Latest / Becker’s Healthcare Podcast / Sarah Greichen, Chief Information & Innovation Officer at Sedgwick County Health Center
Transcript
- 0:02- Every health system executive right now is being
- 0:04- asked to do something that has no useful
- 0:06- precedent,
- 0:07- make durable technology decisions in an environment that
- 0:10- looks meaningfully different every six months.
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- 0:34- built around the questions leaders are actually wrestling
- 0:36- with.
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- 0:46- that hold up over time.
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- 1:01- This is Laura Dierda with the Becker's Healthcare
- 1:04- podcast.
- 1:05- I'm thrilled today to be joined by Sarah
- 1:06- Grecian, chief information and innovation officer at Sedgwick
- 1:10- County Health Center. Sarah, it's a pleasure to
- 1:11- have you on the podcast today.
- 1:14- Thank you for having me. It's great to
- 1:16- meet you.
- 1:17- Absolutely. Now I'm I'm excited for our conversation
- 1:19- and just to really learn a little bit
- 1:21- more about what you're doing at Sedgwick County
- 1:23- Health Center. But before we dive in, can
- 1:24- you introduce yourself and just tell us a
- 1:26- little more organization?
- 1:29- Yeah. Definitely.
- 1:31- So Sedgwick County Health Center is located in
- 1:34- rural Northeastern
- 1:35- Colorado in Western Nebraska.
- 1:37- We are a critical access hospital with three
- 1:40- clinics, a nursing home, and an assisted living.
- 1:43- And the community that we serve is largely
- 1:46- agricultural
- 1:47- and frontier population.
- 1:50- In my role, I oversee
- 1:52- IT, clinical informatics,
- 1:54- and digital patient experience.
- 1:56- I've been with Sedgwick County Health Center for
- 1:58- a little bit over three years. And during
- 2:01- that time, we've gone from focusing primarily on
- 2:05- modernization
- 2:06- and foundational technology,
- 2:08- to being able to think now much more
- 2:10- strategically about innovation
- 2:12- and the future.
- 2:16- That's amazing to hear. You know, what a
- 2:17- fun position to be in to have that
- 2:19- more strategic thinking lens and,
- 2:22- you know, innovation
- 2:23- as it can be
- 2:24- very exciting, to think about the possibilities and
- 2:27- potential. But I'm curious, could we start off
- 2:29- the conversation, talk a little bit about some
- 2:31- of the forces shaping digital health and IT?
- 2:34- What are you seeing right now, and what
- 2:35- do you anticipate you'll
- 2:37- how things will evolve over the next couple
- 2:39- years or so?
- 2:41- Well, when I first came to SCHC, most
- 2:43- of our technology
- 2:45- conversations were about just getting the basics into
- 2:48- place.
- 2:49- For example, electronic health records systems.
- 2:52- At the time, we had had seven different
- 2:55- disparate EHRs across organization.
- 2:58- Our assisted living facility was completely on paper,
- 3:01- and we didn't have an internal IT department.
- 3:04- And then beyond that, we were missing many
- 3:06- of the foundational pieces to needed to manage
- 3:09- technology strategically.
- 3:11- So we've spent most of our time over
- 3:13- the past few years consolidating systems,
- 3:16- improving our network, our tech stack, building an
- 3:19- internal IT team,
- 3:21- creating an clinical informatics department,
- 3:24- and then creating a lot more clear processes
- 3:27- for how technology decisions were made
- 3:30- and managed across the organization.
- 3:32- Now three years later, our conversation around technology
- 3:36- has changed quite a bit bit from basically
- 3:39- trying to figure out how to catch up
- 3:41- to the organizations
- 3:42- around us to focusing how technology can help
- 3:45- us
- 3:46- work smarter and better to support our patients
- 3:48- and staff.
- 3:50- One of the biggest forces that are shaping
- 3:53- our decisions today
- 3:55- is that rural health care especially has to
- 3:57- do a lot more with less.
- 3:59- We have workforce shortages,
- 4:01- financial pressures, and then a lot of increasing
- 4:05- demands on staff that aren't going away anytime
- 4:08- soon. For example, whenever there's a regulatory
- 4:10- change, that's another hat that we have to
- 4:12- put on a staff member.
- 4:14- So because of that, we're constantly looking for
- 4:17- ways that technology
- 4:18- can improve
- 4:20- efficiency,
- 4:20- reduce administrative burden with the goal of preventing
- 4:24- burnout,
- 4:24- and then helping our teams
- 4:26- spend more time focusing on the most important
- 4:28- thing, which is patient care.
- 4:31- And then at the same time, another driving
- 4:33- force is that patients expect health care to
- 4:36- work a lot more like the rest of
- 4:38- their lives. For example, being able to just
- 4:40- buy something with one click on Amazon.
- 4:43- They want it to be easier to schedule
- 4:45- their appointments,
- 4:46- communicate with their care team and their provider
- 4:49- to receive information, and then navigate the very
- 4:52- complex health care systems.
- 4:55- So those expectations are becoming a major driver
- 4:58- for
- 4:58- technology investments for us,
- 5:01- but we also have to balance that with
- 5:04- being in a rural community with an older
- 5:07- population where some patients still have,
- 5:10- flip phones, for example. So figuring out that
- 5:13- balance between
- 5:14- more convenience
- 5:15- using technology but still accommodating
- 5:18- our patient
- 5:19- population.
- 5:21- The last driving force for us is cybersecurity
- 5:24- and regulatory requirements.
- 5:27- Rural hospitals face the same threats and
- 5:31- compliance requirements that the larger health systems
- 5:34- do, but with far fewer resources.
- 5:36- So we just have to be very intentional
- 5:38- about balancing
- 5:40- innovation
- 5:41- and risk management.
- 5:43- And then looking ahead into the next year,
- 5:46- the driving force that we're focusing on is
- 5:48- AI and automation
- 5:50- continuing to play a much bigger role,
- 5:53- especially in helping us stretch our already limited
- 5:56- resources.
- 5:57- So So we're already seeing a lot of
- 5:59- value from things like ambient documentation,
- 6:01- and we'll continue
- 6:03- looking for ways to reduce administrative burden and
- 6:07- improve workflows
- 6:08- without breaking the bank.
- 6:11- So for me, the biggest change over the
- 6:12- past few years is we're finally in a
- 6:14- position to think beyond modernization,
- 6:17- and we can spend more time asking how
- 6:20- technology can improve
- 6:21- patient outcomes and then support the long term
- 6:24- sustainability
- 6:25- of our organization
- 6:27- and rural health care as a whole.
- 6:31- I think that makes a ton of sense.
- 6:33- And I love how you put that finding,
- 6:34- you know, all of the right balances between
- 6:37- technology and and the financial pressures between innovation
- 6:40- and compliance and really, you know, looking at
- 6:43- how all of those things come together with
- 6:45- the best interest of the patients and the
- 6:47- community in mind. And I'm curious, you know,
- 6:49- as you're going through some of these decision
- 6:51- making processes, obviously, it's always important to think
- 6:54- about resources and and, what's gonna have the
- 6:57- most value or bring back the most value
- 6:59- long term for the organization. But what are
- 7:01- those conversations like with your, c suite team?
- 7:05- How do you kind of manage all of
- 7:07- this, especially given,
- 7:09- as you alluded to, the,
- 7:11- less resources that, you know, rural health care
- 7:14- facilities typically have when compared with others across
- 7:17- the country?
- 7:18- Oh, whenever we have these conversations, we have
- 7:21- to
- 7:22- bring in multiple diverse perspectives. Like, we'll bring
- 7:25- in,
- 7:26- myself from the IT perspective, our chief medical
- 7:29- officer, our chief financial officer,
- 7:32- and then other varying departments depending on what
- 7:35- the decision is.
- 7:37- And we have everyone give
- 7:40- their thoughts and their perspectives,
- 7:43- and then make a decision from there. And
- 7:45- we'll oftentimes
- 7:47- bring in
- 7:48- other organizations
- 7:50- that have done something like that before. Like,
- 7:52- we'll always look to a lot of our
- 7:54- here
- 7:55- rural hospitals
- 7:56- if they have already made
- 7:58- a decision like that. For example, implementing a
- 8:01- new EHR is a massive decision.
- 8:03- When we were making those calls, we would
- 8:05- go to those similar sites, see how it
- 8:08- worked in their environment,
- 8:09- and then bring it back to the table
- 8:11- with all those
- 8:12- leaders from diverse perspectives and then make a
- 8:15- decision together.
- 8:17- And that's where I think it's really cool
- 8:19- in rural health care. We're small,
- 8:21- and we wear a lot of hats, but
- 8:23- in that way, we're also
- 8:25- not siloed, and it's easier for us to
- 8:28- make
- 8:29- those decisions together and bring something
- 8:32- brainstorm something together as a team.
- 8:37- I love that. It makes a lot of
- 8:38- sense. You know, it's really helpful to have,
- 8:41- those
- 8:42- other colleagues from other organizations to lean against
- 8:45- and, you know, have discussions to to make
- 8:48- those connections and understand
- 8:50- what things are are like in practice.
- 8:52- Now could you tell us about a big
- 8:53- project or a big swing that you took
- 8:55- in the last year that paid off? What
- 8:56- did you do, and what were the results?
- 8:59- Yeah. One of the biggest risks that we
- 9:01- took in the past year was we
- 9:04- completely changed how IT works at our organization.
- 9:08- For about twenty years, we relied on the
- 9:10- same managed services model. And while that approach
- 9:13- had served the organization
- 9:15- well for a long time, we have reached
- 9:17- a point where we needed technology to play
- 9:20- a more strategic role in supporting the organization's
- 9:23- goals instead of the classic break fix.
- 9:27- Historically,
- 9:28- most of our technology decisions were driven externally
- 9:32- because IT was entirely outsourced, and we wanted
- 9:36- to bring technology strategy
- 9:38- back into the organization
- 9:40- and then ensure that it was aligned with
- 9:42- the broader organization goals.
- 9:45- So today, we now own the technology strategy
- 9:49- internally. So we're the ones that establish
- 9:52- priorities, define milestones, measure progress, and then we
- 9:55- work closely with our partners
- 9:57- to execute that strategy.
- 9:59- So technology is no longer something that just
- 10:02- happens to our organization.
- 10:04- It's something that we actively use to help
- 10:06- move the organization forward.
- 10:09- The timing was challenging because we were also
- 10:12- asking a lot of our staff
- 10:14- over the last few years. We've replaced
- 10:17- or modernized almost all of our systems,
- 10:21- moved much of our technology environment to the
- 10:23- cloud, implemented entirely new workflows,
- 10:27- introduced all new tools and processes that didn't
- 10:29- exist before. So our staff have been through
- 10:31- a lot.
- 10:32- And change isn't always fun when you're in
- 10:34- the middle of it, especially when people have
- 10:36- been through a lot of change.
- 10:38- There are definitely times when they were tired
- 10:40- of another project or another system or go
- 10:43- live.
- 10:44- We did try and make it fun with
- 10:45- snacks and fun outfits and parties,
- 10:48- but we're now starting to see the payoff.
- 10:52- We've completely strengthened our cybersecurity
- 10:55- program,
- 10:56- improved visibility into our technology
- 10:59- environment. People actually know what's happening
- 11:01- in IT,
- 11:03- And then we've built a much stronger
- 11:05- relationships
- 11:06- across the organization
- 11:08- and then created a foundation that positions us
- 11:10- well for the future where we can bring
- 11:12- in,
- 11:14- new solutions.
- 11:15- So what I'm most proud of is the
- 11:17- shift in perception here.
- 11:20- Technology is no longer seen as the break
- 11:23- fix team that people call when something breaks.
- 11:26- Granted, they still call us when something breaks,
- 11:29- but that's no longer seen as our primary
- 11:31- purpose.
- 11:31- So today,
- 11:33- when a department is considering a major change,
- 11:35- for example, bringing in a new reference lab,
- 11:39- technology is involved from the very beginning of
- 11:42- the conversation.
- 11:43- A few years ago, we would get involved
- 11:46- after a decision had already been made, and
- 11:48- today we're getting to help make that decision.
- 11:52- And over time, that approach has built a
- 11:55- lot of trust
- 11:56- and fundamentally changed the role that IT plays,
- 12:00- in our organization.
- 12:01- And we're not just
- 12:03- supporting the business
- 12:04- anymore behind the scenes.
- 12:07- We're actually helping shape where it's going.
- 12:13- I I love that. And I think it's
- 12:14- so key. When you look at the the
- 12:16- business of health care and the whole organization,
- 12:18- what it takes in order for it to
- 12:20- run efficiently and effectively, I mean, having the
- 12:23- technology as a backbone and,
- 12:25- powering a lot of what's going on there,
- 12:27- whether it's the clinical care or the administrative
- 12:29- operations.
- 12:30- You know, it can make a big difference
- 12:32- to have
- 12:33- a strategic minded,
- 12:35- CIO and IT leaders who can really see
- 12:38- that big picture and then bring it into,
- 12:40- the organization smartly.
- 12:42- And, you know, when you look at that,
- 12:44- change management, obviously, you mentioned, you know, it
- 12:46- was a little bit different at the beginning.
- 12:48- And then now people understand the the value
- 12:50- of having,
- 12:51- technology leaders there and working more strategically.
- 12:56- What do you think was most effective in
- 12:58- in making that change, or or what kind
- 13:00- of ways did you communicate out initially and
- 13:02- then, you know, as time went on to,
- 13:06- I guess, become efficient and effective with it?
- 13:08- I
- 13:09- would say the most effective thing that we
- 13:12- did was have each department, each leader really
- 13:15- own their own area,
- 13:18- and understand the why behind it. Like, for
- 13:20- example, when we were implementing our new EHR
- 13:23- a couple of years
- 13:24- ago, we went to every single leader and
- 13:27- we were like, hey. What is your purpose
- 13:30- for implementing this and implementing it well?
- 13:33- And every single leader from there on out
- 13:36- had that why so that even when
- 13:39- things got really hard or they had to
- 13:41- do
- 13:42- or they had to work an extra ten
- 13:44- hours that week, they had that why behind
- 13:48- it.
- 13:49- Another piece of it is we made it
- 13:50- fun. Whenever we do a large project, we
- 13:53- always
- 13:54- add a theme to it. We add fun
- 13:56- food,
- 13:57- some fun outfits. Like, during our EHR implementation,
- 14:01- we did a Trolls theme, which all the
- 14:04- staff had voted on.
- 14:06- So we made a bunch of Trolls headbands
- 14:08- for everyone,
- 14:09- and they wore them during all of our
- 14:11- events in go lives.
- 14:13- And you can't be mad at someone when
- 14:15- they're wearing a troll's headband. So it made
- 14:18- it a lot of fun for the consultants
- 14:20- that came on-site and then our staff and
- 14:22- really kept morale up.
- 14:25- Food bribery
- 14:26- was also a very effective thing.
- 14:29- People were laughing and having a good time
- 14:31- with it while also
- 14:33- feeling like they had,
- 14:35- that ownership in the project. And I would
- 14:37- say that was the most effective thing for
- 14:40- change management.
- 14:43- That what a great example of keeping things
- 14:45- light, but also being able to troubleshoot the
- 14:47- issues and and, you know, really clearly getting
- 14:49- done what needs to get done.
- 14:51- Now that you are you know, have been
- 14:54- able to make that shift and that transition,
- 14:56- what's the most important problem that you're trying
- 14:58- to solve with AI or technology today, or
- 15:01- or or do you foresee in the next
- 15:02- couple years?
- 15:04- The most important problem that we're trying to
- 15:07- solve right now and also into the future
- 15:09- is capacity.
- 15:11- Like many other rural health care organizations,
- 15:14- we have workforce shortages, limited resources,
- 15:18- and a lot of people that are wearing
- 15:20- many hats.
- 15:21- We don't have large departments where we can
- 15:23- easily be redistributed.
- 15:25- So when we can save someone some time
- 15:28- or remove administrative burden so they can go
- 15:30- on vacation,
- 15:32- it has a very real impact. So that's
- 15:34- what we're mostly focusing on when it comes
- 15:37- to
- 15:38- implementing AI and new technologies.
- 15:41- For example, we just implemented
- 15:44- ambient documentation
- 15:46- to reduce documentation burden
- 15:48- on providers. With that, we've seen a significant
- 15:52- reduction in after hours charting, and all of
- 15:54- our charts are being completed within twenty twenty
- 15:57- four hours, which also makes our CFO really
- 15:59- happy.
- 16:01- And then we're also leveraging AI for smaller
- 16:03- things like meeting summaries, drafting documents, other administrative
- 16:08- tasks that no one wants to do and
- 16:10- takes away from patient care and strategic work.
- 16:13- And then on the patient side of things,
- 16:15- one of the biggest themes that came
- 16:18- out of our community health needs assessment
- 16:21- was that patients want better communication
- 16:24- from us and then also easier access to
- 16:26- care.
- 16:27- So in response, we're implementing a new patient
- 16:31- communication platform that will support things like better
- 16:34- appointment reminders, scheduling,
- 16:36- digital communication with our care team.
- 16:40- And yeah. And then at the end of
- 16:42- the day, we're not implementing AI or any
- 16:44- of these solutions because they're exciting.
- 16:47- We're implementing technology where it helps solve real
- 16:50- problems.
- 16:51- So for us, that means helping our staff
- 16:54- spend more time on meaningful work, helping patients
- 16:57- access care more easily, and then hopefully making
- 17:00- the organization more sustainable in the long term.
- 17:07- It makes a ton of sense. And I,
- 17:09- you know, love that idea of,
- 17:12- really looking at ways you can leverage technology
- 17:16- in AI,
- 17:17- so that the work has that real impact
- 17:20- across the board. I think it's just
- 17:23- so important to
- 17:25- improve that capacity and then figure out where
- 17:27- people are gonna be excited to,
- 17:29- you know, to to use it and leverage
- 17:32- it. Now before we wrap up here, what
- 17:34- are you most curious about for the future?
- 17:37- What I'm most curious about is what the
- 17:39- role of AI will ultimately be in rural
- 17:42- health care and how we can use it
- 17:44- to strengthen rural health care without losing that
- 17:47- human element that makes it so special and
- 17:50- is essentially the brand's essence of rural health
- 17:53- care. And everyone is talking about AI right
- 17:55- now, and I think it has tremendous potential
- 17:57- in health care. It can help address workforce
- 18:01- shortages,
- 18:02- reduce administrative burdens, improve access to care,
- 18:05- and then give organizations like ours capabilities
- 18:08- that might have previously only been available to
- 18:11- much larger health systems because we would have
- 18:14- had to hire a whole bunch of people
- 18:16- before.
- 18:17- But what interests me just as much is
- 18:19- the people side of it.
- 18:21- Rural communities often have older patient populations
- 18:25- and varying levels of comfort with technology.
- 18:28- The challenge isn't just implementing the new technology.
- 18:31- It's implementing it in a way that people
- 18:34- will actually use it and trust it.
- 18:37- So I think the real challenge
- 18:39- is finding that balance. How do we use
- 18:42- AI and automation to make health care more
- 18:45- sustainable without losing the relationships
- 18:48- that are really the heart of rural health
- 18:50- care?
- 18:51- And in many rural communities,
- 18:53- the hospital is one of the largest employers,
- 18:56- if not the largest employer
- 18:58- in the area, and health care is deeply
- 19:01- personal.
- 19:01- Patients know their providers.
- 19:04- Providers know their patients. A lot of the
- 19:06- times, it's neighbors taking care of neighbors.
- 19:09- And I don't think the future is about
- 19:12- replacing people with technology. I think it's about
- 19:15- using technology to reduce
- 19:17- burnout, give people
- 19:19- time back, and then help them focus on
- 19:21- the work that only people can do.
- 19:24- And if we can use AI to strengthen
- 19:26- those relationships
- 19:27- instead of replacing them, I think it could
- 19:29- be one of the most powerful tools rural
- 19:32- health care has seen in a long time.
- 19:35- Historically, rural health care has often had to
- 19:38- wait for innovation to trickle down from the
- 19:41- larger organizations, so I'm excited to see whether
- 19:44- AI changes that equation
- 19:46- and helps smaller organizations
- 19:48- do things that simply weren't possible
- 19:52- before.
- 19:53- Wow. That that's really cool to think about.
- 19:55- And, you know, AI is such a powerful
- 19:58- tool, but, you know,
- 20:00- like you mentioned, certainly,
- 20:01- it is is not always easily accessible,
- 20:04- across the board, especially in healthcare organizations.
- 20:07- So, you know, when you think about rural
- 20:09- healthcare and and how,
- 20:11- innovation
- 20:12- can be most useful,
- 20:15- where do you see AI being able to
- 20:16- just make things easier or or bring that
- 20:19- innovation
- 20:20- quicker,
- 20:21- into the rural setting? What are some of
- 20:23- the possibilities, I guess, that as you're thinking
- 20:26- through what the future could look like best
- 20:27- case scenario, what are the possibilities that come
- 20:29- to mind?
- 20:32- I see a lot of possibilities
- 20:33- on the
- 20:34- revenue cycle side.
- 20:36- It's
- 20:38- really hard for rural health care
- 20:41- facilities to hire staff, especially especially hiring them
- 20:44- to come on-site because a lot of these
- 20:45- towns are so small.
- 20:47- So I see a lot of opportunity in
- 20:49- the rev cycle side just because the talent
- 20:51- pool tends to be a little bit smaller
- 20:53- in those areas, and that tends to be
- 20:55- a area where we always need more people.
- 21:00- I also see a lot of opportunity
- 21:03- in
- 21:04- on the operations
- 21:05- side of things.
- 21:06- We have so many tasks every day, like
- 21:10- regulatory reports, for example,
- 21:12- that are paid and can take people weeks
- 21:15- at a time.
- 21:16- And a lot of our staff that are
- 21:18- providing patient care or
- 21:22- critical operational roles in the organization just don't
- 21:25- have time
- 21:26- to do those things even though they need
- 21:28- to. So I see that as another area
- 21:31- of reducing
- 21:32- the amount of time
- 21:34- that staff,
- 21:36- would need to work on that.
- 21:39- A few other areas is in ambient documentation
- 21:44- on the nursing
- 21:45- and CNA side. We've seen a lot of
- 21:47- success
- 21:48- with the providers.
- 21:50- So I would like to see something similar,
- 21:53- in that area. And then also
- 21:55- lab and radiology, we haven't implemented
- 21:58- any AI solutions with
- 22:00- lab and radiology, but I do see a
- 22:03- lot of opportunity
- 22:05- there where we could reduce some cost and
- 22:07- then also
- 22:09- increase our ability
- 22:11- to take care of our patients quicker.
- 22:15- Fantastic. Sarah, thank you so much for joining
- 22:16- us on the podcast today. This has been
- 22:18- a really fun discussion, you know, very informative
- 22:21- and inspirational as well, thinking about the future
- 22:23- and how technology and AI, can really make
- 22:26- a difference, especially in the rural space. I'm
- 22:28- excited to keep the conversation going at our
- 22:30- health IT and revenue cycle conference coming up
- 22:32- in September. I know you'll be a speaker
- 22:34- there and and talk more deeply into some
- 22:36- of these themes we touched on today. So
- 22:38- looking forward to seeing you in person and,
- 22:41- hearing more.
- 22:43- I'm looking forward to it as well. Thank
- 22:44- you so much for having me.