Vendor relationships don’t have to be difficult — as long as they’re approached the right way.
Kent Sona is a firm believer in that. At Nebraska Methodist Health System, where he has held the CIO role since 2018, his team has always viewed vendor partnerships as precisely that: a partnership. “It’s not them and us; it’s us. That’s what I always preach to my staff,” he said during a recent interview with Kate Gamble, Managing Editor and Director of Social Media at healthsystemCIO.
In fact, he views vendors as extension of the team, inviting them to “roadmap sessions.” In exchange, he expects them to be responsive and ready to roll up their sleeves. “If any issue comes up, we get on a bridge call and work through it collectively.”
Because, like any health system, there is a lot they must work through. In the discussion, Sona talked about how Methodist is tackling the biggest challenges in healthcare today through innovation and strategic partnerships. He also discussed the qualities he values most in future leaders, what it takes to successfully incorporate social determinants of health into the care picture, and the valuable lessons he learned during his time in the military.
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- Methodist is tackling two of its key areas of focus — consumerism and efficiencies — by partnering with Oracle-Cerner on capacity management and pre-registration initiatives.
- One of the key components in leveraging social determinants is to “close the loop” by ensuring patients receive the care they need, and their providers are kept up to date.
- “A vendor partnership is truly that: a partnership. It’s not them and us, it’s us.” At Methodist, Sona’s team holds up their end by conducing regular meetings and “roadmap sessions” with vendors.
- Innovation isn’t just coming up with good ideas; it’s “getting the business engaged and letting them drive it.”
- The quality Sona values most in team members is a willingness to take ownership — even if it’s outside of the normal realm. “If someone reaches out to us, own it. Own and run with it.”
Q&A with Kent Sona, CIO, Nebraska Methodist Health System
Gamble: Hi Kent, it’s great to speak with you. Let’s start with a high-level overview of the organization — where you’re located, what you have in terms of hospitals, things like that.
Sona: Nebraska Methodist Health System is located in Nebraska. We have four hospitals: Methodist Hospital, Methodist Jennie Edmundson Hospital, Methodist Women’s Hospital, which is really focused on women’s health and labor and delivery, and then we have Methodist Fremont Health. We also have 34 clinic locations.
We do about 28,000 discharges a year; around 46,000 surgeries; and 670,000 clinic visits. We do have a little over 1,200 students tied to a nursing and health allied college that’s attached to our system, and we also run a distribution company in four states here for linens and different equipment.
Gamble: What do you consider to be your core objectives?
Sona: From a technology perspective, our primary areas of focus are around consumerism, security, and efficiencies within the system. Those are our key areas.
Gamble: Let’s talk about efficiencies. What are you doing in that space?
Sona: From an efficiency perspective, we have some solutions we’re putting in place around capacity management. We’re working with Oracle-Cerner on discharge progression boards that allow nurses to more quickly see the barriers to discharge and make changes to get patients discharged more quickly.
There’s a percentage they’re going after. They want to have a certain number of patients discharged prior to noon and discharged prior to 10 a.m.. It can improve patient satisfaction, because they’re not stuck there all day waiting, and it improves efficiency for nursing because they’re not having to dig everywhere to see things. They have these nice big boards that they can reference.
As we continue to expand capacity management, it’s really being able to effectively leverage all of the resources in our system as far as capacity. We might have one hospital that’s in the red because it’s full but another hospital that might be green and we can leverage that to shift some patients around for better quality of care from a resource availability perspective. That’s another area we’re looking at.
Another area for efficiency is centralizing functions like nursing and telemetry. We’re looking to establish a central location where a number of resources are available that can be used to do remote visits into patient rooms and maybe go over medication education and things of that nature, which can allow nurses on the floor to focus on the bedside care. When we have a central location, it helps us be a little more efficient in providing services to our hospitals.
Gamble: When you talk about increasing efficiency for nurses, I imagine that’s such a big part of the strategy.
Sona: Absolutely. That’s part of the strategy here. We have five pillars for our strategic priorities, one of which is investing in our people — the tools and solutions that can make them more efficient and make their lives better and their jobs easier.
Another strategic priority is to enhance our care quality. We also want to grow our anchor service lines, support future innovation and partner within our communities.
Gamble: When you talk about efficiencies, it’s not just the clinical side, but also improving the consumer experience. That’s got to be such a big part of it.
Sona: Correct. Some of the things we’re doing on the consumer side are around pre-registration and remote check-in. We rolled that out here just recently and we’re continuing to develop and evolve that as we get feedback from our patients on what they like and what they don’t like. It’s getting away from the paper clipboard and allowing them to use their mobile devices to take pictures of their insurance cards before they come to the clinic. It also stores that information so when they come in, they don’t have to answer all the same questions again. They can either say that nothing has changed or update the items that have changed. That’s been a patient satisfier.
We’re also looking at pre- and post-digital care plans. We’ve rolled out an infotainment system within our hospitals that does a lot of inpatient education and engagement. It’s similar to the interactive televisions you’d see in a hotel room. But we’re taking it a step further and using these pre- and post-digital care plans really educate the patients on what to expect before coming to the hospital. If, for example, they’re coming in for surgery, we want to educate them on what to expect, what to bring, and what’s going to happen. And when they leave the hospital after having their procedure, the education picks back up to let them know what to watch for, what exercises they can be doing, and more. It gets patients more engaged in their care, which can lead to better quality and outcomes. We feel that the more comfortable our patients are about an upcoming procedure, the more it puts them at ease with what’s going to happen. It also helps build the trust between the patients and our providers in that long term relationship with the patients.
Collaborating around SDoH
Another area we’re focusing on is collaborating with our partners in our community around social determinants of health. We’re looking at ways that we can streamline sharing and integrate data for better outcomes and visibility on that continuity of care, and to remove barriers to care.
At Methodist, it’s not just about their time in the hospital or in the clinic, but really about caring for that whole person. We do the healthcare part very well, but we rely on partnerships in our community where we don’t have the expertise. We want to improve the overall health of the community by the way we care, educate, and innovate. We want to leverage those partnerships for better outcomes.
Gamble: I’m sure there’s a wide variety when you’re talking about some of the community partners, whether it’s different organizations or food services, and a lot has to be coordinated there.
Sona: Yes. So locally, we have HIEs. We’ve partnered with CyncHealth to share some data. We share data through our EMR, which is Oracle-Cerner, and we use Unite Us, which covers Nebraska and Iowa. UniteUs has a strong partnership with United Healthcare. We brought everyone together collectively to start the discussion about how to share all this data a lot better; how do we leverage a partner like UniteUs to hand off a patient, or say, ‘this person has their heat shut off,’ or ‘they don’t have adequate food,’ and let them be the experts in the area where they have all those partnerships and relationships already.
But once they find it, or if they don’t find it, how do they close the loop back so that we can see the data within our system. Because, again, our providers are really worried about the whole person; not just the health of those within the clinics and hospitals. We want to make sure people are very well taken care of in the community.
Gamble: As far as the infrastructure that had to be in place, can you talk more about what it took to make that happen?
Sona: It’s really around collaboration and communication. It’s bringing all of the partners together to have conversations about how we can share data. Today we have different ways of sending data, one of which is ADTs. Some of that needs to continue to be real time.
And then you have Commonwealth and Carequality, which organizations use to share data between health systems. We’re working with our HIE to provide that data through the same mechanism so that as data comes into our EMR, our providers see it right there within their workflow.
It’s a lot of data. And so, Oracle-Cerner is developing a product called Seamless Exchange that can provide just the right amount of data for providers so that they don’t have to sift through a whole lot of noise. Our providers are looking forward to that. And if we can get the data from our HIE in there as well, that will be great.
Leveraging pre-registration to address social determinants
As far as social determinants of health, we’re looking at how we collect data upfront from our patients. There are a number of different questionnaires throughout our organization. We’re looking at how we can standardize on that, and what method we’re going to use to collect it. That’s where we’re probably going to leverage our pre-registration and remote check-in capabilities. We can build a questionnaire within it that allows people to answer those questions, and it ties right into the EMR.
Then, with the same type of data sharing through EPIs, we could actually share that information with UniteUs or another partner in that space, who can then use that information to help individuals find housing or food. They would then send the data back to us to close the loop on whether they were able to find housing, where they live now, and things of that nature.
Gamble: I imagine that’s a huge satisfier for patients and families knowing that the care continuum extends beyond the office.
Sona: Absolutely. That’s the biggest thing we hear from our providers and staff. We have counselors that reach out and try to coordinate, but they don’t have the relationships that some other organizations do because it’s not our primary area. What happens is the providers and caregivers get a little frustrated because that loop is never closed; they don’t see it within the EMR. And so, part of this is really getting the data back in and then making it visible so that our providers can actually see that the loop is closed, and the person has been taken care of. Because, like I said, it goes beyond healthcare. We really care about the people overall.
Angel Eye in the NICU
Gamble: One of the other initiatives is around virtual care platforms, with one example being live streaming in the NICU. As a former NICU mom, I can tell you that’s a big difference maker. Can you talk about how that came about?
Sona: Absolutely. We had a generous donor who offered up funds to do something in that space, especially for NICU parents and family who couldn’t see little ones while they were being cared for. We looked at a number of solutions, and selected one that we believed would be a great use case, especially at our women’s center. That was very successful. We rolled out a product called Angel Eye, which has been a huge hit. Our patients love it. Our medical staff loves it. It’s a great solution.
Vendor partnerships – “Never point a finger.”
Gamble: With so many initiatives, it seems like it’s really important to have strong partnerships with vendors. What are your thoughts on what it takes to create and maintain a relationship where both parties are getting what they need?
Sona: A vendor partnership is truly that: a partnership. It’s not them and us, it’s us. That’s what I always preach to my staff, and that’s what I talk about with our vendors. At Methodist, we have our IT division, and our vendors are an extension of that. If an issue comes up, we all get on the same bridge call. We work through it collectively, because there are things we can see on our side, and there are things they see on their side. That’s how you come to a resolution very quickly.
We take ownership of platforms. We never point a finger. We focus very heavily on teamwork and collaboration, and communication is a big piece of that. I often reference one team as we all come together. Within that, we have monthly or quarterly meetings where we sit down and go over roadmap sessions with our vendor partners to say, ‘What are you guys seeing in the marketplace? Is there anything we should be aware of? What do you guys have on your roadmap? What are you working on for innovative future solutions on your platform?’
We share with them things we’re looking to do within our organization, and see if maybe they can help us with our challenges. We talk about our roadmap and where we’re heading. It’s open, honest communication, and being very straightforward; sometimes the news isn’t nice to share, and so you have to be honest and get to the point.
That really helps strengthen the relationship and build trust. And we expect the same in return. I don’t always want to get a sales pitch. I want to think about how we come together and how we solve problems for the providers and the patients.
Gamble: I would imagine that how you respond to a challenge is important when it comes to building trust.
Sona: Absolutely. If I can’t get a vendor on our bridge with us where we can work through it, I’ll start second-guessing that vendor because that’s really part of that partnership. There are lives at stake; you want to make sure things are up and running all the time and that there are no problems.
Gamble: One of the pillars you mentioned was innovation. What are some of your thoughts on what it takes to foster innovation?
Sona: Innovation is a lot of idea gathering and a lot of good communication. As we think about ideas and solutions that can help the business, we put them in front of the business. We always encourage the business to think about ways that they can do processes differently or more efficiently. Let us know what challenges you’re facing so that we can come up with creative solutions to solve them.
It’s getting into the mindset of ‘the why,’ and how you can solve something versus ‘this is how we’ve always done it,’ or ‘that’s not going to work. We can’t do anything about that.’ It’s looking at things as opportunities, and figuring out how we can get innovative around them.
Methodist’s “small innovation center”
Here at Methodist, we have a great leadership team behind that. We’ve created a small innovation center in our IT area where we can bring in new products. The discharge progression board is a good example. It was new and different, and we were able to set it up in that innovation space. We had nurses from all different areas come sit down. We had Oracle-Cerner, our IT team, and some of our resources locally. The nurses talked about what would add value and what they’d like to see, and they were modifying the discharge progression board on the fly. They could see in real-time the value it could add; they took that back to their teams, and it created an excitement around, ‘this is new. This is different. But it’s going to be great.’ That’s how you drive innovation. It’s about getting the business engaged and letting them drive it. You’re just coming to them with options, solutions, and ways to make things better.
Gamble: It’s not necessarily about shiny tools all the time, but rather, focusing on ways to make processes better.
Sona: Absolutely. We have a patient family advisory committee, as well as an Oracle-Cerner physician advisory committee. Those committees are invaluable, right. These people volunteer their time. They share great feedback and information with us; that’s how a lot of these solutions that we’ve put in front of the business get out there. It’s feedback directly from the patients on what they’d like to see. Simple things like, ‘I’d like to be able to pay my bill online or from my app.’ ‘I’d like to be able to do remote check-in.’ And we bring them forward to the business, everyone becomes aware and gets on board, and we deliver.
Gamble: It sounds so simple.
Sona: I wish it was always simple. It’s not without its ups and downs, but with positive attitude, anything is possible.
Gamble: Let’s switch gears a bit and talk about your career. You’ve been in the CIO role at Methodist since 2018, right?
Sona: Yes. I’ve been at Methodist for about 6 years now in total. I started out as director of infrastructure and then moved into the CIO role.
Gamble: I imagine spending time in the infrastructure role really benefited you. Have you been able to draw from that experience?
Sona: Absolutely. Earlier in my career, I spent nine years in the Army, staring out as a combat medic. I worked in hospitals as a patient care tech and a phlebotomist before I went into full active duty. And so, I do have that medical background, and this was during the days of paper charting.
I was a combat medic in the Army for 5 years, then switched over to IT after my deployment to Bosnia. I noticed that the IT guys were always at base camp and they had phones to call home every night. I remember thinking, ‘that’s the job I want.’ Plus, I’ve always had an interest in technology. So I made the switch to IT, and when I got out of the military, I landed a job working in telecommunications. I ran IT operation centers. I ran network teams. I ran development teams. I got a lot of great experience in the civilian sector.
And when the opportunity came up at Methodist, it was a perfect fit. The culture here is phenomenal. Everyone collaborates, works together, and is open to new ideas.
Gamble: When you made the decision to come to Nebraska Methodist, had you been in touch with the former CIO to get to know organization and how things worked?
Sona: Not prior to coming on board. But when I came on board as the director of infrastructure, I was working for our CIO. That first year and a half or so that I worked for him really helped me. He was a provider, and so it helped get that tie in. I also have a great CMIO, Dr. Greg Hutteger. He’s wonderful to work with and has really helped bridge that gap with the providers.
Recently, Dr. Pat Ahrens [Chief Medical Officer] reached out to me to attend some of the meetings he holds to share information. We have great, open relationships.
Gamble: What about your time with the Army — is there anything you took from that experience that has helped you?
Sona: Absolutely. One thing is staying calm under fire. When I first started at Methodist, I noticed that when there was a critical incident, everyone was all over the place. I had to tell them, ‘Relax. It’s not the end of the world.’ Being able to organize and coordinate it, get everyone on board, and do some basic blocking and tackling was huge.
Another thing I brought with me from the miliary were after-action reviews (AARs). Anytime there was an issue, we’d do an AAR: what went right, what went wrong, and how do we prevent it from happening again. And through that process, we were able to reduce the number of significant events from maybe 40 incidents per year to around three. It’s been a huge difference, and the team has responded phenomenally. They just run with it now. It’s been night and day.
Gamble: You talked about the importance of investing in people, namely tools and training. Beyond that, what do you think are the keys to getting the most from people and making sure they’re fully leveraging their abilities?
Sona: I think it’s understanding the why. Our mission to improve the health of our community by the way we care, educate and innovate — that really drives the why. Everybody remembers why we’re here, why we’re doing this. We often joke that you don’t come into healthcare to get rich. You don’t get big bonuses. It’s the mission that drives our people. It’s taking care of our community. Even from an IT perspective, everything we do is in support of those who are on the frontlines taking care of people. We continue to reiterate the why so that people see that what they’re doing is delivering value to lives. It really keeps them engaged and excited about what they do.
They get tons of offers from technology companies offering a lot more money. But I always tell them, ‘The grass isn’t always greener. Remember the why,’ and oftentimes people stay. They love the culture, and they love what we do.
Gamble: As a leader, what are some of the qualities you find to be most valuable in people? What are you looking for?
Sona: The qualities I look for are integrity, honesty, and openness. If you make a mistake, be honest about it. Be open. That’s how we learn, and we get things fixed quickly.
Good communication skills are key. Nobody likes to have to follow up and ask, ‘where are we on this?’ You want someone who is a really good communicator and will keep you abreast of everything.
And a team player is the other big one. Not only being a team player, but also taking ownership. One thing I work on with my leaders is owning things. Even if it’s not our area, if someone reaches out to us, own it. Own it and run with it. And at some point, if you have to hand it off, hand it off, but then close the loop. It makes a huge difference versus just kicking the can over to the next person. People get stuck in vicious loops that way. We often find ourselves owning a lot of new things in IT because we’re willing to take ownership and do that, but it’s good when things get fixed and things get solved. It makes the organization a lot better.
“There’s so much more we can do.”
Gamble: Agreed. The last thing I want to ask is when you think about the direction of the industry, what would you say excites you most as a CIO?
Sona: The thing that excites me most is innovation around healthcare. There is so much more that can be done. There’s so much more we can do from a remote perspective. As awful as COVID was, it really opened a lot of that up. I’m excited to see the future of healthcare and where we can take it. There are a lot of great ideas from the business, and a lot of things for which we’ll need Oracle-Cerner or other partners out there to continue to drive. I think there are going to be huge changes to the typical brick and mortar type of healthcare that we see today.
Sometimes I joke with people and ask if they remember watching Little House on the Prairie and seeing Doc Baker roll up to the Ingalls’ house. We’re coming back to that one day. People want that care in their home and we should be able to deliver it.