Skarulis, who arrived as a new CIO at the prestigious cancer care organization six years ago, hasn't spent a moment letting moss grow on anything. Instead, she has moved forward with alacrity, working hand in hand with Memorial Sloan-Kettering's distinguished specialist physician leaders to implement leading-edge information systems.
Not only have the IT and clinician leaders at MSKCC been innovating across a range of clinical areas, including protocols-driven physician order entry, they have also been developing a leading-edge data warehouse to support both patient care and advanced clinical research. “One of the things that I'm extremely excited about is progress with our data warehouse,” Skarulis says.
“We've got over 1 million patients in it, with data going back over 20 years; and though we had had this data, it had been stored in such a way that it would require very skilled data warehouse specialists days to extract relevant data for queries.”
Given the very heavy needs being pressed upon their store of clinical data, Skarulis and her colleagues brought “a good portion of that data, a subset that is expanding monthly, into a Web-based portal for all our clinicians, administrators, and researchers.” The HIPAA-compliant process facilitates de-identified data extraction for anyone with an MSKCC e-mail address. In order for a clinician or researcher to obtain identified data, they have to go through a detailed approval process (physicians currently involved in clinical trials are the usual types of individuals requesting such data). For a patient care organization whose clinicians are highly specialized and have many patients in clinical trials (MSKCC patients and physicians were currently participating in 496 clinical trials as of press time), such appropriate data facilitation can be extremely important.
And it's all about serving the needs of the organization, its clinicians, and its patients, Skarulis underscores.
That theme also carries through to another change she is proud of, which is helping to create what she calls “an innovative operating environment” for surgeons at MSKCC. Surgeons now are able to make use of broadcast-quality video production for real-time transmission of surgeries. This is far more than just window-dressing; that technology was used recently to facilitate the training of physicians in New Zealand, who were able to observe surgeries at MSKCC in real time, literally half a world away. The technology is available at any time, Skarulis reports, adding that she and her colleagues are still exploring a wide variety of potential future applications for it.
As for her management style, Skarulis offers that simply being herself (which includes being straightforward, candid, and no-nonsense) has always stood her in good stead in her professional life.
What's more, she says, “I love working with our doctors and nurses and hospital administrators. It's something I totally enjoy. And I love to dialogue with the doctors in terms of how they're using technology, what their suggestions are. I think that how you feel about what you're doing shows. It's about being interested in their perspectives, and it's about constantly listening and asking.”
Some information executives might be intimidated by the international-level prominence of the specialist physicians at an institution like Memorial Sloan-Kettering, but Skarulis is not one of them. Her natural, easy self-confidence dovetails perfectly with her genuine interest in the clinicians and in what interests them. And it comes into play seamlessly as she and her IT colleagues regularly share their work in progress with the organization's doctors, making sure to get their feedback before tools and systems are completed.
But beyond such strategies, Skarulis says her key advice to other CIOs who would like to be successful in an academic medical setting (or any clinical setting) is this: “Some CIOs are intimidated by the doctors — some almost seem to be afraid of them — and then they don't dialogue, and things get worse and worse over time.”
Being oneself and engaging with the physicians at their level (and armed with as much knowledge as possible) will always put a CIO on good footing, she urges.
Such attitudes also extend to Skarulis's management innovations. Asked about examples of creative approaches to management, she mentions having instituted the quarterly “coffee with the CIO” session about four years ago.“It's not a gripe session, it's just a dialogue,” she explains, and adds that each “coffee” meeting is designated for a particular type of employee, for example, management- and non-management-level staff members. The coffees have worked out beautifully, she says, and have helped enhance the open-door policy she has striven to maintain.
Skarulis adds that there's one more very fundamental piece of advice she'd offer other CIOs: “Wind up at a great organization. That to me has been a great contributor to whatever success I've had in my career.”
