Founded in 1892, Norwalk Hospital is a 328 bed not-for-profit community hospital located in Fairfield County Conn. The organization serves a population of more than 250,000 residents with approximately 2,000 employees, 500 affiliated physicians and 600 dedicated volunteers provide care. Recently, HCI Editor-in-Chief Anthony Guerra had a chance to talk with CIO Jamie Mooney about her efforts to empower clinicians with information management tools.
AG: How savvy are you when it comes to the CFO aspects of your job? Do you ask for help? Do you find that your skills are being tapped in that area like never before?
JM: You know Anthony, I got an MBA in 1983. I am pulling on those skills, I’m trying to remember what an auction bond is. Again, for day to day, no, I can manage my budget just like I did before, it’s just much smaller.But in terms of understanding the long term implications, I am educating myself. Again, everything the CFO says, I read every single line of what's coming out from all the different financial groups. My business school actually had a session with some of their top professors explaining to the students what's going on in the economy. I sat down in an airport one day and listened to them discussing all the reasons that this is going on. I am self educating so I really understand it. But in the end, one of our Board members looked at us a week ago and said, “You’ve just got to hunker down.” And that’s the mentality and that’s what we’re doing.
AG: What about advice to colleagues that don’t have MBAs, do you think some people are being stretched in their ability to cut back and cut back strategically and intelligently, and do you think that they should employ some of these techniques that you have just mentioned?
JM: I think that being out there and absorbing as much information as possible on what's going on is very important. If you remember, there was a lot of discussion as to how we’re stretching CIOs and how we’re much more about hospital leadership than just technology leadership. And I think that it’s important to us, as a profession, if we want to be looked at from that perspective, to make sure that we do self educate. If the CFO doesn’t understand something technologically, he’ll sit down and say “Jamie, I don’t know what they're saying, what does this mean?” I think the CIOs should have the same freedom to sit with the CFO and say, “I’m sorry, I don’t understand that, could you just put that in more layman’s terms?” We have a CFO who does that for the Board, because not everybody on the Board is a financial wizard. So he’ll put information in modern standard American English so that everybody can understand.
But I think that too many times people nod their heads and say, ‘Yeah, I understand,” for fear of being looked down upon because they don’t understand. Finance is typically not our area of expertise. So I think that we should feel absolutely free to get information or to get things explained to us in a way we can understand, because I think it’s very important.
AG: Very good advice. I’ve heard some executives, CEO level, say that they expect their reports to come to them and offer up cuts proactively, not just wait for the Board or the higher ups to come down and find the cuts. What are your thoughts on that?
JM: I think that it’s very important and actually. we’ve tried doing that here because before the financial crisis, we as a hospital were all focused around the major capital campaign we were hoping to kick off. Again, the finance department made it very clear to us what margin we had to hit, a whole bunch of financial indicators that we needed to hit, so that the bond market (which used to exist) would look upon us favorably when we went to get the financing for this capital campaign. So we were already, as a hospital, in a mode of everybody having this shared goal of strengthening the financials. We were already working on each department, looking inward, and saying "what can we do, how can we get more out of our vendors, what can we do about our staffing?"
I’m actually doing that right now; I’m going to be making some changes within my own team and reviewing positions that have been here for a long time. But if I take a real hard look at them, I can eliminate those positions and fill those FTE slots with skills that I really need right now. And it’s a very difficult thing to do because this has nothing to do with performance; it has to do with skill set. I am doing that right now. The rest of the leadership is very supportive of me doing this because it’s the right thing to do, especially in this economic environment. It’s hard, but it is the right thing to do.
AG: Do you think some CIOs throw up their hands and say, “I can’t do my job with the budget cuts you’re forcing me to make?”
JM: I think some may. I think most of us who are in this seat understand that hospitals have never had big fat budgets to begin with. We’ve always been fighting for resources, we’ve always been fighting for dollars. “Is it a new bed, or is it a new server?” — this is nothing new to us. So I think because we do come from a background of more scarcity than plenty, we’re not all that spoiled. I think that actually the proper attitude is closer to what one of my directors said to me when I started talking about how our budgets were going to be severely cut. He said, “You know what, that’s fine.” There are so many things that my team has been saying, “If we only had time to do X.” He said, “Well guess what? Now that we don’t have a bunch of brand new projects, we have the time to do X.” So what my team has done is looked at this as a time to take what we have now and get the most out of it.
AG: That’s great advice.
JM: It was wonderful, and it really just permeates throughout the whole team. This is the time to optimize what we have now. It’s good because it’s the right thing to do, but it’s also the fiscally sound thing to do. A lot of times I’ll be asked by other senior leaders in the hospital why we’re spending a lot on this particular system. Are we getting the most out of it? So this gives us a wonderful opportunity to take a pause and try and, as I said, optimize what we have in place.
AG: And that’s absolutely what we've heard over at the magazine, that it’s time to get deeper and wider usage with the systems that have been implemented. So now you have that opportunity?
JM: That’s right. And the director who said this to me is actually my technical director. He’s looking at how our servers are configured, etc., let’s work on those things. Not only can you say that for all the application projects, which is typically where you see the new implements, but also on the technical infrastructure side.
AG: In this tough environment where you have to make some cuts, how do you decide which projects to fight for?
