When Jeff Sturman’s title was changed from CIO to chief digital officer a few years ago, the rationale was clear. Memorial Healthcare System wanted more focus on the consumer experience, and they wanted it to come from the top. As part of the shift, call centers now report to the CDO, which provides the opportunity to shape the experience from the beginning
“We have to figure out our competitive advantage,” Sturman said during an interview with Kate Gamble, Managing Editor at healthsystemCIO. “Instead of patients coming to us, I think we need to get to them, and that means delivering where they want.”
During the interview, he talked about his team’s core objectives – including moving to a new ERP system; how they’re leveraging analytics to improve patient flow; why partnerships are more critical than ever; and the ultimate goal of taking the friction out of healthcare.
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- “We’re really good at hospital-based medicine. We know we’re not as good at some of the other ways in which patients and consumers want to get care.”
- One of his core objectives? To act as a cohesive organization, rather than 6 different hospitals. “We’re trying move as a health system, and focus on creating standards, creating tools, and creating consistency in experience.”
- Implementing Epic’s command center to improve patient flow in the ED and get patients out of the hospital and into post-acute settings quickly and more efficiently.
- Migrating to a new ERP after 25 years is a big lift, but Sturman believes it will “get us to the next level in terms of how we manage our business.”
- As with any initiative, the most critical component in implementing a new ERP is “the cultural lift” and the change management piece.
Q&A with Jeff Sturman, CIO, Memorial Healthcare
Gamble: Hi Jeff, thank you for doing this. I want to talk about some of your core objectives at Memorial, what you guys are looking at for next year, and then some of what’s happened as far as the restructuring of leadership. First, for some background, Memorial Healthcare is located in South Florida and you have six hospitals?
Sturman: Correct. We’re about a $2.8 billion healthcare system with 2,300 providers on our medical staff, and almost 15,000 employees. We’re a public system. We’re the South Broward Hospital District so we own essentially a third of the county; the other two-thirds is our sister health system, Broward Health. They’re smaller in terms of revenue and employees, but that’s because we continue to serve a lot of areas even outside our general geography.
It’s a great healthcare system. I love being here. It’s very family and community focused, and I think we’re doing some great things on the digital front.
Partnering with Broward Health
Gamble: I definitely want to get into that more. But just for clarification, what’s the relationship like with Broward as far leadership?
Sturman: We’re very close, which is relatively new in that closeness in the last year and a half. Shane Strum is their CEO; he’s a good friend of mine and is a terrific leader. He used to be with Memorial and was also the former chief of staff for three different governors in Florida.
We’re working in partnership with Broward Health right now. One of the first areas out of the gate is IT collaboration. There’s a lot going on there. Our relationship is very good. I’m actually doing double duty these days as the interim chief digital officer as well as my role with Memorial.
Gamble: That’ll keep you busy. So let’s talk about some of the digital transformation you guys are doing and what you’re seeing for the near future.
Sturman: Sure. Everything we’ve been doing in the last few years has been pandemic-focused to some degree, but we’re really trying to look at how we engage our consumers at a different level. For a long time, my executive team probably didn’t want me to use the word ‘consumer.’ They’d want me to say ‘patient.’ I think they’ve evolved in that respect.
We have a new CEO, Scott Wester, who is incredible. He came from Baton Rouge, Louisiana, and has been with us since the summer. He’s progressive, he’s smart, he knows healthcare operations, he knows strategy, he knows partnerships, he knows financials, and he knows IT. We’re really excited to have Scott here. And it’s influencing our agenda and our strategy. The things we’re doing in digital and IT are really focused on how we’re facilitating the overall healthcare system strategy.
Improving care outside of the hospital
For example, I mentioned partnerships. We’re working with a lot of different companies right now to think about delivering care in different ways. We know we’re really good at hospital-based medicine. We know we’re not as good at some of the other ways in which patients and consumers want to get care — things like hospital-at-home, home health, orthopedics, and women’s services. And so, we’re looking at different partnerships that can help facilitate those areas of movement and get healthcare out of the hospital. Obviously technology plays a huge role there with remote patient monitoring and virtual care.
Moving “as a health system”
One of the major areas I’m looking at right now is taking virtual care to the next level for primary care, urgent care, and behavioral health services. That was born out of necessity during the pandemic and certainly has carried over now.
The other thing that we’re focused on — and there are so many — is the fact that we have six hospitals and several ancillary facilities, but we have historically thought of them as almost independent from each other. And so now, we’re pulling those organizations together to be a healthcare system. I know that doesn’t exactly sound novel, but for a lot of organizations, it is novel.
We’re really trying to move as a health system, and focus on creating standards, creating tools, and creating consistency in experience. As part of that, we’re standing up what we call the command center or our Care Coordination center to help with patient flow.
The patient flow problem
We have a considerable problem, as many others do, with patient flow. Two of our biggest hospitals, one on the east side and one on the west side of our county, are both holding a huge number of patients every single day in their emergency department. We’re not getting patients out of our hospitals as quickly as we need to in order to get them to the various post-acute settings, whether it’s long-term care, home health, rehab facilities or what have you. We think the care coordination center we’re standing up will make an impact.
And technology is at the foundation. We’re implementing Epic’s command center function in the Care Coordination center. That’ll be a huge lift both from a technology standpoint but also operationally, because everything we do has a huge operational slant.
From EHRs to ERP
The third point I’ll mention — and this might not seem sexy — is that we’re moving away from our ERP that we’ve had for 25 years to Workday. The analogy I like to use is that we implemented Epic’s EHR a dozen years ago, and that was all about patient care. Now we’re looking at our ERP, which is how we really manage our business. Everything from supply chain, HCM, HR, and the whole financial analytics part of Workday.
We’re doing a big bang. We kicked that project off a few months ago. We’re working with some consultants as well as the vendor. That will get us to the next level in terms of how we manage our business. And we already have a sophisticated enterprise EHR with Epic. We’ll actually be in a really good place.
Rolling out Epic to the community
The last thing is our ongoing effort rolling Epic out to the community. We have a connect program with the District of Palm Beach, just to the north of us, where we provide Epic services to them. We also provide Epic to a number of volunteer medical staff members in our community.
I mentioned Broward Health; we’re contracted to provide IT services to them. Now we’re looking at how we can take that to the next level, whether it be a shared services model or a new joint venture. Our EHR will sit at the bottom of that; it’s still a work in progress as to whether they’ll go with our instance of Epic, or maintain Cerner.
Gamble: That’s a lot. You mentioned ERP. It may not be sexy, but it’s a huge priority for a lot of organizations right now. What has that been like as far as moving to Workday?
Sturman: One of our guiding principles, and we have many, is let’s not recreate what we had. We’ve been on our current ERP instance for 25 years. It’s funny; we think Memorial’s different than every other healthcare system in the country — or the world for that matter — when the reality is we’re all probably 95 percent the same. And so, the way we deliver care and the way we take care of our employees is very common. Let’s take those leading practices from Workday, where they’ve done this elsewhere, and apply them here instead of recreating what we did for the last 25 years.
Cultural change: “That’s the hard part”
Because frankly, it’s inefficient. It’s not best practice in a lot of cases, and at the end of the day, it’s not creating the standards in the world class way in which we all want to live and work. The cultural life and the change management is the hardest part. The technology, I think, a lot easier to deal with. When you layer in the people and the process side of the equation, that’s the hard part.
Gamble: But in the long run it’s going to make things easier and make everything flow better. You just have to get to that point.
Sturman: Absolutely. It’s a year and a half of work, but I know it’ll pay off in time.
Working in analytics
Gamble: Right. So, can you talk more about the Care Coordination center?
Sturman: The Care coordination center for us is multi-purposed. One is to focus on patient flow. The primary purpose is to get the patient to the right care setting whether it be in one of our hospitals, or out of the hospital, in the right bed where we’ve identified capacity based on data and analytics. It’s taking the subjectivity out of it and making it much more quantitative in analysis. That’s one component of it.
The second is putting remote sitters in our care coordination center so we can see a number of patients at a single time in a single pane so we can see how they’re doing. We can see them better, communicate more broadly, and cut down on things like falls.
Because everyone’s dealing with nurse staffing shortages. Everyone’s dealing with this common problem of staffing in general. We think there’s an opportunity to do more with one person and give them the visual cues and analytics to help support them clinically.
The final component is that, in the short term, we’re bringing some telehealth and virtual capabilities into the Care Coordination center so that we ca do consultations across our system more effectively.
Gamble: Patient flow is something a lot of organizations are struggling with.
Sturman: It’s terrible. As a patient or a family member, when you think you’re about to be discharged, and then six hours later you’re still in the bed, that’s unacceptable. First of all, it’s bad for patient care, it’s bad for the psyche, and it can leave a huge burden on the whole system. And so, if we could make that just a little bit better and cut down our average length of stay, that’ll be important financially as well. So yes, our focus is on the clinical side first and foremost.