The Healthcare CIO Look Back / Look Forward series with Mark Amey,
Chief Information Officer at Alameda Health System.
The Healthcare CIO Look Back / Look Forward series with Mark Amey,
Chief Information Officer at Alameda Health System.
Bill Russell: 00:04 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 want to thank our founding channel sponsors who make this content possible, health lyrics and VMware. If you want to 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 CIO, I was really overwhelmed at first and one of the first things I did was to sign a CIO 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.
Bill Russell: 00:55 If you want to learn more, visit health Lyrics .Com or drop me a note [email protected] Over the next three weeks We have a huge treat for you. I’m really excited about it. 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 I look forward at 2020. You’re going to hear, um, 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 going to 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 them really quick and some of you listen at one and a half times speed.
Bill Russell: 01:43 So it’s gonna go like that. Uh, we’re going to publish one a day with a few news day 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 Amey 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 come on the air and we were talking about how he, I was really impressed with how they use social media to really share what was going on in the, uh, in the implementation. And I almost felt like I was a part of the team. I got to see the camaraderie and see, you know, people working through challenges and uh, you know, the go live, the events and those kinds of things. 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.
Bill Russell: 02:37 So here we are from the chime fall forum 2019, and we’re meeting with CIOs and we’re, we’re running through a handful of questions. I’m joined with, uh, Mark Amey, thanks for, thanks for coming on board. I appreciate it. Oh, pleasure. Newly, well not newly. You’ve been there for about a year. About a year. Yeah. Alameda, Alameda health system. Okay. And, uh, I saw the, I saw the social media. You just completed your Epic implementation.
Mark Amey: 03:03 Yes. I didn’t know if the social media was a good thing or a bad thing, but it was a thing.
Bill Russell: 03:07 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, 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.
Mark Amey: 03:23 Absolutely. Now I’m blessed with a great team, actually a combination of my own team, we call it the Sapphire team as you might have seen from the video that we had out there, but the Sapphire team and then Epic was certainly a great partner. And then we had several of my partners on board with this as well.
Bill Russell: 03:40 Did you inherit that or cause you’ve only been there for a year?
Mark Amey: 03:43 So the Epic contract was actually done when I came on board. And so that contract was that completed timelines and set and scope had been set so I came onboard for the exit execution piece.
Bill Russell: 03:56 So, um, it’s one of those, you knew the risks involved, you bought your tickets so well, yes.
Mark Amey: 04:03 But you always find a few things along the way.
Bill Russell: 04:06 No, that’s fun. Um, so we, we only have about 10 minutes with you, so let’s get to the questions that, you know, the first one is, how have you seen the role of the CIO changed over the last maybe 12 months?
Mark Amey: 04:17 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, but 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 a CFO now, especially with the move into the cloud. Uh, and you know, you’d think about so much in the decisions we make now are not necessarily technology cost performance means the cheaper in the cloud. Is it cheaper locally, is it cheaper to staff some operations. So certainly the financial, the things I’d say the second is really understanding the 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. As well, as revenue cycle of course.
Mark Amey: 04:56 So on that, but what our clinicians are doing, what the workflows are. But i’d say the third is really driving towards lean and that’s a journey I personally started to follow over the last few years, but you know, gemba, Itell framework, those sorts of things. I think really doing changes for us,
Bill Russell: 05:13 I really resonate with the CIO, CFO linkage. And actually you’re the first one to mention that, but I was just in an AWS session and people were talking about, you know, how is cloud going to save me money? And so much of the conversation centered around capex versus OPEX and I mean, you really have to understand how money flows.
Mark Amey: 05:32 I was in a session too, they just became consumed. And you know, some of my, uh, hearing my CIO brother and, and sister, uh, they just, they were, uh, they were trying to work with their CFOs and obviously it wasn’t, it wasn’t going well and that’s, you gotta figure that part out and then help up.
Bill Russell: 05:47 Uh, so you had the EMR implemented, um, what are three priorities maybe for next year that your health, it is going to support, but I assume it’s optimization,
Mark Amey: 05:57 optimization, optimization, optimization, probably the right answer. I think if I thought about it, yeah. You know, we’re, we’re stabilizing. I put loosely a timeframe in on that stabilization through the end of this calendar year. And then the next six months, I’m just a very focused optimization. Obviously I need to get our governance structure stood up during that time. The big focus for us with our behavioral health hospitals actually going to be streamlining the behavioral health workflows that we have and what we’re doing in those areas. So it’s that that’s actually going to be really critical for us. And then lastly, and kind of the deferred project is I’m at time tracking and we have, I believe, a tremendous opportunity as I’ve been looking at the data around overtime time management, you know, in all areas that all of our operational areas. And so when you think about that as some savings for us, but it’s also patient patiency and ultimately employee morale and get people into working reasonable work weeks.
Bill Russell: 06:52 So let’s, let’s focus those in a little bit and let’s talk about, uh, patient experience, you’re primarily Oakland, Alameda.
New Speaker: 07:02 Alameda County. So Oakland, you know, think of Oakland, the city of that area.
Bill Russell: 07:06 So if I were to go to 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?
Mark Amey: 07:12 Yeah, so that’s actually exciting and sad all at the same time. So the sad part is we are 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 because it’s going to over the phone just is so cumbersome for her.
Mark Amey: 07:37 And so obviously there’s some work we need to do that’s not just technology related in that. Um, but you know, when I, when I think about this, this person, obviously not in good health because they’re doing reoccurring visits with us and having to get on the bus to come to make the appointments. So I think the patient portal, my chart specifically for us is going on a game changer. I use it personally as a patient. In fact, I won’t see a doctor that’s doesn’t use it. And, um, I, I’m, I’ve already am trading notes now with um, with my doctor, dr Jenny. On my chart it’s awesome. And um, I, um, I think it’s going to be a game changer for our patients. It’s also interesting because the demographics that we work with so many underserved, um, you know, folks that are struggling to deal with home needs, with food needs, other things like that.
Mark Amey: 08:22 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 for you to help them start to manage their own health as they’re in and out of our emergency department and other areas like that.
Bill Russell: 08:37 Well that’s exciting and that you now have a platform to build a lot of that off.
Mark Amey: 08:41 We already had, our first signups were up to about 2,500 signups at this point.
Bill Russell: 08:45 This actually sounds like a stupid question at this point. What’s one initiative, that you believe is going to materially improve the clinician experience?
Mark Amey: 08:53 You know, it’s going to be workflow optimization, in that. And there’s three big areas that we’re really focused on. Behavioral health, which I already mentioned, but also our op area is another area that I think you can use some streamlining that we’ve got a great chair there.
Mark Amey: 09:06 Hi Dr. Smith. That I enjoy working with. And then I’m also our surgery areas, I think there’s some work that we can do there and really streamlined that process.
Bill Russell: 09:15 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?
Mark Amey: 09:28 Yes and no. So there’s a few interesting things on that. This is actually my, I was counting it up. This is actually my seventh, uh, electronic medical record implementation. I did four Cerner ones and three Epic ones. So, and I will say this has been my smoothest one. Uh, so I don’t know if it’s a combination of luck or you know, some wisdom maybe with age. Um, I, I think truly a part of it is the systems are getting better.
Mark Amey: 09:50 So we went very close with Epic foundation for the most part that really helped us out a lot and the Epic foundation system is significantly more built out than it was even a couple of years ago. With what they had, I haven’t implemented Cerner in a while now, but I know they’ve evolved their foundation systems as well. But I think that’s, that’s going to be key, uh, as organizations move forward and um, you know, when driving costs down your a lot organizations now are doing this back to foundation move, um, with EMR and that’s going to be important as we started starting to standardize share here across the US.
Bill Russell: 10:23 Yeah. Plus you’re going to quarterly updates right out of the shoot.
Mark Amey: 10:26 Uh, unfortunately I think on that, I might skip the first one. We haven’t decided.
Bill Russell: 10:30 Just give people a little bit of a break. What’s the thing you’re most proud of your health it team for this year?
Mark Amey: 10:38 You know, the implementation. I, they really, I think where I saw everybody come together was at the command center, but there was, you know, that was the icing on the cake, if you want to call it. 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 to our technical dress rehearsal. Then our analysts did all kinds of, um, moving mountains on the build. I really, really am proud of the team.
Bill Russell: 11:10 I joke like, you know, you did the risk involved, but the other thing is you also know that going through those things really builds a team. 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 a really neat experience.
Mark Amey: 11:28 It really was. And we had a good time in our, um, in our command center and, you know, through the pictures you saw. But, uh, you know what, we didn’t have, there’s, we sang happy birthday and several people had their birthdays during the command center, so we had to sing happy birthday to all of them. I managed to fall out of the chair I was standing on during one of those. So luckily there was no camera going.
Bill Russell: 11:46 Again, part of the role, uh, comedic relief, I guess?
Mark Amey: 11:49 Sort of or clumsyness I guess yeah,
Bill Russell: 11:52 you know, I had this question as missed opportunity for 2019 and I don’t like it. 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 on in 2019 that you’re going to have to hopefully get to in 2020.
Mark Amey: 12:10 honestly, everything else. So we got Epic in, but.
Bill Russell: 12:14 but it really consumed,
Mark Amey: 12:16 you don’t really do any other projects during that. We did a handful of moves. We did some, you know, some other things like that, but and kudos to my organization we really focused on this. Our CEO all the way through the entire organization focused on the Sapphire project. It’s our largest project we’ve ever done in part because we don’t own our own buildings. County does. And so when you take construction out of it, this is, you know, $200 million 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 is a competitive race. We were sideline, if you want to call it that, on this very important piece. It’ll help us lead from a lot of other things.
Bill Russell: 12:57 Now you’ve got to put the foundation here because it’s why, you know, the first year when I went to where I was a CIO, uh, we focused 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 a CIO until you don’t get to pass go unless the network works.
Mark Amey: 13:15 You’re absolutely right.
Bill Russell: 13:15 And then you just start moving up the stack.
Mark Amey: 13:17 And frankly I’ve got some of that, that we still need to do, we are very, as a department customer centric, customer focused, which is awesome. We are very processed like, and so what it means is that everything we do with our customers becomes kind of a heroic effort rather than a repeatable process. And so part of that is just us retooling a little bit on how this process is going in, you know, a solid help desk and all of the other infrastructure pieces there. And we’ve got all the right pieces. We’re just going to put it together.
Bill Russell: 13:44 And my VP of infrastructure and operations, you still 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 moon. It’s about the mission. That’s exactly. And uh, he was always saying that when he came in, we had all these people 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? They would look at him like indignant, like, what do you mean? I fixed it? And it’s like, all right, well let’s step back and make sure that no one ever has to work through the night to do that again.
Mark Amey: 14:14 Bill, I actually had an early boss, you may even know him from back in the day, but he actually, I worked through early in my career, worked through the night with my technical team on something and I came in the next day and I’m exhausted and I was expecting a big, you know, go Mark.
Mark Amey: 14:29 And he’s like, no, I appreciate the fact that you fixed the issue, but really wish you wouldn’t have been here all night. I really wish you would have prevented the issue. And it was kind of an aha moment for me on the whole thing and kind of forming my own thought process on how you. I love the saying can from that, hero to NASA, that’s great.
Bill Russell: 14:47 Um, so this is sort of an industry perspective. What area would you like to see the industry really, uh, produce more innovation?
Mark Amey: 14:55 Yeah. So just having come off and go live. I would love to see even more of a playbook on how to implement EMRs. I know that’s a, maybe a little bit self-centered, uh, you know, from where I just was. But when spends so much time, so much money on, on this and you know, in taking our best practice and putting in the system. I really, and I think and I think the other EMRs, are doing as well. So it’s not just a, just them, but I think electronic medical records industry, we need to continue to standardize how we practice and really say this is the best practice across the industry, not just for Alameda health system or, you know,
Bill Russell: 15:32 And there’s still a lot of that work to do with M and a and 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 are going to be hiring?and I think people want to know,
Mark Amey: 15:46 well I’ve got an open position for VP of applications right now. I’ll put a plug in for that. So it’s, so I’m a, 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 be key to us, um, without, with knowledge, but it’s really, that’s kind of the generic. So I’m looking for people that are, that have a strong understanding of business. So if it’s clinical, ideally you come out of the clinical space where you have a strong working knowledge of that. If it’s revenue cycle, you’ve worked in that space, you really understand her. Obviously you’ve got to understand the applications and there’s knowledge and certifications that they’re there to make that happen. Um, work ethic is that is key and I just think the last thing kind of the secret sauce is customer service and that you kind of know that, but it’s a person you to have it and you don’t have it conservatively. But we are so much more of a service orientated organization at this point. And I think that’s just crucial to hire for service.
Bill Russell: 16:40 There’s very few roles even in it anymore where you just sit behind your computer and don’t interact.
Mark Amey: 16:44 You’re absolutely right.
Bill Russell: 16:45 It’s a, it’s a team sport. Mark, thank you for taking the time.
Mark Amey: 16:48 Appreciate you having me Bill, so thank you.
Bill Russell: 16:50 I hope you enjoy the conversation. Remember to check back often as we are going to 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 want to support the fastest growing podcast and 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 friend, 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 [email protected] your insights continue to shape the channel. This show is a production of this week in health it for more great content. You can check out our website at this week, health.com or our YouTube channel. Special thanks to our sponsors, VM-ware and health lyrics for choosing to invest in developing the next generation of health leaders. Thanks for listening. That’s all for now.