Workflow, application inventory, strategic planning… the list goes on for all that is overseen and implemented by a company’s CIO. Things can become complicated quickly so whatever can be done to ‘keep it simple’ is a must. Every CIO has a unique war story. Galen Healthcare Solutions, an IT technical and professional services and solutions company, interviewed several CIOs to discuss their experiences. Here are excerpts from a few of those conversations:
Sue Schade, Principal, StarBridge Advisors, LLC
A nationally recognized health IT leader, Principal at StarBridge Advisors, LLC, and current interim CIO at Stony Brook Medical Center, Schade has over thirty years of collective health IT management under her belt along with a plethora of awards and recognitions from HIMSS, CHIME, and other leading health IT organizations. In this interview, she talks optimization versus replacement, population health management solutions, how to measure success, and the benefits of knowing your application inventory.
The main point with workflow is: do you adopt your workflow to the product or do you adopt the product to your workflow? I think there’s some happy medium there and what you don’t want to do is a lot of hard-coded customization, because every time you get a new upgrade from the vendor you’ll have to do all the retro fitting; Organizations are trying to do less of that so that they can work within the base product. Vendors are exploring how they can be more user-configurable to adapt to the uniqueness of an organization and their specific workflows. This is where your CMIO, CNIO, informatics folks, and clinical analysts are critical in partnering with end users to make sure that the solutions that we deploy make it better for them and not worse. You commonly hear that clinicians understand and accept EHRs are here to stay but still acknowledge how cumbersome certain features are. I’ve been involved in different optimization efforts at organizations post-implementation, and I will say we haven’t focused so much on ROI as we have workflow and user satisfaction.
I’ll tell you, just inventorying your application portfolio can be painful. You have a lot more disparate and duplicate applications than you ever realized, but step one is to get your hands around that current state. Let me just say this, application rationalization is something that often goes hand-in-hand with implementation of a new core EHR because you may be implementing a common system where there have been disparate systems at multiple facilities and that common system can replace a lot niche applications. The current state inventory of applications is a critical initial step. I’ll be the first to say that many organizations don’t have something they can pull up and say ‘here’s our inventory.’ They should, but they don’t.
Perry Horner, CIO, Adelante Healthcare
As a CIO of major healthcare system, one of the most important lessons Perry Horner learned was when he found himself personally forced into the complicated world of connected health. With his new motto of ‘keep it simple,’ Horner is taking on the connected health world full force, implementing new and affordable technologies, always looking three years ahead. In this interview, Horner talks about Adelante’s EHR transition from Vista to Nextgen; his data governance strategy; and what he’s looking for in a practice management system solution.
Anything that’s HTML5, a no SQL database back-end, that true software-as-a-service environment, that’s what I keep my eye on. Any vendor that’s moving that route, has a product there, is large enough to actually interface with others. I never used to be an agile project management style person, but over time I’ve changed and I see the same thing with software. Gone are the large monolithic products, where they do everything. Stick with your core competencies. If you’re doing something well, partner with someone who’s doing the other part well. Make one conglomerate product. That’s where I’m hoping to see things go.
When it comes to solutions, if you can shift the time and complexity away from the end user, make it as simple as possible and most importantly, know and understand your customer. I can’t believe the complexity of some of these devices in connected health that they’re sending home with elderly patients. Really? You’ve got to be kidding me. Keep it simple and affordable.
Susan Carman, CIO, United Health Services
Susan Carman is no stranger to the fast-paced change of the healthcare IT world. United Health Services, where Carman is currently CIO, is in the process of overhauling their IT strategic plan, including a potential replacement of their best of breed EMR/EHR for an enterprise solution. Since the current inpatient EMR was only implemented 3 years ago, Carman is faced with the tough decision of yet another system replacement, both from a fiscal and employee fatigue point-of-view. She discusses the implications behind their review of the enterprise; why being best of breed and having a data warehouse doesn’t always jive; and her key takeaways from CHIME.
We have approximately 175 applications that we run. When I first came in about a year ago, there was no true inventory of those applications. We used a number of avenues to figure out exactly how many we actually had. It was sort of an unknown, but I certainly knew there was quite a few of them. We’re a best of breed shop, the kind you don’t see much of any more. It’s causing us a lot of issues because we have about 200 interfaces running information back and forth. It’s very resource intensive and expensive to run. The application portfolio is basically being kept on a spreadsheet. Another initiative we’re going to be starting next year is we’re purchasing an ITSM system. A lot of our application portfolio should be kept in that system once it’s implemented rather than keeping it on a spreadsheet.
When I first came on-board, one of the things I was charged with was to survey the ambulatory information system and gather information from the physicians as to whether they wanted to enhance the current system or replace it. Overwhelmingly they wanted to replace the current system. Since we had just gotten word from Cerner that Soarian Clinicals would only be supported for a maximum of 5 more years, it made sense to review our entire enterprise. With this information the IT governance team decided that the best approach was to develop a 3 to 5 year Strategic Plan. The most important component of that plan was to decide on a future EMR roadmap. Our biggest challenge is meeting our integration goals but doing it in a fiscally responsible manner.
Thank you to Galen Healthcare Solutions for sharing these important interviews with today’s thought leaders in our industry. We will be highlighting them throughout the summer, stay tuned. Read our series.