Navy Nurse Mary Russell Spills the Tea on EHR Disaster Recovery Planning

[00:00:00] Welcome to the HITea With Grace podcast where we spill the tea on HIT. I'm honored to welcome

[00:00:06] Mary Russell, a retired Navy nurse and senior director for clinical implementation at Clinikon.

[00:00:12] Thanks for joining us today, Mary. Thank you, Grace. I'm so happy to be here.

[00:00:16] And we're so happy to learn from you today. So let's start by having you share with us

[00:00:21] your journey from starting as a registered nurse to becoming, you know, to joining the Navy

[00:00:27] and becoming the senior director for clinical implementation. So what motivated you to transition

[00:00:33] into health care? I want to hear all about it. Tell me about your whole life.

[00:00:36] Okay, well, I will try to be interesting. So I actually I have been a nurse for a very long

[00:00:43] time. I am a well seasoned nurse. I started graduated from college back in 1987 as a

[00:00:52] registered nurse with my bachelor's degree. And in the 80s, nursing jobs were plentiful.

[00:00:59] There was no shortage. You could go to any hospital and get hired. You would have multiple

[00:01:06] offers out the door. So one lovely day there was this very sweet Navy Nurse Corps recruiter

[00:01:14] at the college. And after a somewhat brief conversation, I signed up for the Navy.

[00:01:20] And so upon graduation, I entered the Navy Nurse Corps and had some great assignments

[00:01:28] as an active duty young brand new nurse. It is in the Navy, there's an expectation not only

[00:01:35] that you will be clinically excellent, but that you will develop as a leader as well.

[00:01:41] And so right from graduation, they put you on that track and provide mentorship and direct

[00:01:48] mentorship, which you know, I think we've lost a little love today. And so it was a great time.

[00:01:54] I met my husband, I got married, you know, all those things you do, and got out of active

[00:02:00] duty service in 1991. And then I worked at local hospitals, I had a few different jobs,

[00:02:08] I worked on a surgical care unit with a great team of nurses. I loved that job. I

[00:02:14] loved those people. They were fabulous. And then I went back for my master's degree.

[00:02:21] And then the Navy actually gave me a letter and said, Hey, you're going to have to resign your

[00:02:27] commission as an officer in the Navy Nurse Corps, or you're going to have to start drilling

[00:02:32] as a reservist. So yeah, I was like, I kind of loved that career for me as the Navy nurse,

[00:02:41] and I loved the actual clinical nursing that I had done too. So I thought it would be the

[00:02:47] best of both worlds. And so I rejoined as a reserve nurse. And of course, the world went

[00:02:55] a little crazy, right after that 9 11, and then just years and years and years of war.

[00:03:04] And so I had a number of recalls to care for the wounded veterans at the National Naval Medical

[00:03:12] Center in Bethesda, which is now the Walter Reed National Medical Center. And we were inundated

[00:03:20] with casualties. So it was an amazing time, but again, with an amazing group of people who

[00:03:27] worked together to do our best under difficult circumstances. And that was stateside.

[00:03:34] So all of these things came together, right, the early nursing experience and leadership,

[00:03:39] and then being put into these difficult situations with these combat veterans. And then

[00:03:45] ultimately I got sent to the front in Afghanistan in 2009 into 2010. So

[00:03:54] it was all of that experience what had set me up for that experience there.

[00:04:01] And then when I came back, though, I was, I was a little burned out of direct patient care.

[00:04:09] So a friend of mine who actually works with me now called me and said, Hey, Mary clinic

[00:04:14] comes hiring for clinical analysts. I really think you should take this job. You would be

[00:04:20] really good at it. And we need you and, you know, come join us. So but I live in Philadelphia

[00:04:26] outside of Philadelphia and clinic comp is based in San Diego. So yeah, I really wasn't sure what

[00:04:32] that was going to look like. But I did. And I've been with planet com for 14 years

[00:04:39] from a clinical analyst now to the senior director of our clinical team.

[00:04:43] And it's been a great journey along the way. And I stayed in the reserves until 2019 I retired.

[00:04:53] But the nice thing about that was I had two careers, I had clinic comp career,

[00:05:00] and I had the Navy career and the Navy requires you as a nurse to actually maintain your

[00:05:06] clinical skill set. So I was still able to provide bedside nursing care up until 2018

[00:05:15] with the Navy. So so I really loved I really have had the best of all worlds.

[00:05:21] Oh, my goodness. What a background. Right? Thank you for your service. Thank you for all

[00:05:26] the time dedicated to our country to, you know, our to the US. I mean, you're amazing,

[00:05:32] Mary. I'm so inspired by you, you know, and having served as a Navy nurse for

[00:05:37] in both inpatient and outpatient planetary environment. How did those experiences shape

[00:05:42] your approach to health care and clinical implementation? Yeah, I think that you have

[00:05:47] to when I went to nursing school, it was driven into us that you have to view the patient

[00:05:56] holistically, that this moment in time with a disease process is not only impacting their

[00:06:04] physical health, but all aspects of their life. I think that training combined with the

[00:06:10] inpatient outpatient, I also was fortunate enough to be on the US and as comfort,

[00:06:16] which is the hospital ship and go to countries like Haiti and Nicaragua and really provide

[00:06:26] care in very austere environments. And even here in the States, you need to understand from the

[00:06:31] outpatient side, what resources does this person have? What kind of support? What's their

[00:06:38] diagnosis? You know, are they going to need psychological support, spiritual support for end

[00:06:43] of life, all of those considerations. And I think that framework has helped me to ensure

[00:06:52] that every day in our job, we advocate for all of the staff who are using our products

[00:07:00] in the field and then all of the downstream impact that has on a patient. And are they

[00:07:08] able to look at the whole picture inpatient or outpatient? So interesting to think about it

[00:07:14] even more holistically given that experience you had, we hear a lot about veteran mental health

[00:07:19] challenges, you know, and that being a missing piece in a lot of this. Can you kind of provide

[00:07:24] an example of how, you know, are there any facts and concerns talking about veteran mental

[00:07:30] health that could speak to and how our healthcare organizations kind of leveraging

[00:07:34] technology to try to help address some issues and that whole person care thought process

[00:07:40] and issue? Yeah, obviously it is it remains a big topic, you know, veterans are still 1.5

[00:07:48] times higher risk to commit suicide. And an alarming statistic for me is that when you break

[00:07:57] that down and look at male versus female, female veterans are 2.5 times higher suicide,

[00:08:05] successful suicide, which is shocking to me in so many ways. And I think that speaks to

[00:08:12] all of the difficulties that they encounter on a daily basis. What you know, whether they're

[00:08:19] deployed or stateside, the stresses of leaving your home, leaving your family, you know,

[00:08:25] how well are they supported? What experiences are they having? Obviously this generation

[00:08:32] that is serving now, they are the post 9-11 young people, right? And they have grown up

[00:08:40] in a world full of strife and stress. And I think that we have to keep adapting

[00:08:47] to their mental health needs, you know, things like gender identity, and how does that equate

[00:08:55] to military service? Where do I bunk? How do I dress? Where, you know, all of those things,

[00:09:01] I think we didn't have to deal with those as right as openly. And this generation is,

[00:09:09] they are very well equipped, I think, to speak about their mental health concerns. You know,

[00:09:17] they talk a lot about their anxieties and things. And I think that Veterans Health and

[00:09:24] really so many companies and corporations are trying to leverage technology to empower them

[00:09:32] with tools at their hands, with mobile applications, things that will let them do

[00:09:39] mental health self-assessments as well as coaching, PTSD coaches. All of these are apps.

[00:09:48] And this generation, that's all they know. They grew up with phones, right? Grace,

[00:09:53] you're... Oh, I know. Yeah, we can all know what we call them and understanding that we can use an

[00:09:58] app to help us with XYZ and honestly stay using it. And we want it to look good. We want it to

[00:10:05] be easy to use, right? As long as we add that, we'll use it. So I think that's interesting

[00:10:11] that you say that that is a huge part of this, is that this next generation is ready for that.

[00:10:16] Maybe it will help a lot. Yeah, I'm optimistic. I really hope so. I hope that, you know, that

[00:10:23] they can tap into that. I think that there's young people, you know, think of Veterans,

[00:10:30] the VA as old peoples, you know, that's where the old people go. And that's just not true.

[00:10:37] They're incorporating more and more women's health as part of their specialties. And

[00:10:42] really, they have grown with the times and prepared for the next generation as they've

[00:10:47] done successfully through other generations in the past. Yeah, it's so interesting to me,

[00:10:53] you know, you went from nurse to better, you know, to nurse for the Navy, and then you went

[00:10:59] to a healthcare informatics leader. So I'm interested, what advice would you give to nurses

[00:11:05] now who are interested in transitioning into nurse in the Navy? And then who might also

[00:11:10] then be interested in transitioning into healthcare informatics? I love to hear,

[00:11:13] you know, advice from each of those steps that you feel might be particularly helpful or valuable.

[00:11:19] Do you find that there are skills or experiences that are valuable in each of those different

[00:11:23] steps that you've taken in your journey? Yeah, I think that obviously, I think number one,

[00:11:29] stay clinically adept, whether that's actual hands on nursing practice, or whether it's

[00:11:36] through conferences and continuing education and things like that. You have to know you have to

[00:11:42] be abreast of what the best practices are, because they're always evolving. And you have

[00:11:48] to understand that if you've been away, know where you need to make sure that your skill

[00:11:54] set is up to par. Take advantage of mentors. I am the age group that we're all retiring now

[00:12:02] from the bedside. If you're a clinical nurse at the bedside, you need to take advantage of

[00:12:07] the mentors who are there and have clinical experience. I think that if you want to transition

[00:12:15] to informatics, you need to first learn your system. What electronic system are you charting

[00:12:22] with? What do you use? Understand it deeper, become a super user, work on implementations,

[00:12:28] be an early adopter, be somebody that's going to drive workflows that will optimize your daily

[00:12:36] experience. You can do that right now in your current position. And then if you want to move

[00:12:43] to the informatics world, make sure you're actually really good with computers.

[00:12:47] Make sure that you learn and develop processes and workflows and how to implement a system

[00:12:56] training, things like that. Very interesting. Yeah, with all important

[00:13:01] thoughts to think about. And if you're a nurse looking to get in, get that mentor,

[00:13:05] stay on top of your game, no technology. It's going to be critical for whatever next step

[00:13:10] you take, whether you better your career as a nurse or you decide to change your career.

[00:13:14] And like Mary did, have multiple careers at once with the nurse. That's pretty fantastic.

[00:13:19] So I want to tap now into your clinical implementation brain because I've been hearing

[00:13:25] in the news a lot about all of these tornadoes going through the Midwest.

[00:13:30] Insane, nonstop, not to mention the interruptions of service and security attacks.

[00:13:36] I want to dive in with you about the importance of disaster recovery and the role that

[00:13:41] the intersystem can play to ensure that there's no downtime during these huge events where

[00:13:46] healthcare is needed more than ever. And so let's dive a little bit into this topic.

[00:13:51] I want to hear a little bit about just different strategies you do or respond through

[00:13:58] in relation to this whole idea of clinical implementation and

[00:14:02] clinical ongoing ability to keep going during disasters happening.

[00:14:07] Yeah, it's one thing to implement a system at a hospital or a clinic or wherever you're

[00:14:14] working. But if that system goes down or even if it has scheduled downtime,

[00:14:22] those things are so disruptive to the continuity of care for your patients.

[00:14:28] And so where I work at Clinic Comp, we have a near zero downtime for 40 years.

[00:14:36] It's unheard of and our company has been through those disasters with our customers

[00:14:43] literally around the world. The tsunami in Japan, when that hit we had hospitals there and we

[00:14:52] at Clinic Comp, everybody all hands on deck, we're going to migrate these records and make

[00:14:57] sure that as they evacuate everyone, they have access to their critical health information.

[00:15:04] Because the problem is that a tornado blows in or a flood or a tsunami,

[00:15:10] those things don't wash away your chronic and critical health care needs.

[00:15:17] They exacerbate them. It's a very stressful situation to be going through not to mention

[00:15:22] potentially looking for home, to work. It's just a nightmare.

[00:15:29] Right. Yeah, exactly. And so being cognizant of that, having experience with that,

[00:15:36] certainly at 9-11, we were at a hospital in New York City and our system was one of the only

[00:15:44] things still running. When they had no thing else, they were still able to triage and move

[00:15:51] all of those critical workers and employees, everybody that was impacted by that.

[00:15:57] And then you have Hurricane Sandy. Again, I'm an East Coast person so these things were

[00:16:03] directly in my lifetime.

[00:16:05] Me too, I'm an East Coast girl and all these things impacted my life significantly.

[00:16:09] I can't imagine just with the VHR system how many lives it impacts if it ever

[00:16:18] goes down. You know what I mean? I can't even calculate in my brain how many people

[00:16:21] would be impacted by that.

[00:16:23] Yeah, right. I mean millions of records online, millions of staff and patients.

[00:16:29] You really need to be able to maintain that continuity of care, especially as you said,

[00:16:34] under the most difficult of circumstances. And if you can't get to the data or the information,

[00:16:41] as you said, it's just going to exacerbate the patient's condition and anxieties and

[00:16:46] it's just terrible.

[00:16:50] What is the secret sauce to disaster recovery? Making sure that you stay alive

[00:16:56] in your clinical systems during things like this? What keeps people going and keeps the

[00:17:02] system going?

[00:17:02] Well, I think planning. I think a system architecture that is adaptable and is

[00:17:10] well integrated into the seamless medical record keeping system, one that's mobile,

[00:17:18] one that is sustainable, is just critical. If your infrastructure is not sound, if your

[00:17:25] architecture is just in, then when these events hit, there's nowhere for you to go.

[00:17:32] You cannot move forward for the patients who need you and the nurses and the providers

[00:17:38] and everybody without that underlying sustainable system.

[00:17:43] Very interesting. Thank you for sharing that experience and just the knowledge that you all

[00:17:50] gave for your four years doing it. It's pretty impressive. I'm wondering, how do you see

[00:17:56] the role of health IT evolving in the next five years, 10 years, particularly in relation to

[00:18:02] patient care and disaster recovery and clinical systems?

[00:18:05] Honestly, I think that the current progression in health care and in health IT is already

[00:18:13] ramping up. It has been, especially in the last 10 years that I have seen. I've been with

[00:18:18] Clinicom for 14 years and in this clinical analyst, director roles now.

[00:18:24] I think that we've come, when I started nursing, we were on paper.

[00:18:31] We've come a long way from you wanting to do research to try to come up with a solution

[00:18:37] for a problem. You were sitting and sifting through paper records trying to find that needle

[00:18:43] stack. It was labor intensive, it was long in duration, but now everything is electronic. That

[00:18:50] data is queryable and at your fingertips at any given time. I think that the data scientists

[00:18:56] and the researchers and all of the people involved in AI are going to be able to take

[00:19:04] that data and exponentially move us forward in the next five to 10 years,

[00:19:10] whereas it might have taken us time to get all the data and then to understand how to analyze

[00:19:15] it and then what to do with it. I think everybody that's working in health IT needs to be

[00:19:21] prepared for rapid integration of changes in the way that we manage patients

[00:19:29] and the way that we document on those patients and the way we analyze that data

[00:19:34] and change best practices consistently. That's a great perspective and it's inspiring.

[00:19:39] As a patient and caregiver, I always think about these things. You look at the system

[00:19:44] and it feels like there's no hope because there's so much broken. When you hear about

[00:19:49] innovation and ideas and people like yourself that are leading the way to make changes so

[00:19:54] it's better, you can't help but have an optimistic outlook. Like, wow, Mary's on it. We're good.

[00:20:03] Then I am good. It puts a face to the name of the innovators that are solving the problems.

[00:20:09] I want to encourage our listeners today. I want to know your stories. People need to hear

[00:20:14] your stories of how you're innovating in space. People don't have to hear them because

[00:20:18] it's hope and life-giving. A space that really lacks. Mary, I want to learn more about you.

[00:20:25] You have done so much in your life and have built such a beautiful career. What are things

[00:20:31] that you do as a leader to work your best and make the difference? Are there habits you have

[00:20:36] in your day to day or things that you do to just keep you on your feet? I think that

[00:20:41] yeah, the totality of my experiences have hopefully helped me to be a compassionate leader.

[00:20:51] I think that family first is my mantra with the folks who work for me. That comes first

[00:20:59] and foremost. If they don't feel that things are stable or steady or comforting at home,

[00:21:08] they're not going to work well for me. You have to listen to people. I like to talk, obviously,

[00:21:16] but you have to be a listener. Learning from me, learning the generational changes

[00:21:24] in communication styles, in wants and needs and desires from a career perspective,

[00:21:31] it's not like mine. They have different life goals and ambitions and quality of life.

[00:21:39] I think we can all learn from that. This job is taxing. It's travel. It's a significant amount

[00:21:47] of travel. You really, really need all the support to stay healthy as a family, healthy

[00:21:54] as an individual, healthy as an employee. From my perspective, I want to make sure that everybody

[00:22:01] always fully secured it and not micromanaged. I trust my staff. They're fabulous, smart,

[00:22:10] intelligent people. I learn from them every day. You don't have to know everything as a

[00:22:15] leader. First of all, you shouldn't think you do. If you think you do, that's a bad thing.

[00:22:22] Just take a second and continue to learn and grow, but support, support, support your team.

[00:22:29] Such solid advice, Mary. I appreciate sharing that with us. If you could give your younger

[00:22:34] self a piece of advice, if you could go back and say, see young Mary, just starting or like,

[00:22:41] what's that piece of advice? Grace, that's a great question.

[00:22:46] That was a hard one because it's deep in there. I'm sure there's so much advice, but yeah.

[00:22:55] Because I certainly never saw my career going the way that it did. Not at all. I was born

[00:23:02] and raised in a blue collar neighborhood. Lots of immigrant families, hard working.

[00:23:08] And I went to Catholic school for 16 years. I was taught by the nuns. So hard work and

[00:23:15] discipline were really entrenched in my life. I value those skills, but I think what I would

[00:23:24] say and I think my children would probably agree is I would tell myself, you don't have to work

[00:23:31] that hard. Don't work so hard. Good things will come, but be satisfied. Sometimes it's okay to

[00:23:40] just be satisfied with where you are. I have a tendency to be a little ambitious and I worked

[00:23:49] more than I probably needed to at times. So I think that's what I would tell myself.

[00:23:55] I love it. Take a break listeners. Take a break. Yeah, take a minute. Drink a cup of tea.

[00:24:04] So to finish this conversation off right, where can our listeners best find you on?

[00:24:08] I am on LinkedIn and I think that's probably the easiest place. I've done other bylines and

[00:24:14] interviews and things there. And so you'll often find CliniComp posting my other thoughts and

[00:24:20] ideas about health IT. Terrific. Now before I forget, did you happen to bring tea with

[00:24:25] you today? Drinking tea. Although I drank it the whole time. You chatted the whole time.

[00:24:30] It's cold, I like to talk. Tell me. That's what I love. We want that. We want to learn from you.

[00:24:36] So tell us about your mug or your tea. I would love to hear about it.

[00:24:40] No, yes. This little mug was a gift from my mom. And again, I'm Irish. So I was raised

[00:24:49] drinking tea and I love tea. I love everything about tea. So this is English breakfast tea.

[00:24:55] I will either English breakfast or Irish breakfast. And I just love everybody should

[00:25:00] drink tea, I think because it really starts your day off just right. Right?

[00:25:07] You have to put the kettle on. It takes time for the kettle to boil. Love that sound of

[00:25:12] the whistle. And then you put the tea and you have to let the tea steep. So you do that. So I

[00:25:19] think it just really starts your day. I love the pace of it and eases me into my day. And

[00:25:25] then by the bottom of the cup, I'm full of caffeine and ready to go.

[00:25:30] Even just hearing you talk about the process of making and drinking the tea is comforting.

[00:25:36] We're actually doing it. So that's too good. Thank you so much, Mary, for joining us today.

[00:25:41] Love learning from you. Thank you for the opportunity, Grace. Great to meet you.

[00:25:45] Congratulations to you on all your success. And I can't wait to see how your career continues

[00:25:52] to grow and develop also. Oh, truly appreciate that. Thank you. And thanks to you folks for

[00:25:58] joining us too. Check out the Hi Tea with Grace podcast website for more interviews

[00:26:02] with amazing guests like Mary today. Cheers. Cheers.