When the Guthrie Clinic hired Terri Couts as VP of Clinical Applications in 2016, it was for a very specific reason: her Epic expertise. To say that the Epic implementation hadn’t been going well is a massive understatement. Clinicians were leaving in droves — in many cases, citing the EMR as a key factor.

Couts, however, believed it wasn’t the technology itself, but rather, the way in which it had been deployed. And so, she led an effort to revamp the entire process, “from the time we onboarded a new clinician all the way through upgrades,” and focus heavily on building relationships with users. The strategy quickly paid dividends, as clinician satisfaction rates skyrocketed, and the organization achieved STARS 10 Epic Status.

Even more importantly, a playbook was established for future projects, helping to ensure that Guthrie would be able to roll out projects more efficiently in the future. During a recent interview, Couts talked about how her background helped prepare her for the CIO role — which she took on in July of 2021, why it’s so critical to focus on the end user, and how her team hopes to lessen the documentation burden on nurses through its Nightengale Initiative.

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Key Takeaways

* “It wasn’t the EMR; it was how we deployed it,” said Couts, who was recruited for her Epic knowledge and asked with “right-sizing the ship.”

* Going from 2-star to 10-star status with Epic required taking a hard look at “where we were, how we customized, and how we delivered changes,” and revamping the entire process.

* When it comes to training staff on a new system, leaders need to take “a salesperson approach where you’re not going to get that the sale on the first visit. You need to build that relationship.”

* Individuals with strong network and infrastructure skills aren’t always the best leaders or collaborators. “You need somebody to understand the depth of what’s happening and be able to relate it to your core team.”

* The unintended consequence of physician burnout initiatives? They increased the documentation burden on nurses, which Guthrie Clinic hopes to alleviate through its Nightengale Initiative.

Q&A with CIO Terri Couts, Part 2 [Click here to view Part 1]

Gamble:  Can you talk a little bit about the role that you had before as VP of Clinical of Clinical Applications? I imagine some of the focus is similar to that of CIO; did that experience help prepare you for the CIO role?

Couts:  When I first joined Guthrie, I joined for my Epic knowledge. They hired me because there had been a fair amount of physician turnover; part of the reason, as they learned during exit interviews, was related to the EMR. But if someone is leaving an organization because of the EMR, it doesn’t mean you’re not going to end up at another organization that doesn’t use an EMR. The fact of the matter is that it wasn’t the EMR, it was how we had deployed it.

My main task was to right size that ship. It’s hard to recruit, so we don’t want to lose clinicians due to technology that’s poorly deployed. At that point, I had clinical applications under my purview. Guthrie became at Epic customer in 2003; it was one of the first inpatient go-lives. We had been a longstanding customer and have continued to deploy modules.

“We revamped our total process”

I’m not sure if you’re familiar with the Epic stars rating,