The reality of working in the IT department of a health system — which is often located in a different building or even a different section of town than the hospital — is that it’s easy to become “detached.” When you don’t see patients on a daily basis, it’s nearly impossible to understand how technology impacts their experience, and what can be done to improve it.
It’s precisely why one of Dr. Zafar Chaudry’s first priorities as CIO at Seattle Children’s was to invite caregivers to join the IT advisory committee. But he didn’t stop there; Dr. Chaudry’s team began holding quarterly educational sessions during which parents of patients share their stories to help convey the critical role all staff members play in providing quality care. Each time, it has left the team feeling “energized,” he says.
It’s just one example of how Dr. Chaudry is leveraging the diverse experience he has gained during his career to create a better environment. Recently, he spoke with healthsystemCIO about his team’s top priorities (including an Epic migration), why it’s so important to get the messaging right, and what it was like to go from England to the Pacific Northwest.
- Seattle Children’s and its “large geographical footprint”
- Leveraging lean methodology in day-to-day business and back office functions
- 18-month journey to migrate to Epic
- Caregiver representation on the IT Advisory Panel
- Goal to reduce IT costs by 2% each year – “The less we spend on IT, the more we can spend on patient care.”
- Engagement from teenagers & parents of young children
- Hearing directly from parents – “It grounds you.”
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We’ve adopted that methodology in how we run our day-to-day business, and how we run our back office functions. It’s a constant focus on quality and safety; at the same time, we’re consistently challenging ourselves on cost improvement programs.
The organization has invested heavily in training. Our focus on this has helped keep our costs down and our margins relatively strong, year after year.
Every year, an organization has to take a look at what they spend on IT as a back office function. I’ve agreed to bring our IT costs down by about 2 percent each year for the next five years, because I think the less we spend on IT, the more we can spend on patient care.
We invite parents to tell their stories. They tell us about their child. They show us pictures; they tell us about their child’s condition; and they tell us about their experience and journey. And the focus is always, ‘This is where technology helped me, and this is where technology hindered me.’
It grounds you when you’re looking at a parent, thinking, ‘we’re technologists, and we could easily have resolved it — why didn’t we?’
Gamble: Thank you so much, Dr. Chaudry, for taking the time to speak with us about the work your team is doing at Seattle Children’s.
Chaudry: Thank you, Kate.
Gamble: Let’s start with an overview of the organization. There’s the medical center, but then also what you have in terms of clinics, the research institute, things like that.
Chaudry: Seattle Children’s is a health system. We cover four states — Washington, Alaska, Montana, and Idaho — which is the largest geographical footprint for any pediatric organization in the country. We have about 45 sites. We’re licensed for about 407 beds, and that translates into about a revenue of just over $2 billion. Our research institute is part of the medical center, and we also have a foundation.
Gamble: Let’s talk about Seattle Children’s Improvement and Innovation. How does that serve as a guiding philosophy for the organization?
Chaudry: Seattle Children’s has been focusing on lean methodology practices for over 10 years now. We follow a model similar to what you see in manufacturing; actually, we use lessons we’ve learned from the manufacturing of airbags at Autoliv [an automated safety supplier]. We’ve adopted that methodology in how we run our day-to-day business, and how we run our back office functions, including HR, finance, and IT. It’s a constant focus on quality and safety; at the same time, we’re consistently challenging ourselves on cost improvement programs.
Gamble: Right. The organization has a reputation for being an early adopter of lean. I’m sure it has made a tremendous difference.
Chaudry: Yes. The methodology has been heavily embedded at all levels within the organization. We’re running a model that allows the frontline to take more responsibility for the services that are provided. We have daily huddles by specialty that tend to focus on areas that need improvement, or are causing blockers in the system — we call it our system for daily improvement. That’s been happening consistently.
We also audit teams who are using the system to make sure they’re learning, and make sure they’re actually using and applying the techniques they’ve learned. And so, the organization has invested heavily in training. Our focus on this has helped keep our costs down and our margins relatively strong, year after year.
Gamble: Right. So, at this point, what do you consider to be your most significant priorities?
Chaudry: First, let me provide some context. My IT group at Seattle Children’s has about 422 people. We’re centralized in a single location in downtown Seattle that supports our health system; within the main space of our IT group, we have multiple verticals. And so we’re doing what I call the core commodities. We can fix laptops and run data centers, but we also focus on digital health, and we have a strong enterprise analytics component.
As a group in general, though, our focus over the next 18 months is going to be on our electronic health record. We’ve been running a Cerner clinical and Epic revenue cycle and patient administration hybrid solution for over 10 years, and we’ve recently decided to move from Cerner and put everything into the Epic bucket. That will be an 18-month journey. It’s a huge focus for us, and actually, it was driven by patients.
I’ve been at Seattle Children’s for about 18 months. One of the first things I did was implement an IT advisory panel that’s comprised of patient caregivers and parents. They told us that the model we were running, with multiple portals and different places to access information, wasn’t helpful for them in terms of patient care. And so patient engagement became a huge focus, which then led us to ask, do we have the right electronic health record?
To make sure we have the right solution and can get the right tools in place, our EHR program will have a patient advisor as part of the project. In parallel, patient engagement for us is also about the family experience. So we’re looking at how we engage children and keep them engaged while they’re waiting for their clinic visit.
We’re also focusing on cost improvement. I think that every year, an organization has to take a look at what they spend on IT as a back office function. In looking at this, I’ve agreed to bring our IT costs down by about 2 percent each year for the next five years, because I think the less we spend on IT, the more we can spend on patient care. And of course, we’re looking at cybersecurity, which is a daily worry for all CIOs.
Gamble: Right. So there’s definitely a lot going on. I think it’s so important to include patients and family members on the advisory committee. That’s a very forward-thinking idea. How did you go about identifying people to be on the panel?
Chaudry: It’s quite interesting when you work in the pediatric space, because I always say that when I’m speaking to children, the average 11-year-old is a lot smarter than I am in terms of what they want technologically. At the same time, a pediatric facility tends to interact with patients more. And so, as a hospital system, we have a group of individuals that are focused on engaging patients. When I spoke with them, they said, ‘actually, it’s fine that the hospital system has that advisory group, but we need more focus, so we need some volunteers.’ And they helped me find volunteers.
Interestingly enough, teenage patients and parents of younger children are quite vocal about what they’d like to see from a technology perspective, and it fits very well with the values that our organization has. One of those values is collaboration and providing equity to our patients. We’ve tried to do that by getting our larger patient advisory group to nominate volunteers for the IT group. We’ve been doing this for almost 18 months — the group meets every month, and we’ve had a lot of impact on the team.
One thing that’s very important to me is, I want the team to feel what parents feel on a daily basis. When you’re in IT, you’re somewhat detached from what happens on a day-to-day basis, because you might be in an office in a different location, and you don’t get to see those patients on a daily basis. We wanted to use this group to educate IT. And so every quarter, we run an all-hands session where every IT member is invited to attend, either physically or through a virtual model like WebEx, and we invite parents to tell their stories. They tell us about their child. They show us pictures; they tell us about their child’s condition; and they tell us about their experience and journey. And the focus is always, ‘This is where technology helped me, and this is where technology hindered me.’
Very quickly, you can see the change in the team’s focus to, ‘How does that make you feel?’ When you’re sitting in a room and a parent says they have a 7 or 8-year-old child who probably only has a few months to live and has certain wishes, and those wishes are hindered by the fact that, for example, we can’t stream videos because our Wi-Fi doesn’t have enough bandwidth, it really makes an impact. It grounds you when you’re looking at a parent, thinking, ‘we’re technologists, and we could easily have resolved it — why didn’t we?’
It really gets you focused, and I think it has energized the team to start looking at this differently. I always tell them, we’re not in the business of technology, we’re in the business of patients. Let’s stop focusing on what technology we should buy next week and let’s try to focus on solution provision. And if that involves some technology, that’s fine, but sometimes, you don’t need technology to solve the problem.
Gamble: That’s really powerful, I’m sure. In terms of the Epic rollout, you said that’s going to be about an 18-month effort. What is the status at this point? Are you in the planning phase?
Chaudry: We’re in what Epic would describe as phase zero, so definitely the planning phase. That kicked off early January, and we hope to go live around June of next year.
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