Patrick Anderson, SVP & CIO, City of Hope
For Patrick Anderson, the opportunity to work with an organization that’s doing groundbreaking work with immunotherapy to transform the way cancer is detected and treated was a dream come true. But along with the ability to build decision support capabilities with genomics to determine precise pathways comes quite a daunting problem: harnessing and managing unfathomable amounts of data. It’s enough to turn a dream into a nightmare.
Fortunately, Anderson doesn’t see it that way. In fact, when he came to City of Hope about a year ago, he knew the challenges he’d face as CIO, which included upgrading the entire infrastructure. And while it’s an ongoing task, it’s one he and his team have embraced. Recently, we spoke with Anderson about the “permanent optimization strategy” in place at City of Hope, how he’s using reinforcement to connect IT staff with patients and families, as well as clinicians, and how his past experience helped him build the ultimate toolkit.
Chapter 2
- Clinical & revenue cycle SWAT teams
- Key part of rolling out Epic: “You have to go back and reassess.”
- Creating a permanent optimization strategy
- The “invasive” data modernization project
- Moving to unified communications to enable flexibility
- CIO’s role in reinforcing the mission – “It’s what motivates them.”
- Capitalizing on his “diverse” career background
- Precision medicine – “It’s about being able to build expertise working with data.”
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Bold Statements
We had over 400 findings, and we closed over 90 percent of those findings just by helping physicians and nurses do things the proper way. It’s important when you implement an EMR that you go back and reassess how everybody is doing and how they’re utilizing it.
It’s been very invasive to do this. But it got us to the point where we can leverage the newer technology of switches and start deploying new capabilities.
Moving to unified communications where you’re converging voice, data, video, and wireless, being able to partner with organizations like Cisco, Microsoft and Dell, and being able to build state-of-the-art facilities is really exciting.
You have to reinforce that constantly, and we do that. We do a lot of work around employee engagement and enrichment, but tying them to the mission is really what motivates them and makes them feel like they are contributing to this wonderful mission here.
Gamble: Let’s talk about the objectives you had in terms of the Epic migration, and where that project is now, as opposed to when you arrived.
Anderson: They had already moved to Epic when I arrived. They had been on Epic for about six months, but we had to really work very hard to stabilize it and begin to optimize. That’s what I brought forward when I arrived. I have about 12 years of Epic experience and I was able to bring that forward in driving physician optimization as well as driving high availability as well as governance.
We’ve revamped governance. We put in SWAT teams for clinical optimization and revenue cycle optimization, and we’re on the right path to get the best value out of Epic and to drive the utilization and optimization of the system. We’re getting a lot of help from Epic, along with a few other strategic partners.
Gamble: The SWAT team sounds like an interesting concept. Can you talk a little bit about that?
Anderson: Sure. We put a SWAT team together of Epic analysts, trainers, and even some revenue cycle people, where we actually shadowed physicians and nurses and analyzed their utilization of Epic. We identified a considerable amount of variation and then we start standardizing the workflow and utilization, department by department, so we could start using the Epic metrics and really start identifying who needs help.
Just in the first few months, we had over 400 findings, and we closed over 90 percent of those findings just by helping physicians and nurses do things the proper way. It’s important when you implement an EMR that you go back and reassess how everybody is doing and how they’re utilizing it. Our SWAT teams have been shadowing department by department, and we’re also hitting all of the community clinics to make sure everybody is utilizing it effectively. We’ve had great success with that, but we still have a lot of work to do. There are still a lot more people who need help.
Gamble: I’m sure. You’re dealing with a pretty sizeable number of practices, right?
Anderson: We are, but we’ve added a CMIO in the last few months who has really taken this on. We didn’t have a CMIO for the first 8 months that I was here. I launched that project, knowing how important it is. The CMIO has since taken over the optimization and adoption, which is going very well.
Gamble: Was that something where leadership needed to understand what the CMIO could bring to the table, especially with everything you have going on?
Anderson: I think they knew that, but they wanted to hire the right CMIO. It probably took six months to select and hire someone.
Gamble: Is a lot of your focus now on continued optimization of Epic, both clinicals and revenue cycle?
Anderson: We’re optimizing all of it. Again, you have to go back after you install and evaluate its effectiveness. Epic has been helping us with that. We have to rebuild a lot of the revenue cycle, and we have to retrain the workflows on the clinical side. We’re making great progress; we’re going to keep these optimization teams permanently, and we’re going to continue to round on all units in the hospital, in all the clinics on campus, and in the community, and continue to make this a permanent optimization strategy for City of Hope so that we can get the best satisfaction for our physicians and nurses, and utilize the system as effective as possible.
Gamble: In terms of the new facility being planned, what’s your involvement going to be? Will you be involved in some of the technology aspects?
Anderson: Absolutely. In fact, we have high aspirations for driving a very new model of care in our new Orange County Campus. We’re going to build it with a lot of innovation and we’re going to have some major technology partners help us with the innovation out there in Orange County. With that, we’re starting the sessions now to design and build state-of-the-art clinics and a state-of-the-art hospital in Irvine.
Gamble: I would think it’s really exciting to be part of something where you’re building from the ground up.
Anderson: It’s going to be absolutely amazing. We have so much excitement from the community in Irvine as well as support from a lot of our technology strategic partners, and we’re going to continue to work with our partners to build a state-of-the-art facility and campus there.
Gamble: Earlier you mentioned the data network modernization project, and everything it took to go into those buildings and upgrade the networks. Can you talk about how that initiative was planned and approached? I’m sure it was a pretty daunting task.
Anderson: It was. It was over a hundred buildings, and we literally had to do construction in many of those closets to support the electrical and cooling of the equipment. In the hospital itself, we had to go in and take units offline overnight and on weekends so we could pull out the network equipment and switches and implement the new ones on each unit.
It’s been very invasive to do this. But it got us to the point where we can leverage the newer technology of switches and start deploying new capabilities such as network segmentation, which helps manage security and availability. It’s really been exciting to put in all of the work and then leverage the state-of-the-art hardware for those new capabilities.
Gamble: Obviously it’s a big undertaking, but it will have tremendous benefits in helping to make those improvements that need to be made.
Anderson: Yes. Moving to unified communications where you’re converging voice, data, video, and wireless, being able to partner with organizations like Cisco, Microsoft and Dell, and being able to build state-of-the-art facilities is really exciting. We’re really pleased with the progress we’ve made over the last year.
Gamble: Was that in place or being planned when you arrived?
Anderson: No, that’s all been designed and developed since my arrival.
Gamble: That’s another area where it’s important to have partnerships and be able to capitalize on them.
Anderson: Right. It allows us to be flexible and be able to bring technologies into any building, including conference rooms or operating rooms. Now that we have the infrastructure, we can literally bring in any technology capability to anywhere on the campus.
Gamble: As far as upgrading the infrastructure, where is that at initiative? Are you moving closer to that goal, or is it an ongoing thing?
Anderson: We’re getting really close. The data and network modernization should be complete next month. Replacing all the phone systems is probably going to take at least another year; as we rebuild all of our call trees and our patient access, and literally move to fully unified communications, it will take another year to provide the capabilities to our patients for scheduling and so forth.
Gamble: Switching gears a bit, what was your mindset coming to an organization where there was quite a bit to be done? I’m sure there were a lot of factors to weight.
Anderson: I’ve worked in advanced medicine for health systems over the years, but having the opportunity to help fight cancer and cure cancer; it’s the mission that really excited me. That’s the number one reason why I came here. Obviously, I’ll be able to leverage my toolkit as a healthcare CIO and bring forward our digital strategy and our infrastructure and assist with our science, but it really allows me to bring my entire toolkit as a CIO forward to be part of this progressive leadership team here. The mission and the progressive leadership team is really what excited me; that’s why I came to City of Hope.
Gamble: When you’re in the CIO role with an organization like this, is it somewhat easier to help the IT staff understand their role in patient care?
Anderson: You have to continue to reinforce this with your workforce. You have to reinforce the connection to the patient and the patients’ families and the connection to the physicians and nursing; you have to reinforce that constantly, and we do that. We do a lot of work around employee engagement and enrichment, but tying them to the mission is really what motivates them and makes them feel like they are contributing to this wonderful mission here.
Gamble: So it’s really about constant reinforcement and trying to model certain behaviors.
Anderson: Yes, but also sharing with them our successes in patient care and our success helping research with new breakthroughs by all of us doing our job; sharing with them how we all fit into that research and that patient care mission.
Gamble: Looking at some of your previous roles, how do you think your diverse background has helped shape your leadership style?
Anderson: That’s an interesting question. I’ve worked in different types of healthcare organizations. I’ve worked in very large health systems. I’ve worked in smaller health systems that are very niche; for example, I spent about three years at Hoag in Newport Beach. I’ve been in advanced medicine, institutes of excellent patient care, and safety net hospitals, including a role as CIO for the Los Angeles County Department of Health.
I’ve had a lot of diverse experience with different types of patient care. I spent six years at Sutter Health deploying Epic across dozens of hospitals and clinics, and I think the culmination of all of these different experiences has allowed me to build a very diverse tool kit of partnering with leadership, developing strategy, and then executing on that strategy.
Many CIOs have expertise in maybe one or two of those areas, but being able to build the relationships, build the strategies and execute on them with precision is really what has culminated my experience into that ability. I think it really makes a difference. I think that’s why I’m here at City of Hope — because I can formulate, and I can execute.
Gamble: The last thing I wanted to talk about is precision medicine. It’s been talked about for a while and we know the potential is there, but do you feel the industry is making strides with precision medicine?
Anderson: Yes. But again, I think it’s about being able to build that expertise working with data, and that’s where our focus is going to be. We need to be able to work with that data and drive decision support to patient care, and then also drive the utilization of that data for research. It’s really those two arms, patient care and research and being able to leverage the genomic data effectively.
Gamble: Not easy stuff, but it’s really fascinating.
Anderson: It certainly is.
Gamble: Well, I think that’s about it. I could definitely talk to you longer, but I should let you go. I really appreciate your time.
Anderson: Great, thank you.
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