A bridge between the clinical and technical sides of healthcare would solve so many challenges nurses are facing today. This episode features a very hands-on trauma critical care nurse who turned to informatics when she realized how important it would be in healthcare.
This week’s guest on the SONSIEL Podcast is Kathleen McGrow, Chief Nursing Information Officer at Microsoft. She talks about her journey as a nurse, technology, and communicating clinicians’ needs to developers to push transformational innovations. She explains what it means to take a great idea and deliver it into something actionable for many people, sharing a lived experience where she helped build an electronic health record for the Amazon basin. Kathleen also speaks of the importance of networking and having social support when facing humbling situations and driving innovative initiatives toward development.
Tune in to this episode to learn about leveraging technology to improve processes and patient outcomes!
Kathleen McGrow DNP, MS, RN, PMP, is Chief Nursing Information Officer at Microsoft. Dr. McGrow is the Chief Nursing Information Officer at Microsoft. As a part of Microsoft Health & Life Science, she advises organizations on how innovative technologies can enhance clinical, operational, and financial performance, maximize capacity and patient experience, and transform care models. She is an expert in how specific technologies can best be deployed to address digital transformation imperatives including consumer engagement, provider enablement analytics for population health, and cognitive computing to support a learning health system.
Dr. McGrow’s unique abilities lie in her combination of expert clinical and IT backgrounds. She holds a Doctor of Nursing Practice from the University of Maryland Baltimore and has many years of clinical/critical care experience, as well as being educated in technology. In addition to her current leadership role at Microsoft, she held executive positions in clinical solutions development and product management at Philips and served as head of marketing at Caradigm, a Microsoft and GE Healthcare company.
A nationally recognized authority in the convergence of nursing and technology, Kathleen has presented a variety of educational sessions for professional groups, including the International Nursing Informatics Symposium in Taipei. She has published five articles including about how artificial intelligence (AI) transforms clinical data into wisdom, and how the rapid evolution of AI will transform healthcare delivery more broadly. She has also published on the topic of heuristic evaluation of healthcare information flow for inter-hospital critical care patient transfers. Dr.
McGrow is Co-Chair of the HIMSS Innovation Committee and is an active volunteer in the community, including serving as a Disaster Recovery Specialist for the American Red Cross.
SONSIEL_Kathleen McGrow: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
OR SONSIEL Intro:
Welcome to the SONSIEL podcast, where we host interviews with the most transformational nurse scientists, innovators, entrepreneurs, and leaders. Through sharing their personal journeys, we create inspiration, provide guidance, and give you actionable ideas you can use to be a catalyst for change.
Mary Lou Ackerman:
I’m Mary Lou Ackerman. I’m Vice President of Innovation and Digital Health at SE Health, which is one of Canada’s largest social enterprises, primarily serving clients in their homes, but also, we do provide care in long-term care facilities and hospitals and schools, so really meet people where they are and where they meet their needs. I’m also a founding member of SONSIEL and really happy to be your host today for the podcast. I wonder if we could start with you just sharing a little bit about your background and welcoming, I probably should have welcomed Kathy McGraw, is that how you say your last name?
Kathleen McGrow:
It’s McGrow, Kathleen McGrow. Yep, yep, that’s fine, yep. It’s very nice to meet you. It’s Mary Lou, right? Mary Lou? It’s nice to meet you. So my background is I’m actually a trauma critical care nurse. I was born and raised in Baltimore, Maryland, and we have the R Adams Cowley Shock Trauma Center here, so I was very lucky to have gotten the opportunity to work in the trauma resuscitation unit. As I was doing my clinical, I came to realize I was at, it was at the time where we started to more and more utilize computer systems for patient care, not full-blown electronic health records, it was actually prior to that, we had a lot of homegrown stuff that we would have to use, and so I decided that there may be an opportunity on the information technology side. Really, for me, it was around how do we communicate the clinicians’ needs to the developers. We had some guys in the basement who built a program, 3.2.1 got hematology, 3.2.2 got chemistries, and I wanted to see all my labs together, and when I asked about it, I was told some guys in the basement built this and never asked us what we wanted it for. And I thought, well, I’ve got to figure out who the guys are in the basement, how to get to them, and how do we communicate with them, how, the needs that we have, right, on our end-user needs for our clinical systems. And through part of that, I ended up getting my master’s in nursing informatics because I felt like I needed to have some knowledge of what they were speaking to me about so I could learn that terminology. So I always say I’m the bridge between clinical and technical. I’m very deep clinically. I did clinical for many, many, many years in a multitude of settings, and then I have enough technical to be dangerous. So that’s kind of how I got started in it, and I thought I would take care of more patients than just the two, one or two I was taking care of in the trauma resuscitation unit, frankly.
Mary Lou Ackerman:
Right. Yeah, for sure. No, really important role. A similar background to myself actually with informatics. And I did a master’s, an MBA, but also with a focus in health information management. So really important, I believe, to have nurses at these development tables and that bridge between the technical and the clinical, because if it’s not designed with the right users’ input, we know what happens all too well.
Kathleen McGrow:
Yep, and we’re seeing it now, right? The accumulation of this all those years and I am guilty of it. I, my first job, I implemented a clinical information system for acute care and perioperative anesthesia, and I remember not through any fault of my own, but because I really believed it at the time, we’re going to make you better, faster, stronger when we would go in and talk to the providers. You know, I never mentioned, oh, we’re going to make you slower and make you have your hands on a keyboard 80% of the time and increase your cognitive overload because we’re going to give you so much data that you can never process it in a timely manner. And now we’re seeing the impact of what we didn’t know then, right? I wish we had known more then, but it’s like anything, we have to learn, but we also have to innovate, right, to improve, to make these improvements, we have to see where the failings are and help make the improvements.
Mary Lou Ackerman:
Yeah, absolutely, absolutely. So what has inspired you to work in healthcare and stay in healthcare?
Kathleen McGrow:
Well, I’ve always been about patient care. You know, sticking my finger in a bullet hole was fun to me. So I’m, you know, very much a hands-on clinical provider. I’ve, even in my informatics world, I do one year, one time a year, I try to do a medical mission where I actually do hands-on care. I’ve been to the Philippines, I’ve done a lot in South America. And then during COVID, I started becoming a vaccinator. So I worked with the Baltimore City Health Department and got out and vaccinated folks because I’ve kind of felt like that was my responsibility to volunteer. I also volunteer with the American Red Cross. I don’t necessarily do nursing for the Red Cross. I am a disaster action team member and actually respond to any type of emergency, fire, flooding, and, you know, try to help people out. So I guess I’m a helper, so that’s probably why I’ve stayed more on the clinical side.
Mary Lou Ackerman:
Well, what an interesting clinical experience, especially those medical missions. I would imagine that you see all kinds of opportunities and possibilities when you’re in those situations.
Kathleen McGrow:
Yeah, it’s interesting. When I first started going to well, the Philippines was very interesting. There’s a lot of discussion there because you know many of the Philippino nurses come to America to work. So we kind of do a brain drain and there’s a lot of angst there when you go and you talk to those clinical providers. South America was very interesting. I didn’t anticipate talking about this, but it’s pretty, I think it’s pretty interesting. I went with Microsoft, I’ve been with Microsoft two times across 11 years, and initially, it was in 2007 till 2012. I was in an incubation team within Microsoft and that was the group that actually I went with a group that was affiliated with Microsoft and then an organization called Timmy Global Health, and we went to the Amazon basin in South America and we went in and out of villages and took care of patients. And, you know, typical Microsoft people, engineers, they were like, why are we using paper? And the humidity was so bad, Mary Lou, the patient would literally come to me with one piece of paper, and by the time they got to me, it would be like mush because it was so humid in that environment. So the engineers went back and they built an electronic health record for the Amazon basin and essentially they gave it to the organization, Timmy Global Health was all open source, and so we actually had an electronic health record in the middle of the Amazon jungle. We brought a generator with us. We had one server that they counted as, one PC that was they considered the server and they set up WiFi. So we spent the first 30 minutes using duct tape and Band-Aids to get the WiFi to hang up on a concrete wall, and we actually had an electronic health record, very basic. The important thing was we were able, they wanted to track the population, which was good. And the other thing was they really wanted to have an understanding on medications. Like when we go to a specific area, you know, people, one time we had a very, very long clinic day in those 12 hours. And at the end of the day, they ran out of pediatric Tylenol and we had patients waiting for it, and then we couldn’t just distribute it to them. So that was really a failing that they took very, very seriously. So what do you do? So this kind of helped them with their, I guess, supply chain, right? How would they be able to manage those things? So it was pretty cool and they’re still using it today as far as I know. So it was all good stuff came out of that.
Mary Lou Ackerman:
Yeah, great, great story. So at what point did you recognize in your career that innovation was the path that you wanted to be on?
Kathleen McGrow:
I think I kind of always wanted to be innovative, even when I was a nurse at Shock Trauma, I had a lot of opportunity there. They had a lot of grant funding. We actually were fully media capable there. We did a lot of studies where the, say the resident would do an ultrasound, and the attending physician would actually be in another room and they would relay, it was like a telemedicine, and that was to simulate the theater, right? The war theater. So if you have a soldier who’s injured, you know, in the middle of Afghanistan and, you know, they need to have an ultrasound by a medic, could a physician monitor that and see do they, how quickly they need to get on to definitive care? And I actually was a research assistant when I got my master’s degree and we put these eyeglasses, it wasn’t Google Glass, but we eyeglasses on all of the different trauma providers. And then I had to go through and I had to look at like, who was looking at what, right? So if you’re looking at eye motions, the nurse is looking at the patient’s face and their chest, and their abdomen. If you’re looking at the anesthesia provider, it’s their face and their chest. If you’re looking at the primary physician, it’s, you know, head, chest, abdomen, you know, extremities. And then the medical student was looking at the clock and looking at this and looking at that, right, they were like all over the place. And I found that really interesting that you know, even looking at where someone’s paying attention to a patient could actually impact their outcomes. We did another study around alerting in the OR and alert fatigue. And this was a long time, this was a really long time ago, I don’t want to date myself, you’ll think I’m really old. But I always thought that was really fascinating in how could technology really improve what we’re doing? So I think when you’re looking at technology, you’re always kind of thinking about being innovative, right? Like, how can we make change? How do we do that change management? How do we implement it? How do we convince other folks that what we’re doing is for the best? Because, you know, we have laggards that we need to pull along. So I don’t know if there was like a point in time where I had like aha moment, I’m really innovative. But there was definitely a moment where I thought, wow, this is really cool, and I like doing this.
Mary Lou Ackerman:
Right.
Kathleen McGrow:
That’s probably really more of that point. Yeah, and I was still a nurse. I was still a clinician working at the bedside when that happened. Yeah, I think nurses are phenomenal innovators, right? We’re great multitaskers. We’re really good at motivating people to do things. And by that, you know, we learn from our patients like how do you get a patient to do something they don’t want to do? And then we’re always thinking of great ideas because no matter what we’re trying to do, we’re trying to do the best thing for the patient. I think the difficulty we run into is articulating to someone, how do we take that great idea and deliver it into something actionable for many people.
Mary Lou Ackerman:
Right. Yeah, I love your example of the glasses and monitoring what people are doing and the impact that have, that whole space around the human factors of design and solutioning, so important. And I think the other thing is that we’re, with SONSIEL, we’re also, we have today a methodology and innovation methodology that we share with our members that is continuing to build and grow based on feedback from the membership. So it’s, I think will be a really great tool, it is today, but I think it’ll continue to be a good tool and get better over time with more people using it and more feedback to help nurses with that sort of innovation approach. How do they take that great idea and bring it through their organization or not or venture out on their own with it to help solve some of the big challenges that we’re facing? So what has been sort of the biggest challenge that you’ve faced in your career?
Kathleen McGrow:
I would say I think everyone has challenges, you know, personal and professional. I’ve actually been let go. I was a reduction in force. Boy, was that a humbling experience. We feel like we give so much to our jobs, to our physicians. And you do, you know, you feel like you’re doing a great job. And then to be part of a riff was pretty impactful for me. But, you know, you make lemonade. I actually learned a really good skill set. I learned how to find another job, and actually, it ended up better for me in the long run. And I was part of a multiple-person riff. So it wasn’t just myself, it was many people. And I had seen riffs prior from that organization, they’d had a few riffs prior to that. So I’d say that was something that I think is, some people, that’s a big challenge, right? It’s just the challenge of personal, profession, not only the fact that you lost your job and now you have to kind of figure out how you’re going to make ends meet or live through the day, but just the whole psychological part of it. For me, I’m a pretty high achiever and you’re like crushed. You know, it’s really tough. But, you know what? It was a great learning experience and I moved on, and I do try to impart when I have people who have told me they’ve experienced that, can I help them out? I’ve got some great tips and tricks on what you need to do. And, you know, I learned to grow my network and expand my network. And like I said, I ended up in a much better place than I had been at. So it actually worked out for the best. So I was, I guess I was lucky in that aspect of it, to be honest, Mary Lou. That was probably a tough one. And then, you know, I’ve had loss of family members. You know, it all puts it in perspective. I’m a trauma nurse. If it’s not life or limb-threatening, you got to kind of like just roll with it. So those are the types of things that I think are very impactful, but I have a very tight-knit family, which is helpful. So I always tell people, you know, make sure you have a good support system because I think that that is what really helps us get through those kinds of challenges and the bumps in the road, frankly.
Mary Lou Ackerman:
Yeah, for sure. Those are although, although not a reflection of you as a person or as a professional because it is a reduction in force, but they are also, even with that being said, they’re humbling experiences and, but the ones that we can grow from and it sounds like, you know, so many great words of wisdom there around the networking and social support and making sure you have things in place always, not just for those situations, but for any challenging situations that you run into, especially as a nurse, because we’re so used to helping others we’re not getting the safety nets around ourselves, so thank you.
Kathleen McGrow:
Sure, we’re great helpers, but we’re always not so, we don’t always take help so easily or reach out so easily, right? That was hard for me. You know, when I had my riff, I had to start to reach out to people and I realized that it’s okay and people want to help you, right? As long as you’re kind to other people, right? Don’t burn any bridges. That’s my other learning, I guess, right?
Mary Lou Ackerman:
That network is important.
Kathleen McGrow:
Correct. Correct.
Mary Lou Ackerman:
So how has SONSIEL helped you in your journey as a nurse?
Kathleen McGrow:
Oh, I love SONSIEL. I think that it’s a phenomenal organization. I love the networking, the connecting, the opportunity for the learnings like I’ve attended quite a few of the sessions where they’ve had, where you’ve had folks that have spoken and I just think they are phenomenal. I think it, for me, I think it’s as a nurse informaticist, I feel very strongly that we need to uplevel the nurse informaticists, and I’m sure you probably think of nurses overarching, but for me, I’m kind of in that nurse informaticist role. I feel very strongly we need to uplevel their thought processes, and I think SONSIEL offers that opportunity by connecting to the thought leaders that the nurse informaticists really should be connecting to. I feel we need to, there’s so much more we can do around innovation, it’s not just about the EMR and the data. It’s about the insights we get from the data and how we can action on it, and we can action on it in many, many ways. And we need to be innovative to think about those actions. So as an organization, I feel that SONSIEL promotes that and really helps their members, you know, look at ideas on how they can either launch an idea or connect to other folks who can help them. Like I said, I think it’s all about, a lot of it’s about the network. I won’t say all about the network, but very heavily about the network and who we’re connected to, and who can help us and assist us. And I think in general, most people want to help each other. So that’s, definitely, those opportunities are very helpful, very beneficial. I love the meetings. You know, kind of, could be over 100 people on the meeting and you’re like, oh wow, like I met that person at a hack. And, you know, so I think that’s really great. So I think really SONSIEL offers those types of opportunities and members have the ability to take advantage of them.
Mary Lou Ackerman:
Yeah, yeah, for sure. I think the whole space of nursing informatics is going to explode over the next few years as we’re seeing and I really hope it does, because we’re seeing so much more health data being collected and if we don’t really guide how we’re going to really use that as nurses, I think it will be a hindrance if it’s not done properly. As your early days’ experience of wanting to meet the guys in the basement who are giving you these disparate data sets, that’s going to get worse for us if we don’t really understand and drive and influence AI, artificial intelligence, and how we’re doing machine learning, all of those things so that it really is insightful and useful information as we go forward.
Kathleen McGrow:
Yeah, I agree. I think the tsunami of data is hitting. We need to be able to help people understand that, the other providers, the nurses, the physicians, the patients. I was just, facilitated some panels around precision medicine, and patients get these like bibles back on like DNA analysis of like their cancers or their disease process. They don’t understand it, they don’t know how to dissect it down, it’s a really tough skill set to learn, and I think we’re going to need, nurse informaticists will be part and parcel of that, educating the nurses on the floor as to what they’re looking at when they have CD studies as well as the patients. So I agree, I think nurse informaticists, we’re going to see the role really expand and grow exponentially, and it’s going to be away from the EMR and towards the innovation of what’s going to happen.
Mary Lou Ackerman:
Yeah, for sure. Yeah, good. So what are you most excited about then, in the healthcare space and innovation, in nursing innovation in particular?
Kathleen McGrow:
Well, I’m very excited that, well, I shouldn’t put excited, I would say that I am eager to see how now that the rest of the world realizes how bad the workforce crisis and burden and burnout is. Now, that’s revealed to the naked eye. We’ve always had that, I mean, I’ve been a nurse for a long time and we always work through crises, and we never let it known to our patients. We didn’t want to scare them, right? I mean, I remember many a time where we just, you know, you don’t talk about it. But I think now everyone in the world, it’s a global problem. You know, we have this retention, recruitment, attrition, it’s really horrible. And specific to nursing, I’m really excited that there’s now a focus on nursing and how can we make these improvements. How can we automate manual processes? How can we leverage artificial intelligence, like you mentioned, to assist them to really look at what they need to be looking at in a timely manner? And then how can we leverage all the other goodness around things like conversational AI and computerization or the computational AI things that we can really look at? The nurse could walk in the room and say, hi, Kathleen, how do you feel? And I can say, oh, I don’t feel so good today. And that will be transcribed for the nurse, not just the physician. So I think as nurses, we have to really push for how we’re going to leverage technology to improve our processes and help our patients, right? It’s all about patient outcomes at the end of the day, but that’ll improve our patient outcomes.
Mary Lou Ackerman:
Yeah. I think your point about needing to lean into voice technology is going to be really important so we can move nurses from the screens back to the bedside where they’re most needed. So hopefully we can continue to head in that direction. We’re seeing it in our households with the Google Homes and other devices like that, which are actually working quite well for people, and the adoption rate is pretty high. So hopefully we’ll start to see that come into healthcare more and more.
Kathleen McGrow:
We will. We will. I think we’ll see it more and more. I think it will be closer than we think. My fingers are crossed that we can really push it. There’s a whole, you know, it has to understand the medical terminology and who’s talking. You know, if it’s a child and there’s a parent in the room and things like that, we can do that today, Mary Lou, we got it. We just have to figure out how do we embed these types of technologies into the nurses’ workflow, which is a lot more complicated than a physician where you walk in and you’re sitting in your doctor’s office and you’re just talking between you, right? There’s a lot going on at the bedside when you go into a patient’s room and there’s a lot of beeping and buzzing and things like that. But I have, I’m very bullish on that and I’m very hopeful that we’re going to get that out there sooner than later.
Mary Lou Ackerman:
Yeah, I’m excited about that as well. I’d like to keep in touch with you about that.
Kathleen McGrow:
Sure, absolutely, absolutely. And home care, it would be great for homecare, right? I mean, they have so much going on in homecare, there’s so much that, and we’re going to see that move as well. We’re going to see hospital-in-the-home. We’re going to see that shift where we see more and more healthcare providers have to deliver care in the home, that’s going to impact everything. Nurses leave nursing school now and they go to acute care. That may not be in the future, they may go directly into home care. I don’t know, we have to figure that out. So there’s a lot of complexity to it, and we need to prepare these nurses. They need to prepare when they get out because there is no three or six months orientation anymore. They just don’t have the staff that can, that hospitals, organizations, don’t have the staff that can do that right now.
Mary Lou Ackerman:
Right, right, but I’m sure there are different ways to do that as well that can still be effective.
Kathleen McGrow:
Absolutely, we’ve got virtual nurse mentors. So we’ve got lesser experienced nurses in the ICU with a more experienced nurse that they can do a Teams call, like a Microsoft Teams call, and they can actually see the video, they can show them, they can flip it, they can show them, here’s what I’m looking at, can you help me? We have nurses that are going into the bedside and they’re doing those types of things around double checks of medications on IV pumps that need to be double-checked rather than bringing someone in a room, especially in isolation. So there’s a lot of technology that we’re starting to see more and more on the nursing realm. We just need to continue to push it forward and we need the nurses to give the input into how it’s working for them. And if it’s not working for them the way they need it to work, we need to push to make it work for them the way it should work for them.
Mary Lou Ackerman:
Yeah, yeah. Yeah, we’re seeing a lot of those sort of video consults as well in the home care space as well, and the use of different technology to support e-consults, let’s say, for say wound care some, there’s some nice technology out there now too so that, if you have your wound specialist but she can’t be, you know, you can imagine the distance that they drive, this really helped them to stay in one spot and then have the nurses who are local caring for the clients take pictures, automate measurements, send that to the specialist who then provides guidance. So yeah, lots of cool things happening out there.
Kathleen McGrow:
Awesome, awesome stuff.
Mary Lou Ackerman:
So what’s one thing that you’d like to leave for our listeners today? Words of wisdom.
Kathleen McGrow:
I would, yeah, I would say follow your passion. If you have an idea, take your idea and grow it to fruition. You know, talk to other people about it, continue to network so that you can really understand what’s already out there and available, and, you know, look for people that’ll help you. There’s a lot of people that will help you. You just need to make the reach out. I know there’s a lot of people who are a little hesitant to make a reach out. They don’t want to bother someone or they don’t want to, you know, they don’t want to disturb them, but I think that in general, all of us want to help each other out, and I think that’s how we should be actually, is help each other out. It’s, it is a tribe and we need to grow the tribe.
Mary Lou Ackerman:
Right, great. Yeah, no, that’s, I think those are good words of wisdom that, following that passion and asking for support and finding the people who can help you get there, it’s really important. So, Kathy, I wanted to thank you for joining us today for our podcast. I also wanted to thank you for all the help that you’ve done with the SONSIEL hackathons. Really appreciate your support with those and hopefully, we’ll see you at the next SONSIEL THInC conference, which is coming up this fall in Niagara Falls, the first in-person one since COVID. So we’re really excited to get back together as a group. Hopefully, you can join us, and I would imagine you join us already at the monthly meetups, so.
Kathleen McGrow:
Yeah, I love the monthly meetups. I’m looking forward to the Nurse Hack Pitch that’s coming up, and I’d love to make it to, Niagara is beautiful, so I’d love to make it up there. It’s so nice. Thanks for having me, Mary Lou, I really appreciate it.
OR SONSIEL Outro:
Thanks for tuning in to the SONSIEL podcast. If today’s podcast inspired you, we invite you to join our tribe or support our mission by visiting us at SONSIEL.org. That’s S O N S I E L .org.
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