BIGInterviewThe

Dr. Robecca QuammenCEO AND FOUNDER OF

QUAMMEN HEALTH CARE CONSULTANTS

The Big Interview

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Dr. Robecca QuammenQuammen Health Care Consultants

Quammen Health Care Consultants Founder and CEO Dr. Robecca Quammen is a healthcare business and information systems veteran, recognised as an advocate for transforming healthcare with information management solutions. Her 30-year career in healthcare includes senior management positions in large healthcare provider organizations, at the nation’s largest healthcare software vendor, and with leading healthcare consulting practices. As part of Finance Monthly’s The Big Interview, she takes us through her career from start to finish, leading to the founding of Quammen.

The Big Interview

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What led you to found Quammen Health Care Consultants? Was there an instance where you noticed a gap in the market?

I describe my healthcare career as having three legs. The first leg encompassed my time working in hospitals with patient registration, medical records, and patient financial services. Registering patients on third shift while in college, then progressing through management in large community, academic, ambulatory, and for-profit environments allowed me to establish a baseline understanding of the healthcare delivery system.

The second leg provided an opportunity to see the healthcare software development, sales, implementation and support of what was known at the time as HIS (health information systems) and CIS (clinical information systems) for the largest vendor serving hospitals and physicians from the late 80s through the mid 90s. During this time, electronic health records were little more than order communication systems with some limited nursing documentation.

I noticed that implementation projects were long and expensive at the time and I started to focus my energy on ways to “productize” service – to make these implementations repeatable and less costly to deliver. I developed the industry’s first branded implementation methodology sold as a product. With this innovative thinking, I ventured into the consulting side of the industry by joining the industry’s largest private healthcare consultancy. Management styles tended toward “win/lose” models with the customer or employee being the loser. Projects were long, expensive and frequently motivated by fear generated in the industry. Worst of all, they were rife with failures. It took only a few months working in this environment for me to realize the way information systems services – both vendor and consulting – were being delivered needed to change.

So, I founded my own consulting company – one designed to question the status quo. The following quote was written to guide Quammen Health Care Consultants in those early years and it still rings true today: “We believe we’re making a difference where we work: at the intersection of healthcare, technology and business. To use one very small but symbolic example, our experience led us to take a different approach to consulting: We base employee incentives on client service, not billable hours. And we also pride ourselves on qualities such as living up to our promises and rolling up our sleeves to work with clients ‘in the trenches.’

How did your previous experiences prepare you for this role?

Throughout my career, I raised my hand when there were difficult jobs that needed to be tackled. And even though I’ve held management and executive titles throughout my career – progressing from hospitals to vendors to consulting firms, and ultimately to entrepreneurship – I never stopped walking the halls of institutions where care was being delivered.

Can you explain for our readers what an EMR/EHR system is?

An electronic health record is a complex system of systems. Optimally it is the automation of the entire care process for a patient in the ambulatory or inpatient setting. Generally speaking there is a core product that serves as the order communication, results reporting, and documentation system for nurses, physicians and the care team. Modern versions of these systems include rules, alerts, protocols, embedded education, interaction with outside reference sites for evidence-based medicine, document storage, and reporting capabilities. Many ancillary services such as rehab, radiology, surgery, emergency department, laboratory, pharmacy, etc. are serviced by niche systems designed for these specific areas. In

all instances these niche products must include some level of interoperability with the core system – this can be as rudimentary as passing PDF results to the core system or as sophisticated as sharing patient context as the user moves seamlessly between the systems to perform and document patient care. Quammen’s approach to EMR/EHR has been noted as innovative by reviews. Can you talk us through your approach step by step?

Our approach is distinguished from others by our shortened timelines. Traditionally, many organizations take a phased approach to technology implementation. Under this approach, hospitals might bring an EHR up department by department. As such, it takes a long time to actually realize results – and the pressures associated with implementation linger on and on. We believe that it is much easier and more effective to implement the complete system in one fell swoop across the entire continuum of care. We also work closely with hospitals and other healthcare organizations to leverage EHR systems to actually improve clinical care as soon as possible. We ensure that client hospitals are ready to use their data to change how they deliver care. As such, hospitals are able to use technology to improve population health, safety, quality and the overall sustainability of their organizations.

Comittment to achieve results for all organizations, regardless of size. We have reduced costs so smaller hospital and ambulatory organizations can leverage high end consulting that was previously out of reach. Instead of charging our clients on an hourly basis, we bill clients based on the value that we deliver. Therefore, they are always experiencing a positive return on investment.

In addition, we help all hospitals – regardless of size – to cost effectively bring in the technology that will lead to results. Typically, hospitals are sold big, feature-rich EHRs but when it comes time to put these systems in place, the vendors limit the implementations to very basic, limited features – and the healthcare organizations do not get what’s needed to succeed. We, however, work with hospitals to ensure that they start their selection process by examining their own needs, making sure to source select functions that will support their unique goals. With this approach, hospital leaders look at the full gamut of EHRs, both those designed for small providers and those aimed at large facilities. As such, smaller providers are likely to “right size” large established EHR systems – and to not just get functionality that they can live with but functionality that can truly move their organizations forward. And, all hospitals are likely to implement EHRs that truly

improve clinical care, not technology that offers variety of unneeded bells and whistles

Willingness to help organizations get work done. We provide the alternative staffing services that help healthcare organizations turn their visions into realities. As such, providers get the level of support needed, under a unique pricing model that makes our services exceptionally affordable. Indeed, healthcare organizations can choose exactly what they need from our array of service levels:

• CO-SOURCING, where Quammen team members work side-by-side with internal team members, assuming operational staff roles.

• APPLICATION SOURCING, where Quammen leaders take the helm doing what it takes to recruit, train, and retain staff for specific information technology roles.

• TECHNOLOGY SOURCING, where Quammen consultants ensure information technology solutions meet strategic goals and end user computing needs.

• INTERIM MANAGEMENT, which enables organizations to bridge short or long term gaps before information technology initiatives are negatively impacted.

• CONSULTANCY, where our professionals successfully implement expert software or technology solutions to meet episodic needs.

How do you train a hospital’s staff or physician practice to use a new EMR system?

This is a truly challenging task to accomplish. Whether addressing the diversity of the care team or the continuity of the care to be delivered across the healthcare enterprise, it is critical to understand the impact of individual learning styles. As such, one-size-fits all methods must be challenged. Having just completed my doctoral dissertation on the impact of intuition in information systems success I feel strongly that an individual’s cognitive processing style is critical to the methods in which information systems are taught in healthcare. With three-year-olds using tablets as commonly as we would have used paper and pen, our training methods must acknowledge the notion that healthcare workers born in the information age are armed with significant prior experiences that allow them to intuitively work with technology.

We must continually alter and customize our training methods to meet clinicians exactly where they are at. As such, there is no “one’ method that will work to get all physicians up to speed with technology. Instead, we must always customize our training tactics while focusing on giving

doctors what they want: The ability to actually use technology to do their jobs betters. That is, physicians will rapidly learn how to leverage technology tools if they realize that the solutions will help them deliver better care in a more efficient manner to their patients.

How well are hospitals currently equipped to enter the digital age? Are there a lot of changes to be made?

Arguably significant technology and information systems advances have occurred in the US since the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. HITECH’s requirement for meaningful use of certified electronic records fueled first by financial incentives followed by longer-term reimbursement penalties for non-adoption has irreversibly changed the entire healthcare information technology game.

Indeed, all providers are motivated to adopt and leverage EHRs. But they are running into many obstacles. To start, some organizations are working so hard meeting all of the meaningful use requirements – but are not aligning their information technology implementations to meet their long-term strategic goals. In addition, while they are making investments in EHRs, organizations are grappling with many challenges that are making it difficult to fully leverage technology to achieve improved care, enhanced patient experiences and reduced costs. Staff shortages, skill gaps, constant software upgrades, and spiralling technology costs are all making it difficult for healthcare organizations to get the most out of technology.

What’s more, many organizations are trying to reach a bevy of clinical care and operational goals while struggling with outdated software.

“Anyone paying attention to the way healthcare operates knows it’s bad. In fact, healthcare is so bad at so many things, the opportunity couldn’t be more ripe for incumbent companies (health systems, vendors, and payers) and budding upstarts to team up to introduce operational efficiencies, find ways to increase profitability or present better experiences for patients and providers,” wrote Jonathan Bush, CEO of

athenahealth in a TechCrunch blog. Indeed, Bush is leading the charge to introduce “disruptive” technology that can truly help the healthcare industry move further than is currently possible in its efforts to improve care, enhance experiences and reduce costs.

What’ s needed is innovative cloud based software that can meet healthcare organizations evolving needs. Indeed, the industry is in need of the disruptive technology that can actually make it not only possible but probable for organizations to experience the much sought after triple aim: enhanced patient care experiences, improved care outcomes and reduced costs.

How do you combine your personal life with managing Quammen Health Care Consultants?

I live my life holistically. I carry one phone and use one email address. Whether work or pleasure – it all funnels through the same channels. Technology has made it possible for me to be in exotic places for brief respite while still being accessible and involved. Through the years, I am known for taking “mini” vacations and catching a movie in the afternoon – 2 hours in a theatre away from current demands helps me regroup and put things back in perspective from those moments when I couldn’t take in another thing. I am an ardent multi-tasker and prefer lots of input – books, movies, music at the same time. Technology has also made it possible to skim vast topics quickly to maintain currency.

I am part of the “I can do and have it all” generation of women. To be honest, as I reflect on the past 20 years, I wouldn’t change any of it but I would admit that it is challenging to have it “all”. Something has to give from time to time so I understand the need to make choices and compromises.

What have been your biggest challenges and successes with Quammen?

The healthcare industry is constantly changing and evolving. All kinds of challenges and buzzwords continually flow in and out of the industry. As such, healthcare organizations go from focusing on developing integration

Throughout my career, I raised my hand when there were difficult jobs

that needed to be tackled. “ “

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strategies under RHIOs to zeroing in on meaningful use to implementing value-based care initiatives and back again to developing the integration strategies – but this time under HIEs.

At Quammen, we keep up with this flurry of change, leading healthcare organizations through the intricacies of each emerging challenge. What makes us successful, though, is our focus on the big picture. No matter what the challenge of the day is, we always strategically work with healthcare organizations to help them deliver the top-notch clinical care that will produce the best results in the most cost effective manner. As such, we are able to help healthcare organizations not only succeed today – but any day. In essence, we combine this big-picture analysis of the industry with an intimate understanding of healthcare clinical processes, business management and information technology to develop innovative, transformative strategic plans – and bring them to fruition.

What more can we expect from Quammen Health Care Consultants moving forward?

Lately, I’ve been drawn to the thinking espoused by Jonathan Bush, the CEO of athenahealth and author of “Where It Hurts.” Bush recognizes that healthcare organizations – and, therefore patients – are not having their needs met with current software and services. And he is calling for more disruption in the industry. Indeed, I couldn’t agree more.

Moving forward, Quammen will unravel opportunities in the second generation EHRs that would complement the rising push to cloud and mobility. Moreover, the firm will continue focusing on rapid prototyping of recently patented software products to bridge some of the many gaps between the EHR and Big Data Analytics.

In fact, at Quammen, we recently introduced a solution that can help to stir things up and create the disruption that is needed in healthcare. As a real-time, cloud-based care management analytics solution, AndonCare proactively guides clinicians to navigate all aspects of clinical care as it unfolds. As such, the solution goes far beyond what electronic health records alone can accomplish, AndonCare enables clinicians to proactively:

• Manage complex processes in a dynamic environment

• Deliver optimal care by responding to visual cues

• Easily detect and avoid care hazards before they occur

• Continually set priorities to enable precision care based on actual patient progress

• Meet a variety of regulatory and patient safety goals

• Identify missing, redundant, or unnecessary tasks

• Recognize best practice variations and immediately change course, if needed

With such smart patient care management in place, healthcare organizations can truly experience the operational process improvements that can lead to the very best outcomes for patients. And, as a result, organizations will be able to improve overall quality, reduce medical errors, shorten length-of-stay and cut costs. In fact, AndonCare can bring all the sought-after benefits that will help organizations succeed under emerging value-based care models. It’s truly the type of disruption that is needed not only to challenge the status quo – but to get real, quantifiable results.

Is there anything else you would like to add?

Throughout my career, I have been very successful in getting healthcare professionals to adopt – and benefit from – technology. As a leader in healthcare, I am always looking to put innovative thinking to work on the front lines. My recent research, conducted as part of my

doctoral program, zeros in on intuition and its impact on information systems success. With this research, I am looking to build upon my successes in healthcare IT adoption. More specifically, I am exploring how “intuition” plays a role in the successful adoption of information systems in the healthcare environment.

A survey conducted for the dissertation found that 62% of healthcare executives, managers and consultants believe intuition impacts information system success and EHR adoption. While this study only reveals that intuition could play a role, it is a subject that I am continuing to explore. As such, I am looking to arrive at a richer explanation of the cognitive processes that are at play when users adopt and attempt to leverage technology. More specifically, I am exploring the impact of intuition on information system success under certain environmental conditions. It’s this quest to truly dig deep that will help to make it possible to better guide healthcare organizations toward achieving even greater success with information systems adoption. As such, these organizations will be able to deliver better care and improved outcomes – a goal that truly motivatives me to push everyone in the healthcare industry to reach beyond the status quo and experience the extraordinary.

Contact:

Dr. Robecca QuammenEmail: becky@quammengroup.com | Website: www.quammengroup.com

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