How Hopkins’ CIO Built a Collaborative IT Culture

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Stephanie Reel had what some may categorize as an insurmountable challenge — pull some of the best doctors in the world away from their hectic schedules to chat about IT. Tapping her penchant for innovative thinking, Reel, CIO for all divisions of the Johns Hopkins University and Health System, guessed that maybe the way to a doctor’s heart was through the stomach, not the sternum.

Chicken, wine and IT

That was two decades ago, and her Monday night chicken dinners are still going strong. Dozens of diners come ready to chow down, drink wine, learn from an interesting speaker and chat about the IT tools they’d like to help develop.

“They don’t expect us to go fix their problems,” she says, “but they do expect us to be available to work with them to invent the future.”

Reel doubts she could get such a group together to hash out IT strategy over chicken and wine at just any institution, but the culture at Hopkins allows for just that type of gathering, and it’s an ideal forum for collaboration.

She brings up the often-paraphrased line inspired by the movie Field of Dreams, “If you build it, they will come,” and recalls the adaptation she learned from a friend: “If you build it together, they’re already there.” That’s the approach Reel has taken to building Hopkins IT over the past quarter century. She builds with Johns Hopkins University’s top-notch professors, students and researchers in mind, embracing the challenge with consistent, innovative collaboration that helps inform her strategy across the multiple sites and users she serves.

Finding similarities

Reel “grew up” professionally in health IT and states unequivocally that it is her passion. She also admits to a bit of schizophrenia when she added the mantle of university CIO in 1998. In the early days of holding posts at both institutions, she would sometimes change her wardrobe to adapt to the professional culture at different campuses.

Eventually, she realized that it made more sense to seek similarities instead of differences — and that she could dress the same no matter where she went.

“We said, patients and students are both paying customers, and they both have high expectations,” Reel remembers. “They both come to Hopkins expecting miracles — one needs to get a whole lot smarter, and the other needs to get a whole lot healthier.” So Reel pulls in professors, researchers and students as on-campus collaborators in parallel to physician and nurse consultants. Her approach is general enough to work in multiple settings but still allows her to account for some big differences between the university and the health system.

Addressing differences

Free exchange is essential in university-side academic research, and there are many multicentered initiatives that link parts of JHU to one another and to outside collaborators. On the health-system side, Reel and her collaborators stick to the letter of the federal Health Insurance Portability and Accountability Act (HIPAA). The law emphasizes patient record privacy, security and confidentiality, in addition to accessibility.

Reel notes that 52,000 patients in the Johns Hopkins Health System now have full access to their medical information using MyChart, a HIPAA-compliant personal health record (PHR). They can ask doctors questions based on the information contained in their online record, view lab results, reports, medications and diagnoses — and, above all, gain understanding. Data from within the Hopkins system over the past decade are standardized and brought into the PHR, and Reel is working with her counterparts at other Maryland health systems to launch more regionally integrated PHRs. “I think it’s created a much more empowered patient, and it will get even better over time as people use it more,” she says. Doctors are also getting accustomed to the new platform.

“At first, doctors were nervous about the tool, thinking that they might get phone calls at all hours of the night,” Reel recalls. It didn’t turn out that way, in part because patients who learn to use MyChart know where the information is and how to investigate their own health data. Information access is fueling better doctor-patient dialogue, and people in Reel’s network keep their eyes open for her as they go about their rounds. Reel counts among her allies about 140 “physician champions” and hundreds of nurses who are actively engaged in providing feedback about what they do and how they do it. That real-life usage data makes the systems better for everyone.

Two heads are better

The physicians, nurses and others who make Reel’s chicken dinners a 20-year success story aren’t IT pros, but they are heavy consumers of technology — and they know when things are working and when they aren’t. “It’s running slow today,” doesn’t cut it when a researcher needs to send a big grant application or while a doctor is shuttling between the hospital and private practice.

The dinners aren’t a place for pretense. They’re a place for open exchange about user experience and the types of IT tools healthcare professionals need so they can better serve patients now and in the future.

Reel expects doctors, patients, professors, students and all of her other collaborators to keep challenging her. The internet and people’s expectations of what information can do for us have evolved dramatically since she began, and this evolution is ongoing. The certainty moving forward is that collaboration (and chicken dinners) will continue to drive innovation, keeping Johns Hopkins on the cutting edge of higher learning and healthier outcomes.

Originally published in SmartCEO Magazine, March 2014

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