Inside CHIME: Passion to Improve Healthcare Runs Deep for New CHIME Board Chair

12.15.16 by Matthew Weinstock Director of Communications and Public Relations, CHIME

Liz Johnson, MS, FAAN, FCHIME, FHIMSS, CHCIO, RN-BC
Chair, CHIME Board; CIO, Acute Care Hospitals & Applied Clinical Informatics Tenet Healthcare

Liz Johnson knew at a young age that she wanted to be in healthcare and make a difference in people’s lives. Johnson, CIO, acute care hospitals and applied clinical informatics, Tenet Healthcare, has done just that during her illustrious career. In this interview, the 2017 CHIME board chair talks about her career and goals for CHIME.

What drew you to healthcare and nursing?

When I was about 10 years old, I had a cut on my foot that developed an infection and was taken to Parkland Hospital [Dallas]. The emergency department was extraordinarily busy and intense; there had been a plane crash that night and the injured passengers were being pushed around on stretchers and in wheelchairs. It was very graphic, but I remember making up my mind at that point that I wanted to be like the doctors and nurses who were such a significant part of the scene. In spite of all the scurrying, the disorganization and the chaos, nurses and doctors were making a difference. They were helping these significantly injured people. That’s when I decided I was going to do something in the medical field. Yes, I was only 10, but I was taken in completely.

How long did you work at the bedside?

I worked in direct patient care for about 10 years before I moved into administrative roles. It was an amazing part of my career – interacting with patients and their families in what is often an extremely vulnerable event in their lives. Even though I no longer work directly with our patients and families, I am privileged to be able to provide the tools, technology, data and processes than enable our care providers to make better decisions in a timelier manner and improve outcomes and patient/family/caregiver engagement.

Why did you make the transition to IT?

A year after I finished nursing school, I went to work in a hospital that used Technicon Medical Information Systems, which was one of the first clinically-oriented healthcare information systems. Using Technicon in the late ‘70s meant green screens, pen lights and very rudimentary entries; clinicians were just getting started with clinical documentation. I began to think about how much better it would be for patients if we could document and have knowledge faster at the bedside.

In 1989, I became the chief nursing officer at Dallas-Fort Worth Medical Center. It was the same year that they started using computer systems, but were still way behind on their implementation journey. After taking a close look at the hospital’s systems, I realized that 90 percent of everything we were doing was still on paper, not available, not shareable, certainly not real time. Within a year, I became the hospitals’ chief operating officer and found that the computing options in non-clinical and clinical ancillary departments were much more robust than were the ones being used by caregivers.

In the mid 1990’s, I joined a consulting firm where I was able to use my clinical and operational background to help hospitals figure out how to use systems, technology and data. Right away, I established that I was not a technician. I wanted to explore how we could really start to use data in a meaningful way. At that time, organizations were just stockpiling data so that at some point we would be able to look at trends and determine what things worked and what things really didn’t. I realized that I had to get involved and really start to understand how data works, gain the technical knowledge, learn the lingo so that I could talk to clinicians about what they needed, translate it to technicians, infrastructure builders, and vendors as partners so that we can create systems that actually work.

Along those lines, you’ve been a strong advocate for nursing informatics.

The American Nursing Association describes informatics as a journey that begins with data elements that are turned into information, information that evolves into knowledge, and knowledge that evolves into wisdom. It’s about first cleansing incomplete or inaccurate data so that you can start to involve people that use it. Without creating trust with the data being used, we will never reach the stage where we trust the data to tell us something that is worth acting on. That trust is built by working closely with clinicians. A nurse informaticist is able to help shape what that actionable data looks like for the caregiver at the bedside.

You’ve been extremely involved in industry groups. Why is that important to you?

It’s probably a good combination of the following:

• Wanting to learn from others
• Enjoying the fact that others are learning from me
• Sharing experiences, good/bad/ugly and discussing new ideas
• An opportunity to unify the industry on what needs to happen with important health IT topics,
  establish a strong voice as an advocacy group
• Making sure that nursing/clinicians have a voice in the journey in advancing clinical computing
• Patients, families and clinicians matter to me. I stay involved to keep our voices heard

You also have a strong passion for public policy.

Yes! I want to make certain that our policy priorities stay focused on the right problems to solve. Currently, that means finding ways to support and advance interoperability. Things like data standards and a unique identifier are absolutely crucial in making true patient data interoperability happen. Continued advocacy helps to ensure that the issue resolution is pointed in the right direction even though resolution may feel as if it is moving very, very slowly.

I have always believed that if it matters to you, stand up and be heard. If you wait and take no action, you really are in essence saying I accept whatever happens whether I agree or not.  If you take action, you will not always get exactly what you wanted, but you have offered input and often influenced the outcome.

As you take over as chair of the CHIME board, what key issues do you think the organization needs to address this year?

CHIME will have an unprecedented opportunity to represent our membership and industry with a new administration different from one that we have ever known. It is critical that we determine how to ensure a continuing focus on the power of technology and the use of data in the quest for improving outcomes for our patients. Challenges with managing interoperability and cybersecurity are daunting.  Our CIOs understand the real-life implications of those challenges and are best suited to create implementable solutions and CHIME is best suited to take that knowledge and translate it to initiatives, advocacy and education for both our members and the policymakers at the state and federal level.

CHIME this year will announce a winner for National Patient ID Challenge. We have long known as leaders in the healthcare industry that the inability to identify patients with confidence across multiple venues of care and data exchange leads to medical errors, unnecessary use of healthcare resources and less than the outcomes our patients should expect. Providing a viable solution for identifying patients will provide our members and nation the first giant step toward resolution of this issue.

CHIME will also focus on mentorship and diversity in 2017. Many of our members are well respected, seasoned professionals who have extraordinary wisdom to impart to their colleagues earlier on their CIO journeys. CHIME also recognizes that the diversity of our membership, as well as our emerging leaders, provides opportunities to offer forums to promote diversity and offer networking opportunities to benefit all.

It’s going to be a busy year. How do you ensure that CHIME stays focused on these key initiatives?

Given the number of potential changes, challenges, issues, opportunities, it would easy to become diluted and lose effectiveness. It is very important that the CHIME board, executive leadership and our members determine the most critical components that require our input and expertise, make the tough choices and stay the course. Surprises will arise and we will respond, but then we should return immediately to our core values: Our members and their needs; our industry, the opportunity for significant positive impact; our patients and better outcomes.