Kathryn Crous, Network CIO, Kings County Hospital, NYC Health & Hospitals, Chapter 1

Kathryn Crous, Network CIO, Kings County Hospital, NYC Health & Hospitals Most CIOs deal with a great deal of complexity, but what Kathryn took on when she started with Kings County Hospital nearly a year ago takes it to another level. The hospital is part of NYC Health & Hospitals, which recently began an organization-wide conversion to Epic, while at the same time going through a major governance transition. Adding to it is the fact that NYC H+H is a public system, meaning all leaders report to the mayor’s office. In this interview, Crous talks about what it’s like to lead through change, the advantage she had in having to “test drive” the organization as a consultant first, and her thoughts on the evolution of patient engagement. She also discusses her leadership mantra — “listen twice as much as you speak,” her interest in EMR forensics, and why healthcare shouldn’t be compared to other industries. Chapter 1 * About Kings County & NYC H+H * Governance in transition — “We’re in that middle valley right now.” * Reporting to a corporate office * Transition away from QuadraMed — “Support was diminishing.” * Complex interfaces for billing * “We have a lot of moving targets.” * Working with Ed Marx on Epic conversion — “We’re taking those lessons learned and building a template.” LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED Bold Statements It’s a little confusing at the moment because the actual table of organization hasn’t been released and titles are changing and chairs are changing. And so we’re kind of in that middle valley right now where things are not clear as to how we’re going to proceed. We’re changing from one business model to another in the midst of an EMR implementation, in the midst of moving from Unity to Soarian, and in the midst of many other projects. We have a lot of moving targets right now. Some of our billing comes out of QuadraMed, some of it comes out of Unity, so the analytics is complicated, but not withstanding the fact that we have a lot of integration, the analytics are actually pretty good for such an old system, and the amount of effort it takes to get the data into a data mart. The conversion was very calm, and probably one of the calmest I’ve ever been on. And so, Ed and I were looking at each other and saying this is a little frightening. But nonetheless, we went through the usual trajectory of lots of incidents, and then it trailed off over time. We’ve hired those senior vice presidents and then IT will be reporting up to those senior vice presidents that are going to be determining the strategy. And so, some of that complexity is also how do you build the governance structure so that you include all the facility leadership and the clinical leadership and the IT leadership appropriately to make sure that you’re making the best decisions. Gamble:  Thank you, Kathryn, for taking some time to join healthsystemCIO.com today. To get things started, can you give maybe like a general overview of Kings County Hospital, what you have in terms of bed size, ambulatory offerings, things like that? Crous:  Kings County Hospital is part of New York City Health and Hospitals. It’s the largest public healthcare system in the country. Kings County itself has over 800 beds and ambulatory clinics that cover almost every specialty and subspecialty you can think of. We serve the greater Central Brooklyn area and we have a very diverse population here. We have had to translate into 95 different languages our discharge instructions. Gamble:  Oh wow. How does it work as far as NYC Health and Hospitals? Do you operate somewhat independently or how does that work? Crous:  It’s in a great deal of transition at the moment.