Michael Marino, CMIO, Providence St. Joseph Health, Chapter 2

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

Chapter 2



* Path to the CMIO role

* Being interim CIO: “It honed my understanding of the entire picture.”

* Burden on physicians & nurses

* Engaging caregivers: “We’re going to talk about what we want to take out.”

* KLAS’ Arch Collaborative

* “It’s an exciting time.”

* Evolution of the CMIO role – “You have to be part MBA, part physician, part tech executive.”



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Bold Statements

To be honest, as much as it’s a great, interesting challenge to argue about servers and WAN — and I can certainly have a conversation about that now — improving the experience for our patients and our caregivers is my first love.

Sometimes within healthcare systems, the supporting technology is a little clunky. Your logon is slow or the network goes down. It’s the red-light phenomenon. No one cares if the network goes down when you’re not busy, but if you’re in a crisis and it crashes, that’s different.

We need to prune the EMR, because after it has been implemented for a while, you start to add things. When you first turn it on, it’s pretty lean, but as organizations start to optimize, they add order sets, alerts, nursing assessments, and rules. They get bigger and bigger. Documentation gets longer and longer.

If we lose our physicians and nurses because they’ve decided to do something else, we’re in big trouble as a society. And so I think putting a focus on maturing the tools and adding mobility will become increasingly important.

Applying those same options into practices or hospitals is where we need to go. I think the mistake we made in the past was looking at a trend that’s leaning toward one of those, and putting all of our eggs in that basket. I think we finally got bright enough to understand that we’re going to have to provide access to all of those.

Gamble:  The last time we spoke, you had a different role with the organization (as Chief of IS operations and Clinical Systems). Now you’re CMIO of Providence St. Joseph’s. Can you talk about how that came about and give your thoughts on having this role?

Marino:  To paint the picture of my own journey, I was CMIO for St. Joseph’s Health — the legacy system, which included 17 hospitals. Just before the merger, the CIO at St. Joseph’s left, and I was given the opportunity to fill that role. It was a great opportunity. It honed my understanding of the entire picture much better than if I had been a pillar on...