Michael Marino, CMIO, Providence St. Joseph Health, Chapter 1

One of the biggest crises facing healthcare leaders is burnout. Physicians and nurses have had an enormous burden put on their shoulders, and they’re tired of carrying it. Organizations have realized this, and racking their brains to try to find the answer.

But perhaps brain-racking isn’t the right approach. As the ancient law of parsimony (also known as Occam’s razor) suggests, perhaps the simplest solution is the correct one. It’s this philosophy that the leadership team at Providence St. Joseph is leveraging, by going right to the source: caregivers. According to CMIO Michael Marino, a key priority has been to engage with those on the frontline and ask simple questions like, “What would make your life easier?”

In this interview, Marino — who happens to be a physician — talks about the key initiatives his team is working on (including a three-year journey to move to a single Epic instance), how they’re striving to stay aligned with the business side, the changing landscape when it comes to managing opioid use. He also discusses what he learned during his brief CIO stint, where he believes retail health is headed, and how the CMIO role has evolved.

Chapter 1



* Providence St. Joseph’s 51-hospital, multistate system

* Plans to migrate to a single instance of Epic

* “You can’t let everything else slide.”

* Workflow changes – “Things don’t always make as much sense to 1,000 people as they did to 10 people.”

* Staying aligned with the business

* Mobility as “additive,” not a “disruptive shift.”

* Prescribing pain meds: “You have to really tightly manage it.”



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Bold Statements

If you had that conversation with anybody in healthcare three years ago, they’d say ‘everything’s going to go mobile.’ In reality, there are multiple access points, and there are going to be multiple access points.

If you want to contain your patient population, you’re going to have to be able to provide different avenues. That’s where we’re changing, strategically. We want people to be bonded to us; we want continuity of care. As people transition in their lives, we need to be in all these spaces.

I have to ping the CURES site if I’m taking care of you, to see if anyone else has written you an opioid prescription. And we’re working with several vendors across different states — because each of those states has to be treated individually — to bring that into the EMR.

You have to be on top of it. I think what we didn’t realize as a healthcare industry, or as a medical community, is when you loosen that up and you hit more and more people with opioids, you’re going to hit people whose biology is susceptible to becoming addicted.

Gamble:  Hi Michael, it’s great to speak with you again. Can you provide some basic information about Providence St. Joseph Health — what you have in terms of hospitals, states covered, things like that?

Marino:  Providence St. Joseph Health represents the coming together of multiple organizations, the two largest being Providence Health and Services and St. Joseph Health. We cover the west from Alaska to Texas. We have a presence in Alaska, Washington, Oregon, Montana, California, Texas and New Mexico. Today we’re about 51 hospitals and, at last count, 850 clinics. We also do home health. And we have some housing for the indigent, and two educational programs: one in a high school in Southern California and one in a university in Montana.

 

Gamble:  Is there one EHR system in place, or do you have multiple systems at this point?

Marino:  Great question. Today we have three versions of Epic; I say ‘today’ because if we were having this conversation next year, we’d have one version of Epic. And so,