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The Healthcare CIO Look Back / Look Forward series with Mark Amey, 

Chief Information Officer at Alameda Health System.

Transcript

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 Welcome to this Week in Health IT events where we amplify great ideas with interviews from the floor. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It a set of podcasts and videos dedicated to developing the next generation of health leaders. We wanna thank our founding channel sponsors who make this content possible, health Lyrics and VMware if you wanna be a part of our mission to develop health leaders.

Go to this week, health.com/sponsor for more information. This episode is sponsored by Health Lyrics. When I became A-C-I-O-I was really overwhelmed at first, and one of the first things I did was to sign ACIO coach to walk with me through the journey. This was someone who had wisdom that can only be gained through years of experience.

It was invaluable to my success in the role, and I now coach CIOs through health lyrics. If you wanna learn more, visit health lyrics.com or drop me a note at Bill at this week in health it.com. Over the next three weeks, we have a. Huge treat for you. I'm really excited about it. Uh, I just got back from the Chime fall forum in Scottsdale, which was a great event, and we caught up with 12 active CIOs from various size health systems and asked them to take a look back at 2019 and a look forward to 2020.

Uh, you're gonna hear, uh, what they're excited to have accomplished last year and what they're looking forward to accomplish next year. I asked each of them the same eight questions, and I think you're gonna be fascinated to hear the similarities and the differences . Based on where they're at, geography and other things.

Each of these interviews is about 10 minutes long, so you can listen to 'em really quick and some of you listen at one and a half time speed. So it's gonna go like that. Uh, we're gonna publish one a day, uh, with a few Newsday episodes sprinkled in through the end of November. So check back every day for the next episode, and don't forget to look back to see if you missed any.

Mark. Amy is the CIO for Alameda Health System in Oakland, and they just finished a significant epic implementation up there. And, uh, mark and I were actually talking before we, we come on the air and we were talking about how he, I was really impressed with how they use social media to, uh, to really share what was going on in the

Uh, in, in the implementation and I almost felt like I was a part of the team. I got to see the comradery and see, you know, people working through challenges and, uh, you know, the go live, the events and those kind of things. It, it, he really did a great job of that. Uh, we get a chance to sit down and talk about the eight questions and I.

Really enjoyed it. I hope you enjoy as well. So here we are from the, uh, chime, fall Forum 2019, and we're, uh, meeting with CIOs and we're, we're running through a handful of questions. I'm joined with, uh, mark. Amy. Thanks. Thanks for coming on board. I appreciate it. Oh yeah. Pleasure. Thank you. Family, uh, cio, uh, newly, well, not new.

You've been there for about a year, right? About a year, yeah. Just a little while. Alameda, correct. Alameda Health System. Okay. And, uh, and I saw the, I saw the social media. You just completed your Epic implementation. Yes. I don't know if the, uh, social media, . Was a good thing or a bad thing, but it was a thing.

Well, I mean, you were, uh, a lot of it was, was celebrating your team, right? Which is part of the role of the CIO is to, is to, there's so many points where there's so much pressure and it's to, it's to just lighten the load of the team and, and, uh, and celebrate the accomplishments. Absolutely. No, he is, and I, um, I'm blessed with a great team, actually a combination of my own team.

We called it the Sapphire team, as you might have seen from the video that we had out there. But, uh, the Sapphire team and then Epic themselves. They were a great partner. And then we had several, um, uh, partners on board with us as well that definitely helped with that. Did, did you inherit that or did, because you've only been there for a year?

Yeah, so the Epic contract was actually done when I came on board. And, uh, so the, the, the, um, contract was, uh, completed. The, uh, timeline has been set and scope had been set. And so I came on board, uh, for the exit, the execution piece. So, um, it's one of those You knew the risks involved. You bought your ticket so well, yes,

Okay. But you always find a few things along the way. So, no, that's fun. Um, so we, we only have about 10 minutes with you, so let's get to the questions. The now the first one is, how have you seen the role of the CIO o change over the last maybe 12 months? Yeah, I think it's, uh, it's really been an evolution and I don't know if it's been in the last 12 months.

It's certainly an evolution on what's going on. Uh, there's really three things that I'm kind of seeing. One of them is I think the CIO has to be a lot more of ACFO now, especially with the move into the cloud. Uh, you know, you think about, so . Much of the decisions we make now are not necessarily technology, they're cost performance.

Yeah. Is it cheaper in the cloud? Is it cheaper locally? Is it cheaper to SAA operations? So certainly the, uh, financial end of things. I'd say the second is really understanding workflows and, you know, as a non-clinician, I feel like I sometimes have to work twice as hard to figure out what my clinicians are doing, you know, as well as revenue cycle, of course, uh, on that.

But, uh, what our clinicians are doing, what the, uh, workflows are. I'd say the third is really driving towards lean, and that's a journey I personally. Started to, uh, follow over the last few years, but, you know, gemba, the ITIL framework, those sorts of things, I think are really doing changes for us. Yeah. So I, I really resonate with the C-C-I-O-C-F-O linkage, and actually, you're the first one to, to mention that, but I was just in the AWS session and people were talking about, you know, how is cloud gonna save me money?

How? And, and so much of the conversation centered around, you know, CapEx versus opex and, I mean, do you really have to understand how money flows? I was in a session too, and it just became consumed and. Some of, uh, my, uh, here and my CIO brethren and sister, uh, they just, they were, they were trying to work with their CFOs and obviously it wasn't, wasn't going well.

And, uh, so you gotta figure that part out and help, uh, help, uh, all that. So you, you have the EMR implemented. Um, what are three priorities maybe for next year that you're, that health it is gonna support going into, I assume it's optimization, gonna be one? Optimization. Optimization. Optimization. Yeah. So , that's probably the right answer if I thought about it.

Uh, yeah. You know, we're . We're stabilizing. I, I put loosely a timeframe in on, uh, stabilization through the end of this, uh, calendar year. And then the next six months on just a very focused optimization. Obviously I need to get our governance, uh, structure stood up during that time. The big focus for us with our behavioral health hospitals actually going to be streamlining the, uh, behavioral health workflows that we have and what we're doing in those areas.

That's, uh, that's actually gonna be really critical for us. And then lastly, in kind of a deferred project is, um, time tracking. And we have a, I believe, a tremendous . This opportunity. I've been looking at the data around overtime, time management, you know, in all areas, all of our operational areas. And so, you know, when you think about that, some savings for us, but there's also patient safety and ultimately employee morale.

Um, yeah. Get people to working, uh, reasonable work rates. So let's, let's focus those in a little bit and let's talk about, uh, patient experience. What's, uh, in, in, you're primarily Oakland? Alameda, yeah. Uh, Alameda County. So Oakland, you know, think of Oakland, uh, uh, . The city of that area. Yeah. Running. So if I were to go to the, the patients in that community and say, Hey, here's what you have to look forward to, what's the one thing that you would point to?

Yeah. So that's actually exciting and sad at the same time. So the sad part is we were actually, we have a patient experience group with some patients on and we're talking with them pre Epic. And there's many things obviously that we need to improve as an organization on this. But we actually have, one of our patients, she gets on a bus, comes to us to schedule her appointment.

'cause doing it over the . Phone just is so cumbersome for her. And so obviously there's work we need to do that's not just technology, uh, related to that. Um, but that, you know, when I, when I think about this, this person obviously not in good health 'cause they're doing reoccurring now visits, uh, with us, and they're having to get on the bus to, uh, to come out and make their appointments.

So, you know, I think the patient portal, um, MyChart is specific for us, is gonna be a game changer. I use it personally as a patient. Uh, in fact, I won't see a doctor that doesn't use it. And, um, I, um, I've already, I'm creating notes now with, um, with my doctor, Dr. Jenny. On, uh, on MyChart, it's awesome. And, um, I, um, I, I think it's gonna be a game changer for our, uh, for our patients.

It's also interesting because with the demographic that we work with so many, um, underserved, um, you know, folks that are, you know, struggling to deal with home needs, with food needs, other things like that. And, but one of the things that the homeless population actually has, they may not have a home, they may not have a computer, but they usually have a smartphone.

And so it's a great way to be able to help them start to manage their own health, uh, as in, out of our emergency. Department and other areas like that. That's exciting. And you now have a platform to, to build a lot of that on. Yeah. Yeah. We've, uh, we already had our, uh, first signups. We're up to about 2,500 signups at this point.

This actually sounds like a stupid question at this point. You know, one initiative that you believe is going to materially improve the clinician experience. You know, it's gonna be workflow optimization, uh, in that, and there's three big areas that we're really focused on. Um, behavioral health, which I already mentioned, but also our OB area is another area that I think we can do some streamline.

And we've got a great chair there, uh, Dr. Smith that I enjoy working with. And then, um, also our surgery, our, uh, surgery area. So I think there's some work that we can do there and really, um, streamlining that process. So let me ask you, I mean, so, uh, you know, a lot of implementations have happened before yours.

Did you find like they came with a significant playbook before they got to you? Yeah. Yes and no. So there's a few interesting things on that. Um, this is actually my, I was counting it up. This is actually my seventh album. Electronic medical record implementation. I did four Cerner ones and three epic ones.

So, wow. And, and I will say this has been my smoothest one. Uh, so I don't know if it's a combination of luck or, uh, you know, some wisdom maybe, uh, with age. Um, I, I think truly a part of it is the systems are getting better. So we went very close with Epic Foundation for the most part, that really helped us out, uh, a lot.

And the Epic Foundation system is, uh, significantly more build out than it was even a couple of years ago, um, with what they had and haven't implemented Cerner in a while. All now, but I know they've evolved their, uh, foundation systems as well. But I think that's, that's gonna be key, uh, as uh, organizations move forward and, um, you know, in driving costs down, you know, a lot of organizations now are doing this back to foundation move, um, with, uh, with their EMR.

And I think that's gonna be important as we start starting to standardize how we spike care across the us. Yeah. Plus you're going to quarterly updates right? Outta the shoot? Uh, unfortunately, I think on that, I might skip the first one. We haven't decided. , just give people a little bit of a break. Exactly.

What, what's I, I, what's the thing you're most proud? Of your health IT team for this year? You know, the implementation, uh, they really, I think where I saw everybody come together was, um, at the command center, but there was, you know, that was the, uh, icing on the cake if you wanna call it. I mean, there was many long hours by our team.

Um, my leadership team by the staff themselves, our analysts are phenomenal. Our desktop team worked like every weekend for like two months before that to get our technical dress rehearsal in. Our analysts did all kinds of, um, um, . You know, moving mountains on the build. I, I, I'm really, really proud of, of the team that you work with.

Yeah. I, I, I joke, I'm like, you know, you need the risks involved, but the, the other thing is, um, you also know that going through those things really builds a team. Yeah. There's, you overcome an awful lot of challenges. It's very compressed. Everyone's pulling for each other, everyone's relying on each other.

It's, it's a, it's a really neat experience. No, it, it really was. And, and we had a good time in our, um, in our command center and, you know, a few of the pictures you saw, but, uh, you know what, we didn't have . As we sang Happy Birthday, several people had their birthdays during the command center. Uh, so we had sang Happy Birthday to all of them.

I managed to fall out of the chair was standing on during one of those. So luckily there was no camera going. again, part of the role, uh, comedic relief I guess is well saw or clumsiness. So yeah, club . So, you know, I had this question as missed opportunity for 2019 and, and I, I don't like, I didn't like the way it was going.

And I guess what I would say is, you know, what's one thing you wish you had had more time to spend? End on in 2019 that you're gonna have to hopefully get to in 2020. Uh, honestly, everything else, so we got Epic in, but you know, that, that comes at a across, but it, it really consumes those Yeah. You know, you don't really do any of the projects during that, you know, I mean, we did a handful of moves.

We did, you know, some other things like that. But you, and in, um, kudos to my organization, they really focused on this, our CEO all the way through the entire organization focused on, uh, the Sapphire project. It, it's our largest project we've ever done, um, in part. 'cause we don't own our own buildings, the county does.

And so when you take the construction out of it, this is, you know, 220 bucks project. It's a significant project. But it was so consuming for us that there is many other things. And you know, if you think about implementation and staying current as a competitive race, we were, you know, sidelined, if you want to call it that on this very important piece.

It'll help us leapfrog, but we've got a lot of other things. Now you, you've gotta put the foundation here. It's why, you know, the, the first year when I went to where I was ACIO, um, we . Focus on the infrastructure. Well, I came in following, uh, six outages to the data center. You know, you don't get to do anything as ACIO until you don't get to pass go unless the network works.

You're absolutely right. And then, and then you just start moving up the stack. Yeah. And, and frankly, I've got some of that that we still need to do. We are very, as a department, very customer centric customer focus, which is awesome. We're very process liked though. And so what it means is that everything we're doing with our customer becomes kind of a heroic effort rather than a repeatable process.

And so part of that . It's just us retooling a little bit on how we do these processes, building in, you know, a solid help desk and all of the other infrastructure pieces there, and we've got all the right pieces. We just need to put it together. Yeah. My VP of infrastructure and operations used to always say, we're trying to go from hero to nasa.

NASA is all about the team. No one's more important. We're all putting somebody on the, it's about the mission. That's exactly it. And uh, he, he was always saying that. 'cause when he came in, we had all these people that are like, oh, I worked through the night to do this. And he would sit back and go, why did you.

Have to work through the night and they would look at him like, indignant, like, what do you mean I, I fixed it. It's like, alright, well let's step back and make sure that no one ever has to work through the night to do that again. Bill, I actually had an early boss, um, you may even know him, um, from back in the day, but, uh, he actually, I, I worked through early in my, uh, career, worked through the night with my technical team on something, and I came in the next day and I was exhausted and I was expecting a big, you know, go mark.

And, uh, he's like, you know, I appreciate the fact that you, uh, fixed the issue, but really wish you wouldn't have been here all night. Really wish you would've prevented the issue. And it was kind of an aha moment for me. Uh, on the whole thing. I'm kind of informing my own, uh, thought process of how do you, you know, I love the saying, going from a hero to NASA's.

That's great. Such, um, so this is sort of an industry perspective. What area would you like to see the industry really, uh, produce more innovation? Yeah, so just having come off of Go Live, I would love to see even more of a playbook on how to implement, uh, EMRs. I know that's, uh, . Maybe a little bit self-centered, uh, audio from what, where, where I just was.

But we spend so much time, so much money on, on this and, you know, in taking our best practice and putting into the system, I really, and I think Epic and I think the other EMRs are doing it as well. So it's not just, uh, just them, but I think the, uh, electronic medical record industry, we need to continue to standardize how we practice and really say this is the best practice across the, uh, um, across the industry, not just for Alameda Health System or you organization.

And there's still a lot of that work to do with m and a. Stuff going on. Absolutely, absolutely. And the final question is, uh, again, we talked to our users and they said, Hey, could you ask these CIOs, you know, what roles they're gonna be hiring in? I think people want to know, well, I've got an open position for VP of applications right now.

I'll put a plug in for that . So, so I'm, uh, I'm looking for that. Um, I was, I was thinking a little bit about this as we kind of retool our organization. You know, analysts are gonna be key to us, um, uh, with, uh, with knowledge. But it's, it's really, you know, that's kind of a generic, so I'm looking for people,

That are, that have a strong, um, understanding of the business. So if it's clinical, ideally you come out of a clinical space or you have a strong working knowledge of that. Yeah. If it's revenue cycle, you've worked in that space, you really understand it. Obviously you gotta understand the applications and there's knowledge and certifications, uh, there that to make that happen, um, your work ethic is, uh, is uh, key.

And I think the last thing, kind of the secret sauce is customer service. And that's, uh, you know, you kind of know that, but yeah, as, as a person, you either have or you don't have it to a certain degree. But we are so much . More of a service oriented, uh, organization at this point, and I think that's just crucial to hire for service.

There's very few, few roles even in it anymore where you just sit behind your computer and don't interact. You're absolutely right. It's a, it's a team sport. Mark, thank you for taking the time. Appreciate you having me, bill, so thank you. I hope you enjoy the conversation. Remember to check back often as we are gonna drop an episode a day for most of November of 2019.

Following that, please come back every Friday for more great interviews with influencers. And don't forget, every Tuesday we take a look at the news, which impacts health It. If you wanna support the fastest growing podcast in the Health IT space, here's a few ways that you can do that. The first, share it with a peer, share it with a friends, share it with somebody who's working right there next to you.

Number two, sign up for Insights and staff meeting. These are services designed to help you in your career. Number three, interact with our social media content on Twitter and LinkedIn. Number four, post or repost our content. And number five. Always send me feedback. Bill it this week in health it.com. Your insights continue to shape the channel.

This show is a production of this week in health It from work great content. You can check out our website at this week, health.com or our YouTube channel. Special thanks to our sponsors, VMware and health lyrics for choosing to invest in developing the next generation of health leaders. Thanks for listening.

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