It may seem counterintuitive to hear a healthcare IT leader say she encourages her team to “get out of IT.” But to Tanya Townsend, who has held the CIO role at LCMC Health since 2014, it makes complete sense. She believes the most critical skillset for digital health leaders is to “understand the business of healthcare,” which means getting out of firefighting mode and focusing on “how we make a difference for our clinicians and our patients,” and tell that story.
During a recent interview, Townsend talked about LCMC’s significant growth – and what that has meant from an IT perspective; the most important lessons they learned during the pandemic; and how her team is ‘Putting the Patient First.’
She also discussed the keys to change management in a large organization, the challenges they faced moving several independent hospitals to an integrated platform, what she hopes to accomplish during her tenure as CHIME Board Chair (which begins in January of 2022), and how she has benefited from her involvement with the organization.
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- LCMC Health’s strategy in rolling out Epic across the enterprise was to “slowly but surely” demonstrate results over time. “It wasn’t to rip the Band-Aid off” and expect everything to be “magical.”
- Rather than rewriting the strategic plan every few years, Townsend’s approach has been to maintain the core objectives while “changing tactics or initiatives from year to year.”
- LCMC is leveraging its status as a teaching facility by recruiting residents as EHR champions and partnering them with new clinicians to learn the system.
- The lack of a standard patient identifier “has been a problem from the beginning of healthcare IT,” making interoperability “almost impossible to achieve.”
- One of the most important skills for current and aspiring CIOs is to “really understand the business of healthcare,” which Townsend hopes to build by encouraging her team to “get out of IT.”
Q&A with Tanya Townsend, Part 2 [Click here to view Part 1]
Gamble: When you’re looking at forming an integrated network from independent hospitals, I imagine a lot of it is about building trust. How were you able to get over that hump? Did you have champions or super users?
Townsend: Honestly, I think the biggest thing was results. Going through any type of change is going to bring about skepticism. Is this really going to be better? Is it going to be a cheaper, more efficient, and better experience? And so our strategy was slowly but surely proving it through incremental results over time. It wasn’t just rip the Band-Aid off and go live with Epic and everything’s magical. We had a lot of preliminary milestones going into that massive transformation. It was everything. Looking back it seems so simple, but part of the culture change is things like consolidating email platforms and changing our domain — even things like that came with some frustration, because it was part of the identity that had been so longstanding.
We also used the typical approach of standing up a steering committee and identifying the correct participants, and making sure you have the right service lines represented, and the right decision-making models in place — that whole governance model.
It’s an evolution. As you continue to mature with that process, it continues to advance and evolve over time. But the biggest thing is communicating what you’re doing and proving the results constantly — it’s not just a one-time thing.
Gamble: And when organizations have been independent for a long time, I would guess it requires a lot of patience as well.
Townsend: Exactly. And we’re a fairly large organization. We’re now over 12,000 employees and 1,000 beds, so it’s not something we can change overnight. It takes time, understanding and patience; it really is a journey. Having said that, we did do a pretty rapid implementation. It was about a two and a half year project to get that large of an organization converted over to a single platform from what was multiple different versions.
Gamble: You mentioned clinicians before. Can you talk about how you’re working to ensure they have a positive experience while also balancing all of the other components such as security?
Townsend: Definitely. All of these things require time and attention. Everything that we’ve talked about so far is part of my IT strategic plan. We’ve had the same core strategic plan for several years; we just changed the tactics or initiatives from year to year. Cybersecurity, for example, isn’t something you work on one year and then retire it and move on to something else. It’s something that you have to always focus on.
Each one of the programs that are part of the strategic plan have a new fresh look from year to year; we either advance tactics within it or we change the goals. For example, if we wanted our clinicians to achieve a CPOE rate of 90 percent upon go-live, we would advance that this year because we want to pursue HIMSS Stage 7, which requires a 95 percent adoption rate of CPOE. We advance the goals from year to year.
We actually have a program as part of the IT strategic plan called ICEH (Improved Clinician Efficiency and Happiness). That’s one of the programs we evolve year over year through various tactics, whether that means we’re measuring CPOE or measuring user happiness through surveys, or just making sure we’ve adopted all of the capabilities and tools that Epic has to offer. That’s a focus.
We report on that program on a monthly basis. And it’s not just physicians; it’s nurses as well. On the nursing side, it’s ensuring we have solid flowsheet capabilities so that they’re not spending too much time charting at the end of the day. We actually can measure through this system how much time physicians or nurses spend on various aspects of the EHR. We have data to very quickly deploy resources, respond, and support in those areas.
Because we are a teaching facility, we do have residents who actually enjoy using the EHR and teaching their peers, and so we leverage them a lot when we think a provider might be struggling based on the data. We can deploy the residents to go with them to personalize the EHR, and/or if we have new clinicians being onboarded, we’ll partner them off. We also have medical informaticists and nurse informaticists who help us analyze this data and deploy it based on the strategic goals within that program.
Gamble: Right. Now, I also wanted to talk about the work you’re doing with CHIME — why it’s important to you and what you hope to achieve as 2022 Board Chair.
Townsend: Sure. I’m honored to be part of CHIME. It’s an incredible privilege. I’ve been a member for many years, and it’s been such an amazing experience for my own career development. I’ve participated in the many levels of membership, from education opportunities such as Boot Camp, to mentorship advisories, to all of the different forums and education events CHIME has to offer. It’s been such an incredible experience to now serve as the incoming chair. I’ve made so many friends. I’ve had advisors, mentors, and peers that I’ve been able to connect with and learn from, both on the healthcare IT leadership side, and the foundation partner side.
One thing I’m looking to accomplish during my tenure or term is to continue to advance membership growth. When I started about 15 years ago, it was a pretty small organization. At that time, it was only the CIO or the top IT executive within an organization; now we’ve really expanded that and I hope to continue that.
I want to grow the ecosystem of what we consider healthcare IT. There are so many avenues now through CHIME at all levels of IT leadership and various levels of career development, whether it’s informatics or security or technology or digital or applications, there’s so many now additional levels of membership available. I look to continue to advance those leadership and education opportunities for members. And then of course, we want to be the organization for healthcare IT education across the world, so we’re definitely looking to continue to expand our footprint.
In addition to that, I am also an advocate for our CHIME Diversity and Inclusion Committee. I mentioned it already, but this past year definitely highlighted a big need for change around injustice and inequities. It brought to light, as I look at my own organization and CHIME membership, the need to ensure we have diversity in place so that all backgrounds have an opportunity to participate.
As a woman in technology, there have been many times over the years that I’ve been the only woman in the room. That has changed, but we need more of that. I want to encourage more women and more people from diverse backgrounds to seek out leadership opportunities.
Also I want to commend this committee and CHIME for not just saying that it’s important, but also producing avenues to do just that. We now have a scholarship available for diverse members to continue to develop in healthcare IT and take advantage of the education available through CHIME. I’m excited about that and want to advocate for more of that.
Last but not least, I have to include a plug whenever I can for the need for a universal patient identifier. Through CHIME Public Policy, I will continue to support them and we will continue to advocate on why it’s so important; why we need the universal patient identifier. This has been a problem from the beginning of healthcare IT. It makes things like interoperability almost impossible to truly achieve when there is no perfect match going across disparate platforms. Trying to make a match on a patient can be unsafe, and it makes it very difficult for those requirements to be met. That’s another opportunity through CHIME that I’m hoping to help support and advocate going forward.
Gamble: The last thing I wanted to touch on is the evolving CIO role. What do you think it will look like going forward? What skills or attributes will CIOs need to have?
Townsend: Great question. I think the biggest evolution that we’re now seeing is a shift away from the back-office, keeping-the-lights-on type of model that’s focused on ensuring systems are available and measuring helpdesk statistics. Those will continue to be important, but I think we need to move away from firefighting and toward innovation.
I would say the biggest skill for up-and-coming healthcare IT leaders is to really understand the business of healthcare. I try to encourage my own staff to, as I call it, get out of IT. Get out of the day-to-day firefighting and service tickets and help desk tickets. Those are important, but that’s routine work at this point. Let’s really focus on how we make a difference and communicate those results. Tell that story.
Everything we do should focus back to our clinicians, our patients, and our community. How do we translate what it is we’re doing into how it benefits our organization and our community? I call it key performance indicators (KPI). Let’s get out of firefighting mode and focus on those KPIs that make a difference and that we can tell a story around. Whether it’s implementing best practices that resulted in improved safety or improved patient outcomes, or implementing new revenue cycle functionality that creates efficiencies, earned us more revenue, and/or even reduced cost for us — how do those things make a difference for patients? Now they have access to online scheduling. They have access to a patient portal where they can communicate more readily with their care provider, which can result in improved patient satisfaction scores.
That’s the biggest thing — really understanding how we make a difference for our clinicians and our patients. And it’s not so much about how we make sure the systems are available and safe, which we always need to do, but taking it that step further and telling the story.
Gamble: I really like how you put that. It really is increasingly important to be able to communicate effectively and tell that story. Thanks so much for your time, and I hope to speak again soon.
Townsend: I appreciate it. Thank you.