Danny Scott considers himself to be ‘a cheerleader by nature.’ Perhaps that’s why he wasn’t fazed by the idea of taking on an IS leadership role just weeks before a scheduled Epic go-live. And it wasn’t a simple conversation; Good Samaritan was migrating from an in-house EHR to a hosted Epic model. The staff, understandably, were “shell-shocked,” but Scott saw it as an opportunity to create a better environment.
Three years later, the IS department at Good Sam is barely recognizable. Not only are service and ticket management processes in place, but now, thanks to an enormous effort, IT is viewed as a “true partner.”
Recently, healthsystemCIO spoke with Scott how he was able to develop a strategic plan, the change in thinking that was sorely needed among IS staff, and the importance of communicating and assessing needs when creating a strategic plan. He also talks about why he’s “excited, but anxious” about the future of healthcare, the skills he believes are most valuable, and how his background has helped shape him as a leader.
- About Good Samaritan
- Entering a “frazzled” IT environment
- Individual staff meetings – “I got a lot of great feedback from that.”
- Small organizations thinking big
- “You can be a world-class organization even if you don’t have a $50 capital budget.”
- 5-year strategic plan
- Installing a ticketing system to “manage the chaos”
- “Our job in IT is to enable our constituency to do their jobs better.”
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There was no strategic plan. There was no, ‘where are we going?’ People would come in and do what they had to do for today, but there was no real vision as to where we were going as an organization. That’s something I’ve been able to implement.
IT was really looked at as a side entity; we were just there. They could call on us when they needed to, but they didn’t see us as having any value. And so a big part of my job has been to do a lot of marketing and show people the value we bring.
If you say, ‘go,’ what’s going to happen? Some people will go forward, some will go backwards, some will go left, and some will go right. They’re going to bump into each other and knock each other over. That leads to chaos.
The challenge to my team is, do we want to stay with the same model that IT has had for years of having a data center and doing that type of work, or do we want to be a technology solution provider?
Gamble: Thank you, Danny, so much for taking some time to speak with us today. We appreciate it.
Danny: I’m glad to be here.
Gamble: Let’s start with some information about Good Samaritan — number of beds, where you’re located, things like that.
Danny: Good Samaritan is an independent hospital located in Southwest Indiana, right on the border with Illinois. We’re about 100 beds, and we have a convenient care clinic. We’ve just started up an FQHC. We have behavioral health — all of the specialties you might expect. We have about 1,900 employees. We service 10 counties, the majority of which are in Indiana, with a few in Illinois as well.
Gamble: Do you have any affiliations or partnerships?
Danny: We have a community connect model with our EHR system, which we can talk about more. But that’s the only major partnership we have.
Gamble: And you’ve been with the organization for about three years?
Danny: Yes, about three and a half. I started in May of 2016.
Gamble: I’d like to talk about what the IT environment looked like when you arrived, and what happened from there.
Danny: I would say that I really flipped things upside down. When I walked in the door, they were in the midst of implementing a new EHR system. People were kind of frazzled at that point. There were two managers; one person had half the staff and another person had the other half — but there was no rhyme or reason behind it. They didn’t have service management. There was no true incident management, no problem management, and no change management. There was a lot of disorganization, and not a lot of good documentation.
I reorganized the department, promoting some people who had been here a while and belonged in more of a leadership role. There was no IT security either, so I created an IS security officer role. So again, I put some people in leadership roles and created a whole service management discipline to where we now have a service desk, and we actively do incident management and problem change. We also have an asset management tool. We purchased a cloud solution to be able to do that, and our infrastructure services — our hardware, desktop support, those type of things. It was really just formalizing that and putting a design on everything.
When I arrived, there was no strategic planning of any nature. There was no, ‘where are we going?’ People would come in and do what they had to do for today, but there was no real vision as to where we were going as an organization. That’s something I’ve been able to implement.
Gamble: That’s a lot to deal with. What was your first priority?
Danny: I think it was getting people organized. I had one manager who had been here for 20 years. He’s jokingly what I call a ‘gearhead.’ He’s an expert with servers, infrastructure, and programming, and he was leading the financial management team that supports our ERP solution. So it was really about getting people organized.
The biggest thing I did was to sit down with every staff member individually and have one-on-one meetings. I did that for my first couple of weeks: tell me who you are, what you’re all about, and where you see the good things and bad things. I got a lot of great feedback from that.
Gamble: So instead of cleaning house, it was more about how to put people’s talents and abilities to better use.
Danny: Exactly. I had an application analyst who was probably the number one person on our team. I was able to promote her, and she’s been fantastic. That’s one example.
Another was getting a security officer in place. As you know, having security in place is absolutely critical in IT. But there wasn’t anyone in that role when I got here. I think the mentality was, ‘We’re a smaller, independent system.’ They thought that way. So I said, ‘We’re going to think big.’ Because your capital budget doesn’t matter. Your size doesn’t matter. You can be a world class-type organization, even if you don’t have a 600-bed hospital and a $50 million capital budget. You can be great with what you have. And that’s been our motto since I arrived: being the best of the best. That’s what I want.
It’s funny, people will call me and say, ‘I hear you guys are doing great things. Tell me more about how you’re getting from point A to point B.’ Because the way IT looks today is nothing like it was when I got here. IT was really looked at as a side entity; we were just there. They could call on us when they needed to, but they didn’t see us as having any value. And so a big part of my job has been to do a lot of marketing and show people the value we bring to the organization.
One of the big issues we had is that people would go out and buy software and would call IS the day before or the day a vendor shows up, and say, ‘You guys need to come here and help get this implemented.’ It was crazy.
That was probably the number one thing when I got here. Now, people look at IS as a true partner. When discussions are held about new systems or new applications that clinical or business need, we’re called to the table immediately. They want us engaged, because they see us as a true partner. That’s where we’ve really changed things. They see the value of what IT brings to the organization.
Gamble: Let’s talk about the strategic planning piece. How did you approach that?
Danny: When we did our strategic planning for that first year, leadership was offsite for a whole week. On the first day, I brought in an old mentor of mine to speak to the team. We talked about our current projects, what’s coming up, and what are the things we need to kind of be working on.
If you say, ‘go,’ what’s going to happen? Some people will go forward, some will go backwards, some will go left, and some will go right. They’re going to bump into each other and knock each other over. That leads to chaos, and you can’t have that in an organization. What you want to is to be able to say, ‘go,’ and have people walking together in step, in sync, in alignment, and have everybody know what everybody else is doing. To me, that’s what a strategic plan is all about. You can’t just tell people to go from here to there; you have to give them the path and lead the way.
Part of our effort is around the whole concept of digital transformation — how do we go through that? We’re focused more on a five-year plan. We have a whole marketing strategy to let the organization know how we want to transform over the next five years.
Gamble: Right. You also mentioned service management, which obviously is a big piece. Can you talk about the practice of putting that into place and making sure that really everybody knew about it and knew how to use it?
Danny: Sure. I have a strong background in service management; I’m certified in ITIL Foundation. So I brought in a manager to do that. Again, the big thing was educating our staff, because up to that point, they had no real idea what it was about. We had to teach people about incident and problem management. We had to design flowcharts and procedures around how to do that, and then we had to find a tool that would help facilitate the whole process.
We did have a helpdesk at the time, but there was no real structure around it. We had no good documentation process. And so I asked every team member to list all the work they do, and how much documentation we have around it. As it turned out, probably 40 percent of everything people did was actually documented. So that’s what I’ve been working on the past three years; getting all of this documentation.
The tool we use has a knowledge base; we call them solutions knowledge-based articles. We’re just about to hit a thousand. In the course of three years, we’ve developed 1,000 pieces of collateral that our service desk uses as a means to determine how to resolve issues, provide information to people, and so on.
And so, it really was all about education; explaining to people why we do this. Now, we have a ticketing system. People can open up an incident record, and along with that comes a whole service request process. Again, in the past, everything was done by email. It was done by people talking in the hallway. Whoever yelled the loudest got their needs met. Now we have a very formal, structured process for how that takes place. The purpose of all of that is to manage the chaos. That’s why we do it, and it has helped us immensely.
Gamble: Right. In terms of the strategic plan, what are some of the key objectives there?
Danny: For us, it’s really looking at where we go over the next five years. The challenge to my team is, do we want to stay with the same model that IT has had for years of having a data center and doing that type of work, or do we want to be a technology solution provider? That’s the big thing I’ve preached here: our job is to enable. That’s really what IS does. When you think about it, people have been providing healthcare for hundreds of years, and have been doing it without technology. But technology allows them to do it faster, better, and hopefully more efficiently with EHRs and other tools.
Our job in IT is to enable our constituency to be able to do their jobs well, and in an efficient and timely way. So we’re focusing on that. We’re looking at more cloud-based initiatives, because that’s where things are going. That’s how technology is going to drive the way the world operates.
We have basically two sets of customers. One is the consumer; the person who comes to our hospital, our doctor’s offices, or our clinics for healthcare services. What do they want? They want convenience, accessibility, and interoperability. They want to be able to see their information whenever and wherever they want, from any location.
The second is our internal customers. What do they want? A lot of it is the same. They want integrity. They want to make sure the information they’re looking at is right, and that it’s what they need, when they need it. They want convenience. How do we make that happen? That’s what we’re tasked with doing, and I think a lot of cloud solutions are designed around that.
Then you think about security; from a Windows perspective, how many updates need to be done continuously? It’s a fulltime job just keeping that updated. If you go to a cloud solution, I think you’re going to have less of that burden. It’s up to the cloud provider to get that done. That leaves us open to providing more solutions versus just being in maintenance mode all the time.