In collaboration with CHIME, Becker’s Hospital Review’s new "Life of a Healthcare CIO" series features leading hospital and health system CIOs from across the country who are sharing their experiences, best practices and challenges.
To recommend a CIO to be featured in this series, please contact Helen Gregg (hgregg@beckershealthcare.com).
An interview with Heath Bell, CIO and vice president of revenue cycle at KishHealth System in DeKalb, Ill. (Interview has been edited for length and clarity.)
Question: How long have you been with KishHealth?
Heath Bell: I've been with KishHealth for almost eight years.
Q: Have you always held both the CIO and vice president of revenue cycle titles?
HB: No. I had the role of CIO when I came here, and then the revenue cycle part was added in 2010, so I've had that title for three years.
Q: How has your job changed since assuming the revenue cycle responsibilities?
HB: Well, I got all of the revenue cycle department responsibilities, running the business office, managing registration, financial consulting. As far as what it did for my role overall, it definitely broadened many aspects of it. Before as CIO, I was running operations in IT which covered a lot, from systems support to overall hospital strategy to technology. But with this position, I am now also worrying about collections and payer contracts, and even just individual patient interactions. I think it gives me a perspective I don't think a lot of CIOs get.
Q: In your time with the hospital, what has been your biggest accomplishment?
HB: I think we've had a lot — it's hard to narrow it down. I'd say the thing I am most proud of is modifying the organization's attitude towards health IT and the IT staff. When I first came, customer service [to the rest of the hospital staff] was not top of mind for some in IT. I started rebuilding a department where we had more of a customer-focused mentality, a the-customer-is-always-right model, and increasing our level of service and becoming more responsive. It made staff more responsive and ended up elevating IT staff morale.
It's also changed the way IT is viewed within the organization. Before, people would ignore IT and get the solutions they needed without us. Now, we're the first call they make. Now they ask us what we can offer them or how we can help them find what they want. It really changed the organization as a whole, and I'm very proud of it.
Q: What do you see as your biggest misstep or mistake?
HB: Without going into details — we've had two instances where we chose a solution and ended up having to deinstall it. For one of those instances, the selection happened before I arrived, for the other, the selection happened after. The reason behind both was vetting the vendor inappropriately. You have to make sure you vet your vendors and make sure the promised user functionality actually exists.
I walked into the first one; on the second one, we had done the vendor vetting and identified the functionality we needed, but the functionality was lost in the implementation. We had in IT established a model where IT staff would implement the technology and then lean on "superusers" in the department to help with adoption. We still do this, but the superusers in this department weren't as tech-savvy, and it created confusion with the app and people lost confidence in its usability and with the vendor as well. We had to ultimately start re-vetting vendors and have chosen a second, but it was a costly mistake. I would encourage anyone putting in new technology to truly vet the vendors and stay close to the superusers throughout the implementation.
Q: Looking back over the past month, what has taken up the majority of your time?
HB: We are currently undertaking a variety of initiatives under population health management. That's really consumed the majority of my time, especially because in my dual roles it's hitting me from both sides. With IT, I'm vetting vendors, working with the population care management and community wellness departments on education and getting patients into the database to see the continuum of care provided by our health system and others. From the revenue cycle side, I'm working on the same topic, but it's more about how we're going to survive in a new payment model, evaluating whether we should become a part of an ACO and how to maintain some level of our regular patient volumes while we're designing these new models — that has occupied all of my time.
Q: What is the biggest challenge you're facing right now?
HB: Definitely from the overall health system perspective, population health management is the biggest oncoming challenge we're dealing with. In IT specifically, as it has been historically for IT, there's too many demands without enough time or resources to make it all happen. I was having a conversation with our CEO about how we need to balance projects and make sure the organization as a whole has its priorities in place so the IT staff doesn't feel overwhelmed. We're still dealing with meaningful use and preparing for ICD-10 and all the other things we need to do to keep the organization running while we're figuring out our population health strategy.
Q: What is one lesson you've learned during your tenure you'd like to share with other CIOs?
HB: One of the things I've learned — and I think more and more CIOs are getting this — is the relationships you have outside of IT are so important. Learn the operations of the areas you're supporting. You don't need specific details, you don't need to know how to walk into a department and draw blood, but it's about watching or observing or listening to how the work is done in an area so any solution you implement there doesn't totally interrupt the workflow.
The whole industry, through adopting EHRs and doing so rapidly, is running into the challenge of workflow optimization. We're collecting the right data, but not always in the most efficient way. We need to figure out how to streamline the process without interrupting the clinical side and make sure to give clinicians time to deliver care rather than spend time collecting data. It's definitely a looming issue. We're starting to see it in our organization as we enhance our EHR and undertake population health management, now we just need to eliminate the inefficiencies we created unnecessarily.
More Articles on Healthcare CIOs:
The Life of a Healthcare CIO: Mt. San Rafael Hospital's Michael John Archuleta
Beyond the EHR: Sentara Healthcare’s IT Strategy
The Life of a Healthcare CIO: Lutheran Health Network's Keith Neuman