When Patrick McGill, MD, became involved in the Epic optimization initiative at Community Health Network, it was, admittedly, for “selfish” reasons. “I wanted to make Epic more efficient for me to maintain the practice I had,” said McGill, who already had a full plate as a family physician. “I wanted to have a seat at the table to make sure we didn’t lose what we had, and it just blossomed from there.”
Despite lacking a background in computer science or informatics, he was named Chief Analytics Officer in 2018, and has relished his time in the role. Recently, McGill spoke with healthsystemCIO about his core objectives to become a data-driven organization, maintain a solid data governance strategy, and leverage analytics to address social determinants of health.
He also talks about why CHN restructured to separate analytics from IT; how they’re partnering with community organizations and competing health systems to more effectively address social determinants; understand why gaps exist and identify strategies to address them; why having a well-rounded team with diverse backgrounds is critical; and how he’s leveraging analytic snapshots to tie his team’s work to the overall mission of the organization.
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- On his relationship with the CIO, McGill said, “We really push each other and challenge each other to think differently and think strategically.”
- By pulling analytics out of IT and making it a separate department, CHA has been able to focus on “advancing technologies, transitioning the data warehouse to the cloud, and developing the skills of our analysts.”
- Two ways in which CHN hopes to achieve the system-wide goal of improving the measurement and capturing of SDoH data? By partnering with a social care network to connect patients with services, and launching a pilot to administer universal screenings during wellness visits.
- It’s inevitable that health systems will compete in several areas; understanding social determinants of health, however can’t be one of them, said McGill.
- At CHN, one of the core goals for 2021 is to improve the measurement and capture of SDoH data, and “identify network strategies through partnerships with community benefit organizations.”
Q&A with Patrick McGill, MD, Chief Analytics Officer, Part 1
Gamble: You’ve been with the organization for a few years, and in your current role since December of 2018. Can you give an overview of your core responsibilities?
McGill: Absolutely. As Chief Analytics Officer at Community Health Network, I oversee all of our data and analytic functions, including our Analytics Center of Excellence. We also have analysts deployed throughout the network. We have a unique structure at Community in that I also oversee all of clinical informatics and nursing informatics as well. I also oversee all of our all of our information technology, which means the CIO reports to me. In addition to that, I oversee our enterprise services, which includes our business process management, portfolio management, and regulatory reporting.
It’s definitely a unique structure. We pulled analytics out of IT in December of 2018 and created the chief analytics officer role, which I took on. And then about nine months later, we moved IT, informatics and business process management under a single vertical. We feel that marrying IT, analytics and informatics — especially with some of the digital transformation — really makes sense for our organization.
I always talk about how different organizations have different organizational structures and cultures that morph and match into their system. This one works for us at community. And I’m actually a family physician by training; I still practice and see patients one day a week.
Gamble: So you certainly wear a lot of hats. With IT falling under your purview, what’s your relationship like with the CIO?
McGill: I have a very close relationship with the CIO. Obviously we have a direct reporting relationship, but we really push each other and challenge each other to think differently and think strategically. He has a deeper IT background. That’s why we work so well together; there are complementary skills and knowledge. I can offer the perspective of patient care, informatics and data analytics, and he has infrastructure and architecture background. We’re able to leverage each other’s strengths through that relationship.
Gamble: What was the thought process behind pulling analytics out of IT?
McGill: We had been dabbling in analytics for quite some time. We’ve partnered with Health Catalyst since 2014 and we’ve been on epic since 2011. Around that time, our executive leadership became very interested in advancing our analytic capabilities. They were frustrated with where we were analytically, and they wanted to do more with clinical variation and population health.
And so, as part of a consulting engagement, Gartner came in, did some evaluations, and made some recommendations. They felt that for our organization, culturally and structurally, pulling analytics out of IT and making it a separate department was the right move; that focusing on building out analytics for the Center of Excellence, advancing our technologies, transitioning the data warehouse to the cloud, and really developing the skills of our analysts would be critical to our long-term success.
“It made sense to align those.”
We also had a lot of folks throughout the organization doing analytics that were embedded in the individual business units. And so it tied back to a central team it terms of skill and capability development with data quality, data definitions and data governance. It made sense to align those, and it’s been very successful.
We’ve been able to create a lot of automation of reporting, and as a result, reduce staff time. They were living in Excel; we’ve been able to leverage some visualization tools and automation to drive analytics. It’s the same thing with many organizations. I speak with folks around the country, and I don’t know of any organization that does not experience frustration with data and analytics, especially when they want to be data-driven. And so that was the principle behind that.
Gamble: Talk about some of the work your team is doing to leverage analytics for EHR optimization and workflow redesign.
McGill: We’ve been on Epic since 2011, and we’ve really focused our informatics efforts on EMR usability for provider wellbeing. Now, we’re partnering with our informatics team on a lot of decision support capabilities to really drive outcomes improvement, reduce waste, and reduce unnecessary care. As part of that, we’re focusing on social determinants of health and driving those workflows.
Social determinants of health is a great example the intersection of IT, informatics, and analytics. We can improve the workflows in the EMR to capture the data, and on the backend, be able to measure outcomes of patients, and identify network strategies through partnerships with community benefit organizations and other initiatives. It’s a great marriage of clinical practice, clinical informatics, and analytics, as well as patient outcomes and patient improvement.
We’ve also looked at productivity and efficiency — how we can utilize analytics to identify where the friction points are with usability in the EMR, and try to improve those.
Gamble: Social determinants are really interesting. It seems like organizations are gathering the data, but the next step of being able to apply it has been somewhat of a roadblock.
McGill: We had a lot of initiatives around social determinants prior to the pandemic. I think the pandemic highlighted a lot of gaps in the measurement and identification of some of the social determinant needs. And so, we’ve taken a few different approaches to try and assist with this. We’ve partnered with a company called Aunt Bertha to help embed that into the EMR to connect patients with services in the community. We did that for about a year before the pandemic; that’s been very helpful. And then about four months ago, we launched a pilot. We’ve spread it throughout all of our primary care offices for universal screening of social determinants during annual wellness visits or physicals.
We’ve seen a huge improvement in the capture of social determinants from our patients, especially in some of our populations. For example, we have a large LatinX population, Russian population and Burmese population. And so, for some of the underserved patients, this has really been eye-opening for us.
Leveraging analytics to “fill the gaps”
We’re using analytics and leveraging partnerships to be able to import publicly available social determinant data — including things like census data and other similar factors — to drive opportunity analysis and build patient personas that help augment our social determinants work as well. It’s enabling data capture in the EMR workflow and partnering. It’s utilizing data capture in the EMR workflow and partnering with machine learning algorithms to build those personas. And then the connections with our community benefit organizations help to actually fill the gaps.
I’m proud to say that one of our 2021 goals — and this is a network goal — is to improve the measurement and capture of social determinant data from our patients. But then also look at the number of gaps that were identified, and how many of them are being closed within a year. And so it’s not just a measurement exercise, but an improvement exercise to close those gaps.
Gamble: That’s so important. In terms of screening for social determinants, is that something you would share with other organizations?
McGill: Absolutely. This year we’re partnering with other health systems in central Indiana on our community health needs assessment. Obviously, social determinant data is a huge factor in that. I’ve said this many times; we as health systems can compete on a lot of different things, from who has the best joint replacement services or who has the best outcomes for quality and safety following surgery, but we should not be competing on social determinants of health. And so we’ve taken a collaborative approach with other health systems in Indiana to say, how we can partner to engage with community benefit organizations to help close these gaps? How can we leverage each other’s strengths and resources in these to help patients? Like I said, we can compete on a lot of things, but we should not be competing on social determinants of health.
Gamble: I read that your organization did some work around analytics with virtual care visits. What were you looking to learn?
McGill: Like many organizations, we went from nearly zero virtual visits to 100 a hundred percent. And so the analytics were driven around what activities telephone and video visits were being used for, especially as we’re trying to stand up the functionality. We also launched some patient experience surveys to learn things like, did patients prefer telephone to video? What was their experience? Were there certain populations of patients that preferred one over the other? How do gender and race factor into preferences.
Over the long-term, we wanted the data to be able to show, as things open back up, what the activity was with virtual visits, and where it was trending — do people want or prefer face-to-face visits or is there some stickiness to these virtual visits?
We launched eConsults at the same time. That gives us a good picture of what patients seem to prefer outside of a face-to-face visit.
Part 2 Coming Soon…