Eric Raffin, CIO, San Mateo County Health System, Chapter 1

When Eric Raffin took on the role of CIO at San Mateo County Health System in 2013, he knew it would be a challenge, and not just because he’d be the first to hold the positon. The organization needed someone who could help create a sense of unification — not an easy task in a best-of-breed environment where there was little communication between departments. But nearly two decades with the Department of Veterans Affairs helped prepare Raffin to take on the challenge, and four years later, SMCHS is making great strides.

In this interview, he talks about his approach to being the new CIO (which involved “a lot of listening” and learning), how he worked to incorporate change management strategies into the IT governance framework, and the question his team asks to help prioritize projects. Raffin also discusses how they’re laying the groundwork to facilitate data sharing and improve outcomes, why his EHR 2.0 strategy involves much more than just the EHR, and what it’s really like to work in a public health setting.

Chapter 1



* About San Mateo County HS

* Community outreach with street medicine

* Best-of-breed environment for 20 years

* Reimplementing multiple systems — “It’s tons of organizational change in one big bite.”

* A “new, united EHR footprint” with EHR 2.0

* “There’s a lot of spaghetti connecting systems together.”

* EMPI’s Master Person Index



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Bold Statements

It’s really about strategically managing the information and making sure all the right information is available at the right place, at the right time, for the right provider. That’s very challenging, but we’re making a lot of excellent progress in being able to present information on demand.

That affords us the great opportunity to deal with most important thing: where is the information, and is it getting to where it needs to go? We’re taking a novel approach to being able to deal with some of the information needs first, and then dealing with the tremendous change management task of implementing a new unified EHR footprint.

We realized that our organization has never taken a bite out of that apple, and so we found the apple and we took a big bite out of it, and have been dealing up until this point with planning for what we ultimately call our EHR 2.0 program.

It struck us that if we have this Master Person Index in place, it’s not terribly challenging to implement an internal health information exchange.

Gamble:  Thank you Eric, for taking some time to speak with HealthsystemCIO.com today.

Raffin:  It’s my pleasure.

Gamble:  I think the best place to start is to get some information about San Mateo County Health System in terms of size, where you’re located, things like that.

Eric:  San Mateo County Health System is based and serves the county of San Mateo, which is in the San Francisco Bay Area, nestled between San Francisco and the rest of Silicon Valley to our south. The health system is one of 16 public health systems in the state of California. When you combine those with the five University of California healthcare organizations, it makes up California’s healthcare safety net. We are a direct delivery organization in the safety net, which means we have a hospital: a medical center, and a clinic system. It also means we operate a complete behavioral health and recovery services program, which stems from mild to moderate to severe mental illness, as well as the alcohol and other drug recovery programs that a lot of people hear about, but don’t know that they’re often managed by your county behavioral health office.

In addition to that, we provide healthcare services to our county jail system. We also have social services functions under our umbr...