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.
- European vs US care models: “We treat patients the same way.”
- Working in pediatrics – “I’ve always been drawn to it.”
- His diverse career path
- “You have to learn about different people before you can work and gel as a team.”
- Shift to value-based care
- Technology’s role in driving down costs
- Digital health – “It’s very exciting if we truly embrace it.”
- Seattle’s “mix of different cultures”
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I’ve always been drawn to working in pediatric hospitals. Every day when you come to work, you know why you’re here.
I’ve tried to balance my career between different health systems so that I can learn. I’ve also been on the vendor side and the provider side, and learned a lot of lessons along the way. It’s quite interesting to watch how healthcare is delivered in different parts of the world.
People are moving care outside of their walls. We don’t want children to come to our emergency room as the first port of call. We’d rather treat them in the community at primary care or urgent care facilities and keep those volumes low, because the cost of treating someone in an ED is so much higher than it is in other setting.
This whole digital health world is very exciting if we truly embrace it. We’ve got to start looking at mainstreaming and also reimbursing for the type of technologies using the data that we have, in order to make better decisions.
If you look ahead to 2019 and 2020, the whole concept of taking voice application, artificial intelligence for decision-making, and robotic process automation practices and trying to standardize them is something we need to focus on.
Chaudry: In terms of healthcare being healthcare, we treat patients the same way. There are more wait lists in the European model than there is in the US model, depending on specialty, of course. But in terms of quality of care, if you look at the rankings the World Health Organization does rankings every year, publicly-funded health systems still have very good quality and patient outcome scores compared with any other systems. And we’re using similar solutions. At Cambridge, we did a big Epic implementation, and were using Oracle as the ERP system. At Seattle Children’s we use Lawson versus Oracle, but we’re still using the set class of vendors to provide those back-office and front-office functions.
Gamble: So you’ve spent time at many different organizations. What was that appealed to you about this particular opportunity at Seattle Children’s?
Chaudry: Previously in my career — about 15 years ago — I had been CIO at a pediatric facility in the UK. I’ve always been drawn to working in pediatric hospitals. Every day when you come to work, you know why you’re here. And so when I was asked to interview here and they flew me out to Seattle, it rejuvenated, in my mind, why people work at pediatric hospitals.
Our organization is led by a pediatrician — he understands; he’s completely focused on patient care. The whole senior team is very energized around what we do for children in the Pacific Northwest, and that excited me. I’d like to be part of that journey if I can make a difference; if I can come and have an impact in the areas in which I’m specialized. That’s what brought me to Children’s.
Gamble: Was this your first position in the United States?
Chaudry: No, I spent 15 years in the U.S. in the early ‘80s. I did a lot of my clinical training at University of Illinois and did startup work and hospital work in the Chicagoland area. But because I grew up in the UK, I went back there in 2002 to take on a CIO role, and ended up staying. I’ve also worked at Gartner; I traveled the world and did global healthcare for them before I landed back in a CIO role. And so I’ve tried to balance my career between different health systems so that I can learn. I’ve also been on the vendor side and the provider side, and learned a lot of lessons along the way. It’s quite interesting to watch how healthcare is delivered in different parts of the world.
There is no secret sauce to this. When you look at culture and you look at people, everywhere you go it’s slightly different. If you’re working in the Middle East, there’s a lot of money being pumped into healthcare, but do they deliver projects better than anyone else? Not necessarily, because in IT, for example, they’ll have people from 70 different nations working in the same team, and that diversity causes issues sometimes. You have to learn about different people before you can work and gel as a team.
On the other hand, if you’re in the UK, the predominant mix of people isn’t from 70 different countries. It’s probably from just a handful of countries, and so they’re able to work together well. When you come to the Pacific Northwest and see how their culture is, it’s slightly different than what you would find in the European model. You have to flex your leadership style to try and understand that, and that brings both challenges and benefits.
Gamble: I’ve noticed there seems to be a heightened interest here in working with leaders from other countries to see how they’re dealing with the same challenges. It’s great to see, because it hasn’t always necessarily been the case, but I think it can benefit both the US and other countries.
Chaudry: I think it’s being driving by value-based care. The publicly-funded health systems in Europe or Canada have been doing value-based care a lot longer than they’ve been doing it in the United States, because money has always been scarce, and the volume of patients continues to go up. You really want to keep the patient out of an acute care facility if you can, so there’s a huge focus on primary care services, which seems to lack here in the United States. Keeping people out of hospital keeps your costs down and keeps them healthier in general.
And so, as you see US-based organizations trying to shift to value-based care and learn from that global model, you’re also seeing us shifting that care out of our hospitals. People are moving care outside of their walls. We don’t want children to come to our emergency room as the first port of call. We’d rather treat them in the community at primary care or urgent care facilities and keep those volumes low, because the cost of treating someone in an ED is so much higher than it is in other setting. That’s why we have these clinics in different states — we’re trying to take care of those chronically-ill children before they actually end up in hospital.
I think that’s what brings the cost of healthcare down, and the UK is a good example. They’ve had the National Health Service for 60-plus years and the focus has always been community-based care first, and then hospital-based care, if needed. Now with technology parachuting into all of this, you’ve got wearables, you’ve got remote patient monitoring, and you’ve got telehealth and telemedicine — those are all avenues that people are using now in the United States to keep those patients out of hospital and keep those costs low. It’s always cheaper to deliver care via virtual visit than it is physical.
It’s quite interesting because when you survey patients and ask, ‘How do you feel about coming to a hospital?’ the number one complaint patients have is parking. And it’s really hard to provide parking if you’re in the middle of a busy neighborhood like we are in Seattle. We always lack parking. If I can keep those patients happier and out of the situation of trying to find parking and feeling stressed, my patient and family engagement scores will go up.
Gamble: Right. I think it’s such an interesting time right now as we’re seeing technology play a larger role in improving the care experience.
Chaudry: This whole digital health world is very exciting if we truly embrace it. We’ve got to start looking at mainstreaming and also reimbursing for the type of technologies using the data that we have, in order to make better decisions. Now we have voice applications, which seems to be the next trend that I see coming along.
In fact, we recently ran a pilot here with Alexa Voice around flu immunization. We worked with Amazon, which make sense because we’re in Seattle. We programmed Alexa to our outpatient clinics to answer questions people had about flu immunizations. It was quite interesting to watch children engage with Alexa and to watch parents ask questions about the flu shots. We want everybody to get the flu shot, even our staff — we want to be at 100 percent.
What was also very interesting about voice technology is kids are more familiar with using it than adults are. They were very quick to learn they could get Alexa to play Christmas music instead of answering questions about the flu. So that’s the downside.
Gamble: Very interesting. Are there plans or hopes to do more with Alexa going forward?
Chaudry: I think it makes sense with voice technologies to explore how they can be beneficial to patients as well as the limitations they have. If you look ahead to 2019 and 2020, the whole concept of taking voice application, artificial intelligence for decision-making, and robotic process automation practices and trying to standardize them is something we need to focus on. It will help us drive down costs.
Gamble: Absolutely. The last thing I want to ask is how you were able to adjust to life in Seattle. How did that go?
Chaudry: It’s very picturesque here in Seattle. What I find really interesting — and what’s good news for me — is the weather is the same as it is in the UK. It rains. It’s cloudy. So for me, it wasn’t a shellshock to arrive and see that it’s raining and misty a lot of the time. We get a similar effect in the UK. The bigger difference is that the summer here is much better. It’s less humid than in the UK.
In terms of the city itself, I came from Cambridge, which is small and crowded. Seattle is also a small city that’s quite crowded. So I was used to the traffic. But it was very interesting to see the culture. There’s a lot of more of a cultural mix here than in the UK. There are folks from the Hawaiian Islands and from Indian tribes. So far it’s been a very good experience. The teams here have been very welcoming of my strategy and my focus on patients and patient engagement, which has been great.
Gamble: Okay. Well, that about covers it for now. If I have anything else, I’ll follow up, but I really appreciate you taking some time to speak. It’s been very interesting to hear about the work that your team is doing, and I hope we can catch up again down the road.
Chaudry: Absolutely. I appreciate your time, Kate.
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