Karen “K” Marhefka Collaborates Toward Transformative Change

Karen “K” Marhefka grew up in a family divided between two professions: direct patient care and business. By the time she enrolled as a student at East Carolina University, however, Marhefka didn’t see herself following either path. Fortunately, she discovered an alternative in medical records science, a program in the school’s allied health department that falls under the umbrella of the field now known as health information management.

“I realized that I didn’t necessarily have to be at the patient bedside, and I didn’t necessarily have to be an accountant. I could do something right in between, and that really spoke to me,” says Marhefka. “I never would have known in a million years how much that relatively unknown degree program would propel me into what I have to say has been a really fabulous career.”

In the latest stage of that fabulous career, Marhefka serves as deputy chief information officer (CIO) at RWJBarnabas Health (RWJBH), the largest academic healthcare system in New Jersey. Since joining RWJBH in 2020, she has taken an active part in leading the system’s implementation of a single electronic health records (EHR) platform across its many hospitals and medical group office locations, in collaboration with her executive peers.

Marhefka is no stranger to large-scale transformations, nor to team efforts. “I’ve been part of a team since the day I left college and started as an assistant manager in a medical records department,” she confirms. “And I’ve been very fortunate to be on teams where I’ve been able not only to shine in my own way but also to encourage and give space to other people to shine.”

For close to twenty-five years, Marhefka was part of the team at UMass Memorial Health, where she spent much of her time as an operations executive. “I was gaining this wonderful experience about how to take care of patients and how to streamline workflows for providers and staff. At the same time, the healthcare industry was moving more and more toward enhanced EHR systems,” she says. “UMass gave me a wonderful opportunity to take both my operations experience and my passion for what was happening in the health information technology world and help lead the huge transformation for that organization to go from predominantly paper to electronic.”

Following the conclusion of the project, Marhefka pivoted to the consulting world to assist other healthcare organizations in making the same transformation she had just facilitated at UMass. A decade later, she was ready to pivot again. “I had an opportunity to go back to the provider space to a large organization that was, again, going through a large transition—not from paper this time but from disparate EHR systems onto one single EHR platform,” she explains. “That organization was RWJBH.”

Today, as one of two deputy CIOs reporting up to enterprise CIO Robert Adamson, Marhefka focuses on RWJBH’s ambulatory space. “My day-to-day role is to collaboratively make sure that everything is working well from a technological standpoint for the organization and then, from an ambulatory-focused applications standpoint, that all of the tools are in place for clinical documentation and patient care when it comes to health information technology,” she elaborates.

Beyond that, Marhefka shares responsibility with some fifteen other leaders for the massive undertaking of bringing all of RWJBH onto the same EHR platform, Epic. “We’re almost into the fourth year of the five-year journey to implement Epic across our entire organization,” she says. “The plan includes six waves, or go-lives, which has given us the opportunity to learn from one wave to the next. There has been constant improvement from how we did things in wave one to how we’re doing things now in wave five.”

Marhefka credits the project’s leader, Adamson, with putting in place a framework that has prioritized patient safety as well as problem-solving by committee. She approaches her own role as a leader through the lens of teaching.

“I’ve noticed over many years that, given how complex our industry is and how complex IT is on top of that, it’s very difficult for lay folks to understand how data works,” she says. “I learned early on that the more I embraced and employed the teaching aspect of my leadership style, the more I sensed an appreciation for clear, simple explanations.”

Her background in operations—including a doctorate in healthcare administration—only enhances Marhefka’s ability to break down technical topics for her non-IT peers. That background also gives her a leg up when it comes to being proactive and strategizing around RWJBH’s next steps, which will entail continuing to strike a thoughtful balance between embracing emerging technologies and accounting for what patients and providers actually want from their digital tools.

With the Epic project nearing its conclusion, Marhefka is eager to lend her insights to RWJBH as the healthcare system embarks on the next chapter of that balancing act.

“Where do we go now? What are the most important things for us to focus on that make sense for us? Every organization is different in what they see as their digital journey,” she says. “I am honored to be part of the leadership team that undertakes those questions at RWJBH.”