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.
Bill Russell: 00:11 Welcome to this week in health it where we discussed the news information and emerging thought with leaders from across the health care industry. This is Bill Russell. Recovering healthcare CIO 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 were recording a series of discussions with industry influencers at the Chime Himss 2019 conference. Here's another of these great conversations. Hope you enjoy.
Bill Russell: 00:46 If you could introduce yourself, that would be great.
Andy Crowder: 00:47 Yeah. Andy Crowder corporate senior vice president and chief information officer prescripts Health.
Bill Russell: 00:52 And you just finished an epic implementation?
Andy Crowder: 00:55 Yeah it has been a fun ride the past three and a half years,
Bill Russell: 00:57 three and a half years. And uh, San Diego, San Diego market. Uh, you guys are one of the leaders down in that market. So four years, what were you doing prior to that?
Andy Crowder: 01:07 I had lead a turnaround of an epic implementation MaineHealth and before that I was with Adventist health system for about eight years and a CTO role, CIO role and a couple of other things outside of it.
Bill Russell: 01:18 So you took over that main, that was, that was front page. Yes. Uh, it was a revenue cycle or some sort of,
Andy Crowder: 01:26 they went big bang with about 40 applications and Erp at the same time. Um, so yea, they had a lot going on
Bill Russell: 01:32 and it did not go well. Since it made the front page of
Andy Crowder: 01:34 It did not go well out of the chute. That's correct.
Bill Russell: 01:36 Wow. So that's something that you and Darren Dworkin have in common and you get to come in and fix.
Andy Crowder: 01:41 So MaineHealth was a great organization. It was just a time where some decisions got made that put them in a bad path from implementation. After about 90 days, we got to turn it around and been doing very, very well with epic now.
Bill Russell: 01:53 All right, so you spent the last couple of years really buried in epic, but um, but there's a lot going on in healthcare. I mean we just heard, you know, talk about AI and machine learning and other things. What kind of, what trends are you looking at right now that you think are going to impact yourself?
Andy Crowder: 02:07 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 in virtual and digital and AI, so we've got 55 million in 19 alone or rolling out for virtual care, online triage, video visits, video consult, really trying to transform the way we deliver care from a consumers point of view specifically in the ambulatory space.
Bill Russell: 02:31 So it's really about the consumer experience.
Andy Crowder: 02:33 Absolutely. We want to be the differentiator in our market and we've got strong competition from sharp and Kaiser and a lot of, a lot of ground to take that.
Bill Russell: 02:41 Yeah, I mean sharp and Kaiser. So sharp has a lot of managed care lives. Do you guys play in that?
Andy Crowder: 02:46 Yeah, we do play in that space in commercial cap is an area of significant growth for us. We set ACO from an MSSP point of view this past two years now. So we've got about 200,000, 150,000 and 200,000 lives and our in some type of capitated arrangement and we see that growing significantly.
Bill Russell: 03:02 So it's interesting. So you have multiple models here. So you are, you're competing for consumers. Do you have a health plan?
Andy Crowder: 03:09 Yes.
Bill Russell: 03:10 All right. So you have a health plan and you really go after value based care because you have the, you have the, the population. So from a, you're looking at video, you're looking at, um, are you doing anything with like transportation?
Andy Crowder: 03:25 We're not doing anything with transportation right now. Okay.
Bill Russell: 03:28 Um, social determinants
Andy Crowder: 03:31 kind of starting to play in that space. Yea the presentation was done today and gives us all a lot of inspiration for where we actually have a significant opportunity
Bill Russell: 03:39 at the JP Morgan Conference, I think Geisinger got up there and talked about, 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, they don't have housing? Or don't have food? Um,
Andy Crowder: 03:51 I hope that just means that we've got to leverage our partners in the community our FQHCs lot of our different social services areas and look at it holistically. Whereas today we just looked at it as health care providers.
Bill Russell: 04:01 Do you see that as one of the things that's changing in the CIO role is that you now, it used to be, you were talking to clinicians and your bidding together networks. Now you're essentially going outside of that, you're going to, uh, the federally qualified health plans as well as beyond that evening.
Andy Crowder: 04:19 Yes. 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 health care system at all. It's far outside there. So we've got to be in different places and collaborate very differently than we've done in the past. It's an exciting time.
Bill Russell: 04:39 So, Andy, let me, uh, just getting a little geeky here. So a big epic implementation. You can go just to straight up my chart path, but you're talking about building a digital experience. Are you going to do anything a little different or are you just going to roll out?
Andy Crowder: 04:53 No, so we're going to take a full benefit of everything that we can do in my chart that we're also going to leverage content from Mayo. We're going to embed AI and intelligence into all of our digital consumer facing technologies. That's social, that's mobile and I don't think my charts will be able to answer all of it, but we're certainly going to leverage it and try to integrate it. And you've got other patient engagement solutions that help us with certain disease states and we'll leverage those significantly.
Bill Russell: 05:18 Yeah, and so epic broke apart. I want you to get to the Api so you could actually,
Andy Crowder: 05:23 you know, they've really opened their tool kit up. I have to give them, a lot of credit for that and I think it's getting, look what's happened in the APP orchard the past year? It's just exploded when I see that continuing.
Bill Russell: 05:31 So you're going to take advantage of everything that's in there. Try to create experiences. How do you engage the consumers to find out what experiences they're looking for?
Andy Crowder: 05:41 Voice of the customer. We've got a significant effort from our marketing team that is actually engaging directly with customers. We've got a couple of online tools and give us feedback on what they like and what they don't like and quite honestly, we are consumers too? So we have to listen to our own families and friends and they'll tell you if you ask them. Oh and they're not short on opinions.
Bill Russell: 05:59 It's funny cause when you go to go to a dinner party, you have to decide whether you're going to reveal who you are or not cause you don't get the, Oh, let me tell you about my experience. And you just, you know, to a certain point where we're getting, uh, we're, we're just starting to enter this consumer experience space. We're not Google or Amazon by any stretch or Amazon really and others. So we're, we're trying to figure this out. Do you find that the skills are gonna are gonna have to change within or within your it department? I mean, I don't want to put you on the spot.
Andy Crowder: 06:33 So, you know, fortunately at scripts we've got some of the most brilliant um, uh, resources. Our team, our informatics and clinical resources are just wonderful to work with. And when we built the epic team, we recruited, recruited people from within the organization was, 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 that are really transforming the customer experiences where we get a lot of significant learning,
Bill Russell: 07:06 it's going to be, you're in a great market. I mean, there's so much
Andy Crowder: 07:09 great and competitive market as well.
Bill Russell: 07:11 Yes. Yeah. Choice, a lot of startups down there. I don't think people realize how many startups down in San Diego,
Andy Crowder: 07:18 it's a melting pot for that type of activity in it. And that's actually some feedback from our board members that, you know, you don't have to go this alone. We'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 part of our JV strategy in business partnerships are really focusing on that in 2019 and 20.
Bill Russell: 07:36 I'm not familiar to you. Do you have an innovation arm or,
Andy Crowder: 07:39 we don't have any innovation. you know, I was just back in Florida a couple of weeks ago with a colleague of mine, Tim Thompson and Baycare and 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 CEO, it's his pet project. It's five elevated projects every year. Here's the funding source, run the 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 engage the consumer in that, uh, they got it from the Ochsner model. We're looking at doing that. We just haven't figured out how to really structure it to get the best benefit.
Bill Russell: 08:11 It's interesting. I mean you, so you just finished a significant, uh, EHR project 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 EHR project, it does consume a lot of resources. It puts a, you can't fail.
Andy Crowder: 08:28 Well you can't fail. You've got to get it right. And that does minimize where you can have the opportunity to collaborate, where you can spend your time. Now we're in a really unique spot coming out of it. Um, very successful implementation and it's time to start collaborating, engaging others, which is why I love these. We're going to be all over the floor this year and the vendor demos and our emails had been blowing up weeks before we got here. So there's that.
Bill Russell: 08:49 Well, that's the last one. The last question I usually ask is how are you going to, what are you going to do with the show? Or are you going to go booth to booth? Or do you really have it scheduled out?
Andy Crowder: 08:57 We have 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 AI, all of the top vendors in that space.
Bill Russell: 09:15 That's great. So you've split it up.
Andy Crowder: 09:17 We'll see if they remember their, their assignments after this podcast.
Bill Russell: 09:21 Well, and revenue cycle absolutely is an engagement. Anyone who's ever received 15 bills from an organization, but that's not a technology project. It's as much as it is for, hey, let's talk through how we generate a bill and how we make it understandable.
Andy Crowder: 09:35 Yeah. We actually, um, our patient experience off for Doctor Cazalet in our revenue cycle team, are actually getting ready to launch the single billing office. And that's a single guarantor statement, much easier to read a stripped out all those healthcare terms that are relevant to the patient, the consumer. And so, and that's been an area where we've struggled as an industry. So we're going to try to hit that hard in 2019
Bill Russell: 09:55 it's exciting. I mean, uh, I'm not sure we're going to be able to recognize health care five years from now. Getting that single bill. That's really easy. Being able to schedule things online and everything we need to do. Andy, thank you very much. Appreciate the time. Take care.
Bill Russell: 10:10 I hope you enjoyed this conversation. This shows a production of this week in health it for more great content. You can check out our website @www.thisweekinhealthit.com or the youtube channel at thisweekinhealthit.com/video thanks for listening. That's all for now.