5 questions with Scripps Health CIO Andy Crowder

Although Andy Crowder has only held the CIO role at San Diego, Calif.-based Scripps Health since January 2016, he has already made his mark in health IT space.

Prior to joining Scripps as corporate senior vice president and CIO, Mr. Crowder served as senior vice president and CIO of Portland-based MaineHealth. He previously served as CIO of Orlando-based Florida Hospital and Altamonte Springs, Fla.-based Adventist Health System. Mr. Crowder has nearly three decades of IT experience and a strong background in EHR implementations.Andy Crowder Head Shot 2017

Here, he spoke with Becker's Hospital Review about Scripps' upcoming Epic EHR go-live, what he's learned in his first year at the health system and the best advice he's ever received.

Editor's note: This interview has been lightly edited for length and clarity.

Question: You've been in the CIO role at Scripps Health for a little more than one year. What have you learned in your first 365 days?

Andy Crowder: The interview process was pretty lengthy, so I was able to do a lot of research on [Scripps]. In addition to all of the marketing material, I read a book by the CEO, Chris Van Gorder, called The Front-Line Leader. Books can sometimes be deceiving, but it was incredibly reassuring to see the things written in that book were true about Chris. He does view himself as the frontline leader and he models that every day.

The second lesson has to do with the strength of the senior leadership team and the way they interact. As a new leader, it was critical to be embraced as part of that executive team.

Q: What are the top trends you're seeing in the health IT sector?

AC: All of the CIOs out there today — myself included — are keenly aware of a constant and relentless focus on cost, quality and the patient experience while you're deploying technology. It creates an incredibly stressful dynamic at times.

The second trend regards the Medicare Access and CHIP Reauthorization Act and the Merit-Based Incentive Payment System. Our patients and the communities we serve are looking for an integrated healthcare system. This legislative change aligns incentives so we can start to achieve that.

It's interesting to see what changes will take place in the White House with the ACA. There are a lot of opinions that will keep us on pins and needles as we see what comes out of Washington.

Another trend surrounds artificial intelligence, genomics and consumer-facing technologies aimed at personalizing care. How are they going to change how we provide care to populations?

The last one I'll share is that as Scripps looks to the future, we're striving to tear down silos to provide better coordinated care. For the first time in the past two to three years, I'm starting to see new healthcare organizations launching partnerships with each other. I think we're going to see a lot more partnerships in the coming years.

Q: You played a key role in implementing the Epic EHR at MaineHealth and you're currently putting your Epic knowledge to use at Scripps. What are your key takeaways for heading up an Epic EHR implementation?

AC: The first thing is any organization embarking on a transformation initiative of this magnitude has to have a robust governance structure. In any endeavor of this kind, there's a significant investment. It can't be a technology-lead project; it has to be lead by the key stakeholders in an organization.

The second takeaway is hard to do. Although there's safety in daily rituals, it's key when you're implementing an EHR that you don't replicate your current state [and practices]. It can't just be about the same day, same type of business approach.

Third, people are always looking for ways to improve. When you say yes to an initiative of this magnitude, you have to be willing to say no to something else.

There are always going to be risks and concerns. What's key is that you have a culture that allows people to escalate those issues and concerns in a manner through which they feel safe. Additionally, you can burn people out fairly quickly if you don't consider lightening their load. We've partnered with our internal wellness teams to diligently look at [our employees' wellness] daily.

Q: Scripps is working with Epic on the design of its integrated enterprise EHR, which is slated to go live in the middle of this year. Is your go-live schedule running on time?

AC: The organization is now in the final steps of implementing Epic's Enterprise Suite of Solutions for our Wave 1 launch on April 1, 2017. The Wave 1 activation includes Scripps Green Hospital, 1,200 ambulatory providers within Scripps Medical Foundation (Scripps Clinic and Scripps Coastal Medical Center) and Mercy Clinic, enterprise revenue cycle and Scripps Health Plan. We've been on target and under budget since we kicked off the initiative. We're in a good place!

After that, we take a bit of a reprieve for six months as we focus on stabilization, optimization and preparedness activities for our Wave 2 activation. Wave 2 includes Scripps Memorial Hospital La Jolla (Calif.) and Scripps Memorial Hospital Encinitas (Calif.). After that, we take three months of reprieve and bring up the two campus hospital of Scripps Mercy Hospital San Diego and Scripps Mercy Hospital Chula Vista (Calif.). 

Our focus today, however, is all about our Wave 1 activation on April 1.

Q: What's the best piece of advice you've received?

AC: I'm fortunate to have had great personal leaders in my family as well as great professional leaders.

The first piece of advice came from a prior leader. We were working in a setting where we were trying to make a few tough decisions. He said, "There are very few absolutes in life. It's not important that you have a long list of absolutes, but it's important that you have yours."

The second is from my wife, who has had a long, successful career in healthcare IT and entrepreneurial leadership. She says, "Far too often, people are given to making bold statements without facts. Yet in a leadership role, it's key that you manage the comments you make because they impact the organization." It reminds me to be mindful of providing sound guidance and not just opinions.

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