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March 21: Today on TownHall Karla Arzola, Former Director of Information Technology - Swedish Medical Center at HealthONE speaks with MariJo Rugh, Vice President, CIO, UCHealth Affiliates at UCHealth about work-life balance and the past, present, and future of UCHealth’s Affiliate Community Connect Program. What was her career journey to Health IT? What advice does she have for taking that next career step while balancing work and home life? How does her current role fulfill her personal mission? How is her organization measuring success? What is the future of her organization’s program?

As the healthcare industry undergoes a rapid digital transformation, IT security must stay ahead of the curve. CISOs need to think ahead and proactively develop security policies and processes to ensure that healthcare organizations are secure and compliant with rapidly evolving regulations. Join us on our April 6 webinar, “Leader Series: CISO Priorities for 2023” to explore healthcare companies' challenges today and the strategies CISOs can use to stay on top of the security priorities for 2023.

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Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

 Today on This Week Health.

I always tell people, it's okay to fail, but let's don't repeat the same failures. Let's learn from those failures the best part of the program is, that failure, which we started with, has really shaped the program and made it better.

Welcome to TownHall. A show hosted by leaders on the front lines with interviews of people making things happen in healthcare with technology. My name is Bill Russell, the creator of This Week Health, a set of channels dedicated to keeping health IT staff and engaged. For five years we've been making podcasts that amplify great thinking to propel healthcare forward. We want to thank our show partners, MEDITECH and Transcarent, for investing in our mission to develop the next generation of health leaders now onto our show.

good morning or afternoon everybody. I'm very excited to kick off my 2023 this week Health series. This year we'll be focusing on many fantastic women leaders and sharing their success stories. . And so without further ado, I will introduce today's guest, Mary Doe.

She is a healthcare executive with about 25 or more years of experience. And she is the c o at uc Health for the Community Connect segment. So, Mary Jo, welcome to the show. Thank you for the time. And by the way, happy Internationals Women's Day. How you doing today?

I'm good. How are you Carla?

I'm doing fantastic. So thank you for the time. I really appreciate it. Why don't you go ahead and give us some quick intro and tell us about yourself.

Yeah, sure. So, I have roots in Nebraska. I'm a farm girl from Nebraska. And I never would've thought, that I would be living in a city when I was, 10 years old.

I loved to be out working with my dad and never really thought that I would move into a healthcare IT career at the time. My life when I was growing up with my dad was doing whatever he did, which meant sometimes, riding a horse. I learned to ride at a very young age. I drove farm equipment, large farm equipment just really learned to work hard with my dad.

And my mom also had a very musical side to her, so at the same time I was also required to take piano lessons. and so which having kind of both of those aspects of just working outside, being with my dad, working a lot with men there was no, no gender difference. You did whatever you needed to do, regardless if you were male or female.

And so, like I said, I, that's really kind of my upbringing and, I think has contributing. A lot to my work ethic today. I kind of blend my work with my life with my family. I started out as a med tech and worked in the laboratory for a couple of years and kind of made my way over to healthcare it via Cerner.

I. Was with them for a few years and definitely learned a lot about not only the laboratory, because I started out focusing on their lab applications, but ventured over into their other applications. And so just learned a lot about healthcare that I didn't know from my just laboratory perspective.

As I mentioned, I transitioned over to Cerner from the lab and then ended up working for a healthcare organization in Birmingham, Alabama. Started having my kids and we also moved up to Cincinnati. Spent some time. Cincinnati Children's. And so as my kids entered the world, then I all of a sudden had to balance a lot more things and very similar to what I had to do when I was growing up.

It always seemed like we had something going on, multiple things I had to support, and I found that my work life balance was very similar, especially introducing the. Fortunately, Cincinnati Children's had a daycare on site, so I'd pile everybody in the car in the morning. It started out with one, then it was two, then it was three.

so they would go to work with me, I would take 'em to the daycare and then I would walk over to where I worked at the hospital. So, like I said, I've always really kind of blended. My, work with my family and just who I am, there's no real separation. I take what I learn at work to my family.

I take what I learn with my family to my work environment as well. I sometimes think of the people that work with me and for me, like my children, I wanna make sure they're well taken care of, wanna make sure I listen to 'em. So again, lot of communication. I found that to be incredibly important.

So after I worked at Children's and found myself. Three kids. I actually had to take a step back for a little bit with a non-management role, I think the sort of my turning point was when I had locked my keys in my car two weeks in a row. Trying to scramble and rush and make it to a meeting on time and it's like, time out.

I really have to. do something a little bit different here, not only for my sanity, but for my children as well. So I took a step back and actually worked for a couple of years in the physician lounge, and this was a while back. And you had physicians that would come in that literally didn't even know how to use a mouse.

And so I worked side by side them and really helped them learn to navigate the emr. Again, things were very non-integrated. Some of them were on paper, some of them didn't use a computer. So here they were in the hospital being asked to actually enter orders for their patients. So it was really enlightening.

And so even though when I look back and at the time I struggled because what is this gonna do to my career? Is this gonna be a real setback? Because I certainly had aspirations to continue to grow, but it was really a great learning opportunity for me and. I really got to understand , physician's perspective.

Not only did I work with the community physicians, but I also worked with those that were doing research at the hospital as well and, working as attendings. So, certainly, that was a huge opportunity for me to, learn a different side of healthcare and really, at the elbow with the physicians.

Let me interrupt you because I think it's fascinating, right? You're talking about your children, you're talking about having three kids, taking them to work with you, and then you feeling like you had to take a step back because you had aspirations. And just for I mean, and I know you know this, there's many women out there.

They're like going through the things that you're going and they're like, well, you know, I have to take this job and, but I really wanna be a CIO or I wanna be an executive. I wanna take this position, but I can't right now. And they feel like, They have to sacrifice a few things to get to where they need to.

But obviously you're a perfect example of, yes, we can do it. You, it can't be done, it's just gonna take a little bit more time. Right? So how do you go from, it's all these sacrifices, or do you feel it with sacrifice? Because obviously you love your children and maybe at that point you're like, this is what I need to do right now.

But then how do you go from that to, okay now I feel like I'm ready for that next step. .

Yeah. I think, everybody's a little different and had, you know, if you were to second guess, would I be in a different place? Maybe. But at the same time, I'm really happy with where I am right now, both from a, who I work for and what I'm doing.

So, but it was tough and I've actually talked to a lot. of working mothers throughout my career to, just say it's okay. I mean, I remember one day I was sitting in a conference room waiting for one of the project managers to come in and she, kind of comes rushing in and literally her hair's still a little bit, not quite in shape and she just is a little disheveled.

And I was like, you know what's wrong? And she's like, oh, I just don't know if I can do. this And, we kind of talked through it and I said, well, first of all, you're not perfect and no one is expecting you to be perfect, neither your children or your employer. And so you have to do the right thing for you.

And if you, need to. Maybe get somebody to help out of the house so that you don't have to do that when you get home. So we could just, I frequently have found myself talking to other professional women that I've worked with about, you have to do what's right for you and what's right for your children.

And maybe. augmenting, staff in your house will help you feel better and more prepared for work. So, but again, it's a balance. Not all people , wanted to do that, so maybe they needed to take less responsibility. So everybody's a little bit different, but I've certainly had a lot of conversation with women about how to do that.

Um, So yeah, I mean, it's all worked out for me and I think ultimately it will for others as well.

📍   We'll get back to our show in just a minute. We have a great webinar coming up for you in April. We just finished our March. On April 6th at 1:00 PM Easter time, the first Thursday of every month, we're gonna have our leadership series. This one is on CSO priorities for 2023. Chief Information Security Officers, we have a great panel.

We have Eric Decker within our mountain, Shauna Hofer with St. Luke's Health System out of Boise, Idaho, and Vic Aurora with Hospital four Special Surgery. And we are gonna delve into what are the priorities for security? What are we seeing? What are the new threat? What is top of mind for this group? If you wanna be a part of these webinars and we would love to have you be a part of them, go ahead and sign up.

You can go to our website this week, health.com, top right hand corner, you'll see our webinar. And when you get to that page, go ahead and fill out your information. Don't forget to put a question in there. one of the things that we do, I think that is pretty distinct is we. like for today's webinar, we had 50 some odd questions that we utilized, in order to make sure that the conversation is the conversation that you want us to have with these executives.

So really appreciate you guys being a part of it and look forward to seeing you on that webinar. Now, back to the show. 📍

That's amazing. I mean, and I'm so happy to hear that you're that mentor for those others that needs some advice. Right. And it's like you said, it's okay not to be perfect, but you and I had a brief conversation and you talked about your current role and you mentioned to me that this is the role that fulfills your personal mission.

Why is that Do you want to share that with us?

Yeah. So, my current role one of the areas of responsibility is we call it our Affiliate Community Connect program. And basically what we do is we host Epic and other tightly integrated applications such as packs. We've also, OB Trace View is another one.

It's used for fetal monitoring. So we have a whole kind of portfolio of applications that we host along with our E R P solutions for HR benefits, payroll, finance, and supply chain. Oftentimes when we go into these hospitals, is and I'll talk a little bit more about that, but they've got, like an integrated solution today such as a Meditech or a C P S I or.

Something that is, they're ready to move away from it, but , they need a full suite. They need a full solution. So we decided early on that we would host not only Epic, which is very much done out there and multiple organizations are doing it, but we would also offer these other applications.

So what, we really focus on is what are the organizations that we do interact with today, but are maybe, much smaller, can't afford. Epic on their own, they may be too small for Epic on their own. . So it really allows us to give these smaller organizations. Basically a world-class EHR without having to divert, capital for multiple years by doing it on their own.

And we make it very affordable, very reasonable. And not only do they get a world-class EHR and integrated applications, but we also have a really experienced team. So when we started this program, which was back in 20 16, 20 17, I always like to tell people that the first introduction into this, we had a failure.

We were implementing it for the first time with Aspen Valley up in the mountains. And there were various things that contributed to why we didn't succeed. And I can tell you at the time, it felt terrible. I mean, it felt really awful that we had to pull the plug. They felt it wasn't moving in the direction they wanted it to.

So what we did with the failure, I mean, who wants to admit they failed, but , we actually, and I'll talk a little bit more about, lessons learned are incredibly important and we basically took a step back. Looked at, why did we fail? What do we need to do differently? Some of it was technologically induced.

Some of it was we didn't have the right people, we didn't have the right approach, we didn't have the right conversations. Some of it was about the people, some of it was about the process. You know, The whole, the old. People process technology. So we really adjusted, we created a team that was focused and created very distinct roles for those areas that each one would focus on.

And we went live then with our first hospital, with the program up in. Laramie, Wyoming, IVANS and Memorial Hospital in August of 2019. So that was our first hospital. Was it perfect? No. Did we make mistakes? Yes. So what we've done with each one of these, we now have a total of four hospitals live. We also have more than 20 small clinics some large clinics as well.

And we also have all of the CU School of Medicine clinics that are on Epic as well. So our program is really. Grown significantly with the biggest growth being in the hospital area, as I mentioned. So four hospitals live now a fifth underway. We are working on our sixth as well. And well, we actually, kind of back to the failures are okay.

I mean, they, , you know, guide our journey. So not only do successes guide the journey, but failures do. So we actually just as of last week with every implementation that we've done, we do a lessons learned. . And so I said, you guys, what are we doing with that? We spend a lot of time, identifying those And so what are we doing? And so we've pulled them out and we've got literally over 500 lines on a spreadsheet That we're going through and saying, are we doing this? Did we learn from this? And if we did not incorporate it, then we are seeing if we need to incorporate it. So we've really kind of taken the lessons learned to heart.

Taken our failures to heart, and I always tell people, it's okay to fail, but let's don't repeat the same failures. Let's learn from those failures and make new ones. Not that anyone really wants to fail, but let's don't repeat. So I think that's the, again, the best part of the program is, that failure, which we started with, has really shaped the program and made it better.

Yeah I completely agree with you. It's extremely that. I think that's how we all learn, right? When something doesn't work, then you're like, I'll never make that mistake again. And then you kind of take those lessons learned and then improve what you're doing or go from the, use 'em as a baseline, but

how are you measuring your success? Like, what does success look like for you when you're putting a program together? Hospital or a clinic or is it different?

Yeah. Great question and I think. You know, We, from an implementation perspective of our program, we usually sit down with the organization, hospital leadership, and say, what do you want to accomplish out of this?

What are your pain points? It's, you know, we have one system in the ambulatory space. We have one system in the hospital space. Everything's non-integrated. We have, workflows that are problematic and so we really. Sit down with the hospital leadership or the clinic leadership and work together to identify what it is that they do want to accomplish.

And we don't always do a great job of circling back and saying, did we succeed in all areas of measures? But where we do always hone in in on, is the revenue cycle. We always take a look at what was your revenue cycle? What is it current? , what is it? Post Go live. And we spend a lot of time on revenue cycle trying to make sure that, they've reached and oftentimes exceeded.

We also wanna make sure that quality is, , you know, have we, improved quality cuz we're not doing this just for the fun of it. We certainly wanna look at , improved quality so, The answer kind of varies as far as with the implementation in the hospitals, our measures of success, and one of the things we've actually done is we've created an action plan.

And with that action plan, we have different categories. Analytics is always a big deal. I feel like we always fall short on analytics. And so we've created an action plan to say, here are the things that we need to accomplish to make them more self-sufficient in their analytics. And so that's just one category where we've created an action plan and what is the outcome that we're expecting to achieve and did we make it So that is something we review on.

a monthly basis, and I'm not even directly involved in it anymore, but we definitely have identified some actionable things that we want to accomplish as we move the program forward.

So what is the future of the program right now? Cause I mean you have, obviously it's continue to grow. Does, can anybody join?

Do you have specific partnerships or how does that work and. What in your eyes, what's the future of it?

Yeah, so I touched upon this a little bit, but what we're really trying to do is, , create and put technology in communities. So, what goes with that is we can extend the technology that allows the patients to stay in their community.

And, you know, I have real life experience from this. My brother back in 2014, lives out in rural Nebraska, was diagnosed with leukemia. And so he came out to uc Health for his care and. You know, He made it through the treatment, which clearly , he had to be on site for infusions and whatnot. . But when it came to his follow-up visits, he would drive four hours for one, 30 minute appointment because we didn't have the technology in the community.

And so part of the reason I'm so very passionate about this is that we're really extending technology to clinicians, creating the foundation for clinical collaboration, which allows patients to stay in their community. they have access to world class clinicians. And specialists that aren't necessarily in their community, but through the use of the technology and the EMR platform, they can stay right in their community and receive the treatment and the visits that they need.

So that's the future of our program. We currently have a small hospital in Nebraska, we have a hospital at Estes Park and we've got multiple stories where that patient, or many patients were able to stay in their community and receive the care they needed and didn't have to travel to the front range, or didn't have to travel.

People from the country don't like to live or don't like to drive in Denver, so again, they could literally avoid. Situations and a waste of time because we're able to give them the technology. I will tell you, we have a lot of requests. We have a lot of organizations coming towards us and asking for us to extend the emr, but we only do it for

the right ones, the ones that want to be a partner, the ones that don't look at us as a vendor, because we are a partner, we're not a vendor. We want to extend our technology and our, like I said, our world-class E M R, but we're not a vendor. We don't have a team. I don't have a sales team.

I don't have a team that's only supporting. These affiliate hospitals, but they're also supporting uc Health because we have shared resources. There's benefits to that, but there's also downsides. So again, it's really extending to the organizations that need it, that wanna see us as a partner, wanna work collaboratively with us to leverage the technology and really do the right thing for their patients and keeping them in the community.

Yeah. And you talk about extending the technology to the providers whenever they're in those rural communities, but also I believe it's just that, if for whatever reason they had to come to the city, the information is available across the system. And so that's important too, right.

So you don't have to figure it out. You don't have to get that information from the provider and try to figure it out. We're

absolutely it. Yes, it, and that's a great point, Carla. It, it is an integrated medical record, so if we see a patient that comes down from the hospital in Laramie, they come to Northern Colorado for cancer care or any other sort of treatment, the record is available to the clinician here in Northern Colorado.

That was document. On visits up in Laramie, Wyoming. So it's a single integrated healthcare record. So just from a, even from a hospital transformation in that program, there's huge benefits that are almost becoming a requirement, no longer optional, but it certainly lays the foundation because it is an integrated health record.

You're absolutely right.

Well, it's fantastic. I'm, again, I'm so glad that I got to meet you cuz we bump into each other and uh, Kim event and then I was like, oh my God, canal, she's in Colorado. I haven't met this woman and I wanna learn about what she's doing. And so I really appreciate the time.

Is there anything else you wanna share with us before we go? ,

I guess just one last, well, and I touched upon it, or I mentioned the, the people, the process, the technology. I think that my career has been one that's, it's been fun and I think even though I'm in a technology role, what I really love about it is the people, whether it be the patients or.

, the nurses the HR folks. I think that's what makes my job so rewarding, is just getting to work with people that are doing amazing things. And the technology is the secondary part of it. And just if you're a female leader out there, again, do the right thing for you.

There's no right or wrong answers. You can determine what you want your success to be and it's okay to make mistakes.

Perfect closing. Thank you so much for your advice, for your time, and looking forward to more conversations. Mary Jo, have a fantastic day.

Thank you, Carla. You too. Take care.

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