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Cletis Earle, VP & CIO, Kaleida Health, Chapter 1

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Cletis Earle, VP & CIO, Kaleida Health

He’s been in the news recently for his advocacy efforts, but if you know Cletis Earle, you know it’s just one of the many passions that drives him. In addition to heading up CHIME’s diversity initiative along with Liz Johnson and Myra Davis, he’s set to begin a term as Board Chair in 2018. On top of that, Earle is one year into the CIO role at Kaleida Health, an organization that’s going through a period of rapid growth. Recently, he spoke with healthsystemCIO.com about the “adapt and adopt” approach he brought as the new CIO, why leaders need to not just think outside the box, but traditional healthcare when it comes to population health, and why he believes we’ve entered a “new day” with cyber warfare. Earle also shares his thoughts on how his team is looking to “tap into the social experience” with patients, and how the CIO role will continue to evolve.

Chapter 1

  • About Kaleida
  • Bringing 6 facilities on board
  • “IT is a major staple in how these organizations are going to operate.”
  • Cerner as core vendor, affiliates using multiple EHRs: “We’re figuring out how to connect all the systems.”
  • Getting his “sea legs” as the new CIO
  • Adapt & adopt
  • NY’s DISRP initiative

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Bold Statements

I think this organization is a perfect example of how healthcare is going to mature as we move into the value-based world; in essence, not necessarily as one component of healthcare from a particular provider, but multitudes of different providers, and how they’re going to collaborate.

The rationale in growing is that you can have a more robust clinical care paradigm, and in order to do that, your systems have to talk to each other. From the core infrastructure to the application layer, the systems have to uniquely be integrated.

When you come on board a new organization, you have to find out exactly what’s going on, how’s it operating, and what kind of enhancements you’re going to do if things need to be changed. And on top of that, you have to continue to align yourself with the business strategy.

The biggest thing you really have to tackle is different cultures; understanding the culture and being astute enough to take notice of how an organization operates, and be able to adopt.

If you’re able to establish a good trust factor, then you can almost ensure success. But it takes time to get that trust up.

Gamble:  Hi Cletis, thank you for taking some time to speak with us today.

Earle:  Thank you, it’s always a pleasure.

Gamble:  Since we last spoke, you started a new role with Kaleida Health. So I think the best thing to do is to get some basic information about the organization in terms of size, where you’re located, things like that.

Earle:  Kaleida Health is a comprehensive integrated delivery network with approximately 12 to 13 different types of facilities. We are affiliated with multiple organizations in some way, shape, or form throughout the western New York/Northwest Pennsylvania region. Kaleida is the largest healthcare facility in New York City, to be practical, outside of Westchester. So we represent a wide variety of services throughout the community.

It’s exciting. As this organization has grown exponentially since I’ve arrived, and as we continue to grow, there are, in my opinion, a couple of organizations that are going to be left standing within the healthcare segment: those that are being acquired or those that are doing the acquiring. The leadership at Kaleida has decided to be acquiring side, and that’s actually very beneficial.

We’ve done a considerable amount of collaboration. Interestingly enough, with how Kaleida operates, we are collectively involved in multiple joint ventures, even with competing facilities throughout the region. So I think this organization is a perfect example of how healthcare is going to mature as we move into the value-based world; in essence, not necessarily as one component of healthcare from a particular provider, but multitudes of different providers, and how they’re going to collaborate care and work with various different hospital systems that are not even owned by Kaleida. Because care is a community, and I believe utilizing that premise is going to be a main component of how health systems operate in the future.

Gamble:  I saw quite a few when I doing some research. Now as far as Upper Allegheny Health System, is that an affiliation or is it an ownership model?

Earle:  That’s an ownership model. Upper Allegheny Health System comes under Kaleida’s guidance, and we’re moving forward with Upper Allegheny (which includes Bradford Regional Medical Center and Olean General Hospital), Cuba Memorial, TLC Health Network, and Brooks Memorial — that’s six facilities in the Twin Tier area basically coming on board. Right now the first phase is a complete active parent model with Upper Allegheny, and it’s just different models of affiliation for the others until next year, which we imagine would be a completely different model which is almost similar to Upper Allegheny.

Gamble:  I imagine it’s pretty interesting for you to be kind of forging this new path as you go along.

Earle:  Absolutely. Again, it’s being on the other side of the equation. As we talk about continuing to get larger and grow, IT is a major staple regarding how these organizations are going to operate. As you’re well aware, the reason and rationale in growing is that you can have a more robust clinical care paradigm, and in order to do that, your systems have to talk to each other. From the core infrastructure to the application layer, the systems have to uniquely be integrated so that our care providers will be able to see each other’s documents in collaboration efforts, whether it’s x-rays or labs, ensuring there is a synergy of not promoting waste from multiple lab results or unnecessary imaging orders that are being taken care of. IT helps facilitate it all so that there’s a one-and-done process that allows our physicians to work a little bit more cohesively together.

Gamble:  Along those lines, let’s talk about the clinical application environment first of all in Kaleida, are you on one integrated system?

Earle:  We are. In truth, when you put the entire system in place, we have almost every EMR out there, but as far as the core clinical solution, we’re on the Cerner platform. Some of our partners are on Meditech and some on McKesson, Epic, and all the different types of systems that are out there.

But for the most part, the core clinical system for us is Cerner Millennium. We’re somewhat unique. We were one of the first organizations that got on the Cerner platform, so we’re not the typical hosted Cerner solution. We actually have our own Cerner platform, which is self-hosted, and it provides different levels of opportunity for us. That’s how we have it right now. So we’re working along and figuring out how to connect all the various systems together so that we can share data amongst ourselves because that’s important too.

Gamble:  Now, you started with Kaleida about a year ago.

Earle:  That’s right. I just came up on my one-year anniversary.

Gamble:  That’s great, congratulations.

Earle:  Thank you.

Gamble:  So, I know from talking to you that it’s been quite a ride.  So can you talk about what that first year has been like and really what have been your biggest areas of focus?

Earle:  The ride from coming into this organization was more of the growth; for organization to grow so quickly, we had to make some really important strategic decisions and to take advantage of that. That was the major dynamic we had to tackle. Because as a new CIO, when you come onboard a new organization, you have to find out exactly what’s going on, how’s it operating, and what kind of enhancements you’re going to do if things need to be changed. And then on top of that, you have to continue to align yourself with the business strategy. In this case, the business strategy was growth from that perspective. So there had to be a combination of making sure the business strategy is being taken care of as well as the normal processes are included in being a new CIO, which is making sure you have the right team and developing — and having — the right expectations as you move forward with the new organization.

I looked at it when I came on board as drinking from a fire hose, which many people do when you come into a new organization: you drink from a fire hose. It took me a little while to get my sea legs and become comfortable with understanding the organization, and being able to really tackle some of the strategic initiatives and figure out how IT can help do that. So that’s been my mantra for the last year and it’s been exciting.

Gamble:  How exactly do you approach that? You come in as the new CIO knowing there’s a lot of change you want to be able to push forward. How do you do that while also trying to get to know people and get to know your staff? I imagine that’s what you alluded to with the juggling.

Earle:  With anything, the biggest thing you really have to tackle is different cultures; understanding the culture and being astute enough to take notice of how an organization operates, and be able to adopt. There are two pieces: you adapt and you adopt. When I say adopt, you hope other people adopt best practices that may not be part of that particular culture. But in my role, I have to adopt to some processes. You can’t always just push every initiative to the pace. I work at a certain pace, and I’m sure other people do as well. At times, you have to adapt to other organizations and other people and your teams, and get to know each other, because the big thing is trust — particularly from your team.

If you’re able to establish a good trust factor, then you can almost ensure success. But it takes time to get that trust up and working with your business partners, and that include your staff and your direct reports. Establishing that level of trust allows you to be better at your job, once you have your team believing in you and you believing in them. Because at the end of the day, the team members need to believe in you and they have to be able to trust you. If they don’t know you and they don’t know how you operate, it takes a little while for that to occur.

That’s one of the biggest challenges, because you have to do all of that while you’re navigating this new system, new model, and new business, and making sure you still keep the lights on, as we do on a day-to-day basis, while tackling all the endeavors I talked about.

That’s a lot to juggle when it comes to all of those components, but it’s not insurmountable. Luckily I’m still here — that’s a good indication. The organization continues to have success when it comes to some of our technology initiatives, and I’m very happy about that.

Gamble:  And through those partnerships and alliances I can imagine that really one of the big goals is improving population health and building not network and can you talk about what the strategy is either now or what you’re kind of working towards with that?

Earle:  In New York State, we have the DSRIP (Delivery System Reform Incentive Payment) initiative — that’s one definition of what population health or population management applies to the entire state. We have aligned with our PPS (Performing Provider Systems), which is part of the DSRIP, to help us with a particular population, in this case, Medicaid. And we’ve also used the same technology to be our overall population health IT strategy, and that’s using a particular solution to get that done. So from our perspective, as we continue to develop our Medicaids and our other payers and our self-pay patients, we’re using the DSRIP PPS model as a platform for our overall overarching population health initiative. The tools and solutions associated with that particular model are going to help us with overall population health strategy.

Chapter 2

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