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Continuing our series of discussion from CHIME/HIMSS 2019 we hear from Andy Crowder the CIO for Scripps Health in San Diego. Andy discusses their focus on building on the foundation of a successful EHR implementation to build a better experience.

Transcript

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 Welcome to this week in Health It where we discuss the news information and emerging thought with leaders from across the healthcare industry. This is Bill Russell recovering healthcare, c I o, and creator of this week in Health. It a set of podcasts and videos dedicated to training the next generation of health IT leaders.

This podcast is brought to you by health lyrics, helping you build agile, efficient, and effective health. It Let's talk visit health lyrics.com to schedule your free consultation. We are recording a series of discussions with industry influencers at the Chime HIMSS 2019 conference. Here's another of these great conversations.

Hope you enjoy. If you could introduce yourself, that would be great. Yeah. Andy Crowder, corporate senior Vice president and Chief Information Officer for Scripps Health. And you just finished an EPIC implementation? Yeah. Yeah. It's been a, been a fun ride the past three and a half years. Three and a half years.

And, uh, San Diego, San Diego Market. Uh, you guys are one of the leaders down in the, in that market. Yeah. So four years. What, what were you doing prior to that? I had, uh, led a turnaround of an epic implementation at Maine Health. And before that I was with Adventist Health System for about eight years in a C T O role, c i o role and a couple of other things outside of it.

So you took over that main That was, yes. That was front page, yes. Yes. Uh, yes. Was it revenue cycle or some sort of, uh, they went big bang with about 40 applications and e r p at the same time. Um, so yeah, they had a lot going on and it did not go well since it made the front page of it did not go well out of the shoot.

That's correct. Wow. So that's something . That you and Darren DW have in common. You get to come in and Yeah. Fix. So Main Health was a, a great organization. It was just a, a time where some decisions got made that put 'em in a, in a bad path from an implementation. After about 90 days, we got it turned around and they've doing very, very well with Epic now.

Alright. So you spent the last couple of years really buried in Epic. Yep. But, um, but there's a lot going on in healthcare. I mean, we just a lot heard, uh, you know, talk about ai, machine learning and other things. What kind of, what trends are you looking at right now that you think are gonna impact your.

So for us, um, we just finished the implementations. We've got a double upgrade coming up, and the things that are really important for us are virtual and digital and ai. And so we've got 25 million in 19 alone that we're rolling out for virtual care, online triage, video visits, video consults, really trying to, um, transform the way we deliver care from a consumerism point of view, specifically in the ambulatory space.

So it's, it's really about the consumer experience. Absolutely. We want to be the differentiator in our market. We've got strong competition. And from Sharp and Kaiser and a lot of, a lot of ground to take back. Yeah. I mean, sharp and ki so Sharp has, uh, a lot of managed care lives. Yes. Do, do you guys play in that space?

Uh, yeah. We do play in that space and commercial cap is an area of significant growth for us. We've set up our, uh, a c o from an M S S P point of view this past, uh, two years now. So we've got about 200,000, 150,000 to 200,000 lives in our, um, in some type of capita arrangement. And we see that growing significantly.

So it's interesting. So you have a, you have, um, multiple models here. So you are, you're competing for consumer. Yes. Um, do you have a health plan? Yes. Alright. So you have a health plan and you're really going after value-based care. 'cause you have the, you have the Absolutely. The population. So from a, you're looking at video.

Yeah. You're looking at, um, are you doing anything with like transportation? We're not doing anything with transportation right now. Okay. Um, social determinants, that kind of stuff, uh, starting to play in that space and, you know, the, the presentation was done today. Gives us all a lot of inspiration for where we actually have

Have significant opportunity. Yeah. At the JP Morgan conference. I think Geisinger got up there and talked about Yeah, everybody's starting to figure out, it's like, you know what? What do we do when we find out somebody doesn't have air conditioning or they don't have housing, or they don't have food? Um, I think, I think that just means that we've gotta leverage our partners in the community, our FQHCs, a lot of our different social services areas and look at it holistically.

Whereas today we've just looked at it as healthcare providers. Do you see that as one of the things that's changing in the c i O role is that you now, it used to be you were talking . To clinicians and you're, you know, knitting together networks. Now you're essentially going outside of that. You're going to, uh, the federally qualified health clinic as well as beyond that even.

Yeah. So I think that the transformation for us is, you know, we spent so much time in the past eight to 10 years really trying to digitize our own footprint, but realizing that so much of the care and the need doesn't evolve around the healthcare system at all. It's far outside of there. So we've got to be in different places and collaborate very differently than we've done.

The past. It's an exciting time. So, so Andy, let me, uh, just getting a little geeky here. So, uh, big Epic implementation. Yeah. You can go just to straight up MyChart Path. Yeah. But you're talking about building a digital experience. Yes. Are you gonna do anything a little different or are you just gonna roll out?

No. So we're gonna take a full benefit of everything that we can do in MyChart, but we're also gonna leverage content from Mayo. We're gonna embed, um, AI and, um, intelligence into all of our digital and consumer facing technologies. That's social, that's . Mobile and I don't think MyChart's going be able to answer all of it, but we're certainly gonna leverage it and try to integrate it.

We've got other patient engagement solutions that help us with certain disease states and we'll leverage those significantly. Yeah. And so Epic broke apart that and allows you to get to the a p I so you could actually create those. Yeah, there's, you know, they've really opened their toolkit up. I have to give 'em a lot of credit for that.

And I think it's, you look what's happened in the App Orchard the past year, it's just exploded and I see that continuing. So you're, you're gonna take advantage of everything that's in there, try to create experiences. Right. Um, how do you engage. The consumers to find out what experiences they're looking for.

Yeah. So, uh, voice of the customer. We've got a significant effort from our marketing team that's actually engaging directly with customers. We've got a couple of online tools that give us feedback on what they like and what they don't like. And quite honestly, we're our own consumers too. So we have to listen to our own families and friends and, and they'll tell you if you ask them, oh, uh, well, or they're not sure on opinions.

Yes. It's funny 'cause when you go to a go to a dinner party, you, you have to decide whether you're gonna reveal who you are or not. 'cause you'll get the, oh. Let me tell you about my experience and you just, you know, at, to a certain point we're, we're getting, uh, we're we're just starting to enter this consumer experience space.

We're, we're not Google or Amazon, any stretch and or Amazon really, and others. So we're, we're trying to figure this out. Do you find like the skills are gonna, are gonna have to change within or are within your IT department? I mean, I don't wanna put you on the spot a bit. Yeah. So, you know, fortunately at Scripps we've got some of the most brilliant, um, The resources on our team, our informatics and clinician resources are just wonderful to work with.

And when we built the Epic team, we recruited, recruited people from within the organization. So they came from all walks of life that we're accustomed to taking care of our customers every day. That kind of customer focus has really paid huge dividends for our, for our resources. And I think that when we engage with others in the industry and outside the industry, they're really, you know, transforming the customer experiences where we get a lot of significant learning.

That's gonna be interesting. You're in a. A great market. I mean, there's so much. It's a great and competitive market as well. Yes. Yeah, absolutely. We have a choice. Uh, a lot of startups down there. I don't think people realize how many startups down in, uh, San Diego, but it's a melting pot for that type of activity.

And then, you know, that's actually, um, some feedback from our board members that, you know, you don't have to go this alone. You've got a lot of intellectual property here in the San Diego and LA area, and you ought to be tapping into it. And so, uh, part of our JV strategy, uh, and business partnerships are really focusing on that in 2019 and 20.

I'm not familiar. Do you have an innovation arm or an innovation? We don't have an innovation arm. You know, I was just, uh, back in Florida a couple weeks ago with a colleague of mine, Tim Thompson at BayCare. He's one of the ones that has actually stood up an innovation center. So we went to see what that was about.

And the c e o, it's his pet project. It's five innovative projects every year. Here's the funding source, run the quick pilots. And so we learned some things there. They're, um, they had, uh, some pretty cool things they were doing with mobile and wearables and how they engaged the consumer in that. Uh, they got it from the Ochsner model, but we're looking at doing that.

We just have . We figured out how to really structure it to get the best benefit. It's interesting, I mean, you, so you just finished a significant, uh, E H R project? Yeah. And that's one of the things when, when we're talking, when I'm talking to different health systems, they recognize that when they have a major E H R project, it does consume a lot of resources.

It, it puts a, a bright light. You can't fail. Well, no, you can't fail. You've gotta get it right. And that does minimize where you can have the opportunity to collaborate and where you can spend your time. Now we're in a really unique spot coming out of it. Um, very successful. Full implementation and it's time to start collaborating, engaging those, which is why I love these.

You know, we're gonna be all over the floor this year in the vendor demos, and our emails have been blowing up weeks before we got here, so there's a, you know, there's a lot That's, well, that's the last, one of the last questions I usually ask is, how are you going to, what are you gonna do at the show? Are, are you gonna go booth to booth or do you really have schedule that?

No, we, we actually have a pretty, a pretty detailed strategy. So there's six colleagues from my organization. Some are focused on patient engagement, some are focused on revenue cycle optimization. Believe it or not, that's a consumer engagement strategy as well. Um, and then I'll be looking at telehealth and video, and then we've got somebody looking at, uh, ai, all of the top vendors in that space.

That's great. So you've, you've split it up. We'll see if they remember their, their assignments after this podcast. . Yeah. So Well, and revenue cycle absolutely. Is a, uh, uh, engagement. Anyone who's ever received the 15 bills from an organization. Yeah. But, but that's not a technology project, it's much as it is.

Correct. Hey, let's talk through how we generate a bill and how we make it understandable. Yeah. We actually, um, our patient experience offer Dr. . Uh, gazala and our, uh, revenue cycle team are actually getting ready to launch the single billing office. And that's a, a single guarantor statement. Uh, much easier to read, uh, stripped out all those healthcare terms that aren't relevant to the patient and the consumer.

And so that's been an area where we've, you know, struggled as an industry. So we're gonna try to hit that hard in 2019. That's exciting. I mean, uh, I'm not sure we're gonna be able to recognize healthcare five years from now. I, I hope not getting that single bill. That's really easy, being able to schedule things online, do everything we need to do.

Andy, thank you. Hey, thank you very much. Appreciate the time. Take care. I hope you enjoyed this conversation. This show is a production of this week in Health It. For more great content, you can check out our website at www.thisweekinhealthit.comortheyoutubechannelatthisweekinhealthit.com/video. Thanks for listening.

That's all for now.

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