Q&A with Kate Pierce, Part 2: “It’s No Longer an Option to Address Security Needs.”

“We’re pretty much on an island.”

For rural health organizations, it’s a harsh reality — especially ones like North Country Hospital, a critical access hospital based in Northeast Vermont where “the community is very dependent” on its facilities. In fact, NCH owns nearly every practice in the area, some of which are operating at a loss, just so patients won’t be left out in the cold.

Being a rural health facility means having to do more with fewer resources, getting creative with growing talent, and for leaders, having to wear many hats. To some it may seem daunting, but Vermont native Kate Pierce, who started with the organization 18 years ago as a systems analyst, wouldn’t have it any other way.

Recently, she spoke with healthsystemCIO about the transformation the organization is undergoing to improve workflow, how they’re working with other facilities to better manage costs, and how they’ve been laying the groundwork for the shift toward value-based care.

Chapter 1

Chapter 2



* Setting “a foundation for value-based care” with PCMHs

* Cybersecurity challenges – “We don’t have a dedicated team.”

* Rural health networks

* Recruiting trained informaticists

* “There’s a lot of teamwork involved in identifying the right people.”

* 18 years with North Country

* From all paper to creating an informatics dept – “The organization has come a long way.”



LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED

Bold Statements

When there isn’t another hospital for 40 miles, you can’t afford to be in that situation. We take it very seriously.

If I’m looking at which vendor is the best with spam filtering or data loss prevention, I’ll look at how companies are rated nationally. But we also supplement that by calling our friends and asking, ‘What are you using and how do you like it?’

We can train staff on those other skills. But if you get someone who is a great informaticist but can’t work well with physicians and nurses, they’re not going to be successful.

When you’re working in informatics, you’re able to speak with just about every clinician in the organization, and gain that perspective from seeing how everybody fits into the puzzle.

Gamble:  With the move to an integrated system, the ultimate goal is to achieve value-based care. Can you talk about what you’re doing in that space?

Pierce:  When I think of value-based care, I look at a lot of the changes we’ve made as a community over the past few years. Since 2011, our primary care and pediatric clinics have all been patient-centered medical homes. That’s really setting the foundation for moving toward value-based care and achieving success in an ACO structure, because it’s about being preventative with care, and not reactionary. It’s about having services wrapped around patients in order to limit the number of emergency room visits, and the amount spent on high-cost care.

As far as value-based care, developing a good quality program and truly embracing those patient-centered medical home concepts has set us up for success in this structure. We currently belong to a statewide ACO called OneCare Vermont for our Medicaid patients.

 

Gamble:  We’ve touched a bit on some of the unique challenges of rural health, but I’d like to talk more about one of them, which is cybersecurity. For organizations with limited resources and a smaller budget, this really seems to be difficult. Can you talk about how your team is approaching it?

Pierce:  Sure. Like everyone else, our focus on security has grown exponentially over the past 10 years,