Welcome back to Optimum Healthcare IT’s “4 Questions with…” series, where we interview top executives in the Healthcare IT space. We search for the leaders with track records of service excellence, who are passionate about their work and make patient safety their top priority. In this installment, we have four questions for Jonathan Goldberg, Chief Information Officer, Arkansas Children's Hospital.
OHIT: Over the last 18 months, Arkansas Children’s was very ambitious with a multitude of IT projects, including a new EHR and ERP system. As CIO, why did you decide to do so much in a short period, and how did you successfully manage all of these projects?
Jonathan Goldberg: Arkansas Children’s was put in a unique position due to a couple of key decisions. We had just received approval from our board to build a second hospital in Northwest Arkansas, to serve a growing population 3 hours from our current hospital. There were no plans for significant replacement of systems at that point, but two months later that direction changed when the board also approved a new investment in our application portfolio. Arkansas Children’s was beginning a journey not only to expand its ability to serve children statewide but one of excellence. We selected Epic for our EHR, Workday for ERP, Strata for cost accounting, and API for labor analytics with all implementations kicking off at the same time.
Since our current system was an integrated EHR, ERP, and cost accounting system, undoing it would require replacing all those functions. The planned opening date for the new hospital was 18 months away at that point, and we wanted to open it with the new systems, so the clock was now ticking. We selected Epic for our EHR, Workday for ERP, Strata for cost accounting, and API for labor analytics with all implementations kicking off at the same time.
In the 18 months, we implemented all of those systems plus opened the second hospital, built a large primary care clinic, created a statewide pediatric Clinically Integrated Network (CIN), and achieved Magnet designation. We thought about space exploration, but we had to tamper our ambition just a little. It was a wild, yet exciting, time for us as an organization as we began our transformation in such a bold way. The guiding principles that we set out, in the beginning, focused quite a bit on engagement. This could mean both internal and external, from board and community members, to Information Services staff and physicians. Our belief, which has proved itself true, was that our success was going to be directly correlated to how well our engagement was. There was no way we’d be able to accomplish what we needed to in this short time frame without it.
We were very deliberate in trying to find ways to keep people informed and involved where possible. We had 1100 staff and physicians participate in our initial Epic design sessions, we had frequent hardhat tours of the new hospital for community members, and we produced lots of multimedia for education and information. We created a series of unique superheroes, we called them Go-Live Heroes, which we used in communication, and it was a fun way to get people’s attention. There historically has been a more conservative approach to communication, and we took some risk and chances we being a little more informal, conversational, and a bit quirky with our output.
Just before most of our go-live events, Information Services was awarded a Best Hospital IT Department Designation by Healthcare IT News. It was a great recognition, not just for the award, that our staff was saying at the most stressful time that we’ve ever experienced, that this was a great place to work. It was a validation that our actions were working. We also surveyed physicians post-project a couple of times, and over 70% said they are happy with the system and support. Looking back, it is almost a blur, but we accomplished all of our goals on time and budget, and we are most definitely a better organization for it.
OHIT: What challenges do you face in the state of Arkansas when it comes to pediatric care? How do you overcome them?
Jonathan Goldberg: Arkansas sits close to the bottom of the list in terms of children’s health. Our issues span several factors, such as food insecurities, access to transportation, obesity, behavioral health needs, and uninsured children. Arkansas Children’s has committed to try to solve what we can across the state and look for creative ways to solve these issues. There are things that we will not be able to address ourselves, but innovative partnerships with the public and private sectors are part of that strategy. For example, we have an initiative to look at how we can improve our ability to transport patients. We realize that services such as Uber and Lyft are helping to support healthcare, but most of our state is rural, where these services do not exist, so we need to address those challenges.
We have a community garden on property we own which what is grown there goes to a local food bank. We are using telemedicine to help with access to specialty care, and we are in rural schools to help keep kids in school and parents at work. Our CIN is very active in engaging and supporting community pediatricians. Since these physicians are not employed or owned by us, they have their own EMRs. We have 22 feeds from these systems of pre-adjudicated claims into our data warehouse so we can run analytics and have more in-depth surveillance of that population.
OHIT: Just over two years ago, you transitioned from St. Peter’s Health Partners in upstate New York to Arkansas. What differences do you see in healthcare in the South vs. the North East? How are patient expectations different?
Jonathan Goldberg: We do not have sweet tea or fried catfish in the Northeast, which may have some relationship to health. Besides that, I do not sense that there is much difference in the way healthcare is provided, or expectations, between the two geographies. There is certainly a difference between adult-based health care versus pediatrics, where we see a little stronger orientation to the mission. Children are such a vulnerable population and our future, so you do see a rallying around their cause. This was a significant driver behind my move south, and I haven’t regretted any moment of it. At the end of the day, patients want a great health care experience. They want to be helped but done so in a way that they understand what is happening and have resources available to them to assist as needed.
OHIT: What’s next for Arkansas Children’s now that you have completed so many projects? What are your most significant areas of concern or areas of future improvement?
Jonathan Goldberg: Since our 18-month extravaganza, we have been spending time refining our systems and continuing to roll out additional functionality. We just achieved HIMSS EMRAM State 7 for inpatient, which was a great achievement. Like many, we are continually trying to find ways to lessen the burden on our staff as it relates to system use. We are spending time on our “digital front door,” where we want to use technology to make it easy to do business with us. We pay a lot of attention to other industries to see where we can leverage similar approaches to customer engagement. We have a couple of recent agreements with vendors in the AI and mobility space as development partners, which is very exciting. It is our way of dipping a toe in the water with these more advanced technologies.
Overall, our goal is to prove to ourselves and others that we are more than a scrappy children’s hospital in Arkansas. It is fairly amazing, and quite special, what the organization has accomplished in the last few years. It certainly bodes well for our future and ultimately to the children.
