Steve Hess, CIO, University Of Colorado Health, Chapter 2

What motivates the CIO of a large health system? For Steve Hess, it’s “picturing that day when we save someone’s life through the use of informatics.” Of course, it will take — and has already taken — a great deal of blood, sweat, and tears to get to that point, from getting five hospitals and hundreds of clinics onto an integrated EHR system, to creating standardized workflows, to turning data into “actionable clinical decision support.” In this interview, Hess talks about merger that created UCHealth three years ago, why he’s a big believer in going big bang, the “why not Epic?” philosophy that has helped increase buy-in, and how collaboration is more of an art than a science. Hess also talks about the three tiers of analytics, the “real heavy lifting” when it comes to data, and the exciting direction healthcare IT is taking.

Chapter 1

Chapter 2



* Big-bang with Epic — “It’s scary. It’s big, and there’s a lot of change management.”

* 80/20 rule with workflow

* Standardized order sets across UCHealth

* 3 tiers of data

* “Analytics is a never-ending journey.”

* Defining data — “It’s not trivial.”



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Bold Statements

The belief that we have here is let’s rip the Band-Aid off. Let’s go big bang and then let’s maximize the support at the elbow and at the command center, and get to the healing as quickly as possible.

We’re trying to move away from the concept of ‘report writing’ to the point of enabling analytics in such a way that people can answer hundreds of questions with the tools that we provide them, not just answer the one question.

Analytics — or even one metric that you’re trying to monitor — is often a project onto itself, and multiple iterations to the point where everybody accepts how the data’s coming out, how it’s being defined, and how it’s being visualized.

We’ve been treating the metrics, analytics, and dashboard initiatives like projects with very specific scopes, starts, and ends, and steering groups to actually get to the point where the data definition and the data governance is solid and consistent across UCHealth.

Gamble:  What was the approximate timeline of the Epic go-live?

Hess:  It was about 10 months from kickoff to our first ambulatory go-live, and probably 16 months from kickoff to our inpatient go-live. We first went live in our ambulatory clinics and went live with revenue cycle in our ambulatory clinics before we big-banged inpatient. So from kickoff to first ambulatory, it was 10 and then kickoff to hospital, it was 16. For our subsequent implementations where we took Epic across all the rest of the hospitals, we pretty much big banged those and that was ambulatory and inpatient, and it was about a year from kickoff to go-live for the subsequent hospitals.

Gamble:  Judging from a lot of things you said, I can see that the plan was never to do this in phases, and that for all the purposes you talked about, it just made more sense to go big bang and then after that deal with anything that needed to be adjusted.

Hess:  Correct. There’s no right or wrong way. We do believe in the big bang and the reason we believe in it is if you don’t have the big bang approach, you have to create a bunch of temporary interfaces, workflows, and processes that then get undone when you actually go live with that. Often, when you have a big bang, you allow everybody to kind of focus on the future and not have to create those bifurcated or temporary workflows. And then you go live, and it’s scary. It’s big. And there’s a lot of change management, but it allows the entire organization’s focus to be on that event.