An interview with one of the most powerful women in Healthcare IT - Dr Robecca Quammen

Following on with our Game Changers features, Finance Monthly speaks to MyConsultQ’s founder, Dr Robecca Quammen – a forward-thinking and results-oriented industry leader, recognized as an advocate for transforming healthcare with innovative management, information technology, and workforce acquisition solutions. Known for leading organizational change initiatives that truly enhance the delivery of clinical care while helping to improve the bottom-line, Becky’s 25-year career in healthcare includes senior management positions in large provider organizations, at the largest healthcare software vendor in the US, and with leading healthcare consulting practices.


As a veteran with 25+ years of experience within the healthcare industry, how did your career path lead to this area of specialism?

From very humble beginnings as a registration clerk in the emergency of a large tertiary hospital while in college, I quickly realized the reward of combining vocation with calling.  Healthcare is an industry that touches every human life at one time or another. Given the current challenges related to cost containment, quality delivery of care, and the health of populations, there is much work to be done. Bringing forward more than 25 years of progressive support of this industry in the form of planning, deployment and support of information systems solutions has led me to my current passion – talent acquisition.

Workforce or talent acquisition, by all rights, should have become significantly easier given the availability of the sophisticated matching technologies offered in internet job boards and online business groups and networks. Our research tells us the opposite is true. Wading through dozens of candidate resumes that have been matched on key words, only to find that the algorithms failed to identify the most important key words, leads to frustration and oftentimes delayed or bad talent acquisition decisions.

Long term vacant positions, recruiting, on-boarding, training, and retention are not only costly and time-consuming, but have a direct negative impact on an organization’s ability to innovate and compete in the rapidly changing healthcare environment. Other industries have introduced modern workforce acquisition methods through the gig economy that challenge the status quo staffing methodologies used in the healthcare industry.  Healthcare is no stranger to “gig” work as locums, traveling nurses, and consultants of every variety serve this industry in temporary positions. With increasing workforce demands, healthcare is primed for new workforce acquisition sources that employ the sophistication of the internet with the expert matching that reduces the time it takes to match temporary, consultative and long-term resources to business and clinical need.


What are some of the key issues that you face in the process of assisting healthcare organizations with optimizing the use of technology and automation?

Daily we see the growing number of unfilled job openings in healthcare and especially in information systems. The revolutionary move toward electronic health records in the past few years has heightened the demand for skilled talent to insure the deployment, support, security, and adoption of technology. When we see key IS or IT knowledge worker positions remaining vacant for months at a time, we are keenly aware of the inability of organizations to keep up – to remain competitive in their markets. Now more than ever, it is essential, due to the reliance on automated systems, to maintain and strategically grow these systems and to achieve that, it requires a qualified and predictable workforce.


You were recently selected as one of the 75 Most Powerful Women in Healthcare IT by Health Data Management Magazine – can you tell us about the recognition and the impact that it is likely to have on your practice?

Being specifically recognized in the Thought Leader category for this award is truly gratifying but humbling at the same time. With so much of the current political and social climate focused on gender and pay equality as well STEM education, this group of women and others like them have a moral obligation to give back to the healthcare industry. Recognition of this kind provides a platform from which to make that contribution.

MyConsultQ is poised to address the issues of talent acquisition in healthcare.  Having automated virtually every department or venue of care, our team understands more than information technology – we understand the intersection of technology and the care delivery and administrative processes that have been automated. Our on demand marketplace provides sophisticated matching of talent with organizational need — grounded in more than two decades of healthcare and technology experience.


What are some of the key issues that you face in the process of assisting healthcare organizations with optimizing the use of technology?

Talent Acquisition

The first challenge from my perspective is what it has always been – human capital.  Whether it is the purchaser of technology, the custodian of technology, or the end user it is critical that healthcare organizations focus on workforce talent acquisition as a strategic initiative. The levels of expertise that are required in today’s healthcare technology venue require sophisticated network, infrastructure, and application expertise.

Loss of continuity in the workforce is the greatest challenge we face. Strategic and tactical initiatives stall pending identification of new resources to fill vacancies.  Alternative staffing strategies – not just to fill vacancies when they occur, but to ensure the best operational and executive resources are available for any initiative – offer interesting solutions to this timeliness problem. Outsourcing specific functions or roles to gain superior and dedicated levels of skill and expertise with broad exposure that may otherwise not be available seems the best insurance against stagnation of ideas, stalled initiatives, and forward progress. Workforce and talent availability for all roles – executive, staff, physician, clinical, and technology – varies significantly between metropolitan and rural markets. Alternative staffing strategies can close these gaps by ensuring high-quality talent is available when needed to fill positions – short and long term – regardless of setting.


Combining Process Knowledge with Technology Experience for Exceptional Results

Healthcare is data-driven! Electronic Health Records and other physiological monitoring and data collection systems have provided a rich data foundation that is nothing short of transformative for healthcare. Information systems staff can no longer focus on tasks, projects, and simple fulfilment – rather, they must bring new skills to the table to partner with clinicians, physicians, and executives. Innovation is key to quality care and competitive positioning but progressive application of IT is central to innovation. Traditional IT roles must evolve to serve this greater need for collaboration and application of technology to solve problems.


How Today’s Workforce Works

Teleworking allows workers to achieve lifestyle goals while providing companies access to talent regardless of geography or physical location. While not an entirely new concept, teleworking is gaining in popularity and momentum as a way to reduce traditional consulting travel expense and to allow ready access to skills that do not require local or onsite presence. Internet and collaboration tools have opened doors to this method of remote work. It has also opened doors to talent that might otherwise have been unavailable due to physical constraints.


Selective Employment

Selective employment represents a significant emerging social trend in the world. Many highly qualified resources are gravitating toward professional lives that support work-life balance. Specialization, internet access, and control over working hours and assignments have fuelled the growing attractiveness of selective employment. The ability to align and realign resources as needed to solve problems is best accomplished with a vast and fluid workforce that recognizes this trend toward selective employment.


Realistic Expectations

The second challenge is counter-intuitive. It emerges from the very fact that technology has become ubiquitous in its general availability and intuitive use for consumers of all kinds. From birth to end of life, there are ever-present applications and technologies supporting virtually all aspects of life, from how we communicate (smart phones and tablets), to sophisticated blue tooth enabled clinical monitoring. The ability to successfully and easily interact with the simple, intuitive user interface for these consumer-based technologies is misleading when applied to the complex technologies supporting clinical and administrative healthcare venues. The down side is that many healthcare leaders approach sophisticated, complex information systems with the same demand for ease of use and ease of deployment as has become expected and commonplace in consumer-based technologies.

Unfortunately, the reality is that healthcare technology is not keeping pace with consumer-based technologies.  Healthcare delivery systems, especially acute care settings are primarily using applications built on underlying technologies that, at the core, are as much as 25 years old or greater.  Large, complex, multi-transactional systems that primarily consume data but don’t easily produce actionable data form the foundation of virtually every healthcare delivery system.


Changing the Way We Manage Application and Technology Vendors

Further complicating the understanding of technology in healthcare is the fact that the 3 – 5 primary application vendors in the healthcare industry contract their products in traditional term licenses agreements that are capital, complexity, and duration intensive. Emerging technology sophistication found in intuitive, internet-based technologies cannot be leveraged due to the locked in duration of existing contracts and the associated switching costs. All of this results in healthcare clinicians, managers, executives, and board members possessing an unrealistic expectation for ease of use and intuitiveness, derived from their consumer-based experience, which is challenging to accomplish under the circumstances outlined above.


Strategic Importance of Technology

An effective technology or information systems (IS) strategy should be considered as carefully and with as much rigor as any major strategic infrastructure initiative would be. From building highways and public transportation, to urban development and community health initiatives (i.e. population health or accountable care), strategic initiatives have the power to transform the way we conduct business. Relegating IS decisions to the basement under unprepared leadership insures the status quo with cost overruns, delays, diversion from strategic objectives, and failed adoption. While revolutionary in the healthcare industry, the US requirement for implementation and use of certified electronic health records faces much scrutiny from clinicians and executives. It is easy to blame the vendor applications which by all estimation have fallen short of the mark in the eyes of the end user. But does the fault actually rest in our inability to promote IS use as strategic. If we look at organizations that have experienced significant success in their EHR deployment, with the same vendor applications as their industry peers, I believe we will find the overwhelming differentiation between successful and unsuccessful adoption is in the strategic positioning of IS the respective organizations. If we don’t change our thinking, simply changing our technology will not make things better – but it will quite likely contribute to more strategic failures as history repeats itself. Boards, executives, physicians, nurses, and departmental managers are compelled to employ technology as a strategy to navigate the challenging times ahead. There is no other more effective tool available to us as the healthcare industry, estimated at nearly 20% of GDP continues to absorb rapid and transformative changes in consolidations, payment structures, heightened scrutiny on quality outcomes, increased patient engagement, decreased physician satisfaction, security threats, and government involvement.


How do you overcome the challenges presented by the fast moving nature of the IT sector?

The conversation needs to change! Cost and service levels are inadequate measurements of healthcare IT success. The rapid digitization of healthcare requires the dialogue to be one of innovation, value creation, and creation of competitive advantage.  Healthcare IT needs to emerge from the basement with CIOs and technology leaders becoming responsive as strategic partners to the organization.  Locked in vendor contracts, aging infrastructure, transaction-based services, and traditional workforce acquisition methods all doom organizations to the status quo.

There is suggestion in the healthcare industry that CIOs and business unit leaders need to redraw traditional boundaries between IT supply and demand. While it is my fundamental belief that healthcare business leaders must become well-versed and savvy in their understanding, evaluation, adoption and use of IT; careful consideration should be given to the level of IT decentralization employed by organizations. Healthcare business unit leaders have the unique understanding of their respective areas but oftentimes lack understanding of how their unit interacts in the healthcare ecosystem. Additionally our free market society promotes unique products as competitive advantage which can have the unintended consequence of creating information silos.  While not the only considerations, these two factors alone limit the ability of individual healthcare business units to make IT purchase and implementation decisions absent oversight regarding enterprise-wide fit and strategy.  Healthcare, unlike other industries, does not provide business unit level services in silos – rather each business unit contributes to an ecosystem supporting the continuity of care for the population it serves. Healthcare has not yet reached a level of standardization and interoperability that would enable “plug and play” simplicity and as such requires tremendous coordination through centralized governance.


What is the main piece of advice you could offer to healthcare organizations willing to experience improved patient care and financial result?

Consider talent acquisition as one of the most important tasks for any leader in today’s healthcare organization. For decades we have been schooled to believe that our people are our organization’s greatest asset and yet we are stuck in traditional thinking about how talent is identified and retained. The Millennial and Boomer generations are forcing us to rethink the concept of “work”. For differing reasons, representing both ends of the spectrum, these groups of people are shaping a very different workforce in which organizations must adapt to individual requirements for work-life balance, availability, skill specialization, independence, and virtual work.  The emerging GIG economy can have a tremendously positive impact on the healthcare industry, which is known for its high degree of specialization and is becoming known for its virtual and technological presence in our lives, if leaders become creative in their methods for talent acquisition.

Parallel to the changing workforce demographic are the growing demands for unique skill sets in healthcare.  The rise of cybersecurity attacks against hospitals is just one area where new roles are being defined and traditional skills being expanded. Roles such as the Chief Security Information Officer (CSIO) and expert skills in networking (firewall, intrusion, malware protection) are now some of the most important hires an organization will make. Solution architects with deep industry, workflow, and application knowledge represent a critical skill set that is needed to insure IT is deployed strategically and not just to support transaction-based needs. The increased healthcare industry focus on data only strengthens the skill requirements for analytics, business intelligence, and information management. The internet, cloud-based solutions, social media, interoperability requirements, APIs, cybersecurity, patient engagement, and the like all require skill sets that have not existed in the traditional IT department. New and innovative methods for workforce and talent acquisition require healthcare leaders to think differently or risk losing competitive advantage.

-“To achieve our clinical quality and cost savings goals, I need to focus my time on strategically leading a healthcare enterprise to success, not on running an IT shop.”


-Signs Current Workforce Acquisition Methods Are Not Working

  • Job Openings Go Unfilled
  • Specific Expertise Unavailable in Your Location
  • Excessive Consultant Expense to Meet Routine Needs
  • Recruiting is Costly and Time-Consuming
  • Critical Initiatives Stall Pending Availability of Skilled Staff
  • New Hires Are Not Immediately Productive
  • Dependence on A Single Skilled Resource for Mission Critical Work
  • Dependence on Multiple Recruiting Sources

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