<v Jordan Cooper>We are here today with Jeff Fallon, the VP of Clinical and Business applications that main health Jeff, thank you so much for joining us today.</v>

<v Fallon, Geoffrey W>Thank you.</v>

<v Jordan Cooper>So main health has been on a 9 year journey between 2012 and 2021 to implement 10 hospitals on EPIC. Main health is now focusing on projects that will bring improved care, team experience and operational efficiency to your workflow. You've mentioned Jeff, that your largest efforts right now until reimagining your laboratory information system again based on Epic Beaker and the reimplementation of your ERP system including a shift to the cloud.</v>

<v Jordan Cooper>Would you tell our listeners a little bit about that project?</v>

<v Fallon, Geoffrey W>Here I think there really are are two largest initiatives right now and are you know we have a a fairly complex lab environment, part of Maine health is a lab organization called Nordics. They have a core lab. They also operate or hospital labs and have their own independent reference labs, so.</v>

<v Fallon, Geoffrey W>You do over the years they've we've grown a fairly complex IT environment and supporting them and really the the way that we deliver it has changed and it's time for us to take a step back, look at it and rebuild that entire IT infrastructure for the future.</v>

<v Fallon, Geoffrey W>And so we are in the middle of that right now and you know our our goal is there are really simplification, supportability and making sure that what we deliver is the best for both our users of services and in terms of our clinicians, our lab team, Care team members and also our patients.</v>

<v Fallon, Geoffrey W>And.</v>

<v Jordan Cooper>So. So you're how could you go into a concrete example for the benefit of listeners about one use case where you've been improving operational efficiency or the care team experience?</v>

<v Fallon, Geoffrey W>I mean, I think.</v>

<v Fallon, Geoffrey W>I think I'll, uh, you know, I'll give some some simple ones in that, you know over the years are reference lab business.</v>

<v Fallon, Geoffrey W>You had a some different different IT systems, so a patient that was seen as part of the reference business and then a patient who came into the hospital, the provider and the hospital may not be able to see any of the lab results from that reference lab business, so.</v>

<v Fallon, Geoffrey W>And so now we're, you know, we're really reenvisioning the architecture and say this is all one giant lab system. And so we can.</v>

<v Fallon, Geoffrey W>Any any sort of service line that that patient is seen at, we now have their lab results available to any clinicians fingertips.</v>

<v Jordan Cooper>It's somewhat of a unified care record for many different data inputs. Is that correct?</v>

<v Fallon, Geoffrey W>That's correct. And then I think the other thing we're looking at is really when you have less systems and less integration, you can work it, work on streamlining workflows to make things like you know, lab add-on tests easier to order or you know, a cancellation, easier to schedule or to give the lab the ability to have patients do online appointment scheduling. These are all things that we've either implemented recently or will be coming with this.</v>

<v Fallon, Geoffrey W>With this reenvisioning and reimagining of our lab IT infrastructure.</v>

<v Jordan Cooper>It's interesting, Jeff, that you mentioned one of your priorities is to improve the care team experience. A lot of times, healthcare delivery systems are focusing on improving the patient experience, but actually providing an improved experience for the provider care team being physicians, nurses, other sort of administrative support.</v>

<v Jordan Cooper>Uh, how have you found that? Well, first of all, why has improving care team experience been a priority? And 2nd, how have you gone about improving the experience, identifying where you want to prioritize, which steps you want to prioritize?</v>

<v Fallon, Geoffrey W>Yeah. And I think in, in my mind, in many of ours, the care team experience and the patient experience are intrinsically linked and that, you know, if I make it easiest for our users to order the right labs at the right time with this many options, it's gonna make the patient experience better. They're gonna show up at the lab, that test is gonna be waiting for a lobotomist to draw. They're going to get their results quickly. So I think we've focused on care team experience knowing that.</v>

<v Fallon, Geoffrey W>You we need to make sure that we allow our users.</v>

<v Fallon, Geoffrey W>The ability to order the right test, the right time with this little complication as possible.</v>

<v Fallon, Geoffrey W>And and that will improve the patient experience as well.</v>

<v Jordan Cooper>Have you created any sort of feedback loops in order to incorporate clinician input into the redesign of their workflows?</v>

<v Fallon, Geoffrey W>Yeah, I think it starts with our our inclusion of our CMIO on our Executive Steering Committee.</v>

<v Fallon, Geoffrey W>Oftentimes it historically Umm at this organization the lab operated on, you know the lab and it operated without a lot of clinical input from the physician side. And I think we've really tried to make sure that we're rectifying that. We have both our CMIO and CNI or involved in our lab work right now to make sure that we have a strong clinical voice in driving the work.</v>

<v Fallon, Geoffrey W>Know what? When you're looking at something as fundamental as how your lab information systems work, it is a really far reaching impact. We wanna make sure that we get as many voices.</v>

<v Fallon, Geoffrey W>And as part of the project to make sure that we're improving, you know, we're taking this opportunity to really improve the workflow for all the all the users.</v>

<v Jordan Cooper>Pivoting a bit to another topic, but on the same topic of where you're going as an organization, I understand that main health is planning a refuel with EPIC, which will look similar to the current EHR, but it will be more streamlined and more efficient for future support. What do you envision that project entailing?</v>

<v Fallon, Geoffrey W>So I I mean, I think the the genesis of that project is also understanding that you know the the way that we need to support our EHR needs to shift you know many of us implemented Ehrs years ago and really at the time made a lot of decisions based on our organization or our users. And now we're realizing that we need to be more efficient, there's more cost pressure in this industry than there ever has been before. The pandemic has really highlighted that.</v>

<v Fallon, Geoffrey W>We need to be as efficient as we can, so our we're gonna work with epic and go through a refuel process to really look at our have we built everything as efficient as efficiently as possible? Are we leveraging the newest and best build that's available from our vendor because we need to be able to support this, we need to be able to provide the best, newest features and we need to be able to support it in a much more efficient manner.</v>

<v Fallon, Geoffrey W>And.</v>

<v Jordan Cooper>Can you give me an?</v>

<v Fallon, Geoffrey W>And we we know that we've kind of, you know, when when you start an EHR implementation, you often don't start it with the idea of long term supportability in mind. So we're gonna need to go back and revisit some decisions we've made in the past and really streamline things to make it easier.</v>

<v Jordan Cooper>Can you give me or in our listeners an example of what sort of decision you might have made differently when you first on boarded with Epic a few years ago? Had you been thinking of long term sustainability?</v>

<v Fallon, Geoffrey W>Yeah, I would say U M1 would be you know just the way that we build our users, right. So you know as a new hospital came on, they may have said though our medical assistants do that differently and at the time we said great, well, we'll add you a new role for your hospital's medical assistance. And then next thing you know, you have 10 different ways to assign a medical assistant their security in our EHR and.</v>

<v Fallon, Geoffrey W>When a new one gets hired, you know we're trying to do our best to assign them correctly.</v>

<v Fallon, Geoffrey W>Or maybe, uh. You know, we have other areas where.</v>

<v Fallon, Geoffrey W>As you bring on it, uh, new physical therapy group, they say, well, I wanna do my documentation differently and we say great. Well, we'll rebuild this for you. And now all of a sudden I have two different ways that you can document a physical therapy note.</v>

<v Fallon, Geoffrey W>And and when again a new person starts, it's really hard to train them on what the right way to do it is.</v>

<v Jordan Cooper>So it sounds like how'd you been planning for long term sustainability when you first did an epic go live, you would have presented a more standardized approach and would have been less flexible with the different requests of different user groups resulting from M&A, is that right?</v>

<v Fallon, Geoffrey W>I think so. I mean I for us, I don't think.</v>

<v Fallon, Geoffrey W>I don't think we look at as a loss of flexibility. I think we look at it more like.</v>

<v Jordan Cooper>Yeah.</v>

<v Fallon, Geoffrey W>And if we got everybody, if we get everybody together and make the decision once, it just makes it so that everybody can work smoother and cleaner going forward. I think sometimes you try and accommodate a lot of requests and what you end up with at the end is a lot of people who get what they want. But then when you look at it, when you step back and look at it as the sum of all of those decisions you made, you realize, wow, if I had made some of those decisions differently, it would be a lot clearer how to.</v>

<v Fallon, Geoffrey W>How to log in and do your job right now and and sometimes you know we haven't made it that clear on. That's the on how to get your actual work done.</v>

<v Jordan Cooper>Well, that's a good lesson learned. I know that many CIO's listening right now have gone live on, whether it be epic or Cerner or Allscripts, some EHR system in the last decade or two and maybe asking themselves quite the same questions as you, how did you address the need for more efficiency and cost savings and the balance of meeting the needs of different requests of stakeholders with the needs of the whole system to have a streamlined, efficient and standardized process is, I think, a question that many different CIOs will be balancing.</v>

<v Jordan Cooper>Or at least trying to address in their minds.</v>

<v Jordan Cooper>UM speaking about different kind of needs and balancing different responsibilities. Jeff, you're transitioning off the Board of Directors of Health Info NET, which is the operator of the state of mains statewide health information exchange or pie. What's your relationship between main health and health info net and how are you able to, how are you balancing those relationships in your own professional career?</v>

<v Fallon, Geoffrey W>So our main health role of health info net is we are the largest contributor of data to to the statewide HIE. We Maine health is the largest healthcare organization the state and we've partnered with Health Info net to make sure that we have always had someone from Maine health on the Board of Directors you know really as their largest kind of contributor of data and also user of their data it's been.</v>

<v Fallon, Geoffrey W>Helpful for us to have someone who can advocate and and make sure that.</v>

<v Fallon, Geoffrey W>That we are reviewing kind of how we use the system.</v>

<v Fallon, Geoffrey W>I think me health info net in general is very proud of the fact that they were one of you know on the leading edge of really successful regional healthcare information exchanges. They have a great track record of getting data from all of the most of the major organizations in the state. And then so they're participation is excellent and the ability to use that data to drive care is really excellent as well. So we have been.</v>

<v Fallon, Geoffrey W>You know from the outset, happy to be giving, making sure that we're contributing as much data as we're as we can to stay creating that statewide repository of patient data.</v>

<v Jordan Cooper>Do you have any use cases that you're able to share about how Maine health has been using information from health info net, for example, a particular patients care journey and how that could have gone awry if not for the information made available through the HIE?</v>

<v Fallon, Geoffrey W>You know, I think I don't have single patients prepared, but I mean I think when you look at our usage statistics, you can tell that people are using it to drive care on a daily basis and you know the way that we are connecting for Health Care now.</v>

<v Fallon, Geoffrey W>Is really grown in the past few years. I mean, Maine has now connected to an organization and all 50 states as far as.</v>

<v Fallon, Geoffrey W>As far as sharing, sharing healthcare data, you know our providers and our care teams use health info net data to.</v>

<v Fallon, Geoffrey W>You check particularly in areas that have multiple healthcare facilities you can. It is a great tool to be able to see exactly what is happening.</v>

<v Fallon, Geoffrey W>Umm, outside the walls of your institution. And I think we're all excited for things like teffa that are coming in the future. The Trusted Exchange framework to see if we can make that.</v>

<v Fallon, Geoffrey W>And make the idea of collaborating with our peers across the industry even better and make that data more unable to be exchanged and really consumed into one electronic health record instead of just viewed in a centralized hub.</v>

<v Jordan Cooper>So you said that one reason why Maine Health would always like to have a representative on the Board of Directors for Health Info NET is because Maine health is one of the largest contributors to and users of health info Nets data. Do you have any examples you could share of something that you have on behalf of Maine Health have advocated for some sort of position that you have sought to advance within the context?</v>

<v Jordan Cooper>Of the board of Directors of Health Info Net.</v>

<v Fallon, Geoffrey W>Umm.</v>

<v Fallon, Geoffrey W>I think.</v>

<v Fallon, Geoffrey W>I think a lot of it has been around the structure. UM, I think we have some unique concerns around things like cyber security and you know, as a large as the largest player.</v>

<v Fallon, Geoffrey W>And the large contributor of data, I mean, I think we have the most at risk as far as data that we're contributing. I think that's been a conversation that we've been working to advance and you know what, I think everybody in the industry has, this is a topic that we talk about every day and how much data do you wanna let outside your walls.</v>

<v Fallon, Geoffrey W>Because all of those like you know, all that data is now outside of your control. And I think we've been kind of on the edge of advancing that conversation.</v>

<v Jordan Cooper>So how have you been safeguarding data and how do you determine how much data to let outside your walls?</v>

<v Fallon, Geoffrey W>I think I'd have to. I'd really have to phone a friend to answer that question and talk to our our.</v>

<v Jordan Cooper>Yeah.</v>

<v Fallon, Geoffrey W>Chief Information security officer.</v>

<v Jordan Cooper>Yeah, alright. Well, so cybersecurity is an issue and making sure that the HIV I guess that only that how do you I mean is there a way to draw the line, how would you distinguish between information that you think clinicians should have access to outside your walls and what may be the boundary of what's appropriate to share that you may wanna keep inside, do you have a sense of how to draw that line?</v>

<v Fallon, Geoffrey W>Yeah. I mean, I think to us it comes down to you know, are we going to send data to an outside data store like a Regional Health information exchange or do we wanna be part of something like taffeta? That is really more of a point to point connection. And I think we as an industry are kind of feeling our way through that. I think if we had our way, we would really.</v>

<v Fallon, Geoffrey W>We would wanna be more in that point to point connection and environment. The hard part is then you're missing some of the things that health info net does. They have a great analytics package that can help with predictive models on things like risk of readmission and they can cross multiple facilities in determining that risk.</v>

<v Fallon, Geoffrey W>And a model, you know, a point to point model misses that. So I think it's something that we're all feeling our way through right now, which is what is, what is the best way for us to balance the risk of having our data outside our walls.</v>

<v Fallon, Geoffrey W>And but also you know the.</v>

<v Fallon, Geoffrey W>The feet, the abilities that come with having that kind of centralized data to be able to run analytics on.</v>

<v Jordan Cooper>But.</v>

<v Fallon, Geoffrey W>And I don't, I don't think we have an answer. I think it's, I mean we continue to work through.</v>

<v Jordan Cooper>So we are approaching the end of this podcast episode. Jeff, I know it's come very quickly upon us. This has been a lot of fun, a general theme I'm picking up on over the course of this episode is how are we balancing different things? How are we balancing the needs of meeting an individual departments request versus the needs of the whole organization to improve efficiency and streamline workflows? How do we balance the need to keep individual patient information secure with a point to point access?</v>

<v Jordan Cooper>Versus balance and needs to care for population health.</v>

<v Jordan Cooper>I guess as we wrap up this podcast episode, I'd like to ask you one final time. One final question, which is, you know, how would you speak to CIOs around the country who are who are struggling to balance different priorities? Is there a way that you have developed to better balance your priorities?</v>

<v Fallon, Geoffrey W>You know, I think also's leaders in healthcare IT, that's our goal right now, right. There are so many different competing priorities. And how do we balance them? I think our real challenges to build strong governance and leverage that so that we have people that ask these questions to say how do we make the decision, how do we balance our ability to be streamlined with that to be able to customize and where do we.</v>

<v Fallon, Geoffrey W>Where do we how do we balance our?</v>

<v Fallon, Geoffrey W>How do we balance all these different initiatives and and I do think the key is really having strong governance and strong communication with my peers and we just have to continue to build those relationships and build strong governance to help us answer those questions.</v>

<v Jordan Cooper>Well, Jeff, you couldn't have said a better answer for a podcast, which is the best way to balance priorities is to have conversations, which is exactly what healthy data is all about. So Jeff, I'd like to thank you for joining us today.</v>

<v Jordan Cooper>This has been for a listeners Jeff Fallon of Maine Health, the VP of Clinical and Business applications. So they, Jeff, thank you very much for joining us.</v>

<v Fallon, Geoffrey W>Thank you.</v>