Cheryl Larson is chief information officer for California Correctional Health Care Services (CCHCS), the state entity that provides health care, including medical, dental and mental health services, to California’s prison inmates. She is a career state employee with more than 34 years of service and has been with CCHCS since late 2008. Larson’s primary role from 2008 to 2014 was chief of activation at the California Health Care Facility before becoming CIO in October 2014. She entered state service in 1988 with the Franchise Tax Board.
Techwire: As CIO of your organization, how do you describe your role; and how have the role and responsibilities of the CIO changed in recent years?
Larson: We’re a leading health-care organization. I’m responsible for the IT environment, the infrastructure, the data security ... . I support 35 institutions statewide, a central-fill pharmacy. We’re a headquarters campus; regional offices, so a little different than most government CIOs. Our health-care program supports around 95,000 patients ... for all disciplines. So, medical, mental health, dental, we support all of their information technology and data needs. Technology is a part of everything that we do personally and in our day jobs. The role of the CIO has changed from a technologist to really understanding and collaborating (with) our program areas. Health care in a prison setting can be challenging. Understanding the challenges is vital. So that’s where it’s really changed. It’s not the technologist piece and the technology back-office stuff, it’s really understanding their needs.
Editor’s note: Under the tenure of Receiver J. Clark Kelso and during Larson’s time as CIO, CCHCS moved off paper to fully electronic health records, even automating aspects of those records.
Techwire: How big a role do you personally play in writing your organization’s strategic plan?
Larson: I’m a member of the CCHCS executive team, so I directly participate in the planning and execution of our strategic initiatives. I have a seat at the table.
Techwire: What big initiatives or projects are coming in 2021? What sorts of RFPs should we be watching for in the next six to 12 months?
Larson: In 2020, we quickly pivoted because of COVID-19, and we’ve been asked for a lot of things for patient care and data surrounding, so it was really a COVID-19 focus. We really don’t have any large RFPs at this time that are going out. ... We’re doing some really great things surrounding data, dashboards, COVID-19 registries. We’re working with Johns Hopkins (University) on a variety of other things. We do have one (RFP) coming out on nurse call ... we’re replacing our nurse call systems out there.
We partnered with our quality management group ... what we’ve developed is a COVID-19 patient tracker. It’s a near real-time reporting system that is out on the CDCR website. You can go any time and it talks about vaccinations ... . We created functionality within our electronic health record for coronavirus testing, vaccinations, and so we have an interface with public agencies, leading research universities; we have an interface with the Center for Systems Science and Engineering at Johns Hopkins, Stanford University. ... We have interfaces with them to provide all the data on our patients. We’re looking for ... predictive outcomes for the future. The other really exciting thing that we’re doing ... we’re using the RPA (robotic process automation) process, and from a health-care perspective it’s a game-changer. ... When we have a patient that goes from one institution to another ... you have all of your prescriptions, your labs, your next appointments are in this one place – we need to move them to the next place. That was a completely manual process, so what we’ve done is we’ve used the RPA process, our bots, to take them, move them in an automated fashion and on the other side the clinician, he validates it and approves it. Before, that was completely manual. It really allows the clinicians to get back to real patient care. There are some administrative functions that always need to be done in a health-care setting but if we can automate that, that’s a game-changer for us. So we were able to do that. We have folks with disabilities, who are sight-impaired. We’ve actually used the RPA process to be able, along with the JAWS software, to navigate through the electronic health record. There are reports for our pharmacists that have to go to the external agencies. And we have to get that data from our automated dispensing machines. The RPA process is now allowing us to go out, get all of that data from these machines that are all over institutions, 35 times, and it produces the report for them. Think about the reduction in all of these cases of error, manual intervention. It allows our folks to do hands-on clinical work.
Editor’s note: The CCHCS Job Access with Speech (JAWS) Bot was designed for visually impaired health-care providers, to complete workflows in CCHCS’ Electronic Health Record System (EHRS). The bot launches the EHRS application and lets the user select a patient, read clinical notes, write clinical notes, complete forms and review lab results in the EHRS. CCHCS is working with UiPath on process automation. CCHCS contracted with the vendor Cerner on the electronic health records project, believed to be the largest correctional system implementation in the world.
Techwire: How do you define “digital transformation,” and how far along is your organization in that process? How will you know when it's finished?
Larson: I think we’re a leader in this front; I really do. Digital transformation is technology, is evolving and how we leverage this in a fast-paced health-care environment is – it’s technology that’s evolving. And for example ... why I think we’re a leader in this area, we’ve being doing telehealth for over a decade. So when the pandemic hit, we didn’t really need to pivot much in that space. Because we’d already been doing it. If you need to see a specialty doctor and you’re in a prison setting, they can’t always come to you. So, again, we’ve been doing this for over a decade. When do I think that we’re going to be done? I don’t think we’re ever going to be done because technology is always going to be evolving.
Techwire: What is your estimated IT budget and how many employees do you have? What is the overall budget?
Larson: We have approximately, in my organization, 450 IT professionals. The IT budget is $110 million.
Techwire: How do you prefer to be contacted by vendors, including via social media such as LinkedIn? How might vendors best educate themselves before meeting with you?
Larson: We have what we call Vendor Day, and that was the most efficient way for us to get the right folks in the room to meet with us. What we do is, once a month, we have a day, we partner now with CCHCS, CDCR (California Department of Corrections and Rehabilitation) and CalPIA (California Prison Industry Authority), the three of us, we have all the IT leaders from those three organizations listen to ... new products, services so that we can learn about them. ... We give a little bit of information about what services we’re looking for, but we still want to hear from them if they’re not on the list. We ask (vendors) to take a look at what our mission is, our priorities, those things, so that way they can better serve us during that time.
Techwire: In your tenure in this position, which project or achievement are you most proud of?
Larson: I’m really fortunate that I have really very talented and dedicated IT staff who are professionals. As a team, they’ve made significant progress in automating many manual and paper processes. When you have a clinician write you about a process that was formerly very time consuming and by automating it, it allows him or her to have more time for clinical encounters, it’s really satisfying for me and gratifying. And I do get those emails and I pass them along to my staff who have actually done the work. That’s what I’m most proud of, is taking something that the clinicians are doing out in the institution because, as you can imagine, it’s pretty challenging to do health care. And when we can make the process better, it sounds simple but that’s really what we’re here for.
Techwire: If you could change one thing about IT procurement, what would it be?
Larson: I’m sure it’s a common theme with CIOs, but the big challenge would be ... recognition for those folks that do health-care services and their needs, to expedite the process. During the pandemic we were able to use the emergency procurement process. The time that it takes to procure something ... under normal processes for health-care IT is problematic. ... IT procurement can be a CPAP (Continuous Positive Airway Pressure) machine, an X-ray machine. From an IT perspective it’s not just laptops and desktops. It is actually clinical care devices and the X-ray machine. We order them and when we have to take a long time and ours is down, broken, nonrepairable, that’s an issue. They’re connected to the network, they contain data in some cases; they’re IT equipment. And people don’t think about that for IT organizations.
Techwire: What do you read to stay abreast of developments in the gov tech/SLED sector?
Larson: I actually read Techwire and I do pass along articles to my executive team, peers and to my bosses when I see things in Techwire. ... And then I also subscribe to a number of technology and health-care profession-type (publications) out there. I read blogs and stuff just to keep abreast of what’s going on in the health-care technology field as well as technology in general.
Techwire: What are your hobbies, and what do you enjoy reading?
Larson: I am a very active outdoor enthusiast and avid sports fan. And you can put Atlanta Braves in there. I’m sure my peers will give me some ribbing for that but that’s very true. And my vacations and travel are planned around sporting events, camping and fishing. Not a lot of time to do reading these days other than the professional blogs and things. I just like to go out and do some fishing, and that doesn’t involve a book.
Editor’s note: This interview has been lightly edited for style and brevity.
