Q&A with CIO Robin Lang, Part 2: “Your Care Staff Expects Technology to Be Seamless.”

Once a nurse, always a nurse.

It’s funny; Robin Lang never would’ve envisioned herself as a CIO. As a nurse, her passion was caring for patients – both those in the hospital and those living in the community. But the more she became involved in technology, the more she started to believe in the impact she could have in an informatics leadership role. In fact, Lang found that not only could she touch more patients, but she was also able to improve care delivery and help reduce the burden faced by clinicians.

Recently, healthsystemCIO spoke with Lang about her 30-year journey from nurse to CIO, and the work her team is doing at CaroMont Health to move toward an integrated system while making IT as “seamless” as possible. She also talked about how they’re working to provide at-the-elbow support, the organization’s philosophy on growing from the bench, and the enormous privilege of being a female IT leader.

Chapter 1

Chapter 2

• Clinician support – “Being out there in the community makes a big difference.”
• Preventing workarounds
• From bedside nurse to CIO: “I never would have paved this road for myself.”
• Making technology “seamless”
• CaroMont’s career ladder opportunities
• Being “nudged & mentored” by the CMO & CIO
• Her “fierce passion” for patient care

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Bold Statements

Folks are just trying to get through the day. They’re here to see patients and deliver patient care and do it with kindness and compassion — they can’t get bogged down with technology.

Computers can do anything; they’re amazing and incredible, but things that makes sense in the computer world often don’t make any sense in the clinical world.

Your care staff expects technology to be seamless and in the background, and not in the way of providing patient care. The moment it’s intrusive, it becomes a barrier to understanding how the flow of the day works, capturing what must be captured, and meeting the regulatory needs.

I line up behind people who say ‘let’s try this,’ because I’ve found that’s what I gravitate toward. I believe in trying something new and different. I’m fiercely passionate about patient care and what we do for our community.

We had been really successful meeting our goals as an organization by sort of duct-taping systems together, but it was pretty clear we weren’t going to go where we needed to go in the future by doing what we had been doing.

Gamble:  I’m sure there’s something to be said for putting that time and really to get out in front of challenges.

Lang:  Yes, and they’re usually the team that hears long before anyone else what’s not working well, because folks are just trying to get through the day. They’re here to see patients and deliver care and do it with kindness and compassion — they can’t get bogged down with technology.

If something doesn’t work, we are masters in healthcare at working around things. So we never know if something doesn’t work until somebody catches it and says, ‘Why are you doing it that way? Let me help you.’ Or if something’s really broken and they don’t know that, they just accept it for what it is, figuring it’s just a quirk of the system. Being out there in the community of physicians and saying, ‘We’re here for you,’ and asking what’s working well and what’s not working well, really makes a big difference.

 

Gamble:  I would think your background as a nurse plays into this, and has really shaped your leadership style and philosophy.

Lang:  I think it absolutely has helped form who I am. When I look back at my time as a bedside nurse and think about what I would have said to my younger self, it’s amazing, because I would have never paid this road for myself through my own planning. It was sort of a natural occurrence. I was a nurse who got tapped to come in and help with the EMR project; just like a lot of nurses and other types of clinicians — radiology technologists and respiratory therapists — who come in into this side of the world. It’s because there’s such a language barrier. Computers can do anything; they’re amazing and incredible, but things that makes sense in the computer world often don’t make any sense in the clinical world. To the tech people, it’s like, you’ve got to be kidding me. You want the computer to do this, and it does that, but it does it at the wrong time of the patient interaction or whatever the case may be.

I think it’s about being a translator and understanding that patients are here for care. They expect the best technology. You don’t have to advertise having cutting-edge technology; they expect that. You’re a hospital — you should be bringing the latest and greatest to them. But your care staff expects technology to be seamless and in the background, and not in the way of providing patient care. The moment it’s intrusive, it becomes a barrier to understanding how the flow of the day works, capturing what must be captured, and meeting the regulatory needs. How do you make the workflow just do those necessary things without having to think about them; how does it come naturally?

We don’t say anything is a ‘no brainer,’ because everything requires brains. We still have to be a thinking, leading group, whether it’s on the patient care side or the IT side. I think being a nurse and coming with an understanding of the physicians’ world, and understanding the struggles of seeing patients at a frenetic pace in a clinic, or the hectic pace of an OR, or an impatient unit, all the way to hospice — having that experience in many of those clinical areas has really helped set the tone. I love and believe in our mission and vision. We believe in uncompromising, uncommon compassion. That’s what we’ve been known for long before technology has helped advance our care here at CaroMont.

 

Gamble:  You said earlier that this isn’t a road you would have foreseen taking, and honestly, I think it happens that way a lot. Can you talk about how you came into the CIO role?

Lang:  Yes, I’d love to. I love to talk about how my organization grows from the bench and really believes in investing in our staff. We have a tuition reimbursement program. There are scholarship programs. There are career ladder opportunities where, through professional growth, employees can be reimbursed or earn bonuses or other great opportunities by participating in committees.

When the hospital decided that the leadership team was going to expand, we had a very limited EMR that dated back to the early 1990s. We had been a Siemens shop for many years, and when they made the decision to move to Soarian, that’s what we did. This was in the 2003-2004 timeframe. They knew that in order to bring nursing along, there was a need for a really energetic person in the leadership role.

And that’s how I describe myself: I’m energetic, and I have such a passion for what I do. I line up behind people who say ‘let’s try this,’ because I’ve found that’s what I gravitate toward. I believe in trying something new and different. I’m fiercely passionate about patient care and what we do for our community. The opportunity came along to be the informatics liaison as the organization started down the path of putting in a new organization-wide EMR.

At this point it was the hospital, and not the practices, moving toward that. The first time I was interviewed for — and I know this was terrible — but I thought, ‘Who would ever want to be the computer nurse?’ I actually said no at first; I thought I would be boring. I wouldn’t be seeing patients anymore, and so I thought it wasn’t for me. Luckily, my CMO at that time, and the CIO I had the opportunity to work with, saw something I didn’t necessarily see. They nudged me along and mentored me through the first years of my career in informatics, and we grew a team of clinicians that really became the educator, tester, implementer, and communication hub for everything we were doing with Soarian.

We loved that product. But, as you know, Siemens let that line of business go; that vertical is now Cerner. We really embraced the idea of Meaningful Use and an electronic record for all patients, and I become really passionate about how informatics and technology could touch many, many patients instead of just the few that I could touch each and every day. And not only touch and improve the care patients are receiving, but also touch and improve care delivery for clinicians who are out on the floors, struggling with their tools at times, or being burdened by paperwork and regulatory requirements.

As I started to learn more about how technology could change those things, I found this fuel of energy and passion that we can make this better, and should make it better. Everybody can have a voice here and make a difference in what happens when patients come through our system. We had been really successful meeting our goals as an organization by sort of duct-taping systems together, but it was pretty clear we weren’t going to go where we needed to go in the future by doing what we had been doing. What got us there was not going to get us where we needed to go.

Chapter 3