DCH Health System is at the forefront of innovation, and CIO Billy Helmandollar and his team are leading the way. Hear how Billy's approach to continous improvement helped earn him Alabama Chapter ORBIE CIO of the Year, and yielded DCH a spot among Digital Health's Most Wired organizations.
Title: Developing an award-winning mindset
Guests: Billy Helmandollar, CIO, DCH Health System
Host: Christine Parent, Associate Vice President, MEDITECH
Billy: If I don't wake up every day and walk in the door and have a thought in my mind of what am I going to do today to positively influence somebody's life, I picked the wrong place to work because really that's what it's about. How do we make those changes? How do we make that impact into that patient's life, the nurse's life, my staff's life? Because ultimately, IT is about customer service.
Christine: Welcome to another episode of MEDITECH podcast, the leader in healthcare technology empowering you to be a more informed Healthcare consumer and provider. Hear the latest from our friends and colleagues in the US, Canada, and abroad on topics we think you should know about. Today, I'm joined by Billy Helmandollar, CIO of DCH Health System based in Tuscaloosa, Alabama. Billy was recently recognized as the Alabama Chapter ORBIE's CIO of the year in a large corporate category. Billy has built a reputation as a leader, innovator, and visionary. He leads DCH's efforts to accomplish Digital Health Most Wired, and with the help of his team, they've taken their Health Care Organization from a Level 5 to a Level 8 in a matter of just four years. Billy, it's a pleasure to have you on our podcast.
Billy: Thank you so much for having me.
Christine: Congratulations on winning the ORBIE's CIO of the Year award. That's an incredible accomplishment, Billy. I know you've been a finalist previously. Can you tell us more about the process or share any stories about this experience?
Billy: Absolutely, as you mentioned, I was a finalist two years prior to winning. The reason behind that is, this is the first time this year that Healthcare actually won in the state of Alabama. We've been nominated for the whole Continuum of when they started it four years ago. Up until this year, no one in healthcare had really finished across the finish line and won the actual award. It's a tedious process. You have to first be nominated by either a peer or someone else in the industry. This does not only include healthcare. This is banking, manufacturing, and other government entities. It's everybody combined. To win that award being a healthcare CIO is tremendous because I'm being recognized by others outside healthcare. To have them recognize the efforts it takes for a healthcare CIO and what we deal with daily and the nature of our jobs is an accomplishment of its own in the state of Alabama because, like I said, for four years in a row, we've had some very prestigious CIOs recognized as finalists. I was the first to win the award. I take some pride in that.
With MEDITECH being our vendor, we actually were going through our Expanse journey during the time this award was being thought about. We were dealing with COVID, Expanse, and all the constraints that come with that. Again, it just made that process so much more rigid. Everything was virtual. We only met in person twice, but it still meant a lot to cross the finish line and win that award.
Christine: Well, Congratulations and a tremendous recognition to you in healthcare in general for that award. DCH has made remarkable progress in achieving Digital Health's Most Wired and you have played a major role in that. Could you give us a little insight into how DCH has been able to make this progression in the last four years?
Billy: Sure. When I first decided to try the survey, it was really a staple point to understand where we fit in with other like entities of healthcare on adopting technology and how we were applying technology for the betterment of our patients and community. I was a little disappointed the first year to come in at a Level 5 because for the organization, Digital Health Most Wired only recognizes those nationally at 7 and above. I felt DCH was doing better than that and a lot of people wanted to blame our infrastructure, such as MAGIC and some older technology on that.
I took the report back from the first year, started looking at where they were concentrating their efforts and understanding where their questions were coming from and it basically made me realize if we do the best things for our patients our clinicians, and our community to deliver the most efficient and safe quality care, we would hit the points on this survey and be recognized. By doing that the first year, we went from a 5 to a 7. That was a tremendous leap. We received the plaque, got recognition, but I'm still not satisfied. We worked hard the next year to look at where we were low and it seemed to center around patient experience. Even though we were using MAGIC, we were still hitting the marks. We were hitting things we needed to hit. We were on Level 9 on Security, on Infrastructure, on how we were doing our processes in the Business Office. We were struggling a little in Supply Chain and some other areas where we weren't utilizing all the technology we had available. We started digging in and looking at what technology we could bring forward to fill those gaps. By the end of that next survey, we were Level 8.
We have held steady this year with a Level 8. We have already identified by looking at the reports I've dug in and identified where those areas are that we need to start working through to hit that Level 9 mark. Then, eventually, make it to a Level 10. Just to set a frame of reference, only three hospitals in the state of Alabama are being nationally recognized as being 7 or above. We're just slightly behind one of our larger competitors in Birmingham but we will fill that gap now that we're on Expanse and have access to newer technology and we'll close that gap into level 10 as well.
Christine: That's a fantastic journey. I love how they do Most Wired because you get a report afterwards and how you compare against your peers throughout the US regardless of what EHR system and they provide you a little bit of guidance as you were mentioning on those opportunity areas for you to improve upon. Tremendous job. We applaud you in your efforts at DCH to work forward both in your MAGIC environment and now in your Expanse environment really to prove that out. With the help of your team, DCH moved from a 25-year MEDITECH MAGIC solution to the new MEDITECH Expanse platform. How did your staff react to making the EHR switch? How do you lead this change transformation?
Billy: It was a difficult decision. Like you said, we had been on MAGIC for 25 years. It was working well for the organization for what they needed at that point in time. The senior leadership recognized we need to bring better technology to the table. It pushed through the change needed in order to make that happen. In order to shift the culture, it started with the executive leadership. We had to come to the table and have everybody understand, we were the most customized MEDITECH MAGIC shop that I was aware of with over 500 plus documented customs just from MEDITECH, not counting what we ourselves had built to make the system do things it wasn't meant to do and work out and fit our workflow. As a leadership team we convinced them, we needed to go to best practice, standards-based, evidence-based medicine for the betterment of our community and our patient care. We all agreed and we stood fast and we went through the implementation and shifted the thinking from how do we customize the system to fit our workflow, to how do we customize our workflow to fit the system flow?
We've made it through the process, even through COVID and all the obstacles we had to go through with only four changes that made it to Executive leadership and were approved as deviations from amended Best Practice. All four of those changes did not deviate greatly from the Best Practice but allowed it to fit more with what DCH needed to accomplish with the regulatory requirement in the way Alabama processes it versus the way some other states in the nation would process it.
Given that, we also had to shift culture internally with our Nursing staff, our IT staff, and Lab staff. Everyone had to be willing to change. What we found was that the mixture of long-term employees and short-term employees made a big difference in that. The new employees were coming in with fresh mindsets asking why we were using a technology that looked so old and how it became. They were looking at the windows driven part of Expanse and saw the benefits and the efficiencies it could bring. Where the older staff was still stuck in the mindset we've always done it that way. By blending those two together and helping them understand what we would see when we came out the gate on the other side with new technology making their job easier, making them more efficient, making healthcare easier to do the right thing for our patients, we had buy-in at that point. It took about a year and a half to get that buy-in across the board but once we received it, we ran to the finish line. Even though it sounds like it was fast, it still took a year and a half.
Going through that process, they now all understand what it takes to shift from one system to another. Because, let's face it, a lot of them had not been through that change. We had to go through and be very stern in how we handled requests for change. Going through all that, we learned a great deal. We had to work with individuals to help them understand why they needed to change workflow. What we found out was that the biggest culture shock we had was no longer could they do it the way they've always done it and it seemed to work for them. The Best Practice seems to send them in a way that made their job a little easier. Once they saw that, it was better.
A little anecdote of how we gauge the success of the product early. On Saturday, May 1st, when we went LIVE, we were getting hounded by nurses and doctors asking why we ever made this decision and it was awful and why would we do this to them? By Monday at lunch, they were coming in asking us why we waited so long. Just the shift in the mindset of, once they got to feel the system, touch it, play with it, and actually use it in their real-time environment, they actually come to realize it was the best thing. We have not looked back. Now, we are still optimizing the system. We're still making changes based on how they want it to flow and what would work best for DCH. We're still staying within the guidelines of Best Practice evidence-based medicine. It seems to be working very well and we have physicians that are on board with helping us lead that change and it is making a huge difference.
Christine: That certainly is Best Practice these days of trying to do the standardization and keeping everyone moving forward. The governance that you mentioned and the change control is a huge important piece to that evolution of the implementation. As we're discussing the implementation of the rollout of Expanse, you talked a little bit about each department being touched. Let's expand upon this a little bit more about the role of your physicians, both the established and new physicians that you mentioned with the different staffing tenure have played to really advance the MEDITECH EHR and how has engaging them in that design and workflow decisions contributed to your success and what sort of insight did those providers provide?
Billy: Without them, it wouldn't have been possible. Because, as an IT person, you really don't understand the role the physicians have to go through and what their job entails until you sit down with them and learn what that is. Without having Champions at the table. When I say Champions, we had a very broad mixture of physicians, newer physicians, residents, you name it. ED physicians, we had them at the table as Champions and they led that. There's two benefits to doing that. One, you get to understand their workflow and how the system can help them achieve some efficiencies. I will tell you, in my past, all I've heard is "You give me four extra clicks today." That took an extra hour out of my day. If we can reverse that and say, "Okay, sit down and show me how we can take five clicks away." What can we do to help you? Get time to sit down, you can then understand some streamlining you can do to help them and still achieve the same goal. With them willing to sit down with us, it not only led us to have a system that's a little more efficient for providers. I'm not saying it's the best it can be yet. We're getting here but it gives them the insight of what goes into building the system and what we can do and what we cannot do and they understand that a little more.
More importantly, it's their communication with their peers. It means so much more for a provider to provide our communication to tell them what's good about the system and how it’s going to help them than an IT person trying to translate that same message. It just doesn't have the same context when we do it versus another doctor talking to a doctor to say the same thing. We had a great group of Champions. They're still with us today helping us lead change throughout the system. Even when we have to tweak it, when we go through an update, they're there to help us understand what we need to do to make sure it's right for the physicians. Without them and having the good range of those knowledge bases, we wouldn't have been able to make it efficient for the whole continuum.
Christine: Interoperability is top of mind these days, what is your vision of interoperability, and do you see it steering DCH's path forward to a successful future?
Billy: Interoperability means different things for different people. The way I envision it, is being unified across the continuum to have records shared that everybody can read and understand to make it the best interest of the patient no matter where they present. We're starting down that path. Some of the things that led us into is joining the state HIE so we can communicate our information up. That still has its limitations because it's only as good as the information you're sharing and the information you can share back with you from the other entities so you have to have participation. We are looking at how we can bring new technologies to help our clinics and our patients understand their healthcare. What can we do to make it more accessible for them?
With all the paths that were being given, the Regulatory Compliance, like Information Sharing, No Blocking. Things along that line are causing us to have to open up more and more. As we're opening up more and more, we need to make it easier for the patient and the provider to get the information they need when they need it. Ultimately, it's going to be a very good market. It's a tough road ahead. Some of the things we're looking at is I want to be able to build a DCH app, not necessarily just because it's branded DCH but that we’ll put everything in there the patient would need to be able to have a successful experience and a pleasant experience. It's appointment scheduling, appointment reminders. When they get here, where do they park? Give them directions to wayfinding inside the organization to find the right place, making sure that when they get on campus they get a button that says, "Hey, we see you've arrived, please click here to let us know you're here." They click here and then we respond back, "Hey, please park in the parking lot, we'll let you know when it's ready to come in when it's your appointment time.
That would be so much more to the patient because let's face it, healthcare is turning into a consumer-driven business. We are now being looked at like Walmart's and the shopping centers of the world and we're expected to have the same thing in place but we will catch up and make that gap go. I think overall where are you going to see this industry go is one record for that patient across the entire Global community of Healthcare. It's going to take a while to get there and everybody's gonna have to get comfortable with it but I think the way the regulations are coming out and the way the government is steering us there's not going to be a choice. It's going to be a matter of when.
Christine: Billy, Congratulations on signing to be an early adopter for the Google Health MEDITECH collaboration on the search and summarization. Can you tell us what benefits you expect to gain?
Billy: I think it's going to bring information to the clinician's fingertips in a much more rapid motion without the clinician having to go find the information. So many times I hear a provider saying, "I did a search for EKG and I can't find the result I was looking for it and I dug 30 minutes in the chart." This new platform is going to fix that problem. I think it's going to bring a lot of value to our clinicians. When I say clinicians, it's not only the providers and the doctors. The nurses, the respiratory therapists, the physical therapist, anybody looking for that information. It's going to bring the world of the internet to their hands based on the data we've been able to collect over the last 27 years.
Christine: Billy, you've made a name for yourself as a leader and innovator. What motivates you to keep making technological headway in the EHR field?
Billy: It's really a passion. I never envisioned myself when I was younger and in high school as being a healthcare IT person. My first passion was being a doctor. I was talked out of that by some family members due to some issues that they didn't think I could handle, blood and things like that which ended up not to be true but still it led me down the path of being technological. My first two jobs were as a programmer in the coal industry and industrial gas industry. Then, I had the opportunity to come into the hospital and work in healthcare IT. I've not looked back since then and it's been my passion. If I don't wake up every day and walk in the door and have a thought in my mind of what am I going to do today to positively influence somebody's life, I've picked the wrong place to work because really that's what it's about. It's how do we make those changes? How do we make that impact into that patient's life, the nurse's life, my staff's life. Because ultimately, IT is about customer service. We're here as a utility for the organization. We're here to help blend that gap of the need versus technology that's available.
If we have not done our job right, the patient's experience is not going to be everything it can be because I've had to explain to my staff, "Yeah, you have a hard time relating from an IT perspective because you're behind the scenes, what are you doing to help that patient's experience? What are you doing to help that patient stay? Help that patient get better?" If you're rude to a nurse when they call for assistance and they're having trouble with their computer, how do you think their next interaction with that patient's gonna go? You may have taken them from having a very good day to a very not so good day in just one phone call. Everything you do matters. If you don't do your job correctly, they don't have the tools they need to do their job. If we haven't got our portal up and running correctly or if it's not available, the patient can't check their results, that causes anxiousness.
We work together on a daily basis to make sure we're delivering the technology needed by those who deliver the care. We're making sure they have the data they need to make the right decisions. We work with each other to understand what can we do better, make the system better by itself? What can we do to make a change in the organization? We do a collaboration of efforts on what we can see on the market for technology and how we could innovate that to bring it into healthcare. I'll be the first to tell you I don't know all the answers. Neither do my staff. While working with peers and being collaborative, such as the Mississippi, Alabama MEDITECH Collaborative where all the CIOs and MEDITECH hospitals and those states get together and we start talking about issues we've had, troubles we're having, or the solutions we've come up with. Between the group of us, we normally can walk out with a solution that may work for everybody or may work for one person that was looking for it, so it's huge to have that collaboration with others to bounce ideas off of that are at your level and have been through the same sort of struggle.
Christine: Billy, it was such a pleasure speaking with you today. I always like to close our podcasts on a more personal note. What's something that you could tell me that not many people know about you?
Billy: I'm a huge car nut. I love sports cars and I do have a 'Need for Speed'. One of the things a lot of people don't know is I've actually driven at almost 190 miles an hour wide open on a Speedway. I've been in a semi-professional race and I do own a sports car that has over 800 horsepower, currently. I do enjoy driving it. It is fun but I mean I've always had that passion for cars. I do my own work and I've always had the 'Need for Speed.' I just hope someday it doesn't get me in trouble.
Christine: Does your race car have a name or a number?
Billy: My race car does not have a number currently but it does have a name. Its official name is Snake Venom because it is a 2020 Shelby GT500.
Christine: Thanks for tuning in. Stay informed and subscribe to MEDITECH podcast and be sure to check out our Resource page for links from this episode. We'll talk to you next time.