As University of Kentucky HealthCare’s CMIO for ten years, Carol Steltenkamp has gotten a daily dose of appreciation for how far IT has come during her lifetime. “When I went to college, IT was much more about large machines in basements of buildings with punch cards and all that,” she recalls, chuckling.
In sharp contrast with that image is, of course, any snapshot of modern-day teenagers and young adults wielding portable electronic devices of all kinds with ease and expertise. “They would not consider doing things without using a computer,” she says of millennials. “It’s their expectation of having information at their fingertips for whatever it is they’re doing. It’s a given, and the healthcare industry needs to meet that expectation.”
Steltenkamp has done her part and then some, as far as the State of Kentucky is concerned. A still-practicing pediatrician, she returned to school for her MBA, and there, she was exposed to IT and consequently grew excited for its prospects in medicine. “I could see the vision of how we could use IT to improve health and healthcare,” she says.
Around the same time, UK HealthCare was in the midst of choosing an EMR for the first time. Steltenkamp’s involvement turned to leadership, which led to her roles at UK HealthCare, first as physician champion, then medical director, and finally as CMIO—the physician acting as a liaison between all other clinicians and the IT department. “Early in my career, that would be someone who translates a clinician’s medical record into reality,” she says. “Now, it’s about leading the implementation of EMRs.”
But Steltenkamp’s work has extended well beyond UK HealthCare’s ample boundaries. Steltenkamp also served as principal investigator for a grant received by the Kentucky Regional Extension Center (REC) that brought in more than $10 million so that smaller providers could implement, adopt, and use EMRs as well. The US Health Information Technology for Economic and Clinical Health (HITECH) Act, which is part of the Affordable Care Act, allowed for the entire state to be covered. “That was incredibly ingratiating,” she says. “I really felt good that we were able to lead the Kentucky REC. The grant dollars are gone, but they continue in a nonprofit way now.”
In addition to all of this, Steltenkamp is also cochair of the board for the Kentucky Health Information Exchange (KHIE), an organization that helps facilitate patient care when going beyond their hometown becomes a necessity. Plus, Steltenkamp only recently completed her term as chairperson of the international board of the Chicago-based Healthcare Information and Management Systems Society (HIMSS), where she says she had the privilege of being involved in the nonprofit organization’s transition from national to international. The impact of HIMSS—which operates with the goal of using IT to improve healthcare rather than to simply make records more accessible—can now be felt in Europe, Asia, and parts of South America and Australia.
“If you want to stay in the game of educating our next generation, you have to be on top of that, or the patients will go elsewhere.”
Regardless of location, Steltenkamp has found that clinicians in their forties and fifties tend to be the most difficult to convert to EMR technology. “It’s difficult to be an adult learner and change the way you do things,” she admits. But she knows how critical it is for that change to happen.
“If you want to stay in the game of educating our next generation, you have to be on top of that, or the patients will go elsewhere,” Steltenkamp says. “That’s where the demand is. They have to shift. Even if the doctor is thinking, ‘Why change? It’s just between me and my patients,’ it’s not. It’s also about the residents and other younger personnel. You have to change for them.”
Change in her home state is perhaps Steltenkamp’s greatest source of pride, with Kentucky REC and KHIE making it possible for people in smaller and/or more rural communities, such as the Appalachians of eastern Kentucky, to get EMRs. The goal, of course, is for the technology to manifest as improved healthcare. “To be able to step outside of the university while having UK’s blessing . . . what a great opportunity to go out and serve and help others,” she says. “Which is really the right thing to do for all our patients.”
As for the future of UK HealthCare itself, Steltenkamp looks to continue putting it in a position to meet the needs of the Medicare Access, as well as the US CHIP Reauthorization Act of 2015 (MACRA)—to step up to that federal regulation, she says. Continuous evolution and optimization of EMRs is key to that process.
“I also want to beef up educational offerings around health IT,” Steltenkamp says. “All six medical colleges at UK are within walking distance of each other, which allows for great collaboration possibilities.”
Those collaborations can now be shared with the entire state. “UK HealthCare is truly dedicated to the citizens and the commonwealth of Kentucky,” Steltenkamp says. “That’s what makes it a privilege to serve here.”