Q&A with CIO Mathew Gaug, Part 1: “We Have to Build Brick by Brick.”

For many people, the key to a successful balance in life is in keeping work and family separate; ensuring the two worlds never collide. Some, however, have a completely different – and perhaps, more realistic – approach. Mathew Gaug, CIO at Memorial Hospital and Health Care Center, views his team as family, often applying the same conflict resolution and communication strategies as he does in his own home. “We’re together for the majority of the week, and so there are going to be struggles,” he said in a recent interview. “The ability to work through that, to talk through it, and to be open and honest with each other really helps drive that commitment and engagement.”

Gaug, who started with Memorial this past summer, talked about his initial priorities as CIO (which included selling the organization on an integrated EHR platform and choosing a vendor), how his team is involving multiple stakeholders in major decisions, and the keys to growing an IT department at an appropriate rate. He also discussed the importance of effective vendor management, his open-door leadership philosophy, and how his family is adjusting to life in Indiana.

Chapter 1

• About Memorial Hospital & Health Care Center
• Onboarding done right – “Everybody here is extremely welcoming.”
• Orientation checklists
• From best of breed to an integrated approach – “We didn’t want to reinvent the wheel.”
• 4 components of the EHR selection process
• Partnership over software
• Growing the IT department “brick by brick.”
• Using visualization to sell integration: “It drove home why we needed to do this.”
• Memorial’s mission to “be for others”

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Bold Statements

Choosing a new EHR isn’t something where we’re breaking new ground; where we are breaking new ground is in how we choose an EHR for our organization.

I didn’t have to go in and say, ‘This isn’t an IT project.’ They already knew when I came in that this was going to be an organizational project.

Being able to visualize that and see a color-coded map of the multitude of applications we had really changed that perspective. It really drove home why we needed to do this. It opened up everybody’s eyes.

I don’t want to implement technology looking to solve a problem, or have to create a justification for having the technology. I want to partner with providers and with the clinical staff to learn and understand the business so we can create solutions using technology to improve patient care.

We’re taking the idea it’s not just about ‘me’; it’s about a department or a certain workflow. It’s more about our workflow and how can we ‘be for others’ through our integrated process.

Gamble:  Hi Mat, thanks so much for joining us today. Let’s start with some basic information about Memorial Hospital and Health Care Center, which is located in Indiana. Can you talk about some of the care offerings?

Gaug:  Sure. We’re located in Jasper, which is in Southern Indiana, and we offer multiple different services. We’re a Trauma II healthcare center. We offer services around cardiology for the area. We also have multiple specialty and family practice clinics in seven different surrounding counties, so we’re spread out a bit. Basically, we run the gamut when it comes to healthcare and the services that we provide for our community, but I would say oncology, cardiology, and surgical practices are our big hitters.

 

Gamble:  Memorial covers a pretty large geographic area. Are you fairly rural?

Gaug:  We are.

 

Gamble:  And you’ve been with Memorial since August. It’s always an interesting time when you’re starting with a new organization. Can you talk about how you approached the CIO role — how you got to know the people, the organization, and the culture?

Gaug:  This organization is very unique in the sense that everybody here is extremely welcoming and extremely open to helping people get accustomed to the area. The people here didn’t just welcome me, but also my wife and my three girls, to the community. They were just as interested in helping me get acquainted and accustomed to a new role as they were making sure my family was getting situated with the town.

For example, we moved here about four or five days before school started, and so the entire community made sure my girls had everything they needed. They even invited them to come in for a personalized tour of the school since we missed the open houses when we were in the process of moving. Everybody had an open-door policy.

There’s also what I would call an orientation checklist where new leaders meet with all the directors and executives in the organization, as well as their teams. From top to bottom, everybody was so welcoming, and so willing to show off their departments and how they help care for patients, whether or not they’re in direct patient care.

The mission here is something people take very seriously; everyone is in patient care, no matter the role. They all understand and want to live that mission.

The orientation process here was unique to me. It starts with each member of our executive team introducing themselves to each individual person. I already knew the executive team, obviously, but they introduced me to everybody else in the orientation class as part of the executive team. We do those executive introductions each and every month during orientation. Then on the second day, we have what we call a confirmation where we confirm each other to the organization and to our mission. We’re a Catholic-based hospital, and so it’s a confirmation service held in the chapel. It’s very powerful, and it really drives home the mission of the organization to everybody.

 

Gamble:  Right.

Gaug:  From an IT standpoint, we’re facing a very big task to upgrade our EHR. We don’t have an integrated EHR in place today; we have separate systems for the hospital, for the ED, for our ambulatory practices, and for home health. Now, we’re trying to go from best of breed to an integrated approach, and we have to choose the right partner for our organization.

When I came in, we started the process by picking up the pieces that were already in place. We didn’t want to do rework. We didn’t want to reinvent the wheel. Choosing a new EHR isn’t something where we’re breaking new ground; where we are breaking new ground is in how we choose an EHR for our organization.

Memorial Hospital was a National Baldrige winner last year; through that process, we created a 90-day team. This was unique to me. I had never been part of a 90-day team before. And this team is multidisciplinary. We have people coming in from all across the organization, and we’re putting them in charge of selecting the recommendation for the EHR. Through the team, we created a scorecard which consists of technology and informatics components, but also business and partnership components. That’s critical because we may have thought it was the absolute best piece of software out there, but if a company can’t partner with us and accept our mission and our vision statements, maybe it’s not the right partner for us.

That’s very important to us; not just for decisions of this magnitude, but smaller decisions as well. Every little thing counts — that was very clear. I didn’t have to go in and say, ‘This isn’t an IT project.’ They already knew when I came in that this was going to be an organizational project. This is number one on our strategic plan. It’s going to be a lot of work, but everybody’s really looking forward to doing it.

 

Gamble:  Right. So you knew this was going to be a big focus right from the start.

Gaug:  Yes. During the interview process, there was a lot of discussion around doing the key strategic things within IT, and bringing IT together to make sure we have a strong team — which we do — and using that to implement best practices around any EHR. We’re small and mighty, but we’re planning on doing some growth in the IT department. And so part of my first 90 to 120 days is going to center on recommendations for how to grow the team strategically so that we don’t go from zero to 100 in a day. We have to build it brick by brick.

 

Gamble:  Was the 90-day team structure something the organization already had in place, or was that something you implemented?

Gaug:  It definitely wasn’t my idea; the organization already had it in place. The piece I brought was around EHR implementation — what to look for in terms of the strategy behind the EHR vendors, and what I felt would be important when it comes to the demos, the questions, and who needs to be involved.

 

Gamble:  Yeah, and had you been through this process before?

Gaug:  Yes. When I left Lima Memorial, my previous organization, they were (and are) implementing Meditech Expanse. It was a much different process there, but similar in the sense that they were looking for a new EHR. In that case, it was more of an upgrade, going from one Meditech platform to another, but it was still an EHR implementation.

 

Gamble:  I’m sure you’ve been able to draw from that experience.

Gaug:  Oh yes, and even from my experience of implementing Epic at the Cleveland Clinic years ago. It’s putting all of that together — the pieces and the strategy of what it takes and what to expect. This hospital has not done an integrated EHR project. The last time they did an EHR implementation was years ago; many things have changed. The whole idea of looking at an integrated system versus something to solve a specific need (the best-of-breed approach) is where I’ve been able to take all my experience and help the organization plan what to expect and what are the pitfalls of big implementations.

 

Gamble:  Very exciting. A lot of hard work, of course, but definitely exciting.

Gaug:  Yes. Coming in, I needed to know what I had and what I was working with when it came to the systems we had in place. I needed an application road map. Creating a roadmap in an Excel spreadsheet helped me, but I could see it wasn’t helping my executive counterpoints or the board. And so we made it a visual representation of the number of applications we had, and I put it on a large sheet of paper and I organized it by vice presidents. In this organization, each vice president has a lot of different applications; they don’t all report into IT at this time, which is something we’re going to change. But being able to visualize that and see a color-coded map of the multitude of applications we had really changed that perspective. It really drove home why we needed to do this. It opened up everybody’s eyes.

 

Gamble:  And those who were going to be using the EMR also understood the need?

Gaug:  Yes. It’s great; as we’ve been developing the 90-day team, one of the first things we do once we get done with demos is to really refine our elevator speech. That way, if someone is riding up an elevator and people ask, ‘Why are we spending so much money on something we kind of already have?’ we have those brief talking points. One of those ideas is changing from ‘me’ to ‘we.’ We’re taking the idea it’s not just about ‘me’; it’s about a department or a certain workflow. It’s more about our workflow and how can we ‘be for others’ through our integrated process.

That concept to ‘be for others’ is part of our mission statement. We’re tying it all together so that our EHR integration directly ties in with our mission and our strategic plan, so that it really drives home why we’re doing this.

 

Gamble:  What’s the timeline as far as when you have to have that decision made?

Gaug:  Our goal is to deliver a recommendation that comes from the 90-day team that I lead, to the board the first week of February. We want to be going forward with contract negotiations in February/March, and start the implementation from there.

 

Gamble:  That’s obviously a critical part of the strategy. What are some of the other priorities the organization is looking at?

Gaug:  The next strategic priority for me is cybersecurity. I want to make sure that not only are we secure in the sense of the general cybersecurity platforms, but I also want to be sure we have a strong investment in disaster recovery or business continuity plans to ensure that what we in IT believe is a proper downtime procedure matches up with what clinical and other business units believe is a proper procedure. What we think is important is validated by what they know is important.

And then, we’ll look at whether our technology plan matches our business need. I’m not one to implement technology for the sake of technology, and I don’t want to implement technology looking to solve a problem, or have to create a justification for having the technology. I want to partner with providers and with the clinical staff to learn and understand the business so we can create solutions using technology to improve patient care.

I know I’m not called upon to be a direct patient care provider, but I do believe I was called to help those who are. I want to do that in a smart way and make their lives easier. I don’t want to be part of the problem where we have burnout because our administrative duties are too cumbersome. Whether it’s the EMR or any piece of technology, I want to be helpful — not hurtful.

Chapter 2