September 27: Today on TownHall Karla Arzola, Director of Information Technology - Swedish Medical Center at HealthONE speaks with Deanna Towne, CIO at Contexture about Contexture’s recent merger of HIE’s. What was the strategy behind the recent merger? How did Contexture plan for the merger from a change management perspective? What are some key technology initiatives currently being worked on at Contexture?

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Today on This Week Health.

I think we've evolved from, Hey, we need to make sure people have data to what we really need is to make sure they have actionable information. And they're not the same thing.

It's not the same to just send someone a whole bunch of adjust seven data. If they can't do anything with.

Welcome to This Week Health Community. This is TownHall a show hosted by leaders on the front lines with interviews of people making things happen in healthcare with technology. My name is Bill Russell, the creator of This Week Health, a set of channels designed to amplify great thinking to propel healthcare forward. We want to thank our show sponsors Olive, Rubrik, Trellix, Medigate and F5 in partnership with Sirius Healthcare for investing in our mission to develop the next generation of health leaders. Now onto our show.

Hello everyone. My name is Carla Sola and I'm the it director of Swedish medical center, an ha hospital here in Colorado. And today we have one of my favorite women leaders in Colorado Vienna town. Deanna is the CIO of contextual, which is the health information exchange for Arizona and Colorado.

And it is the largest H IE in the Western region. Deanna previously served as a it director and acting deputy chief customer officer of the governor's office of information technology. And last month, Deanna was honor as CA of the year in the corporate category of the Colorado or the awards. So, Deanna, thank you for sharing this space with us and welcome.

So why don't you introduce yourself?

Thank you so much, Carlin, really a pleasure to be here with you today and have an opportunity to partner on something that seems so exciting and so fun. So thank you very much. Very thankful to be part of this. Again, I am the chief information officer at co.

I have been in the HIE space for about four years now in it for, well over a decade, most of my career was in the public sector. So I've spent a lot of time in state and local government and am just really excited to be part of such a, an important and fast moving and fascinating industry of healthcare information technology.

Awesome. Well, thank you Deanna, for that. And something else that I wanted to bring up is September is Hispanic heritage month, and the timing couldn't be better. I know Deanna that you have a Hispanic background and before we talk about your work, can you share a little bit about your heritage and maybe a fun story or a fun.

Absolutely. I was born and raised in Pueblo, Colorado. My grandparents were both born in Mexico, my grandmother in MIS con Mexico and my grandfather in a border town Eagle pass on the United States side. My mother's maiden name was Jimenez. A fun fact about my family is that every Christmas like Mami Hispanic families, we make tamales.

And every year, even though our family size goes down, the number of tamales seems to go up. And so last year we made 16 dozen tamales Mollys because the more people find out that we make Tamas, the more ask for it and expect them to be delivered and shared at Christmas time. So a great tradition as long.

My mother has been alive, which she just turned 69 this week. We have never missed a year. So even with the passing of my grandparents, we are proud and excited to carry on that tradition and really enjoy doing that as a family.

Oh, that's amazing. So, what is your favorite flavor? I have to ask,

I'm a basic, I love the pork cut pork red chili inside.

Although we have made the sweet smallies with raisins and sugar and all sorts of different, but for the most part, I'm a traditional, the hotter, the better.

That's awesome. But thank you for sharing that with us. I know I've heard. I mean, we talked before and you are my fellow Mexico. I'm from Mexico too.

So it's always fun to hear other stories and, it seems like everybody has something in common. I mean, we do the same thing my grandma passed and unfortunately after that, nobody in my family cooks. Tamales anymore.

Well, come make Tama.

I'm have to thank you for that. Yes.

every year. Every

absolutely.

Absolutely. Well, thank you. So, okay, so let's jump into business. We talk about, and we talk about to HIEs and I know that was a recent merger. And so can you give us a little bit of background and share with us? What was the strategy behind.

Absolutely. I think we see this in across the health information exchange market overall.

A lot of mergers acquisitions, consolidations. I think everyone recognizes that the days of a patient going to one place and being seen in one facility only are having a single primary care. Doctor or staying in one place, those just don't exist. And so the more information, the more data, the more clinical meaningful data that we can fold together to give our providers and the healthcare community, trying to serve our patients, the more holistic view of the patient, the better.

So a great driver of our merger was we had two very large HIEs in states with close proximity, doing very similar functions. And so as it overall, I mean it expense just continues to increase. As new threats are out there in risks, new security features are needed and new security packages, and it just is this continually increasing cost center.

As we're able to pull similar functions together. We should see additional economies of scale and slow the rate at which we see it expense increase while promoting a more holistic picture of the patient.

Yeah, you're absolutely right. And so speaking of that, right? So you bring two big companies together and obviously everybody has different processes, different technology.

Just different people period. And so, obviously during a big merger, there's

you know,

you have to have a very solid management or change management process to be able to be successful and make sure that those two organizations are aligned. So, can you talk about that and how do you prepare for

this?

Absolutely. I think there are two components of change management and both are equally important. The first is. Organizational change management. How do we make sure that our people are coming on board, that they buy into the, idea they're supportive and that they feel part of the process. And that started at the very beginning of the merger room and will continue well into the future, the technical change management has been something that I'm really passionate about.

We leverage it, service management, kind of the principles following Itel it information library and have pushed out a fairly rigorous. Technical change management process. So we have a policy in place. We have a process that's followed and that has really allowed us to be very thoughtful in the way we make changes to our production environments.

That's been especially important as now. We're trying to manage multiple we're managing in a too large health information exchange infrastructures across two states. So being really thoughtful about the way we push changes into our environments and ensure that we really understand. What the touch points are, what the risks are.

Do we have a rollback plan? Just to make sure that as we're trying to evolve and merge and bring infrastructure together, that at the end of the day, our most important thing is that we do no harm to our current participants. We want the systems that they've come to rely on and value to be there when they need them.

And so our technical integration can't put that at risk. And so we work really hard. To do that. It's of course not always perfect. Sometimes we push a change and it breaks something and that's where, again, it, service management is so valuable because we also have stood up major incident management where we have a really formal process of something happens.

What do we do? Who's called in? Who responds? How do we respond? How do we document? And then of course that flows right into problem management. So once you get on the other side of getting the systems back up, what were the root cause? Not just the system went down, but why. What exactly happened and how do we make sure we don't repeat it in the future and making sure we have documentation at every step along the way.

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Absolutely. And so during the transition, right, I'm sure you've had, I mean, many successes obviously, but I'm sure you've had challenges as well. Can you talk about both and how do you guys, approach either of those challenges and success.

One of my favorite principles of not just leadership, but just approaches to the day to day work is continual service improvement to be willing, to try new things.

And that really does take, I say this all the time, but it takes a level of confidence. I think one thing that we've done really well is we're willing to try. We're willing to change. We're willing to fail and it's fail fast, fail often. Learn from it, pick it up and do it again. you know, I love that about if, you would think about a toddler learning how to walk, they don't take a few steps, fall and decide.

Nope. Tried. It didn't work. I'm over. It's not gonna happen again. They pick themselves back up, take a few more steps, fall again, and it's that process by which they then learn. And then of course, all of a sudden they're walking and you're like, well, you please stop moving. But I think that that's one thing we've done really well within contextual as an organization is we are willing to training things.

We're thoughtful about it, but we try it and then if it doesn't work. Start right back over and do it again. And so, , as we're bringing in infrastructures and new processes and trying to take lessons learned from two organizations we're gonna hit those bumps over and over, and we're just gonna keep going because at the end of the day, I think just like that little person, the end of the day needs to learn how to walk.

As an organization, we need to learn how to cohesively function and keep moving and again, deliver products and services that help the community. Who's trying to take care of the people who need.

Awesome, but that's awesome. I'm so happy that it's, obviously going well for you guys.

You've been on this journey for quite a bit, but officially your marriage, I believe somewhere mid last year. Was it April, may,

July 1st,

July 1st,

20, 21 time flies. I'm not so happened, but yes,

I know it is crazy. It's going by too fast. And so, what are some of the key technology initiatives that you guys are working on?

Right.

Our primary focus right now is again, kind of consolidation and integration on just on a given month, we bring in 55 million plus HL, seven messages. All of those messages are identity managed. We provide normalization and terminology services. And so we really are at just this massive repository of data.

One of the efforts that I am the most proud of and have been the most excited about, and I can't wait to see really grow legs and, start being spread across many communities in both states is of consolidated care summary product. We built this in close partnership with our partners at HCA health.

One. It's a product that's really cool because when a patient shows up in an ER, the ADT message that's automatically triggered from the EHR and already coming across to us automatically in the interface, we use an, a one or a oh four trigger. The second that hits our infrastructure, we go and gather all of the HL seven data from hospital centers and all of the ambulatory data that we have from various clinics.

We normalize it, we do duplicate it and we remove all of the health, one data and drop it right back via direct, secure mail into an inbox. So that then the data is parsed and the provider can get the information they need. On average. I think it, last time I looked, it was less than 10 seconds. So from the admission trigger, 10 set plus 10 seconds that provider has all the information that's in the HIE and what a robust amount of information, whether it's coming from skilled nursing facilities, pediatricians, we now have connections with this, a wide range of different types of facilities so that emergency room physician can actually provide the best care because they have the most information.

And it's not just a whole bunch of data that they can't get through. It's been cleaned. And when they're not seeing echoes, they're not seeing the same data they already have in their EHR. It's actually value add data. And I, just think that that's a product that really can make a huge difference in patient care.

Wow. That's amazing. Cuz really that's really what we need in order to be able to take care of our patients. Not only when they come to the hospital, but obviously. Post care. And that has always been one of the biggest challenges in healthcare is the interpretability right systems and having a HIE that is able to provide that information is extremely valuable.

And so you mentioned health, one being one of the health systems doing this. Do you have more candidates? I mean, are you planning to expand this to other healthcare systems or what's that.

Yeah, absolutely. That's a great question. So a couple things, one is that the use case I just described was built, like I said, in partnership with health, one specifically for the emergency room use case, but the same technology can be used for a member file.

So if someone, if an organization's trying to do risk stratification or wants to get all that information on just their standard patient list to have in their, eh, We can do that as well without a problem. So there's a lot of flexibility there. We recently moved to a new pricing model that is enterprise pricing.

And what that allows is for most of our large hospital systems that have now shifted over to enterprise pricing. A they have full access at the platinum level to all of our products and services. But B in a lot of cases, it's much more cost effective because it includes support for the hospital transformation program too.

What I think will happen as a result of those hospitals shifting to the platinum agreement, it includes our consolidated care summary product in their packaging. So I think we're gonna see a lot more coming knocking on the door. We also can filter it by the specific facilities. If someone just wants data.

From a specific center, a specific facility. I only want data from this facility. We can send just that too. So lots of flexibility there. And again, I think we've evolved from, Hey, we need to make sure people have data to what we really need is to make sure they have actionable information. And they're not the same thing.

It's not the same to just send someone a whole bunch of adjust seven data. If they can't do anything with. Right.

Absolutely. But that's super exciting. And like I always sell my CIO executives especially in our Colorado community. I mean, I appreciate all the work that you guys do, cuz you're really committed to the care of our patients and our population.

So, it's very exciting to hear that we have passionate people such as yourself doing, great work. And is there anything else you wanna add, Dean?

I wanna say thank you so much, Carla to you for, having me and for doing something so exciting and wonderful. It has been a pleasure to get to know you and many other health. Care leaders, I think now is the time for all of us to make a difference.

And we'll do that by working together by recognizing we share the same challenges, we have the same opportunities sitting in front of us. And the more that we can collaborate and share information and learn from one another, the better we're all gonna be on the other side of it. At the end of the day, of course, we all need to make sure that our organizations can stay in business and function, but we really do all care about patient care.

And I think that's the goal and that's where we're all moving.

Absolutely. Well, Deanna, thank you so much for your time. I really appreciate it. And congratulations on all your accomplishments. I know there's more to come from you, so thank you so much. And I appreciate the time. Take care.

Thank you, Carla. Take care. Bye

. Thank you. Bye.

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