Susan Marino, CNIO, Hartford HealthCare, Chapter 3

It was five years ago that Hartford HealthCare began its journey to become an integrated system, and five years ago that the organization named Susan Marino as its first CNIO. The timing is no coincidence; in fact, it was a deliberate move by leadership to appoint someone with a deep knowledge of both nursing and informatics to help establish governance, guide the training process, and most importantly, ensure that the front-line staff was able to work as efficiently as possible. In this interview, Marino discusses the “never-ending” Epic rollout that’s becoming a game-changer at Hartford, how hear team is working to optimize the system without placing too much burden on physicians and nurses, and their biggest priorities for the coming year.

She also talks about her own journey, reflecting on the hurdles she faced early on and the “one win at a time” approach she took to bring nursing to the decision-making table, and emphasizes the importance of leveraging technology to increase satisfaction among nurses.

Chapter 1

Chapter 2

Chapter 3



* EHR rollouts & staff burnout

* “It’s meant a lot of extra learning while staying focused on patient care.”

* Dealing with naysayers — “Why would we need a nurse to help build this?”

* “Dual role” of informatics & staffing

* Guiding the Epic rollout as CMIO

* “The technology & the role came along side by side.”

* Reliance on early adopters: “It’s tough work. You have to get over the bumps.”



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Bold Statements

It’s something that we continue to look at, in terms of getting to the optimization and efficiency stages where we now go back in and make sure that we’re really trying to lessen the documentation and the number of clicks. How can we make viewing the whole record better?

The technology and the role came along side-by-side. I was very fortunate in working with some great leaders throughout the years, and it was a natural next step for me to join the executive leadership team as we began our Epic journey.

There were some areas that pushed back; that didn’t really feel it was necessary to do it electronically. But there were early adopters that you help make the case for, and they would take that system and run with it. They really helped us in developing it to make it efficient and make it work for the staff.

It’s really important that we have individuals who understand how to put those programs in place, how to work through the workflow challenges, how to make sure you have a team representing the space and the topics that are critical to understanding the technology.

Gamble:  What you’re talking about speaks to things like fatigue and burnout and really trying to staying on top of these things as best you can.

Marino:  I’m not sure we did any favors with roll out of a big Epic system in the last few years. I know it has meant taking on a lot of extra learning, while at the same time trying to be focused on patient care. That’s very difficult, and I think that has been a strain on our staff and leadership, as well as the site caregivers or physicians. So, it’s something that we continue to look at, in terms of getting to the optimization and efficiency stages where we now go back in and make sure that we’re really trying to lessen the documentation and the number of clicks. How can we make viewing the whole record, and what’s happening with the patient on a day-to-day basis, better?