Q&A with CIO Andy Crowder, Part 1: “We Don’t Want to Be Looking in the Rearview Mirror.”

It takes quite a bit to entice an established CIO to pick up and move across the country. For Andy Crowder, it came in the opportunity to join Atrium Health, an organization that’s growing at a rapid, but deliberate pace, and establishing itself as a leader in innovation. In fact, due to its size and scale — particularly after merging with Wake Forest School of Medicine — Atrium has become “a living laboratory” where researchers can test ideas, and clinicians apply them in practice.

Recently, healthsystemCIO spoke with Crowder about his objectives at Atrium, the difficult balance leaders face in maintaining systems while also fostering innovation, and what has surprised him most about the 42-hospital system. He also talks about the groundbreaking work clinicians have done during the pandemic, the skillsets needed in today’s “new office,” and how he’s adjusting to life in the Tar Heel state.

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Key Takeaways:

• Through the recent merger with Wake Forest Baptist Health, Atrium hopes to create “a new academic teaching model,” as well as a leader in innovation.
• As remote work continues to gain traction, “different skills and different muscles” are required to ensure teams stay connected while also maintaining a healthy work-life balance.
• Because of the solid processes and infrastructure that were in place, Atrium has been able to stay on target and under budget with several initiatives during Covid-19.
• Atrium Health has a rich history in terms of EHR capabilities and digital tools, but it’s important not to focus too much on the past. “It’s about what’s the next thing to do. What’s the next interaction?”

Q&A with Andy Crowder

Gamble:  How long have you been in North Carolina?

Crowder:  Since July of 2019.

 

Gamble:  So a little over a year. Let’s talk a bit about the merger with Wake Forest Baptist Health. What’s the status there?

Crowder:  Yes. We actually just announced it publicly. All of the new work structure notifications went out internally. We’ve been under FTC due process — that started a few months before I joined the organization. I think we all thought it would’ve been done sooner, but it was just recently finalized.

 

Gamble:  So this is creating a pretty large organization. I want to get your thoughts on how it’s going to impact your strategy — or how it has already.

Crowder:  During the interview process, I was able to connect with executive leadership at Wake Forest. They were part of the final rounds of the interview process, and so I developed a relationship.

It’s a phenomenal combination. We believe we’re going to create a new academic teaching model for the nation. Our total employee head count increased to about 65,000. In IAS (information and analytics services) alone, between the Navicent and Wake markets, it’s increasing to almost 1,700 FTES that make up information and analytics services.

We’re pretty excited about the innovation corridor and all of the innovation work we have going on in the core market. We are attempting to create a Silicon Valley on the East coast, which is a pretty lofty goal, but we believe it’s one we can capitalize on. Along with Rasu Shrestha, MD, who came here from UPMC, several of us collaborate through the Strategy and Transformation Office, of which I’m a member. We have an investment portfolio where we partner with leading-edge — and sometimes, bleeding-edge — technology companies in the HIT space. When you’re able to bring the academic part of it together with innovation and research, that’s something to be excited about.

 

Gamble:  When you talk about having a Silicon Valley-type model, what does that mean to you?

Crowder:  Both Atrium Health and Wake Forest have been doing clinical research and clinical trials at a significant level. This combination gives us the capability of leveraging our financial strength to choose strategic partners that take our game to the next level from an academics point of view, and from a patient care point of view.

Absent the academic teaching institution portion, I think we would have been limited in the amount of focus we could put on research and education. By bringing those two things together, we have rich data sets across the organization that we’re able to utilize; Atrium Health, based on its size and scale, is a living laboratory. We certainly want to capitalize on those. And although you can’t partner with all of those, a few strategic partnerships can make a pretty significant difference in our industry.

 

Gamble:  You mentioned a new model for academic institutions. What do you foresee happening with that?

Crowder:  Gene Woods [president and CEO] and Julie Ann Frieschlag [Chief Academic Officer] are phenomenal collaborators. When you think about what a medical student has to go through in terms of the cost of that education, we want to bend that curve. We also want to have a more diverse education portfolio than we do today. If you look at medical education and what it takes to get into some of the schools, we think we have an opportunity to reach a broader group of candidates and bring them through the education system a lot differently than what’s been done historically.

 

Gamble:  I can imagine it’s an area that has really felt the impact of Covid. Can you speak to that?

Crowder:  Education and learning have been dramatically impacted, not just in higher education, but across all levels. Things that we never thought could have been done virtually have been moved to virtual. There is a dynamic in medical education that’s about caring for people and touching people and doing that in a safe way. Those things are never going to go away, because it is a human business centered on relationships and trust. And some of that can be done virtually — a lot more of it than we thought, as we’ve learned during the Covid-19 timeframe. But a high percentage of the in-classroom training has been moved to virtual because right now it’s just not safe to congregate.

I believe this to be true — and I think others in the industry have seen it — that there’s going to be a whole book of business that never goes back to brick and mortar. We see that with our teammates. When Covid started, we moved 10,000 employees remote.

If you look at it from a productivity standpoint, there are some benefits. You’re going to see a high percentage of workers never go back to the office type of environment. This is going to be the new office. You have to figure out how to not live at work — or sleep at work. So it’s about having boundaries and staying connected; all those things require different skills and different muscles. That’s a big focus for our organization at large.

 

Gamble:  I would imagine it’s an ongoing process.

Crowder:  Absolutely. It really is all about safety — doing the right thing and caring for all of our teammates. Early on, probably in the July timeframe, we said we’d extend remote work until the end of the year. There’s a high probability that we’re going to push that to July of 2021 when we create a formal recommendation around our long-term strategy.

 

Gamble:  As far as some of the other major things on your plate, where is the organization now in terms of Epic? Are all of the hospitals live at this point?

Crowder:  Wake Forest has been on Epic for some time. We have Epic’s Revenue Cycle implemented everywhere, and the CRM system has already launched. We’re also moving everyone onto Epic’s virtual care platform for video visits.

We do have several hospitals on full clinicals, revenue cycle, inpatient, and outpatient. Navicent in Macon, Georgia is scheduled to go live as part of the enterprise design and build on July 4 weekend, and we plan to have all of the core market hospitals live by August of 2022.

 

Gamble:  Has the timeline been affected by having 10,000 people go work remotely?

Crowder:  No. Actually, Epic is just one leg of our digital acceleration strategy. We have Epic. We have Core Connect, which is an Oracle cloud ERP transition. We have our virtual care, predictive analytics, One Cloud, and all of our consumer digital front door advanced tool sets. So there are six major initiatives. Epic is just one of them.

Initially when we started this, we were concerned obviously about what the impact would be. I can tell you that we’ve been able to stay on target and under budget; our teams have really been able to focus on the work in front of them in virtual mode.

This is my third organization implementing Epic. And I have say, our ability to stay on track and execute the Epic milestones and build dates has been more effective and efficient here than any of my other organizations. I think it’s a combination of focus and purpose.

When you’re in a pandemic and you’re doing things virtually, you’re focused on the task at hand, as opposed to all of these other items that can be distracting. I do think it has made it hard for people to not have 12- and 14-hour days to hit some of those tasks. And so teammate health and wellness is something we’re really focused on, but right now we haven’t slowed down a single thing, despite having all the Covid activities going on.

 

Gamble:  That’s pretty amazing. I’m sure it’s an easy trap to find into if you’re not used to it. Like you said, having those boundaries is important. You mentioned that Epic is just one of six initiatives. Can you talk about some of the other work being done, especially in that digital front door?

Crowder:  Sure. From the time our customer has an interest in their health and wellness options, we want Atrium Health to be top of mind. We want the things that our customers need and want to be readily available, and in a multitude of different mediums — everything from clinical taxonomy, dynamic search capabilities, chat, and AI to provide them content and information in a frictionless way.

If they’re an existing customer, or even a new customer, we want them to have the ability to engage 24/7 with our care centers, and to have all of that rich data ingested into the CRM cockpit that the resources in the call centers have, to be able to know our customers and our patients on a very different level. That’s an incredible capability for us. It’s taking care of the existing patients and customers we have, but it’s also about growth and new customer acquisition. If you don’t make it easy for people to find the things they want, select them and feel like they have a trusted relationship with you, you’re not going to have the market growth you want to have. That’s one of the lenses.

Another one is really centered on our virtual care activities. As we grow into markets that don’t have caregivers in that space or rural markets, having a robust virtual platform is really important. Within 5 to 7 days of the pandemic, we rolled out a Covid virtual hospital at an acute and non-acute level and leveraged our medical staff to visit people in their homes and take care of them — that helped us with surge capacity as well as a host of other things.

Virtual is a big part of our digital acceleration strategy; thankfully it’s an area in which Atrium Health has made significant investments. We were able to scale it over the course of six weeks. We brought on another 2,500 providers to that platform, because 80 to 90 percent of care in the ambulatory space was all about virtual.

The third leg of the strategy is digital analytics. Omer Awan [Chief Data & Digital Officer] and our other resources have done a phenomenal job. Wake Forest has a rich history there, and Atrium has done really well in terms of EHR capabilities and digital tools, but we don’t want to always be looking in the rearview mirror. It’s about what’s the next thing to do — what’s the next interaction. And so we’re really making significant strides in our analytics capabilities. We’ve already moved a host of our hub and spoke resources and self-serve capabilities, but we have more to do in that space.

With Core Connect, our ERP solution, we’re taking away some of those laborious processes to allow teammates to engage in self-service activities. That’s rolling out in January, so 2021 is going to be a very busy year. I don’t think we’ll go more than 90 days without some form of major go-live, whether it’s EHR, ERP, or digital consumer capabilities.

The last one is something I’m really excited about. Eric Christian, our CTO, has been leading a strategy for several years around moving to the cloud. We’re not in a position to move away from our on-premise data center business; within the next 18 months, we should be out of the data center business altogether, and using public cloud or private cloud solutions to give us speed and agility so that we can move faster from a growth perspective.

That’s enough to keep us busy. The other thing is, we’ve got such phenomenal teammates in this group and brilliant engineers and informatics resources. Harnessing those specific skill sets from an innovation point of view is going to be really interesting. How do you keep those major initiatives going, but also drive innovation and create a culture that says it’s okay to innovate and fail fast, so that you can keep going?

Part 2