Breakthroughs in technology and medicine increasingly come from diverse teams. By bringing together a multitude of different perspectives, experiences, and identities, we foster an environment where people are free to share their ideas and work together to find creative solutions.
Our combined efforts are enabling the continuation and further development of Michigan Medicine’s research, education, and patient care mission.
Through our partnerships with clinicians, researchers, students, and staff, Michigan Medicine now uses technology to identify young patients at risk for sepsis, match researchers with collaborators and funding, and ensure curriculum is accessible for all medical students.
While there are countless examples of collaboration between HITS and the greater Michigan Medicine community, the stories collected here truly encompass the dedication and excellence of our teams. By leveraging one another’s unique strengths and capabilities, we instill a sense of unity, collective pride, and strengthened optimism.
Andrew Rosenberg, M.D.
Michigan Medicine Chief Information Officer
Application Systems Analyst / Programmer, Lead
My favorite thing about my job is being part of an amazing team. As Cogito Admins, we administer existing tools like Radar dashboards, Reporting Workbench, SlicerDicer, and the Epic databases (Clarity and Caboodle); implement new ones; and in various ways strive to have our voices heard by software vendors. I think I speak for the entire team when I say we give everything to our jobs, especially knowing that data, reporting, and analytics are essential for most users."
Business Systems Analyst, Learning Management Team Lead
For me, the BSA role tends to be a lot like detective work, searching for clues in order to solve a problem by interviewing people, recreating the problem, or digging into documentation to find answers. I enjoy working with customers to understand a problem and the requirements needed to solve that problem, and then discovering a more effective solution. I love it when I am able to help make a customer’s job easier or more efficient."
Jill Fogg, JD
Contract Administrator Lead
I spent 18 years in the private sector practicing law, negotiating defense and healthcare contracts, and developing contract management organizations within world-class companies. Since holding previous staff positions in Sponsored Programs and Business and Industrial Assistance, I’ve been committed to creating contract processes to the standard of excellence needed to fully support Michigan Medicine. I enjoy finding consensus among parties with competing interests and memorializing the agreement in a contract vehicle."
End User Computing Specialist
I’ve been working in IT at the university for 34 years. As a responder for the Service Desk, I’m constantly talking to people...and I love it. I take pride in helping people. Working for HITS makes me feel like I’m part of a family, and I couldn’t imagine myself working anywhere else. My daughter now works here, making her the fourth generation of my family to be a part of University of Michigan’s staff!"
Evan “Buzz” Nau
Manager of Service Operations Support
Early on, I knew that IT would be a natural fit for me because of my personal interest in computers and my military training. I’ve been working in IT for 32 years, and I’m the happiest I’ve ever been as the manager of Service Operations Support. Working with my staff, department, and customers is what I enjoy most. I love making those connections, and I’m proud to work in a department that doesn’t fear change and continues to improve."
Data Security Analyst
Computers fascinate me. From the Apple IIc that we had before I was born, to the PC running Windows 3.1, learning about and tinkering with computers has been a passion. I’m thankful to be able to take the joy I find working with computers and apply it to my career. Every day represents an opportunity to make a difference by solving a problem or improving a process, which I am able to do on the Identity & Access Management Services team."
Research IT Technical Lead
Because research is so diverse, it requires context and understanding, not just of the research itself, but of the processes and workflows being used. Each interaction with researchers is unique, fresh, and personalized. The ability to be creative and leverage other services within HITS allows my team and I to work with researchers to provide complex and expanding solutions efficiently. I’m proud that we can design more holistic solutions that impact an entire lab or a department."
Information Assurance Program Coordinator
With my role as cybersecurity program coordinator, I get to pair the best of both worlds — technology and people. I love being able to talk with Michigan Medicine employees and help them better understand their role in protecting the institution, all while making cybersecurity a more approachable topic. The field is constantly evolving, so I appreciate the many professional development opportunities that I can expose myself to as my interests grow."
Network Architect, Systems Researcher
My work is at the intersection of IT, communications, and the physical environment. There is real satisfaction in having thousands of people use my technical creations. I enjoy working with colleagues who are deeply dedicated to making healthcare succeed. U-M is in my bones: As a teen in the 1970s building and programming computers for my father’s campus lab and in the ‘80s and ‘90s at the Engineering School building networks, computer labs, developing Unix systems, and advancing visualization platforms."
Barb Zimdars, MPA, PMP
Business Analyst, Team Lead
The work we do matters; whether it’s helping with patient care or meeting business operational objectives and efficiencies, our work helps others. The strategic planning I’ve done and projects I have been involved with have improved patient care, helped workflow efficiencies, increased revenue, ensured we met regulatory requirements and institutional policies, and secured the integrity of the medical record."
Michigan Medicine uses EHR to identify pediatric sepsis patients
While anyone can get an infection, infants and young children are often more susceptible to sepsis — the body’s extreme response to an infection. Nearly 5,000 U.S. children die from sepsis each year, with an economic cost estimated at $5 billion.
“Sepsis is a leading cause of death in all patients, but particularly pediatric patients, and it’s completely preventable,” said Kera Luckritz DO, assistant professor of pediatrics. “If we can identify and treat patients sooner, we can prevent sepsis from turning severe or into septic shock. If we catch patients earlier in the disease progression, we can make a difference.”
No specific test exists for diagnosing sepsis, and its symptoms often mimic a fever or disorientation, making it difficult to diagnose. Because it spreads so rapidly in children’s small bodies, detecting the disease early and starting immediate treatment is often the difference between life and death.
“For every hour a septic patient isn’t treated, their risk of mortality increases by eight percent,” Luckritz said.
From October 2015 through September 2016, sepsis tripled the length of stay for patients and, even more concerning, 36 percent of C.S. Mott Children’s Hospital patient deaths involved a sepsis diagnosis.
With a goal to reduce sepsis mortality and hospital-onset severe sepsis by 75 percent by 2020, a team of Michigan Medicine providers partnered with HITS to create a sepsis early warning system in the electronic medical record.
“This was, by far, the most integrated project I’ve ever worked on,” said Marie Phillips, HITS application coordinator. “We brought clinical and IT teams together to talk about how the system could work. Our team took that feedback and delivered a predictive analytics model that combined objective and subjective data to help identify potential sepsis patients.”
Using a weighted scoring system, the predictive alert continuously monitors patient vital signs, like heart rate, respiratory rate, temperature, and blood pressure. When values fall within a predefined threshold, the system triggers an assessment for nurses to gauge their patients’ mental state, breathing, perfusions, and family concerns. Nurses who suspect sepsis can use the sepsis trigger tool to page a Rapid Response Team to the patient’s bedside.
“Because sepsis patients do not present the same, we designed the tool to leverage both vitals and RN expertise. If intuition says something is wrong, a nurse can immediately bring a team together to complete an evaluation,” Phillips said. “The Rapid Response Team can review the information to determine whether to treat for sepsis as fast as possible.”
The predictive model is currently being used on four general-care floors in Mott, the Pediatric Intensive Care Unit, and the Pediatric Cardiothoracic Intensive Care, with plans to use it in Neonatal Intensive Care. Since it became available in April 2018, 61 huddles have been initiated with 51 patients subsequently treated for sepsis.
“We’re continuing to learn from the data we’re collecting. There is a lot we can discover from the charts of the 51 patients who were treated,” Phillips said. “This tool shows the power and potential when IT and care providers come together.”
Home for Dinner: Reducing physician burnout
Last year, HITS instituted a program called Home for Dinner, to help physicians use MiChart more efficiently.
Provider exhaustion is a significant issue across the medical community. While MiChart, the electronic health record (EHR) at Michigan Medicine, can enhance coordination and quality of care, it can also have unintended negative consequences.
Michigan Medicine providers are spending significant time catching up on data entry during off-hours, which contributes to record levels of burnout and lower job satisfaction. Data from the MiChart vendor, Epic, indicates that Michigan Medicine providers spend more time per appointment than 75-to-90 percent of peer institutions, and over one-third of physicians experience stress related to using MiChart.
The two-day Home for Dinner program teaches providers new ways to streamline their efforts and maximize MiChart features like customized workspaces, clinical review, In Basket, and notes. Learners are given hands-on support from highly proficient trainers and physicians and can practice using these tools in the actual EHR (instead of in a test record). This method has the added bonus of making customizations available immediately after the class is over. Participants can receive up to 15 continuing medical education (CME) credits upon completion.
All of the U-M providers who participated in Home for Dinner reported improved proficiency with MiChart and said they would recommend the class to colleagues.
“Home for Dinner training is a huge help. It increases efficiency and cuts down time to document,” said John Allen, M.D., professor of internal medicine.
Marie Baldwin, director, HITS Learning Design and Delivery, said this about Home for Dinner, “We want to make our customers’ lives easier. HITS has the skill, expertise, and desire to positively impact our customers. MiChart can be complicated. This program teaches providers how to focus on the patient without creating significant after-hours work. We hope to use the momentum from the success of this program to gain support for other similar clinician programs at Michigan Medicine.”
Cybersecurity excursion shows career in IA is attainable
The Information Assurance: Michigan Medicine (IA) team was awarded a Diversity, Equity and Inclusion Innovation Mini-Grant from the Office for Health Equity and Inclusion. With the goal of spreading awareness of the field of cybersecurity and available job opportunities, the IA team developed a two-hour interactive introduction to the field of information assurance. Participants learned about the role that IA plays in keeping Michigan Medicine secure and showcased the many possible opportunities and career paths that this field offers.
“The grant from OHEI gave us the time and resources to develop a strong format. We could potentially use this as a model for other types of learning experiences,” said Maggie Lin, project manager for IA.
Some research cites that women comprise about 11 percent of the cybersecurity workforce and minorities comprise about 26 percent. Within the industry, there is an awareness of the lack of diversity, but women especially have reported not knowing how to break into cybersecurity. The result is a self-perpetuating cycle: the field is composed largely of white men; women and minorities do not see individuals they can relate to in IT security roles. Women and minorities redirect their efforts and attention to more “realizable” or “attainable” fields; and the status quo is maintained.
Jack Kufahl, chief information security officer (CISO) at Michigan Medicine, pointed out two reasons these stats are significant.
“The demand for cybersecurity professionals is increasing at a rate that outpaces the talent pool — there are more jobs than there are available people with training in cybersecurity.”
He also mentioned that cybersecurity threats are becoming more creative and sophisticated, which means the solutions have to be more creative and more sophisticated. Creative thinking requires diverse perspectives, and team diversity often fosters creative thinking and inventive solutions.
HITS offers apprenticeship program for aspiring IT professionals
Apprenticeships are typically associated with the skilled trades, for example plumbers, electricians, and welders. But that convention is changing. The HITS Service Desk Apprenticeship Program, created by HITS and Washtenaw Community College to help attract and train aspiring information technology professionals, is broadening the application of apprenticeships.
The program pays entry-level candidates to serve a one-year apprenticeship in front-line technology support, receiving extensive on-the-job training and formal technical coursework at WCC in the process.
At the end of the program, apprentices receive a U.S. Department of Labor journeyman’s card, earn a 16-credit Computer Systems Technology certificate from WCC, and emerge with a deeper knowledge of the IT architecture of a world-renowned medical center. The WCC coursework is paid for by the program.
“Apprenticeship has been a proven model for hundreds of years,” said Jarrod Sandel, manager of the HITS Service Desk. “This is not a new concept. It’s just a novel approach to a more modern job.”
The HITS Service Desk receives 250,000 calls, online submissions, and walk-ins each year while operating in an industry that averages 40-percent annual turnover.
Lousayni Benson is a recent apprentice who was hired full-time from the program.
“I wanted to complete my education, but I also needed a job,” Benson said. “When I saw this job placement at Michigan Medicine, it was basically like going back to school and having it paid for. Finishing this program was a great accomplishment.”
Sandel said career advancement opportunities are likely for apprentices.
“Keeping people is difficult because they become familiar with a broad collection of technology and become super attractive to hire, both in my IT department and across southeast Michigan,” Sandel said. “Creating this program was the right choice for us and the right choice for the organization. We’re excited to see where we go from here.”