Marc Chasin, MD, VP & CIO, St. Luke’s Health System, Chapter 1

Rolling out Epic across an organization the size of St. Luke’s isn’t a project; it’s a journey that requires an enormous effort to stay on course. It also requires a lot of change, and when that becomes too much, leaders must be willing to hit pause. It’s precisely what CIO Marc Chasin did three years ago, and the result was a more standardized, collaborative approach. In this interview, he talks about how his team is looking to optimize and stabilize its EHR, the federated approach they’ve adopted with data warehousing, and the ultimate goal with patient engagement. Chasin also discusses the application rationalization process, the two types of CIOs we’ll see going forward, and what he hopes to accomplish as a member of CHIME’s Board.

Chapter 1



* About St. Luke’s

* Fully on Epic since 10/2016 — “We’re in stabilization mode.”

* 6-year journey with a year-long hiatus

* “The organization had hit their threshold for change.”

* Dealing with detractors — “We had to manage the message.”

* A federated EDW model

* Managing at-risk lives—“We have to learn how to be competitors and partners.”

* Focus on data governance



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Bold Statements

This installation, while a heavy lift, has been hugely successful for our organization — and not only for the deployment of technology. We really are starting to function as a health system and realize that we are more similar than different.

We essentially put those providers on an island. They were communicating very effectively, as long as the patient was in the ambulatory setting and seeing specialists and primary care doctors. As soon as they had to cross the threshold into the hospital, we still had the same problems.

Communication is key and imperative, and it’s a competency that CIOs don’t focus on. I’ve learned this is one of the things I have to focus on, because if I can communicate things succinctly, people will buy in; people will come along on the journey.

We’re looking at a federated model in which we don’t have to consolidate and have one large data warehouse. We should be able to pick and choose based upon the question our end user is asking, and serve that information up in the most appropriate way possible.

If you get poor data capture, the information you’re trying to glean on the other end is going to be off by a magnitude. We want to make sure that our data stewards, as well as our end users, have the highest confidence in the information that they are receiving.

Gamble:  Hi Marc, thanks for taking some time to speak with us today.

Chasin:  Thank you.

Gamble:  I know we spoke about three years ago, but can you give a high-level view of St. Luke’s Health System — where you’re located, number of hospitals, things like that?

Chasin:  Sure. St. Luke’s Health System is located in Boise, Idaho — at least the corporate office is. We are the largest health system in the state. We have eight acute care hospitals, and over 450 employed physicians that span the lower southwestern part of the state.

Gamble:  The last time we spoke, you were in the thick of implementing Epic. What’s the status is now? Is it implemented in all of the hospitals?

Chasin:  Sure. As of October 1, 2016, we are completely installed through our inpatient and our ambulatory environment — the entire Epic suite. Additionally, 60 days post-install we achieved HIMSS Stage 6 designation on both our inpatient and our ambulatory environment.

Gamble:  As we had talked about, the hospitals had previously were on different systems; so it was really a big initiative. Now, especially since achieving HIMSS Stage 6, are you on optimization mode at this point?

Chasin:  We are still in stabilization.