completed, you’re done. Other than doing updates to ensure it’s still engaging, especially if you’re building a video game of some sort, because we all know that after a while, the students will learn the answers. And so you have to change the scenarios so there’s always a challenge. But once you implement it, it’s done, and it can be replicated. You can add to it, but the upfront cost is already done. After that, it’s just maintenance.
Gamble: That concept of meeting students where they are is the same idea we’re seeing with patient engagement and trying to meet people where they are, whether it’s certain tools or technologies, or other areas. Do you think gamification has potential on the patient engagement front as well?
Cordero: Absolutely. All of this is born into the medical side of the house. My current role is more on the medical training side than the actual delivery of healthcare, but the concepts are the same. By nature, I’m a healthcare CIO, not an education CIO. And so when I look at initiatives, I’m also thinking about it with my healthcare hat on — how does that relate?
Patient engagement is not just ensuring the patient is involved in their care — it’s also looking for strategies to ensure the patient continues to be an active member in their care when we’re not around. For us to assure that patients take their medication or monitor their blood sugar level daily, how do we do that when we’re not there reminding them constantly? This is where I see gamification can have an impact. We can design a game where patients ensure they are taking their medication or whatnot because they want to get the reward — that trophy or star. I always think of Fitbit and Nike Plus and those types of athletic applications which showed us that a little bit of competition can make people do something they wouldn’t want to really do. That’s really what gamification is. It’s not about a game; it’s not Candy Crush. It’s about making people change their behaviors.