Higher Marks at Maryland

University of Maryland Medical System senior VP and CIO Jon Burns on how he helped integrate a major academic health system, leading to improvements on every side of the triple aim

Upon joining University of Maryland Medical System in 2006, Jon Burns helped it start down a road towards consolidation. Ten years later, the major academic system is providing more efficient care and enjoying big savings as a direct result. Burns spoke with AHL about this and other changes he’s seen manifest over his time there.

What’s the secret to overseeing all of the IT and supply-chain operations for eleven hospitals?

Jon Burns: For me, the key is establishing a great team of folks. That team is very energetic, thoughtful, and committed. My job is to give them support and guidance. I’ve been blessed with a great team. It doesn’t matter what level; I think we have a group of folks that contribute to the organization, and they’re really focused and concerned about the health and well-being of our patients. We’ve been able to develop a strong, trusting relationship that gives every member of the team the ability to execute his or her role with integrity and passion.

What went into the process of consolidating IT and supply-chain operations for the entire UMMS?

Burns: When I arrived in 2006, the University of Maryland Medical System functioned more like a holding company of hospital function. It was more of a confederation of hospitals, if you will. We really weren’t an integrated delivery system at that time. However, we’d discussed moving down that path. In 2006, finance had begun a level of consolidation, but even they were challenged functionally because of the lack of a common systems. During the early stage, we spent a lot of time on creating a visual for the organization of what a consolidated IT systems and supply-chain operation would look like, what it would do in terms of providing and laying the foundation of an integrated delivery system.

We did have to take time to understand the environment, the culture, and individual anxieties associated with consolidation. Once the vision become clear, we had to communicate and message along the journey. What has been very important was to keep the vision in sight at all times, even when the route there needed to be modified; forward motion always.

How has this consolidation improved efficiency for the system’s overall operations?

Burns: From the supply-chain perspective, we changed our contract and business processes a great deal. The development of system-wide contracts, which leveraged the scale of our enterprise, now approaching $4 billion, was paramount. That’s a lot of scale that we can leverage, so we try to do that. We are now moving beyond price and are focusing in on utilization of supplies and products to drive even greater savings.

The other thing I’m proud of that the supply-chain team has done along the way is how they established a commitment to community engagement, which grows participation for minority businesses. We have substantially increased the utilization of minority-owned business. Our supply-chain team now looks for these opportunities as a normal course of business for us. It has won at least a half-dozen local, state, and national awards because we are really focused on where we can give minority businesses an opportunity.

From an IT perspective, as we began to consolidate IT functions and applications, it became a foundational element for other system-wide initiatives. As we began to consolidate to a single EMR platform, we created user design centers, which brought together organizational brain trust in functionally similar disciplines who, in many cases, did not know each other. This process facilitates functional leaders working together to define common system standards, and functionality that supports our “one patient, one record” concept.

“Our doctors, nurses, and patients are mobile, and so they must have access to data when they are on the move.”

On the supply chain side of things, how have you managed to help save the organization so much money—$25-$30 million in some cases—every year?

Burns: We have a very talented supply-chain team who focus on critical opportunities. What’s really been important is the engagement of the supply-chain team with our clinical business leadership across the organization. We don’t operate supply chain in a vacuum. We typically engage business and clinical leaders to help us around product selection, buying practices, etc. We’ve established several forums for this to occur. We focus on whether we can scale the medical system, leveraging our GPO, establish joint purchasing ventures, and establish direct contracting relationships when it makes sense.   

The engagement with physicians, nurses, and business leaders helps us with certain buying practices. For example, we partnered with spine surgeons from across the Medical System, led by Dr. Steve Ludwig. Steve facilitated the team of surgeons with our supply-chain staff, and we drove down the number of spine products that were being used in the organization. That will save the medical system approximately $4 million annually.

From the IT perspective, what are the benefits of all faculty members being on Epic?

Burns: Having all of our physicians, both faculty and from those our Community Medical Group, on one EMR platform is critical to our patient care goals. Patient-focused care, we believe, is enhanced when all of the information is put together through a single EMR. It aids in both high-quality and lower-cost medicine. Obviously it is the physicians and nurses that affect that change, but we believe the EMRs are a foundational element that allows them to do that.

We also believe the EMR has been a catalyst for change, and when applied with predictive analytics, best practices, and metrics, we have a real opportunity to enhance the experience of our clinicians and our patients.

What are the challenges that come with improving quality, but also reducing the cost of care? How are you able to use data to overcome these challenges?

Burns: As a good-sized healthcare enterprise, sometimes managing everyone’s priorities is difficult. It’s an ongoing partnership. More recently, we have developed a strong clinical informatics team and are beginning the development of an enterprise analytics team in my areas of responsibility. They have been focused on workflow management and are beginning to create some interesting data analytics models.

We’re pulling data in a real time way out the EMR and through our analytics engine to facilitate actions that will increase quality and lower costs. When we can predict with some level of sensitivity patients that might have a likelihood of being readmitted or who might have an onset of sepsis, we are affecting both quality and cost.  Obviously, from a quality-care perspective, you want to do that right things for that patient, at the right time, and not overtreat them.

What are your ideas on how to engage the new, mobile- and convenience-minded generation?

Burns: It’s a good intersection between the use of technology and keeping the data secure. Obviously, certain mobility has to play a key role in our IT strategies. We have to make sure we deliver the right data to right people at the right time with the right device. As you might think, our doctors, nurses, and patients are mobile, and so they must have access to data when they are on the move.

We have to make sure our technology and architecture has the ability to provide reasonable mobility at different points of time and [on] different types of devices anywhere, from a smartphone to an iPad and PC. However, we also have to make sure that delivery has a high level of security wrapped around that so that the architecture has to be flexible enough to support various cohort groups, and have the right level of security not to compromise the data or the people who are using it.

Why do you believe that the CIO plays such a critical role in healthcare’s large, current upward trend of mergers and acquisitions?

Burns: I’ve been around a long time [laughs], and the role has really evolved in all industries, and certainly healthcare is no different. The job today, I believe, is less about technology and it’s much more about managing the strategic intersection of clinical operations, business operations, and using technology to begin to blend the organization together, assist in advance care, and connect our various communities within the organization and to those we serve.

It really has become more of an operational function than a technology function. My beginnings in healthcare started in finance, I migrated to operations, and I landed in information technology.

That may make me a bit of an oddball, but I think the experiences have served me well. AHL