John Kenagy, PhD, SVP/CIO & CISO, Legacy Health, Chapter 1

With 20 years under his belt, John Jay Kenagy is no rookie to the CIO position — and yet, he’s continuously learning and evolving. In his current post at Legacy Health, he spends more time than ever before focusing on the best way to bring independent physicians into the fold, working to ease their skepticism while at the same time not “overselling.” In this interview, Kenagy talks about his team’s efforts to facilitate data flow throughout an ever-changing organization, the security “arms race” the entire industry is grappling with, and the “people first” philosophy he’s employing while leading through an acquisition. He also discusses what it has been like to work for four such different organizations, the need for “confident, yet humble” leadership, and what he believes is next for the CIO role.

Chapter 1



* About Legacy Health

* Hosting Epic for community physicians

* Population health: “We’re crossing organizational & legal boundaries.”

* The complex post-implementation world “where we don’t manage all the moving parts.”

* Physician skepticism — “The biggest barrier is switching from a different product.”

* Clinically integrated network “field advisors”



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Bold Statements

We don’t require an exclusivity to join our group or become employed. This is not a subtle way of growing an employed physician base; it really is our mission of being a community hospital system and working with community physicians

I’ve been a CIO at a number of organizations, and I would say that this is the first organization where probably every other day, I’m thinking about how our strategies impact the independent physicians, and how we can exchange data more effectively, and how we can provide them better services.

It’s funny, we literally finished this 20-year pathway in our industry toward system integration and suites of applications, whether that’s provided by Epic or Cerner or Meditech, and now it’s, ‘okay, you’re going to have to work very effectively across this very complex ecosystem where we don’t own or manage or control all the moving parts.’

It’s an interesting message, and you filter it based on your perspective. So if you have less of a trusting relationship or paradigm with the hospital, and the hospital is just trying to take you over or dictate your practice goals, then you’re going to be more skeptical of a program like Epic Connect.

There’s a high penetration of EHR, and switching is a psychological and a technological and an information barrier, but there’s a lot of interest.

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

Kenagy:  Sure.

Gamble:  To give our listeners and readers a little bit of background, can you talk a bit about Legacy Health?

Kenagy:  I’m happy to. Legacy Health is headquartered in Portland, Oregon. It is the only locally controlled managed health system in Portland. As of June 1st, we now have seven hospitals, with Silverton, Oregon, about an hour and a half south of Portland, joining our system. We have two anchor urban hospitals, Emanuel and Good Samaritan, three suburban hospitals, one rural hospital and a children’s hospital. We were founded in 1875 with the Episcopalian community wanting a health system to serve them, and about 25 years later the Lutheran community had the same goal, on the east side of the main river that runs through Portland, Willamette, and we have been going strong since then. It’s a great organization local here to Portland and Southwest Washington.

Gamble:  Looking at the clinical application environment, you have Epic in the hospitals?

Kenagy:  We do, at all of our hospitals. At Silverton, which just became a part of us,