AG: Tell me about your relationship with the clinicians. Do you have a close relationship with the CMO, the CMIO. Most CIOs say it’s critical to get involved with the clinicians and to have people with clinical backgrounds on the IT staff.
BW: Well, the only way you can help change healthcare is involving the clinicians from the very start — I think that’s a fundamental. Two things that I have found very helpful: one is listening intently and understanding, just like you would understand a business process if you were talking to financial people, or operational people. You really have to get into the business office, into the physician’s office, and understand what their day is like. It’s intense, it’s high-demand, and there is little respite for a physician or nurse in healthcare today to think and act differently when the pressures of delivery are so high.
So that is step one, to understand the environment we are looking to transform. Part of that is really tapping their expertise, in what I call reengineering and process redesign. You have to get the experts in the room and say, ‘We are going to take a look at current processes and systems, and our goals are safety, quality and satisfaction. Tell us about how it works today.’ Go through the basics that other industries have employed in reengineering and get them involved from the start.
And the thing that I found by bringing the nurses and physicians in at the early stages — the conceptual stage — is I see so much passion ignited around the reformulation of the healthcare delivery model. That level is absolutely essential in the ultimate outcome attainment. That’s the long way to say that the doctors and nurses know what is going on, who better than them to help us process change and redesign and apply technology? So I am a big believer is building a broad coalition and working directly with physicians and nurses in our hospitals and other facilities. I mean the nurses can’t be undercounted. One of the early learnings was that the nurse really makes new systems and transformation go. And their ability to grasp and understand it is a key ingredient to physician adoption and success.
AG: How much were you able to evaluate the IT architecture at CHW before you took the job?
With dozens of hospitals, I can’t imagine how many different products and applications are being used. At some point, did you white board it out and try and figure out all the SLAs and other contracts?
BW: I didn’t go into a formal detailed technical assessment. I think the role of CIO primarily needs to focus on strategy, on encouraging, building and equipping the organization to be able to deliver IT and technology. I knew that any organization this size is going to have a rich history of a variety of systems, particularly when a number of our hospitals have come in through acquisitions and partnerships, and those kinds of things.
One of the things that I look forward to is how well the governance model works. How do we make decisions, how do we priorities with limited resources? So, those were the areas that I focused on more than getting into the technologies inside. I did understand it and was aware of the major platforms that we have. In my experience and career, that’s a pretty normal fact of any organization. It’s just going to be a variety of systems. But I focused on asking, ‘Do we have the necessary systems to do the fundamentals, to support the business? Are we responsive? Are we delivering a good, secure process? Do we have fundamental controls in place?’ I looked at some auto report findings and felt comfortable that we were in a good position. In the two months I’ve been here, I haven’t found anything that surprised me.
AG: You’ve got 1,000 people working for you. That’s quite an org chart. Do you plan any changes to it?
BW: Well I haven’t made any changes at this point, but the way it works now is we are outsourced to Perot Systems who is providing us with network management, helpdesk, desktop support applications, and a whole list of services. And we also have quite a number of projects in process at this point, financially and clinically. The way the organization works now is I have a very small team of CHW internal IT leadership, about 15 folks. That group is primarily focused on financial systems, but we also have clinical systems folks. We have a very strong operation with our CareConnect Program (an EMR and CPOE system) which is our clinical transformation process. We have folks that manage the contracts and finances and the economic parts of the business, and then the compliance and risk management, and then the other is the technology structure and architecture.
Beyond that, the service delivery is with our partner Perot, who we are very close with. They are part of our team. We have individuals at each facility that are called site executives. They’re involved in the local executive teams. They represent IT, and with that they have a number of staff on the ground at the hospital or facility that attend to desktop support, break/fix, telecommunication those kind of things. We’ve centralized our help desk and applications management function and some of the broader areas of the business into our Phoenix operations. And, right now, that works pretty well. So as of now I don’t see major issues other than it’s time in the business cycle to take a look at where we need to go.
