HOPE VALLEY — With her probationary period ending in a couple of weeks, Alison Croke, the new president and chief executive officer of Wood River Health Services, says she’s hoping she will be asked to stay.
“I report to a 12-member board of directors and they are discussing doing a formal evaluation in probably the first or second week of January, because that would be the end of the 90 days,” she said.
A former vice president of Medicaid-Medicare integration at Neighborhood Health Plan of Rhode Island, Croke has also held positions in health care policy, research and Medicare-Medicaid benefits management. But after 23 years working in the health care field, this is her first hands-on administrative position at a large community health center, so she has spent most of her time observing, listening and learning.
Croke succeeded Michael Lichtenstein, who had led the health center since 2010.
“In general, my plan had been, the first three months, orienting myself to health center operations,” Croke said. “In order to do that, what I’ve done is set aside a specific time with each department. For example, I sat with the front desk when they were checking in patients, checking out patients. On Monday next week, I’m sitting in the phone room.”
In getting to know the operation and its 65 specialized employees, Croke said a few issues quickly emerged, most notably the electronic medical records system, which needs to be adapted to Wood River’s requirements.
“For the clinical folks, the people who see patients every day, they struggle with our current electronic medical record, which is the system we use for all of our documentation, all of our scheduling, clinical notes, billing,” she said. “We implemented a product in 2012, but no customization has occurred to the product.”
In talking with other health centers that use the same product, designed by California-based NextGen, it became apparent that they had customized their systems and Wood River would have to do the same.
“After they did this type of customization, the level of provider satisfaction increased exponentially and I would say our level of provider satisfaction is low. They’re very frustrated by it,” she said.
David Henley, Wood River development coordinator, noted that grappling with unwieldy medical records software was a significant contributor to health care provider burnout.
“Some recent studies showed that these electronic health record problems are a major source of burnout for physicians these days. It sounds like a silly thing, but when physicians burn out, they don’t take as good care of their patients,” he said.
Another priority for 2019 will be the preparation of a new strategic plan. The plan, which will guide operations and policy for the next three to five years, is a requirement for continued funding by the federal Health Resources and Services Administration and constitutes approximately $2 million, or 20 percent, of Wood River’s operating budget.
The strategic planning process is expected to continue throughout 2019.
“It involves both staff and the board, as well as the stakeholders in the community,” Croke said. “We will engage with a consultant to help us do some of that work.”
Behavioral health, which is already integrated into the Wood River patient care program, will offer more services in 2019.
“We have another new clinician that started about two months ago,” Croke said. “He is a psychiatric nurse practitioner and he is a prescriber, which is great for this area of the state, and he can see patients 16 and older. And we also have another grant that we will use to hire another behavioral health clinician, and we’re just putting the finishing touches on what that job description would look like. Ideally, that person will be able to see kids … We really have a need for someone that can treat the whole family and the kids in particular.”
Croke said she also hoped that Wood River would realize an expansion goal. “An area that staff and the board have been longing to do for over a decade is to really expand our services into Westerly proper,” she said.
As she has settled into her new job, Croke has confronted a reality familiar to policymakers in South County: the feeling that the needs of communities in the southern part of Rhode Island are sometimes ignored.
“It did come as somewhat of a surprise when, for example, you’re talking to state officials, like folks at the Medicaid agency or the Department of Behavioral Health, and they’re launching great programs to address issues, but they’re much more focused on the urban areas — sort of Warwick to Woonsocket, even,” Croke said. “That northern part of the state, it’s understood and the geographic issues are addressed, but South County is often forgotten.”
Croke and administrators from the other southern Rhode Island community health center, Thundermist, are working together to ensure that the needs of South County communities are recognized.
“We say ‘this is a great program, it doesn’t help us in South County, and there’s need here,’” she said. “So we just continue to be consistent with the message and have our voice be heard. ... Change like that, statewide efforts, they take time, and there seems to be an understanding that South County has been ignored from a lot of these resources and programs. It starts with the understanding and then, move towards commitment to address it.”