Behind the Scenes: Information Systems

Jeffrey Yamada

We recently sat down with KVH Chief Information Officer Jeffrey Yamada to learn more about the function of IT in a healthcare system.

While technology is a part of everyday life, it’s not usually the first thing one thinks of when talking about healthcare. What role does IT play in an organization like ours?

It’s always about the patient, and IT provides the technology and the tools to help patient care.

Just imagine yourself or a family member as a patient in an exam room, where the physician can’t access your records because the computer’s down, or your complete electronic record isn’t available. Our team works to minimize the impact on patients, and guides providers in their use of the systems.

It seems like there’s a wide range of responsibilities covered by KVH Information Systems. 

We have major systems, such as our Cerner Community Works system, that have multiple people working on them. These systems have ongoing changes and maintenance, and with new functionalities comes the question of access, training, and education, which we call change control or change management.

When users let us know their systems aren’t working properly, we manage those incidents through SR (service request) tickets, which feed into the Cerner helpdesk.

There are some 30 additional systems unrelated to Cerner, like HR, payroll, dietary – a mishmash of miscellaneous systems; two of our team members take care of them.

We have maintenance and infrastructure, which covers network and connections across the board, wireless, all the servers in our data centers – which includes the issue of backing up everything in one place in case something happens.

Then there’s IT security, breaches of systems, prevention and protection, and some user education, as well.

How do you stay on top of changes in technology?

Yeah, it goes by pretty fast! Actually, as an industry, healthcare is slow to take on new technology; you can imagine why, when regulatory agencies need to get involved, or there’s a concern that it could impact patients.

What about changes in relation to security?

It’s kind of a catch 22, the way things are currently, because everybody wants their information, and everybody wants it accessible, so how do you do that and still protect everything? Or do you get to the point where you’re so secure that you’re hindering your own people from trying to access information? There has to be a balance.

What are some of the challenges faced by IT?

Number one is user education. Everyone has their own way of using the systems, so guiding people through a standardized workflow is key for avoiding problems that could occur by not following a common process. Not all systems were built from a user standpoint, a lot of them are older systems that have just built upon themselves, so one of the challenges is obviously training and how to train providers and others to use it in the context of their patient care workflow.

There are a number of detailed IT systems – known in the industry as “best of breed” – which take into account the workflow of an individual area, like the emergency department. But what everybody’s going to these days are integrated systems, which connect to the entire enterprise.

The ‘detailed’ systems are more tailored and user-friendly, but the integrated systems allow information sharing, so that patients’ information can be accessed by all of their care providers across the KVH system. It’s definitely a challenge.

What are the rewards of being involved in IT?

We have a great team here, and if you’re focused on the patients, trying to help provide the best patient care you can, knowing that IT plays a big hand, whether the patient is here or even at some other hospital in Seattle, all of their information is available, and it helps the patient through their experience. That’s why we’re all in healthcare at some point.

What’s your background and how did you get here?

I’ve worked in hospitals for 36 years. As a student, I worked at both hospitals in Yakima. After getting my undergrad in Idaho, I went through the medical technology program at Central. It included a year internship in a hospital setting. I worked in the hospital during the day, in addition to classes. Just like other clinical areas, training and education led up to passing the board exams.

I’m originally from Hawaii, so I always said, “Nope, when I’m done, I’m going back, not even a question.” I said that for almost the entire year of my internship, until the lab director at one of the hospitals offered me a job after graduation. I thought, “OK, I’ll grab some experience, I’ll work a year – and then I’ll go back to Hawaii.”

One thing led to another, and I stayed for 36 years in that same hospital.

The lab was highly technical, a lot of electronics, a lot of robotic instruments. I got into that side of it as a systems manager, and implemented two LIS systems (Lab Information Systems). Then there was an opening for an IT director. I thought, “Well, I’m doing it for the lab, I can probably do it for the hospital,” and that was a big leap out of my comfort zone.

Several years later I became the VP CIO at Virginia Mason Memorial. We started with 18 employees, and by the time I left we had around 50 in IT, and some 29 locations. We were considered high tech for a smaller hospital system, and applied to be part of the Top 100 most wired hospitals. So it was a pretty big deal.

Coming here to KVH is kind of fun, because it reminds me of the older days. It’s the family feeling you get with a smaller environment. It’s a different vibe. I like it. So now we’re getting things rolling —

And at some point, it’s back to Hawaii?

(Laughs) Yeah, maybe when I retire.

What would you put in an IT “go bag” for a successful day at work?

Calmness. We have so much equipment, things just happen randomly, and just to be able to be calm and think through things is a great tool. You can go from ‘one thing affecting one patient’ all the way to ‘the entire hospital is down,’ and it’s just like a flick of a switch. You can come in thinking you’re gonna have a great day, and – you just never know. So the goal is to reduce those situations. They’ll still happen, just not as often.

Pack a good sense of humor, keep things light, be able to work as a team, and just be a great communicator.

It’s nothing like you think of a technology person, “I have to have a laptop and my smartphone.” I’m more the opposite. When people who sit next near each other start emailing back and forth, something’s lost by not having face-to-face conversation. In those cases, I say, “Forget the email and talk. Just talk to each other.”