When you have timelines in place and milestones to meet, as CIOs always do, the last thing you want is to delay them. But when disaster strikes – and poses a strain on your team’s resources – difficult decisions have to be made; projects need to be put on hold and expectations need to be adjusted.
It’s a difficult scenario for any organization; particularly one specializing in behavioral health, where “patients can be even more distressed and have more anxiety and worry.” For BestSelf, which was formed by the merger of Child & Adolescent Treatment Services and Lake Shore Behavioral Health, meeting this needs of this population is one priority that cannot be put on hold, according to Kevin Wiese. Recently, he spoke with healthsystemCIO about how his team worked to ensure care continuity during the pandemic, all while ensuring a major EHR migration stays on track, and how he has been able to leverage his previous experience in project management. He also discussed the key challenges in going through a merger, how the organization is looking to improve security, and what he enjoys most about working in the behavioral health setting.
- EHR training with super users
- Leading technology integration during the merger
- Migrating records: “We planned thoroughly and had the right people involved.”
- The “large & lengthy project” of merging data centers
- From the vendor to the provider side
- Value of executive support – “That goes a long way in helping me do my job.”
- Telehealth’s potential impact in behavioral health
- “We don’t want these to be IT projects.”
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It took some time, as these things do, but we planned thoroughly on the IT side, and we had the right people involved.
Our executive team really supports the use of technology, understands the importance of it, and understands the importance of security. That goes a long way in helping someone like me do my job
On the IT side, we look at our staff as our customers. We have a thousand customers here at BestSelf; our top priority is to provide the best service to them that we possibly can.
The behavior health space tends to have a higher no-show rate for visits than other specialties, and so we’re wondering if the convenience of being able to do a telehealth session can help us reduce that rate. Time will tell as we continue to look at the data.
Oftentimes, we end up learning things from our non-IT staff. So, it’s important for us to survey those folks and do a thorough job of testing applications before we go ahead and do a mass deployment.
Gamble: A big part of transitioning to any new solution is training. Can you talk about your approach to that?
Wiese: We’re lucky enough to have a wonderful training department at BestSelf that will play a large part in coordinating and conducting the training program for the new EHR system. We’ll start meeting with them to craft a strategy for how we’re going to involve our super users, get them trained, and develop plans to get the rest of the organization up to speed on the product, hopefully by the end of this year.
We haven’t finalized anything yet, but that will no doubt include things like a training lab where folks can get some hands-on experience with the application. It includes some web-based training as well that makes it easier for folks to attend and view at their convenience, along with some recorded training as well. There will also be an added focus on particular job duties; for example, trainings for counselors, physicians, and administrative office staff.
Gamble: Right. Now, you were at Lakeshore Behavioral Health prior to the merger. What type of role did you have at that point?
Wiese: I was initially hired by Lakeshore as the clinical EMR manager. At the time, Lakeshore had about 250 employees. I was brought in to manage the EHR application; I helped optimize the organization’s use of the application, and ensure it was using all the features and functionalities.
Gamble: How did your role change from there?
Wiese: At the time of the merger, I had been promoted to the vice president of information systems, and so I led the technology integration portion. There were two large pieces to that. One was the traditional IT infrastructure piece — the data center, and the second was the merging of client records in the EMR system. To our advantage, both organizations used the same Cerner EHR platform at the time.
Gamble: I’m sure that made it a bit more manageable.
Wiese: Absolutely. There was a lot less training; in fact, there was very little training that had to take place because of that. The biggest lift was we decided to migrate the active client records from Child and Adolescent Treatment Service’ Cerner database, because they were smaller at the time, so they migrated those records into the Lakeshore database.
Gamble: That aside, was it a fairly manageable merger, and far as everything that needed to happen from an IT standpoint?
Wiese: It went well. It took some time, as these things do, but we planned thoroughly on the IT side, and we had the right people involved. It was more challenging probably for the Child and Adolescent Treatment Services staff, just because they were migrating into our EHR system. And so, although there are a lot of similarities, there were also differences in the types of forms, or the appearance of a treatment plan, or the look of a progress note that required some adjustment for the staff. We really merged two data centers into one. That was another large and lengthy project that took probably about a year. One organization had its data hosted by an IT partner here in the Buffalo area, and Lakeshore had its own onsite data center. And so we decided to pick up those two and merge them.
Gamble: You mentioned before having some experience on the vendor side. What made you interested in coming to healthcare, and specifically to behavioral health?
Wiese: I’ve always enjoyed the healthcare side of things. And actually, prior to my time with the medical software company, I worked at a local hospital in Buffalo. I enjoyed healthcare and I enjoyed technology, and at the time, I decided to move on. Things were changing in the EMR industry. A lot of the practices I was leading already had EMR systems in place, so there wasn’t as big of a need on the new implementation side. I had a desire to get involved with a healthcare organization where I could work on the technology side and work for a company that was delivering needed health services in the community. I found that here.
Gamble: What would you say are the biggest challenges of working in the behavioral health space?
Wiese: Funding is always a challenge in the nonprofit sector, but we do a good job here. We have a team that does a great job of managing those funding sources and taking advantage of as many grant opportunities as we can. Our executive team really supports the use of technology, understands the importance of it, and understands the importance of security. That goes a long way in helping someone like me do my job and deliver good services and support to the organization.
Gamble: On the flip side, what are some of the biggest benefits of being in behavioral health?
Wiese: BestSelf is a wonderful organization to work for. Management is very supportive, and there’s a lot of autonomy. It’s a great place to work from that standpoint. And we provide a great service to the community. Our clients feel that they get a lot of benefit out of the services they receive from our folks.
Everyone here really cares about the services they provide. On the IT side, we look at our staff as our customers. We have a thousand customers here at BestSelf; our top priority is to provide the best service to them that we possibly can.
Gamble: It’s been interesting to see telehealth get the push it needed. And as you pointed out, some patients actually prefer it. What are your thoughts on what we might see as this shakes out, particularly in the behavioral health space?
Wiese: There are a couple of interesting things we’re curious about. One thing we’re continuing to monitor is staff productivity. Obviously, on the fiscal side, we need to make sure our staff are being productive and that we continue to bring in revenue. We have a lot of dashboards and visualizations that allow us to keep almost a real-time look at that.
Another area we’re curious about is no-show rates, and whether we’ll see an impact there. The behavior health space tends to have a higher no-show rate for visits than other specialties, and so we’re wondering if the convenience of being able to do a telehealth session can help us reduce that rate. Time will tell as we continue to look at the data.
Another really big effort is our information security program. In addition to the EHR initiative, that’s a top priority here in 2020. We’ve really ramped up our efforts and are looking to make some big gains on the security side here this year.
Gamble: Do you currently have a security officer?
Wiese: That’s one thing we’ve addressed. I’m actually our HIPAA security officer; I’ve historically managed that piece. We also have a security team that includes our CFO, our IT manager, and our chief compliance officer. But we also recently hired a security compliance analyst, which is going to be a great addition to our organization, and we’ve partnered with an IT vendor in the area for some managed security services. We really felt that we needed to address those two components of our information security program. One is the technical side and the other is the compliance side. We want to ensure we have the proper policies and procedures in place, and that we’re adhering to them.
We just completed a comprehensive review and revision of our security policies and procedures. We’re getting ready to deploy a multifactor authentication solution, and we’ve recently deployed a secure management platform which really helps us on the HIPAA security side as well. So there are a lot of important things going on here on the information side and the cybersecurity side.
Gamble: That’s so important. Do you think that providers understand why it needs to be done, even though these things can disrupt workflow? Has that been a challenge, or is there an understanding of what needs to happen in terms of security measures?
Wiese: We certainly hope there’s an understanding. We have what we think is a pretty good security awareness program where we continually try to train and reinforce threats and things that folks need to be aware of. Like I said, we have good support from the executive team here on these investments.
It needs to be integrated into everything our folks do. With our multifactor authentication project, for example, we did a thorough proof of concept with the vendor. We piloted it not only in IT, but also with about 20 of our program managers and directors to get their feedback and see what types of issues they might encounter, and to be able to leverage them for buy-in across the organization.
Gamble: I would think that can really make a difference in getting buy-in and building trust.
Wiese: We hope so. As the saying goes, we don’t want these to just be IT projects. We want people to feel included, and we want to give folks an option to express their opinions. Oftentimes, we end up learning things from our non-IT staff. So, it’s important for us to survey those folks and do a thorough job of testing applications before we go ahead and do a mass deployment.
Gamble: I’m glad you brought that up — security is such a key component in every aspect of care delivery.
Wiese: Sure. It’s what we’re eating and breathing nowadays.
Gamble: Right. Well, this has been great. I want to thank you so much for your time, and I’d like to follow up down the road, especially as you get further into the implementation.
Wiese: That would be great. I’m always happy to talk. I appreciate you reaching out and I look forward to another conversation down the road.