Perhaps no industry has been hit harder by the great resignation than healthcare. And if qualified technology and clinical people aren’t quitting altogether, they’re being lured elsewhere by bigger paychecks and more flexibility.

That being considered, it may seem surprising that Hospital Sisters Health System, a 15-hospital network spanning multiple states, has made it a goal to grow 70 percent of leaders from inside the organization. If you look at the facts, however, it makes perfect sense. According to Ray Gensinger, MD, the IT team boasts the lowest turnover rate in the company, and the second-highest engagement scores.

Clearly, they’re doing something right, and it’s all about the people. HSHS prides itself on choosing individuals who are “compassionate” about patient care and willing to do hard work, said Gensinger. In a recent interview, he talked about what makes the organization unique (both in its makeup and vision), how he transitioned from CMIO to CIO, why support is such a critical part of implementations, and his thoughts on remote versus in-person work models.

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Key Takeaways

* Although there are myriad benefits to being a CIO, having “a high level of control” isn’t one of them. “You still have a lot of governance to work with and hurdles to go through from a budgetary perspective.”

* “When you’re a CMIO, you’re pitching clinical and safety.” Being a CIO means doing that while also being “able to give the very detailed financial value points.”

* The most important attributes in a future leader? Compassion and a willingness to listen. “If you’re talking, you’re not learning.”

* One way in which HSHS is battling the great resignation (which hit the organization hard last fall) is by growing leaders from within, starting with internships.

 

Q&A with Ray Gensinger, MD, Part 2 [Click here to view Part 1.]

Gamble:  So you were a CMIO prior to becoming a CIO. What was it like to make that transition?

Gensinger:  I’ll start with the short story. It really was a fantasy that there would be a higher level of control than in previous roles. I changed organizations in order to pursue that. And there are many things make me happier in the position I’m in, but the idea that there’s any more control is a fallacy. You still have governance to work with and hurdles to go through from a budgetary perspective. For example, you want to replace your secretary; well, it’s been a tough year, so you can’t. Or, you have 10 analysts — can’t you get the work done with 8 analysts and start cross-training them?

Interestingly, I went from being a CMIO reporting to the CIO, to, at my current organization, a CIO reporting to the chief financial officer. It’s not totally uncommon, but it took Mike Cottrell and I two years to have a level of confidence and trust where if I came in and said I needed something, he would back me up. I also had to learn how to pitch things to him.

When you’re the CMIO, you’re pitching clinical and safety. As CIO, you have to pitch clinical and safety while also giving a detailed picture of the financial value. In many ways, it improved my skillset tremendously. I’m definitely glad I did it.

 

Gamble:  What did it take to build that rapport with your CFO?

Gensinger:  You have to be able to pitch; and by that multimillion-dollar-initi...

With any major decision, having the right representation is critical – even when the decision seems like an obvious one, said Rich Rogers, CIO at Prisma Health, in this interview. “You have to make sure you have a number of folks represented who voice that same opinion.”

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Gamble:  Hi Rich, thanks so much for joining us. I look forward to talking about the work you guys are doing — obviously a lot going on there, and your leadership strategy.

Rogers:  I’m happy to.

 

Gamble:  Let’s start by getting a little bit of background information. Prisma is a large system with 18 acute care and specialty hospitals, correct?

Rogers:  Yes. We do a little over $5.5 billion and we have around 30,000 employees.

 

Gamble:  And you’re mostly in South Carolina?

Rogers:  We’re completely in South Carolina. Prism Health was formed through the merger of Greenville Health System (in Greenville, S.C.) and Palmetto Health System (in Columbia, S.C.).

 

Gamble:  You were with Greenville prior to the merger. Can you talk about what the organization did to come together as an integrated system? I’m sure that was an interesting experience.

Rogers:  Yes. It’s been more than four years now. And while I’ve been through a lot of acquisitions in my career, this was the first with two equal-sized systems. I had never worked in that type of environment.

Bringing two organizations together was culturally challenging as well. We had to interview for our jobs and get selected because we all had counterparts, so we had to go through that process. Then it was about understanding the business strategy going forward and what we need to support.

Sometimes with these types of mergers, you act as a holding company and let the health systems function autonomously in their own markets, and maybe have a small corporate umbrella for doing things like population health.

We quickly realized based on market forces that we needed to integrate and take out as much expense as possible so we could act as one health system. Once that decision was made, we started looking at our systems and how we could start bringing things together.

Big decisions – “It comes down to governance”

The EMR is always one of the most visible decisions that needs to be made. We were on Epic in our Greenville market and Cerner and Meditech in Columbia; one of our facilities had some long-term contracts in place. So that was a little bit more challenging, but it really comes down to governance and making sure we have the right representation. Even when it looks like it’s pretty obvious what you should do, you have to make sure you have a number of folks represented who voice that same opinion before you make a decision.

That’s what we did. Epic made the most sense for us long-term as both the EMR and revenue cycle vendor. Once we made the decision to implement Epic in one service area, it pretty much meant we were going to be one health system. Then we looked at ERP, which was the next core system. We had multiple instances of Infor at the time; once you make the decision to go to a single EMR, you can only land tractions to one GL, and so that forced us to make a decision. We evaluated where Infor was going and what were the costs involved, and saw that it wasn’t expensive. There were also some areas like HR that weren’t thrilled with their offering, and so we evaluated the market, went through another RFP process, and selected Workday as our ERP vendor.

Core system work

The promise of leveraging data to improve care will never be realized as long as its quality is suspect. So how can CIOs and other IT executives — who have little to do with data entry — bring about improved accuracy? And when bad data does go into the system, how and when can it be caught, corrected and normalized? In this important webinar, we’ll speak to leaders who are focused on increasing the confidence clinicians have in their organization’s data so they’re willing to make decisions based off it.

Speakers:

* Rob Bart, MD, CMIO, UPMC

* David Kaelber, MD, PhD, CMIO/VP of Health Informatics and Patient Engagement Technologies, The MetroHealth System

* Dick Taylor, MD, Chief Clinical Informatics Officer, BJC Healthcare

* Dale Sanders, Chief Strategy Officer, Intelligent Medical Objects

A decade or two after the majority of health systems took the EHR plunge, it’s still far from perfect, and the complaints still seem to pile up. But as those who have spent time in both the pre- and post-electronic worlds – and have the benefit of that experience – can attest, the benefits outweigh the challenges.

Remembering that, according to Jason Buchanan, MD, clinical informatics officer at Baylor College of Medicine, is critical. “There were many times when you’d be looking for a patient’s chart and couldn’t locate it. It was like flying blind.”

For leaders, the key is to ensure systems are usable, which means providing continuous education and support. During a recent interview, Buchanan talked about his approach to optimization, the power of listening, how medical school has evolved in recent years, and how he first got “hooked” on informatics.

LISTEN HERE USING THE PLAYER BELOW OR SUBSCRIBE THROUGH YOUR FAVORITE PODCASTING SERVICE. 

Key Takeaways

* Sending out surveys to providers and patients is a great way to gain feedback — as long as leaders clearly state “what they’re being used for and what’s the tentative plan.”

* By spending a half-day or even a few hours with providers, leaders can get “a bird’s eye view of a day in the life of a doctor or nurse, which offers a lot of insight into the organization as a whole.”

* One way in which medical schools are evolving? By providing more emphasis on the business side of medicine. “You have to have a feasible and sustainable framework” to successfully care for patients.

* Barriers between departments will always exist; leaders need to offer cross-training and ensure people have the freedom to say, ‘I don’t understand what you just said. Can you say it in a different way?”

Q&A with Jason Buchanan, Part 2 [Click here to view Part 1]

Gamble:  You mentioned listening as an important part of leadership. Can you give some thoughts on the best ways to do that?

Buchanan:  I think of listening in a few different ways. One is the traditional way where you send out surveys to your providers and patients. That’s the quickest and easiest way to do it. What’s important is to ask the right questions. You want them to be broad, but not overly broad, because you want to get actionable information from those surveys.

A lot of times when people see a survey in the inbox, they think, ‘oh great, another one.’ And so, you have to make sure that when you do those surveys, you clearly state what they’re being used for; what’s the tentative plan for these surveys.

For example, you might say, ‘we’re doing this survey to process the levels of burnout in the organization,’ and share a little bit about your plan to address it. By doing that, you’ll have increased compliance. That’s the first bucket of listening: sending out traditional surveys and collecting data.

What’s also important, especially among upper administration, is getting out on the floor with providers and patients. We know about the typical walkarounds where you have a dyad or triad that goes around to see what’s happening and chat with providers or patients.

Rounding to gain “insight into the organization”

But I think that in some of the really innovative places, folks in upper administration will spend a half-day or a quarter of day with providers, or with patients in the waiting room, so they can see what’s happening. They get a bird’s eye view of a day in the life of a doctor o...

Running an effective IT shop means doing a lot of things right. First off, you must have a sound governance system to ensure the right work is being taken on, then you must have an effective team (and system) to accomplish and track the work. Of course, that’s just the start, because CIOs must constantly communicate with eager customers about the value being delivered while not overcommitting teams that are often on the brink of burnout. CIOs must also figure out ways to deliver innovative solutions while managing remote teams and keeping the organization secure. In this important webinar, we’ll hear from leaders who are working hard to move their organizations forward in times of unprecedented change and demand.

Speakers:

* Bradd Busick, SVP/CIO, MultiCare Health System

* William Walders, CIO & SVP, Operations Support, Health First

* Laishy Williams-Carlson, VP/CIO, Roper St. Francis Healthcare

The best security professionals have always focused on empowering rather than restricting. However, securing today’s work-from-anywhere workforce is putting that noble goal to the test. That’s because working from home (or anywhere other than locations owned by the organization) opens up a can of security worms and questions, such as are folks more susceptible to ransomware and BEC social engineering attacks because the comfort of their own homes naturally lowers their guard? Can, for example, running downstairs to change out the laundry mean your 10 year old will jump on your laptop and click away? Of course, the implications of that happening vary based on whether the end point in question is a work laptop or personal device, and how it’s secured. In this important webinar, we’ll talk to IT leaders about how they balance the need to empower with the need to secure in today’s post-pandemic environment.

Speakers:

* Chuck Christian, CTO, Franciscan Health

* Christopher Frenz, CISO, AVP of IT Security, Mount Sinai South Nassau

* Chris Feeney, Healthcare Workflow Specialist, IGEL Technology

Perhaps no industry has been hit harder by the great resignation than healthcare. And if qualified technology and clinical people aren’t quitting altogether, they’re being lured elsewhere by bigger paychecks and more flexibility.

That being considered, it may seem surprising that Hospital Sisters Health System, a 15-hospital network spanning multiple states, has made it a goal to grow 70 percent of leaders from inside the organization. If you look at the facts, however, it makes perfect sense. According to Ray Gensinger, MD, the IT team boasts the lowest turnover rate in the company, and the second-highest engagement scores.

Clearly, they’re doing something right, and it’s all about the people. HSHS prides itself on choosing individuals who are “compassionate” about patient care and willing to do hard work, said Gensinger. In a recent interview, he talked about what makes the organization unique (both in its makeup and vision), how he transitioned from CMIO to CIO, why support is such a critical part of implementations, and his thoughts on remote versus in-person work models.

LISTEN HERE USING THE PLAYER BELOW OR SUBSCRIBE THROUGH YOUR FAVORITE PODCASTING SERVICE. 

Key Takeaways

* Although the pandemic has proven that remote work arrangements can be very effective, “there’s something to be said for getting together in person,” said Gensinger, whose team has held social functions to break the ice.

* Creating a separate strategic plan for IT isn’t a viable option, said Gensinger. “In terms of the functional applications that support the care process, it makes far more sense to have the system’s priorities and strategic plan aligning and driving everything we do.

* One critical component CIOs can’t neglect: nurses. “They’re doing 90 percent of the care.”

* The “single best investment” HSHS made while implementing Epic? Ensuring clinicians had adequate, onsite support during the training process.

Q&A with Dr. Ray Gensinger, Part 1

Gamble:  We’re seeing so many remote and hybrid working models, and I’m thinking HSHS is probably no different. Is your team remote at this point?

Gensinger:  It’s funny; we were trying to get our people remote for years. It took a pandemic to provide it could work. Probably 90 percent of my staff are remote right now.

 

Gamble:  Do you see it staying that way?

Gensinger:  I think it’s going to flip back to more of a hybrid environment. I really do. If I had my way, I’d ask people to come in three days a week: Tuesday, Wednesday, and Thursday. The big push for us was real estate value. If we could keep people remote permanently, we’d be able to save money. We did actually sublet a floor in one of our buildings and moved people around. That was definitely an advantage in terms of costs.

And even if people don’t have permanent spaces, there are other things you can do like rotate teams. I’m a typical IT introvert, but I believe there’s something to be said for getting together in person.

A few weeks ago, we held a celebration for our staff. During Covid, we had completed three major implementations that were part of a multi-year project. We never had a chance to celebrate that, plus we missed two Christmas parties because of the pandemic. And so, I’ve been on a tour with some of my leaders to get people together. We’ve had happy hours where we buy drinks and food and let people spend time together, and the response has been overwhelming. People are so happy to get back out and interact. They’ve really missed that. And so, while I think there are certainly benefits to working from home,

Unlike unmanaged medical devices — which are known to harbor risk for healthcare delivery organizations (HDOs) — many HDOs seem willing to trust in their vendors and accept the risk of third-party managed devices or, worse, don’t even realize the danger. Security challenges range from patient portals, to EMR access, to vendor access, among others. In this timely webinar, leaders will detail the problem and reveal the best practices for solving it. Topics covered will include:

* Examples of security incidents caused by third-party managed medical devices

* Connecting device security tooling into the SOC

* Tools to assist with third-party and unmanaged medical device security

Speakers:

* Clayton Phillips, CIO, West Tennessee Healthcare

* Tom Finn, Market Development Manager, Medigate by Claroty

* Brian Bradley, Healthcare Services Technical Manager, Optiv

A decade or two after the majority of health systems took the EHR plunge, it’s still far from perfect, and the complaints still seem to pile up. But as those who have spent time in both the pre- and post-electronic worlds – and have the benefit of that experience – can attest, the benefits outweigh the challenges.

Remembering that, according to Jason Buchanan, MD, clinical informatics officer at Baylor College of Medicine, is critical. “There were many times when you’d be looking for a patient’s chart and couldn’t locate it. It was like flying blind.”

For leaders, the key is to ensure systems are usable, which means providing continuous education and support. During a recent interview, Buchanan talked about his approach to optimization, the power of listening, how medical school has evolved in recent years, and how he first got “hooked” on informatics.

LISTEN HERE USING THE PLAYER BELOW OR SUBSCRIBE THROUGH YOUR FAVORITE PODCASTING SERVICE. 

Key Takeaways

* Buchanan became the ‘de facto Epic doctor’ when it was first implemented at Baylor in 2007, which entailed helping docs with issues that arose. “I really enjoyed doing that.”

* Although there are myriad complaints about EHRs, “which are valid,” it’s important to remember how difficult it was to do “something as simple as finding a chart” during the paper era.

* “The main thing is having a plan and having a question you want answered, and making sure that question is going to be helpful to the population.”

* Now more than ever, it’s imperative to create an environment in which people “feel comfortable coming to work,” and it starts by listening.

Q&A with Jason Buchanan, Part 1

Gamble:  Hi Jason, thanks for taking some time to chat. Let’s start with some information about your current role. What are some of your key objectives as clinical informatics officer?

Buchanan:  I’m actually swimming in a number of different pools these days. I work with Baylor College of Medicine and Harris Health. I’ve been there for about 16 years, primarily as a family medicine doctor.

Around 2007, we got the Epic EHR, and I became the de facto Epic doctor, helping other doctors with various issues that arose with Epic. I really enjoyed doing that; I saw the promise that EHRs and data held for the future.

I enjoyed it so much that I decided to go back to school and got a Master’s in Informatics and became a board-certified informaticist. I’ve been doing a number of different projects at Baylor Harris Health, mostly centered around help doctors decrease their burden.

My claim to fame, so to speak, is that I started a program called PrEOP [Provider EHR Implementation Program] as a way to help doctors learn quickly how to use Epic. Because over a period of time, there are so many new features that come into play with the EHR. We don’t know all that it has to hold. And so, I held various workshops to explain the new features and show how to use Epic as efficiently as possible.

I did that until about April of 2021. But I wanted to do more in the informatics realm, and so, I decided to spread my wings. I’ve worked with other entities doing Epic implementations. I’m working with Kind Capital, an impact investment firm that helps fund companies that have a social impact. I helped with their medical and health teach sectors.

I also work on the payer side with Sendero Healthcare based in Austin, Texas, where I help with informatics work. I’m doing a lot of different things these days and loving it.

 

Gamble:  It definitely seems like it. When you think back to that Epic rollout in 2007,

For healthcare leaders, creating a culture of collaboration can be extremely challenging, particularly in groups that include both extroverts and introverts. Laura Marquez has a solution that involves doing something out of character for those in senior positions.

“I have an idea, but I’d like to hear from you guys first.”

Doing so, she said during a recent interview, “opens up the platform” and encourages individuals to float their own ideas. It’s one of many pieces of advice Marquez, AVP of IT Applications at UConn Health, offered to colleagues based on her own experiences.

During the discussion, she shared insights on what it takes to build “a culture of safety, her approach in leading virtual teams, the critical role IT governance strategies can play, and what UConn Health is doing to more effectively engage with patients.

*Editor’s note: After this interview was held, Marquez announced she was starting a new role as Senior Director for Transformation at University of Utah Health in July of 2022.

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Bold Statements

Saying no is hard, but it’s so important. Because the more you deviate away from the foundation system and the more you deviate from how the EMR is set up, the more maintenance you’ll have long-term and the harder it is to continue to support and maintain. (1:15)

With every project, I encourage my teams to ask two questions: what are we missing? What did we not consider? And taking that a step further, what possible downstream impact could this have? Because when we have a questioning mindset, I think that’s what continues to promote a culture of safety. (3:30)

In order to move forward and get to the bleeding edge of pioneering and trying to new things to really digitize healthcare, we have to remember that every single person matters. What they do matters. And we have to reconnect it to our mission, vision, and values. (6:14)

It’s okay to ask for help. It’s okay to block out your calendar. It’s okay to turn off your camera. I think that really helps set clear expectations and remove anxiety, especially in this virtual world. (8:20)

I never thought in a million years that I would be leading virtual teams. I’m an extrovert; I thrive off the energy of others and I love being in the office. (10:05)

Q&A with Laura Marquez, Part 2 [To view Part 1, click here.]

Gamble:  You mentioned that sometimes when requests are put in, the people who make them aren’t aware of the downstream effects. That’s a challenge so many organizations are dealing with, and I imagine it has to be handled pretty carefully.

Marquez:  Yes. Especially before IT resources are dedicated to trying to build out a solution. At one of my prior organizations, tickets could only be submitted by managers and above for enhancement-type requests or optimizations. That had to be vetted at the departmental level because we wanted to make sure there was a little bit more oversight. It couldn’t just be anyone submitting a requested change.

In terms of governance, it’s important to have a body, whether it’s a physician advisory council or nursing advisory council. That’s the next step in our growth to establish smaller councils where we can have that continued input and have physician builders or other informaticists at the table to say, ‘This really doesn’t make too much sense. That’s not a workflow that we would want to support,