By CereCore | Mar 7, 2025
6 minute read MEDITECH| EHR/EMR| Blog| Client Perspectives
Healthcare stands at a crossroads of transformation with technologists and clinicians charting better and new paths for key technologies like EHRs and AI. Darrell Bodnar, CIO of North Country Healthcare, joins The CereCore Podcast and discusses approaches his organization is using to encourage technology adoption, improve clinical workflows through EHR optimization, and manage financial constraints. A strong advocate of process improvement, he shares how employees form an integrated team of trained Yellow Belts who are empowered to pursue improvement and the difference it is making to foster employee growth and satisfaction. For years Darrell has been a keen observer of generative AI, and he talks about ways North Country Healthcare is tapping into ambient listening and how they are working together to pursue the benefits of AI.
Find conversation highlights below and stream the full episode.
Editor’s note: Responses have been edited for clarity and brevity.
The importance of clinical staff in technology adoption and digital maturity
Phil Sobol:
North Country recently achieved level nine in CHIME's Digital Health Most Wired program for acute and ambulatory. In fact, North Country was the only healthcare organization in New Hampshire to achieve this caliber of digital health maturity, which is a tremendous honor. Talk about what goes into integrating technology into healthcare to drive such a high level of performance.
Darrell Bodnar:
When I think of the technology and implementation and what we've done, it's more than the implementation of technologies. It's the adoption. Adoption isn't strictly an IT function. IT has to be intimately involved, and we need to provide guidance for end users, so that they can interpret it, so they can adopt it, and they can build it into their workflows. It takes a long time to do that, especially across three organizations.
We've been building this for years. Initially we started out with the level sevens and so forth and have slowly worked our way into the level nines. I was surprised that we achieved level nine in both of those this year, but it's a testament not to my efforts, but to the entire organization's efforts. It's the team's efforts, and their willingness to adopt and implement best practices that will lead us down that path.
Embracing AI responsibly
Phil Sobol:
Many pressing topics facing healthcare IT today. AI and cybersecurity are probably the top two. You've been studying and watching these disciplines for a number of years now. What are some ways you're preparing your organization for both the current and future benefits of AI? Any advice for leaders as they're talking about these sorts of topics with their stakeholders, clinicians, board of directors?
Darrell Bodnar:
In 2018, I became very interested in watching where AI, machine learning, artificial intelligence was going to lead, and it's gone places that even then I couldn't have imagined. In fact, I'm presenting at Becker's Annual Healthcare Conference about the impact of generative AI on healthcare operations. For me, it's a key component and people have embraced this in so many ways.
The responsible adoption of AI is the key focus going forward—making sure that we do it in a secure and safe manner for our patients. Once again, it's not an IT function. It's an organizational function. It is an organizational risk, if they want to adopt it or implement it. There's a financial risk.
We're piloting using ambient voice technologies. We have 15 of our providers currently using it, and it's going extremely well, but their workflows had to change. You can't just implement this. Our providers are very, very engaged. They say, "I felt odd walking into a room. I had nothing to type. I had nothing between me and the patient. I had to reiterate things I was saying to make sure that they were captured by the ambient scribe."
Going through that process was a complete workflow change. So, it's not the technology, although it's a key component. It's how you adopt it, how you blend it, how you work through it. We're still learning as we go through this.
I think about generative AI, where we currently are. I think about agentic AI, where it's going to autonomously address issues, take care of things without our knowledge. I believe with all my heart that's the path that we will go down. But, the inherent bias that's built into the technologies needs to be called out and made transparent. We can't avoid them. There's bias in our conversation right now but building that in so it's transparent and visible is a key to that success. But honestly, the sky's the limit on this. This is what's going to change our entire healthcare system.
The strategy of continuous EHR optimization
Phil Sobol:
The EHR still remains the foundational technology for clinical care and is an integral piece in helping drive operational efficiencies and clinical workflows. We've been working together on EHR optimization. Tell us about the strategy and process for optimization at North Country.
Darrell Bodnar:
I agree with you entirely that the EMR is still the foundation of all of our work—whether that be good or bad in some people's eyes. Working with the optimization team from CereCore was extremely helpful. The key to the special sauce of CereCore was made up of multiple ingredients, but one key ingredient is the depth that you bring to the table. The depth and experience of your bench is huge, because we can pull from a lot of resources. You are explaining things that we didn't know existed. It's really hard to optimize something when you didn't realize there was an opportunity there before.
Typically, with EMRs, you implement them and then you upgrade, upgrade, upgrade. Rarely do you take advantage of all the functionality that comes out within an upgrade. If you miss something that was two versions ago, you're certainly probably not going to adopt it. You may not even remember it exists. Somebody may stumble across it.
Having a thorough assessment of your environment by an independent third party, who understands the software and has familiarity with best practices and workflow, is a key to this. Because when you can bring those individuals in and they can say, "We would recommend you do it this way."
And the initial response, "Well, I've always done it this way, and it works well." Until you start to push them through, and they get to see that improvement. It's a partnership.
There's no light switch to say, "Now you're optimized." It takes time, and I also think it's an ongoing endeavor. We've gone through a huge optimization opportunity with CereCore and I suspect we will be going through those on a regular basis, because we need to keep improving and keep evolving. As soon as you stop optimizing your EMR, it is going to stop functioning to its fullest potential.
Building empowered, multidisciplinary teams for continuous improvement
Phil Sobol:
It's easy to become overwhelmed. "Oh, there's so much to get done." As a healthcare leader, how do you keep your teams motivated? Any creative solutions to help staff?
Darrell Bodnar:
We've tried to make sure that a lot of our work is driven by the subject matter experts and not IT. That has been a historic challenge. I don't mind identifying technologies to help, but the implementation and use of those really needs to come from the subject matter experts.
North Country Healthcare went through a really unique endeavor. We trained all of our staff in Lean Six Sigma Yellow Belt training. About 1,100 people. It was a huge commitment when you think about the hours of training, but then you have 1,100 Yellow Belts—little engineers out there looking to try to improve process.
Now, when we've tried to drive people towards success, it is more focused. It is not a generic roadmap that's out there.
People are identifying things. We have a clinical information management team that is led up by a variety of different people within the structure. Multidisciplinary teams come together and try our EMR modifications, optimization and improvements. These are the individuals who modify order sets but also will review new AI technologies that we want to bring in and review.
So, having some focus on strategy and direction led by subject matter experts has made it easier on my team, I think, because we are not challenged with identifying solutions. They are identifying some of their own solutions and we're helping vet those out. They know best.
It's built a more integrated team, which I think brings a level of satisfaction. However, to your point, that does not help reduce the workload that comes with all of that going on. And I think the staff still struggle with that, but I think they're more passionate than they've ever been.
We've had some goals this year that were identified and driven by Yellow Belt projects, and they've gone right to the boards. These individuals are delivering their presentations to board levels, to say, "This is what we did to improve." It's really inspiring to watch them and see the results when you do empower staff to improve.
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