Podcast Interview with Craig Richardville, Part 1: “The Crisis Has Allowed Us to Disrupt Ourselves.”

“We’re doing things a lot differently. We’re thinking about a future that looks a lot different than in the past.”

It’s a statement most, if not all, healthcare IT leaders can relate to, but it can take on various meanings. For Craig Richardville, Chief Information and Digital Officer at SCL Health, it means acting less like a healthcare organization and more like a technology or retail company. It means paying close attention to where the disruptors are going and integrating it as part of your strategy.

Recently, Richardville spoke with healthsystemCIO about how the pandemic has served as a catalyst for digital health – at least, for those that had a solid infrastructure in place; how SCL Health has benefited from working with startups; and how they’re leveraging data to move toward value-based care. He also shared his take on the importance of being agile, what Covid-19 taught the industry about vendor partnerships, and why he will admittedly “steal every good idea.”

Part 1

• About SCL Health (8 hospitals in 3 states)
• Preparing to meet the demands of a potential surge – “A lot of good learnings have come from this.”
• Building blocks for remote work – “We had hardened and strengthened our virtual capabilities”
• Continued focus on digital services
• Leveraging chatbots to manage communications & analytics for decision-making
• Role of “clean data” in moving toward value-based care
• Becoming disruptors – “You’re a tech company.”
• Vendors vs vendor partners

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Bold Statements

It’s a bit of a juggling act to make sure we don’t kind of move ourselves to a single way of doing things because all of our environments and many of our communities are different.

Analytics has played a big part in how we understand what’s happening in our country, in our state, in our communities, and how we’re going to use that to drive our decisions.

As we come out of this, we’re seeing that volume isn’t as dependable as it was in the past. You have to learn how to run a business with lower volumes, and that means moving into the value proposition we’ve been talking about for a decade.

The crisis changed a lot of that. Now we’re doing things a lot differently. We’re thinking about future that looks a lot different than it has in the past, with the acceleration of that new world coming sooner rather than later.

We were really able to distinguish between vendors and partners, which has always been very important to me. People who are more about a commodity product or service are vendors, whereas those who are partners really want to join you in the fight.

Gamble:  Hi Craig, thanks so much for taking some time to speak with us. Can you start with an overview of SCL Health?

Richardville:  Sure. We are a $3 billion healthcare system. We are faith-based. We have 8 hospitals in three states and approximately 600 employee providers and about 4,000 providers practice at our facilities.

 

Gamble:  Where are you right now in terms of the pandemic?

Richardville:  A few weeks ago, we started scheduling electives, primarily same-day procedures and things of that nature. We’re starting to see a little more growth in our clinics and into our hospitals.

We’re also reserving capacity for the potential of a surge moving forward. We’ve changed a lot of processes, workflows, and patient flows in order to accommodate demand during a crisis, and be prepared if, for whatever reason, one of our states backtracks in terms of their progress.

A lot of good learnings have come out of it. That’s how we sit today; we’re continuing to get guidelines from the governor’s office, following those, and being very receptive. I know our CEO is engaged in some of the discussions around the guidelines, and so we have some input, but it’s tough for everybody.

 

Gamble:  Are you primarily in Colorado?

Richardville:  We are in Colorado and Montana, and we also have services in Kansas.

 

Gamble:  I imagine you were dealing with a situation where parts of the system were hit harder than others.

Richardville:  Yes. We do have urban and rural facilities, and big business and small business, located in different states and even different parts of the state. And so there’s a little bit of discretion that goes into it, and a lot of complexity in terms of, ‘how do we handle this?’ It’s very similar to what you’re seeing nationally, where there are guidelines or rules you have to follow for specified conditions or for a specified period of time.

It’s a bit of a juggling act to make sure we don’t kind of move ourselves to a single way of doing things because all of our environments and many of our communities are different. We have an incident command team at each of our different care sites, and one at the system office as well.

 

Gamble:  Can you talk about how the pandemic impacted your IT strategy?

Richardville:  When we were first hit by Covid-19, there was a continued learning and understanding of what the crisis was, what it was going to impact, and how it was going to impact things. We started seeing different things happening across the globe, and like many other organizations, we’re trying to learn from what has already happened in order to be prepared for what could happen here.

We created a new structure within IT. We’re also the digital services arm of the organization; our name is ITDS as a result of that. We developed about 10 programs last year, with dozens of projects under each program. It’s very structured and disciplined as to how we move forward, balance our resources, and measure success.

As we started dealing with Covid, there was a reaction that had to take place in order to keep the business moving; one of which was transitioning to remote work. We had hardened and strengthened our virtual capabilities. We had to educate people on a different way of doing things. This was already in our plans, but we had to accelerate it tremendously.

We continued to focus on digital services, which has great returns, and allows us to be able to touch many people at one time. We stood up a couple of chatbots; one of which was external to allow potential Covid-19 patients or people caring for them to be work through a decision-making process guided by a bot. We also had one internally for occupational health for our employees, who needed to learn a new workflow and digitize that workforce. If we had gone the traditional route and just used call centers, we wouldn’t have been able to handle both the volume of calls and the information that was constantly evolving. That was our focus right off the bat.

Next, we started looking more into analytics and chatbots. The chatbots helped us process a lot of the common questions and concerns that were coming through, and the analytics really helped guide in our decision-making. And so we ramped up analytics, and we ramped up the data component. I want to make sure we separate data from analytics. Some people call it data analytics, but to us, it’s data and analytics.

The data component showed us that we had different processes in some of our care sites. We thought some of the information we captured would be similar. But because the workflows and processes were different, the data were different. There were differences in the way that some of the information was being documented, and so there was a whole effort to clean up the data component. Because there were things we weren’t tracking; especially around equipment, the rate at which masks were being used, the types of masks being used, and the ventilators being used. We had four tiers of ventilators. We had anesthesia machines converted to ventilators. We had a lot of different things that we haven’t necessarily had to track, even the number of IV poles that you had to have.

So there’s a lot we’re doing to help clean up our data. We still have a lot of work to do to harden that and make sure we don’t fall back on bad processes, but there are also other processes that may not have been valued at this time, but will be moving forward. This has allowed us to be able to identify some of those, fix some of them, and now we’re going to have to really harden that work.

Analytics has played a big part in how we understand what’s happening in our country, in our state, in our communities, and how we’re going to use that to drive our decisions of where we need to move equipment, move resources, flex it down possibly in some areas, and retool and retrain people to work in different environment or using different skillsets that we would’ve had to seek externally.

We use data to drive a lot of that decision-making. Our Chief Information Officer, Mark Korth, and our Chief Clinical Executive, J.P. Valin, really took a hold of how we were going to operate differently than we had in the past, and be able to respond to the virus rather than react. We started hearing a lot more discussion about the consumers and patients, and making sure we understand volume impact versus the value of taking care of a patient, and creating a different mindset.

As we come out of this, we’re seeing that volume isn’t as dependable as it was in the past. You have to learn how to run a business with lower volumes, and that means moving into the value proposition we’ve been talking about for a decade, where we’re taking care of people and preventing them from coming to the hospital. We’re focused on keeping them healthy and well, addressing their concerns, and making sure they’re not coming in for no reason. All these things place very high in the value world.

In the volume world, you need them to keep coming in order to get the revenue. There’s a whole different approach of how we need to continue to disrupt ourselves within healthcare. I do think the crisis allowed us to disrupt ourselves, versus the technology that was coming in. They were going to do things to us and force us to work in ways we may not be comfortable with or have done in the past — the crisis changed a lot of that. Now we’re doing things a lot differently. We’re thinking about future that looks a lot different than it has in the past, with the acceleration of that new world coming sooner rather than later. 

The other thing is, you had to have the idea that you’re a tech company; that you were a retail company, and you had to earn that right from consumers. You had to be fast and efficient with a digital workforce on the technology side. We had to learn what some of those new disruptors were going to be and to integrate that as part of who we are in order to have that tech company and retail company mindset.

The last thing I’ll say is that we were really able to distinguish between vendors and partners, which has always been very important to me. People who are more about a commodity product or service are vendors, whereas those who are partners really want to join you in the fight. And so, as we were going through this, we saw people even outside of healthcare that stepped up and started providing PPEs or making ventilators, things that show you’re part of a community. On the other hand, there were those who treated it as a sales opportunity, and were looking to give you something for free for a period of time and then charge you for it later.

For me, we really had hardened who we viewed as partners. We already had developed some key relationships with a handful of big companies, as well as the hundreds of other ones that we work with. There were plenty that came to the table to help join in the fight, whether it was through discounting or working with us to provide a service, or creating service plans and helping to execute those plans. As for those who looked at it as an opportunity — I have no desire to do business with them in future.

 

Gamble:  A lot of really great stuff there. I want to talk more about vendor partnerships. You said you already had solid relationships in place. Can you talk about how you made sure that continued during the crisis?

Richardville:  I can rattle off a few that were very good to us. Companies like Google, ServiceNow, Oracle ERP, Nuance, Dell, HP, and Salesforce — they all came to us to help us during this transition and offered services or products in a way that wasn’t about making a sale, but rather, helping you get through the struggles of what was happening. Epic was fantastic as well.

It’s kind of like when you have a crisis in your family; the friends and the family that contact you to help you are the ones you remember. The people that reached out and came in good faith to help us get through this, we’ll remember. And those that either didn’t or who you could tell were at a totally different angle, you remember that as well.

Part 2