Cerner Consultant Corner: Kay Wind Interview

Kay Wind brings a unique combination of skills and experience to clients of the HCI Group.
 A registered critical-care nurse, Kay also has twenty years of multidisciplinary clinical and healthcare-management experience. For more than nine years, she has played a leading role in the design, build, implementation and support of Cerner Millennium Solutions, focusing on PowerChart/IView, eMAR, Clinical Documentation, PowerPlans and CPOE implementations. Kay offers advanced expertise in current and future-state workflow analysis and design to achieve maximum efficiency with EMR functionality in all clinical disciplines. Before joining the HCI Group, Kay’s work included serving as a solution architect for Cerner Corporation.  

Q. You have wide-ranging experience in many disciplines. From that broad point of view, what kinds of things have you learned about best practices in the field of electronic medical records?

A. My recent work has been focused on CPOE, and I’ve found that early involvement of the physicians is very important. Rather than waiting to involve the physicians until just before go-live, it’s important to partner with them earlier. This brings them along as true team members rather than merely as the recipients of the technology at the end of a go-live. Partnering with physicians early on is one of the highest recommendations that anybody who’s been through this process would make.

For example, when I worked at the Seton Family of Hospitals, there were true visionary people at the top. The design process required a current and a future-state workflow. Well, nobody ever involves the physicians with that, but we did, and they just loved it because they got to tell us how they do their work.
They get excited because someone’s listening to them. So they become more like partners. Having that kind of collegial collaboration early on prevents that us-against-them mentality, that technology-versus- clinicians attitude. And it’s an ongoing thing. There’s always something new that physicians have to buy into, whether it’s Meaningful Use Stage Two or ICD-10. So if you get them accustomed to being a partner early on, you‘ve got a great audience going forward. It just makes sense. It’s the right thing to do.

Q. How did you become interested in Cerner?

A. I used to be a computer programmer, and I have many years of programming experience. The first time I saw Cerner, I realized that it was an integrated database, and I could figure out what language it was written in. So that was one of the reasons I went to work with Cerner. I liked what they did with the front end—with what was available as far as code goes—and also with the hardware architecture. The scope and breadth of what they were doing was very impressive to me.

Also, Cerner makes some things very easy. It’s easy to update, because it is a relational database. If I make a change to the database, it goes right in, and I can see that change in every single document, which is really a beautiful and powerful thing. I ended up working for Cerner for four years.

Q. Why did you decide to go to work for HCI Group.

A. I found that all the people at the HCI Group were wonderful, and there was not a lot of bureaucracy, which I really liked. There was an entrepreneurial feel to the company. So it was the right fit for me.
When I first got a call from HCI Group, I was working on an assignment that I really liked. It was going on to be a long-term assignment. But after talking with HCI Group, I agreed to an interview for an assignment with one of their cerner clients. I found that the director at the client was a visionary, and I just thought it was an awesome opportunity to get into a CPOE project at the very beginning. I love that kind of project in which there is excitement and vision. It was an opportunity to do things right from the beginning.

Q. You were recently involved in a major CPOE project. Could you tell us something about that?

A. I just rolled off a two-and-a-half-year stay with a HCI cerner client. It was a large project that evolved progressively through the CPOE implementation cycle throughout the various facilities. They have approximately fifty facilities. It was a huge project and still is, but it’s really getting to the point where many of the facilities are now live with CPOE, as intended, and they’re in more of a production phase now.

Q. Could you describe the scope of the project in more detail?

A. The client had acquired community and teaching hospitals of varying sizes. These facilities had varied backgrounds, too, and their main aim was to bring them under the umbrella of one corporate-wide operating methodology, including electronic medical records and CPOE. Meaningful Use was also important in order to meet the requirements for Stage One and prepare for Stage Two.

The project required extensive background work, strategizing and coordination. When I arrived on the scene, none of the facilities had gone live with CPOE. They had made some progress in some locations with the basics of PowerChart and eMAR, but none had made progress with CPOE or PowerPlan. So when I started, the big push was to get ready to implement CPOE successfully.

In the beginning, they had their facilities divided into hubs. Hubs are groups of facilities within certain geographical areas that are treated the same way because they are part of the same market. So for example, hub one was in California, with five or six facilities there.

Initially, my work involved fact-finding, validation, checking and double-checking as I worked with the Cerner teams to create the integration test scripts before the go-live. So much of the validation occurred prior to actually rolling everything out to these hubs.

Along with that, there was a huge initiative in building PowerPlans based on a large number of paper orders that were gathered from across all the facilities. This was a huge effort that required a lot of physician input from several facilities as well build and validation steps to make sure that everything met the needs of the end users and errors were caught.

Basically I became part of a strategy team that was charged with making sure the build met the prerequisites that were set by the client and the facilities in a joint venture.

Q. How did your career experience help prepare you for success in this project?

A. I was hired because I had an interesting combination of work experiences. I used to be a critical-care nurse, and I also have a background in management and computer science. I had also served as a Cerner employee for four years, and I really learned Cerner from the inside out, learning not only how the applications worked but the database, as well. So I know what is hard-coded into Cerner and what is modifiable. When speaking with end users, that is invaluable knowledge, and it can really improve client satisfaction.

In addition, I can speak with end users from both a clinical and a technical perspective. So with my combined experience, I have the ability to work with teams to identify their vision and then show them how it’s possible to realize that vision in a Cerner environment.

One of the things the client appreciated was that I’ve seen some really complex projects form beginning to end, all the way from analyzing the client’s needs and doing future-state workflows to helping with the build, testing it and offering go-live and post-go-live support. I’ve done that several times, it has proven to be very beneficial.

Q. What are you excited about for the future?

A. I think Cerner is going to keep on improving; it already has. Over the eight or nine years I’ve been involved with Cerner, it has improved dramatically. One of the things I’m excited about is MPages. It’s a front-end graphic user interface that leverages the most recent trends in technology, and it lets you create an interface right on the top of the Cerner foundation. So for instance, a physician can look at the most recent set of vital signs and can make changes right there and then without having to go off that page. And that was invented by Cerner. It’s very hot and very much liked by the physician population.