Q&A with CIO Dustin Hufford, Part 1: Adopting an Agile Mindset & Flipping IT Governance

When Dustin Hufford was named full-time CIO at Cooper University Health Care — after serving as AVP of IT applications and interim CIO — he was ready to hit the ground running. “If I get this, we’re going to jump right into strategy development,” he recalled thinking.

That was in December of 2019, which meant just a handful of weeks passed before his team had to pivot to focus on facilitating new models of care delivery. Like so many other leaders, he realized how quickly things happened when there was a single objective, and so, when it was time to reassess priorities, Hufford adopted a new strategy: agility.

“We were able to move quickly,” he said during an interview with Kate Gamble, Managing Editor of healthsystemCIO. “That’s what we’re trying to harness. How do we get to that level of focus and attention? We think agile is a way to do that.”

During the discussion, Hufford talked about the foundational work his team is doing to take on a new approach, and why they’re flipping the traditional IT governance model. He also discussed the challenges of retaining staff in a competitive market, how he has benefited from his experience with community hospitals, and Cooper’s ultimate goal of improving access to care.

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Key Takeaways

• Among the “key pillars” of the IT strategy are: strengthening the foundation (particularly in terms of staffing), assessing digital capabilities, and converting to an agile framework.
• One of Cooper’s core objectives is leveraging technology to improve access to care and ensure “people aren’t bouncing around” when they contact the call center.
• Number one lesson learned from Covid-19? “When everybody was focused on one core mission, things happened quickly. Decisions happened quickly.”
• Hufford’s team hopes to flip the traditional IT governance strategy on its axis by assigning project owners and making them responsible for the order in which tasks are done.

Q&A with Dustin Hufford, Part 1

Gamble:  Hi Dustin, thanks so much for taking some time to be with us today. Let’s start with a high-level view of Cooper University Healthcare — where you’re located, what you have in terms of hospitals, things like that.

Cooper:  Sure. Our headquarters are in Camden, N.J, right across the river from Philadelphia, which is also where our hospital is located. We’re an academic tertiary care center with just over 600 beds. We have around 120 ambulatory locations as well. That includes urgent care, laboratory locations, and clinics spread out all over south Jersey. We’re the only Level 1 trauma center for south Jersey, and one of the busiest ones in the region.

Our medical school is partnered with Rowan University. It’s a fairly new arrangement — within the last 10 years. We had our first graduating class a few years ago. We’re really trying to build up our research infrastructure along with that and strengthen our program. It has grown really fast; we have quite a few residents and staff at this point.

 

Gamble:  I can imagine that’s going to be a game-changer once you’re able to get more students and residents into the rotation.

Hufford:  Definitely. We have goals around how many we convert into full-time employees after they’re done with their medical school stint. It’s a good feeder for our programs and for our academic mission. It helps us to be innovative with our clinical delivery.

 

Gamble:  And in terms of clinical applications, you have Epic in the hospitals and clinics?

Hufford:  Correct. We’re on Epic across the board. The only two systems we haven’t converted are lab and cardiology. The rest is all on Epic.

 

Gamble:  Are there any plans for upgrades or updates in the near future?

Hufford:  We try to stick with their quarterly upgrade scheduled as much as possible. Right now, we’re in a six-month cycle, so we do two quarterly updates at a time. We have a good rotation with that now. Every six months we pull the updates, and they’ve been pretty smooth.

Epic has done a good job with debugging; we’re able to pull it up with very few errors at this point. It’s almost a non-event. It wasn’t always like that, but recently it’s been pretty stable.

 

Key pillars of Cooper’s IT strategy

Gamble:  At this point, what do you consider to the core objectives from an IS standpoint?

Hufford:  As we came out of the pandemic, we took a lot of time to focus on our strategy for technology. In the first quarter of 2021, we did our overall IT strategy, and born out of that was our digital transformation strategy.

There are a few key pillars to that. One was strengthening our foundation — that had a lot to do with staffing. We found that we were pretty understaffed compared with organizations of our size and revenue. And so, we built it into our plan over the next couple years to basically get to the point where we should have been a few years ago.

That put us a little behind on things like Epic upgrades and keeping some of our departmental systems up to date. The strategy really addresses all that in terms of getting staffing where it needs to be, and then catching up some of those systems.

Also on the roadmap is our overall portfolio. I mentioned some of areas in which we haven’t cut over to Epic. It’s in our plans now to at least get cardiology on Epic; lab will happen pretty far down the road because it’s an expensive, large project that’s going to be a strain on capital. We want to be innovative in the next couple years and to keep up with what’s happening in the market, and so it doesn’t really make sense to cut lab at this point. And so, the foundation is one of the pillars.

Another is the digital strategy, which is where I’ve been focusing a lot of my time on things like building out the staffing infrastructure. There are a lot of new roles and capabilities we need in order to harness digital.

Converting to an agile framework

We’re also focused on our operating model. This year we’re planning to basically convert the entire IT operating model over to agile framework or agile scrum. We’ve cut over five teams so far. We’re running it like a traditional agile model where the project owner is staffed from outside of IT. We do this because it takes up 50 percent of their time to help us with the road mapping and lead the team through the transformation exercises.

Improving access to care

We’re focusing on a lot of the same areas as other health systems, one of which is streamlining access to care. That includes things like omnichannel communication with our contact center and first-call resolution. For example, how do you make sure that people get to the right spot, the first time, as much as possible, so that we’re not bouncing people all over the system until they get what they need?

Things like online scheduling are also in their bucket, but we’re thinking a little differently now. We’re trying to think about our agile teams in terms of journey-mapping the patient experience, the physician experience, and our staff’s experience, and making it as smooth as possible using digital tools inside and out.
We have some other big initiatives as well. We’re replacing our PACS and switching out our ERP, going from Lawson to Infor CloudSuite. That’s a pretty massive project; we’re transforming across the board.

 

Lessons learned from Covid-19

Gamble:  That’s a common theme we’re hearing. Can you talk a little bit more about adopting an agile framework?

Hufford:  There’s a lot of change management involved, obviously, with moving to agile. We’re trying to learn from the lessons of the pandemic. One of the things that kept coming up, not just within IT but all around the health system, was that when everybody was focused on one core mission, things happened quickly. Decisions happened quickly, and you were able implement things that would’ve taken months or years in a really short timeframe. I’m sure you spoke with a lot of health systems that said, ‘we brought up virtual care in four days.’ You had to. Everybody dropped everything else to roll out things like virtual care. All of the eyeballs were on it. And so, if a decision had to be made, there were multiple calls happening each day to push that along.

 

Agile’s role in IT governance

You were able to move forward quickly — that’s what we’re trying to harness into the future. How do we get to that level of focus and attention? We think agile is the way to do that. It also solves a lot of the problems with governance of IT projects. People like to give presentations at conferences about governance, and then when you pull back the covers, you find that they made some cool graphs, but they’re not really governing because it still comes down to whoever screams the loudest gets what they want — or whoever has the budget for software. They’re able to get it pushed through legal and you’re caught with an implementation you didn’t plan for.

This flips that on its head and says the project owners are responsible for the order in which we do things, but you have a clear schedule you can communicate to the rest of the organization. They can come talk to you and negotiate about the schedule, but that’s the only way to get work done, versus having fast-acting teams that are focused on whatever’s on their plate at that moment.

Change management is still a big part of that. We’re working through that with our own staff — some of them think something’s going to happen to their job. It’s scary because they’re used to supporting an Epic module, and now you’re talking about cross functional teams where they’re going to have to look at things outside of that world. We’ve gotten comments from people who think they’re going to get laid off, but that’s not the case. We’re staffing up big time over the next couple years.

It takes time to get folks to understand what we’re trying to do and that it will be a good thing for their career to have that broad, cross functional knowledge and understanding of how the business works. That’s our thought process.

Part 2 Coming Soon…