HIStalk Interviews Shelli Williamson, Executive Director, Scottsdale Institute

Shelli Williamson is executive director of Scottsdale Institute of Minneapolis, MN.

Tell me about yourself and about Scottsdale Institute.

I have been in healthcare all of my life. I spent 21 years with the combination of American Hospital Supply Corporation and Baxter Healthcare in a variety of roles. I was fortunate to get a broad perspective on different components of the healthcare system through those years.

When I left Baxter, I joined First Consulting Group, where I was immersed in the IT world. I was introduced to the Scottsdale Institute through that relationship. I’ve been at the Scottsdale Institute managing our programs for about 12 years.

We are a 501c3 not-for-profit association, primarily consisting of large health systems. We are designed for networking and collaboration among our members. We’re here to help our members help each other. Scottsdale Institute acts as the convener for systems to learn from each other and share what they’re doing as it relates to strategic information technology-related initiatives. Boy, has there an never been a better time for talking about that.

Our programs consist of face-to-face initiatives, such as our conferences and collaborative meetings. A lot of virtual activities — we do about 80 teleconference sessions a year. Last year, about 10,000 people participated in our live weekly teleconferences. We do two publications a month. We really want to act as a convener to help people share what they’ve learned and hopefully help people avoid reinventing the same wheels that are being reinvented across many health systems.

How do you position your group against VHA, Premier, CHIME, and HIMSS Analytics?

There are many excellent groups out there. We’re not a GPO, so we have no GPO-like activities. Certainly many of our members belong to all these other groups as well – it’s not an either-or and I wouldn’t try to position it that way. 

Our meetings are designed for executives of all types, so we’re not functionally organized. It’s not just CIOs, CMIOs, CMOs, and CEOs, but rather all of the executive types together. I think people enjoy that idea of being able to exchange different perspectives based on the fact that chief nursing officers are in the room with CIOs and CEOs and others.

We do not technically do research. Some of the groups that you might think of publish research papers and do those kinds in-depth studies. Our activities are more peer to peer — networking, collaborating, sharing of information. It’s more in the trenches. It’s not academic in any way. It’s really how we’re doing things that we’re doing, what we’re learning, what we’re doing well, and what maybe we didn’t do so well and might do differently another time. It’s more those kinds of exchanges that we try to support and foster.

The other thing that might be noteworthy is that our membership is a flat fee. We do not have a limit to the number of seats or people within the organization that can participate and download and access and so forth. Some of these large health systems, such as Ascension Health, Trinity, and others … there are many hundreds even bordering on thousands of actual users within those organizations that access SI resources and participate in the weekly discussions.

From that perspective, it’s a great value for these large health systems who want to expose their team members to education and these kinds of collaboration opportunities, but without the cost of necessary travel and being away from the office.

Also, our benchmarking service is open to all health systems, not just SI members, and is no charge as part of our 501c3 mission.

I see on your website that you offer some conferences and publications. What kind of topics do you typically cover?

Our conferences in recent years have been focused around reform-related activities. Anyone can see all of agendas for our conferences on our website. Those links are public,  so anyone can feel free to browse the agendas.

The face-to-face meetings are small, intimate by design, and exclusively for the senior officers and senior management teams. While I mentioned that we will have a variety of title types at these meeting, this organization was started 19 years ago by a handful of CEOs who saw the writing on the wall that IT was going to be strategic and wanted to start this organization to provide a venue where people and executives can look at IT from a strategic point of view.

I think 19 years ago … that was very, very forward thinking. We take that for granted, but at that point in time, the genesis for Scottsdale Institute was the idea that IT was going be strategic. We still keep that as a main focal point of our conferences and publications.

The publications, in a similar vein, are written for the busy healthcare executive so that person — be it a CFO, CNO, or board member — can get a handle on what these challenges are around IT and begin to understand and appreciate things that all of us in IT know and are near and dear to our hearts. The publications are written in simple English. They are not in tech speak, and are purposely written that way so that busy executives can begin to get comfortable with the IT issues and solutions that their organizations are adapting and implementing.

My experience with IT benchmarking has been mixed. It’s always a tradeoff between doing a survey of reasonable length that someone can complete without becoming frustrated. Also, it’s tough to start up a program like that since you need enough organizations to give participants a good probability of finding benchmark partners that are like them. How do you approach that?

You hit the nail on the head when you talk about the tradeoff between getting every piece of information possible versus something that people are willing to sit down and fill out. We have tried very hard to keep it brief enough on critical elements so that people are able to sit down and do it in 30 minutes.

The purpose of our program is not to try to come up with industry averages or recommendations about what is the right amount of money to be spent on IT. We don’t believe that has any place, at least in the program that we have offered.

What we have done is create a tool where you and your health system or anyone can pick out two, three, four comparable peer organizations based on demographics and then normalize your data with them to see where you are. It creates more of an apples-to-apples comparison. IT budgets are not created equal. Some people include biomed, some include HIM, some include physician or patient portal and their IT budget, some have the CMIO in the IT budget and others don’t. Some have PACS, some have part of PACS, some have telecommunications.

What this tool is designed to do is compartmentalize all of those costs. If you count HIM as a part of your IT shop and I do not, I take your HIM number out, and then we look more and more apples-to-apples. Same thing with biomed, same thing with security and privacy. Even depreciation, which is a huge number. If that’s part of the IT budget in your world and it’s part of the finance in my world, the tool automatically normalizes that information. 

It helps peer organizations get closer. It’s certainly not perfect and nothing is, but it gets a lot closer to apples-to-apples comparison. If you and I are spending the same amount of money but you’re further along in Meaningful Use than I am, that tells us something. I need to learn something from you about what you’re doing.

The other problem with IT benchmarking is the people usually participate because they believe they’re above average and want to back it up so they can tell their organization what a great job they’re doing. But if their expenses are higher, they always question the methodology or the quality of the data from the peers who submitted. What do people typically do if their results don’t show that they’re above average?

Our approach is to help people if they wish to connect with their other peer organizations to see, once they normalize, what is driving the differences. If you’re at HIMSS Level 6 and I’m HIMSS Level 4, that explains a lot money. We have that point of comparison in there as well. Same thing with Meaningful Use data. If you’ve already attested and I’m a long ways away, that could be an explanation — you’re further along in terms of advanced clinical IT deployment.

All we’re trying to do is help people understand the differences. Then, if they wish, connect with these peer organizations to dig deeper into individually what’s going to help each person answer that question.

The end result of benchmarking is you always want to talk to the peer organizations to find out what the survey didn’t tell you. So you facilitate that contact?

Right. I think that’s where the real value is. It’s in the learning. The data is hopefully the beginning point for participants as they work with each other. We don’t necessarily get involved in those discussions. You would be talking to one of your colleagues from another organization without our intervention.

The other challenge that I’ve not seen convincing proof that IT cost correlate to — much less cause – a change in quality. Are you being challenged to help clients prove value beyond just having a reasonable expense?

That is an excellent point, and probably the future. We are not at this moment trying to address that, but certainly cost does not equate to value. That’s what we need to learn — how to equate this IT expense into value. Of course, it isn’t just the IT that does anything — it’s the people on the process. We can’t say cause and effect, but we can show correlation between IT and quality.

Thomson Reuters just completed a study which we’re going to be discussing at our Spring Conference in Scottsdale, Arizona. That actually shows some correlation between the Thomson Reuters Top 100 Hospitals — as the way they measure it — and the use of advanced IT. So again, correlation, not cause and effect, because obviously people have to make this stuff work. But there is a correlation there that we’re excited to be talking about next month.

Any final thoughts?

This is such an exciting time, as we all know, to be in healthcare, and specially to be in healthcare information technology, I feel that every day, somebody says to me, “Thank you for what you all are doing for us.” That just is a very motivating and thrilling kind of place to be.