AG: What we’re talking about here is really CIOs taking an active role in facilitating adoption through these different techniques. To what degree do you think CIOs should be on the hook for actual clinical clinician usage of these systems, 50 percent, 80 percent, 20 percent?
NG: I would say if I was forced to pick a percentage, 50 percent would be realistic or reasonable.
AG: Who would have the other 50?
NG: Whoever the business unit owner is, the executive owner. So if it’s nursing, it would be the CNO, if it’s radiology or lab, it would be the VP of clinical services; whoever your counterpart is at that level who has the direct staff responsibility for that area. I think that CIOs can’t run from the fact that we are bringing change tools to the table, and that oftentimes our customers aren’t skilled in change management methodologies, and we have to help bring that to the table.
So early, I think the CIOs have to have a lot of accountability in that, maybe even more than 50 percent, let’s say 60/40. And then ultimately, you get to a 50/50 level, and then as the organization matures and your user base’s experience with technology and understanding of why the technology is in place matures, maybe we can even see that shift to 40/60, where the CIO has a little less accountability to the compliance and a little more shift to the business unit executive.
AG: I’m sure you’ve been in implementation situations where the person in that ideal champion role — the CNO or head of cardiology — was not a champion of IT. Have you experienced that, and how did you deal with it?
NG: I have, and it is a difficult situation. Ultimately, this has got to be a top-down exercise, so from the board to the CEO on down, the support has to be there to implement these technologies. And if it’s not, and you're at the same level as the CIO, let’s say with the CNO, who is resistant, you're going to face a huge uphill battle, because ultimately you’ve got to make sure that message is coming from the people above both of you that say this is the way we’re going to do it, like it or not. Now in the absence of that, it’s the traditional relationship-building things, you try and educate and get them to see why all this was done and communicate that.
One of the things we did in this implementation is we formed a specific committee that was called a change management committee, and we actually installed our VP at HR as a chairperson of that committee. We realized that there is a lot of change happening here, and we’re so wrapped up in the process of the technology, that if we don’t really do a good job of communicating, we’re going to overwhelm our staff, our line clinician. So this group was put in place, and we looked at even some professional change management services (very expensive), and we said we’re not sure we can afford to do that, but let’s at least take some lessons learned from them and look at some of the communication tools they put in place. We created a specific Web site on our intranet that was there for anybody to go and see what was going on and frequently asked questions and you can post questions and get your answers there, and we had newsletters that went out. We had events and fairs that were done to communicate things, in addition to the full scope of all the training that had to happen.
So this was run by HR, and myself and other executives sat in on the committee, but it was by the VP at HR and had some line participation as well from people in the nursing area and some of the ancillaries.
AG: If you were to name the top challenges that you think CIOs face today, would this be one of them — encouraging or fostering clinician adoption — and if so, what would be a couple of others?
NG: I think clinician adoption is definitely up there. I think the broader theme is delivering value and user adoption, whether clinician or otherwise, that you're going to have a steep hill to reach the value proposition. But that’s got to be our goal. We’re putting in the technology and the systems not simply to put them in or because a gap assessment said we’re missing a time and attendance system. It’s got to be because putting in that particular system is going to make the organization more efficient. And we, as CIOs, have to ensure that we’re able to demonstrate that (A) we understand the business needs but (B), that we’re meeting those business needs and hopefully exceeding them.
AG: As a final question, I think it’s important we discuss networking because you are the President of the New Jersey Chapter of HIMSS. Tell me a little bit about what you have going on there and the importance that you put on networking in order to be successful.
NG: I’ll give you a little background on the New Jersey Chapter of HIMSS. We started out as a state organization called HISMA (Health Information Systems Management Association). We were spawned out of the New Jersey Hospital Association decades ago. I joined the board about nine years ago, and we were really just an educational board, a group of CIOs who put on two events a year in the state, and we had a very tight camaraderie. We built a lot of relationships out of core networking such as educational group. We realized that we hit a plateau. We had the same 100 people showing up to all of our events and we seemed to be focusing on the central New Jersey area. So as we looked at how we can begin to expand this, and we all were members of HIMSS and most of us are members of CHIME, we said we need to become a HIMSS chapter, a robust chapter. New York has a large chapter; it’s not always quite as robust as they probably like because of how dispersed everybody is. But New Jersey didn’t have a chapter. So we said that’s a natural fit for us. About two years ago, we became a formal chapter of HIMSS.
I put a huge value on networking. I think it’s critical, not just to CIOs, but to anybody who has aspirations to send into the management ranks. I think that we don’t do a great job in terms of mentoring, at least, here in New Jersey. We don’t see a lot of mentoring and growth and development opportunities. I think this is our opportunity to create a real environment around healthcare IT. I mean one of the charges that we’ve got as a board is to build relationships out to our legislators, because we want New Jersey HIMSS to be the go-to resource for those legislators when there is a question on healthcare related IT. There are more and more questions coming up. And we don’t know where they're going for their information right now. So we believe they need to be coming to us, and we’re trying to work to build those relationships out, and we also want to build those relationships to our federal legislators.
But then second to that is we’re beginning to reach to out to the academic communities. There is not a good pipeline in academia for people to come into healthcare IT. There are MBA programs, MBH programs, and they do fill the need that exists for that kind of executive-level training, but there is not any kind of a pipeline, or robust pipeline, for people to come out of college programs trained to be healthcare IT professionals. There is a distinction between just being a computer science grad or an engineering grad and understanding the healthcare business, because it’s such a unique business that we really believe there is a market for this. We’re working also with some of the universities in the state to try and get them to promote that. We’ve seen some traction there. In fact, the New Jersey Institute of Technology has asked us to come and sit in on an advisory panel for a program they're trying to create, and we’re very excited about that.
So these are some of the things that we’re trying to do to create this end-to-end networking, starting from the beginning of your career to end of your career and have this path where we can mentor people up along the way, and have a pipeline of qualified talent in the state that will begin to deliver a lot more value. And plus, let’s be honest, I mean technology is also the kind of area where there is a lot of turnover. If organizational needs change and somehow you find yourself on the wrong end of a change like that; it’s important to have a community of people you can go back to and look for help from.
