First-day jitters are common to anyone starting a new job. The anxiousness that comes with finding the break room, a lunch buddy or simply exchanging smiles with so many new faces is completely understandable. But for a hospital CIO, the first day, weeks and perhaps even months can be a bit more challenging. Just ask Gretchen Tegethoff, the relatively new Vice President and CIO at Athens Regional Medical Center (ARMC) in Athens, Georgia.
Tegethoff, who previously spent nearly seven years as CIO at George Washington University Hospital in Washington, D.C., is just five months into her tenure at ARMC, and says that, thanks to healthcare reform and Meaningful Use, she faces quite a checklist of challenges - all a bit more daunting than finding the company conference room. At the top of her list include developing a Meaningful Use roadmap, assessing and building her team, creating governance structures, and developing an eHealth department.
Billian's HealthDATA recently sat down with Tegethoff to discuss these challenges, and how, as a relative newcomer to the hospital, she is striving to effect clinical and technological change.
Moving from George Washington to Athens Regional, what sort of cultural workplace differences (if any) have you noticed so far?
Tegethoff: "One workplace difference is that employees at Athens Regional tend to stay with the organization for longer periods of time than I'm used to seeing in the D.C. area, and I do think this difference is attributed to the regions (as well as Athens Regional being a great place to work).
"One other difference is the strong focus on community and being involved in different causes. Being active in the community is encouraged at all levels of the organization."
On your very first day at ARMC, or perhaps even during the interview/recruitment process, what came across as the most pressing challenge you would face in your new role as CIO?
"One challenge that I identified during the interview process was that I would be coming into a new organization and quickly have to assess our Meaningful Use readiness and work towards those efforts, while at the same time getting to know my staff and managers, getting up to speed with current projects, learning about operations, and meeting physicians and other members of leadership, among other priorities.
"Moving into a CIO role in a new organization is a lot of work and requires time to learn the organization, and to do this during such an active time with Meaningful Use, ICD-10, and other projects on the national HIT landscape is a lot to manage - but I was up for the challenge."
Meaningful Use Roadmap
Where is ARMC currently at with Meaningful Use?
"We are currently doing a rapid review of our MU readiness, which is something I felt we should do so that we could have a solid understanding of the remaining gaps and develop a plan to fill those gaps. ARMC had an existing roadmap and steering committee in place, and this rapid review was set up to build upon the existing efforts and move our focus to a new level."
What healthcare IT vendors are you currently working with? Did you/do you plan to initiate relationships with any based on previous experience with them at GW?
"We are currently working closely with Allscripts, as we have Eclipsys for our acute setting. I am trying to meet with our existing vendors to form relationships and learn about some of the products and solutions we are using at Athens Regional. I am in communication with a couple of key vendors based on my previous experience with them at GW, and the need for such solutions at Athens Regional. I am working with my team to evaluate how they might work in our environment."
Is staff at Athens Regional embracing the transition into Meaningful Use? How are you helping them to realize the short- and long-term benefits?
"I think some in management and in IT may have a difficult time embracing this transition, especially with regard to selecting and implementing certified systems in specific timeframes, while sometimes having to hold on other projects. This effort has to be much more coordinated and strategic, and also have more of an organizational-wide focus rather than an individual department focus.
"I take every opportunity to communicate the benefits during meetings, discussions about system needs, and larger forums for directors and physicians. Leadership is embracing this transition, and we are focusing on communicating and educating physicians and the Board. From the more clinical staff perspective, I am still in the process of meeting people through meetings and rounds, so I'm working towards understanding their point of view with the changes that will impact their workflows."
Assessing and Building the Team
It seems a number of Athens Regional executives have been at the hospital for a year or less. Does having such a new team help or hinder the projects you're working on?
"I believe it helps having fresh perspectives. One thing that I believe would hinder the projects that I am working on is if I heard "that's just the way we do things here" but I have not heard that once. The executive team is open to new ideas and change, which was very attractive to me during the interview process. Also, with a relatively new team, we can all relate to being new, so there's a lot of support."
Are you (or the hospital at large) hiring for any particular positions based on the IT projects you've got in the pipeline? If you are hiring for IT positions, are you doing so internally or externally? What specific qualities make a candidate stand out?
"At this point, I have a few positions that I'm looking to post soon, such as program and project managers to support my efforts with IT governance, MU, and other priority projects, and security professionals. In addition, we'll be hiring clinical analysts and clinical informatics roles to support both our inpatient and ambulatory systems.
"I do have qualified, internal interest for a project management role and all other positions will be open to internal or external interest. Having a clinical background plus technical experience or understanding continues to be an in-demand skill set and one that we are looking for in filling analyst and informatics positions."
Governance Structures to Manage Projects
How is Athens Regional developing its governance structure to oversee current and future projects?
"I am still in the process of developing an IT governance structure. Currently, there is a small IS Steering Committee, consisting of the CEO, SVP of Health System Operations, and myself that I established while I work towards a more formal structure.
"A parallel effort to this will be the implementation of a new project portfolio management system to manage project intake, approved projects, project outcomes and project visibility.
"We are re-establishing the Physician Advisory Board to assist with decision-making, ongoing communication, and issue-resolution related to software and hardware. In addition, I am also in the process of forming a data and analytics governance structure to assist the organization in identifying the types of reports needed, how they are used, the data sources, etc.
"We have existing BI tools and data warehouses, as well as very skilled individuals focusing on analytics, and I believe we really need to define what information is important to us as an organization and also at department levels, and work towards developing a more advanced and coordinated focus on how we currently use or should be using the data that exists in our systems."
Are your vendors involved in helping to guide you in establishing these structures?
"Our vendors have contributed their thoughts on the governance structures but the establishment is being done more internally."
New eHealth Department
What will this department include (equipment, type of staff, exam rooms, on-site, etc.)?
"A primary focus for the eHealth department at this time is the selection of a patient portal solution, as well as launching a new website for Athens Regional this summer. The scope for eHealth has expanded to include all portal technology (patient/consumer, physician, employee and Board). eHealth is also responsible for social media and has a strong community focus."
Will telehealth programs be incorporated within the department?
"Yes, telehealth programs will fall under eHealth. This is a future initiative, since the department is still very new and in the process of growing."
Was this department your idea, or was it already in the works? Why did Athens Regional decide to move forward with this initiative?
"This was already in the works but I was excited to have this department reporting to me. Athens Regional recognized the need to have a consistent focus on our Web initiatives and social media presence to keep the system at the center of our community's healthcare experience, which is how the initiative got started. Then, as the need for patient portal and other portals became evident, the department further developed under new leadership. I really see this department as not only having a marketing/IT focus, but also a community outreach and exchange function."
What eHealth tool/solution do you believe is most promising when it comes to reducing costs and increasing levels of quality care?
"I believe any tool that we can provide to help patients become more engaged in their health is the most promising. Our patient portal will be an important step towards engaging our patients and providing them with information and resources that they can use to stay in communication with their physicians, ask questions, and receive information. I also believe health information exchange plays a key role."
Tegethoff obviously has her work cut out for her, but seems well prepared for the challenges ahead. She is well aware that, in order to afford the Athens Regional community the best possible care, she and her team must fully understand and embrace the scope of all they are trying to accomplish. It seems that with Tegethoff now at the helm of the hospital's IT strategy, the Classic City - as Athens is sometimes called - is likely to see clinical change for the better before her first year is out.