One-on-One with Hartford Hospital VP of Information Services and CIO Steve O'Neill

KG: Hartford is known for being one of the most wireless hospitals in the country. Do you consider your organization to be on the leading edge of technology?

SO: Yes, very much so. We view ourselves as kind of the destination hospital for critical care in this part of Connecticut. We really serve the northern tier of the state; we're a Level 1 trauma center and we have the largest number of ICU beds in this part of the world. And we have a very strong consulting staff. It's an organization that really likes to have the best of everything. We really do try to stay at the forefront of the industry.

KG: What were some of the drivers in becoming a wireless organization, and how did the process unfold?

SO: We realized that we needed to become increasingly wireless, just based on the needs of our clinicians. They couldn't be tied to a PC plugged into a wall someplace. They needed to be able to move around the hospital and still have access to clinical systems. So we began to plan wireless technology about 5 to 6 years ago; that started originally in our emergency room area, and then began to move out to the patient care areas in the hospital. Now we have it almost everywhere within our physical plant here, which is quite large. We cover about 70 acres of ground in Hartford, and we have over 2 million square feet of space - I would say that probably 75 percent of that is now wireless.

We also offer a full public wireless access here, so anyone can access our visitor network. We've seen the entire bandwidth that we allocate to public wireless double in the last couple of years, so we know it's being used heavily.

KG: Do you have any plans for RFID?

SO: We do; we've been kind of waiting until the technology stabilizes itself, but we're going to run a couple pilot projects this year, just to begin to adopt RFID within our facilities. We have the same challenge every hospital does in keeping track of valuable medical equipment, and that's where we would begin. But our expectation is to begin to extend it out to other uses; for instance, patient tracking and employee tracking and identification, things like that. It's going to be a component here, we've just been holding off until we have the full wireless system.

KG: We've heard some CIOs are waiting for the RFID market to stabilize before choosing a solution.

SO: Yes, definitely. There have been a lot of vendors exiting and entering the field, and no clear direction within the healthcare industry on what a normal standard would be. But I also think a lot of the RFID applications we looked at required the wrong specialized network, and that doubles the cost of deploying a wireless system within the hospital. So we were waiting for something that would run off the regular wireless radios.

KG: How did you get involved in Transforming Healthcare in Connecticut Communities (now called eHealth Connecticut)?

OS: It's a long story. There was an organization called eHealth Connecticut in place for about three years. And that organization originally was planning to deploy a health information exchange (HIE) in Connecticut, but for one reason or another, they weren't able to bring the industry together and coalesce on a single product.

So about eight months ago, a number of the CIOs in the Hartford area were getting together and talking about how nice it would be to have an HIE because we share patients quite often, and we decided to take a look at just doing an HIE locally for our area here in Hartford. And as we began to do that, we developed a plan working with Misys open-source solutions. The original scope of the effort was just the six or seven hospitals within the immediate city of Hartford area that would be linking with a local HIE, with the idea that when the statewide HIE became available, we would plug into that.

When we realized that Misys technology really did support almost any hospital in any setting here in the state, we began to talk to our other CIO partners and colleagues in other hospitals around the state. We had a common mission, and Misys open-source technology seemed to make sense to us, so we put together our own statewide HIE.

We went back to talk to the folks at eHealth Connecticut to discuss what we were developing, and it was very close to what they had wanted to do, so it just made sense for our two organizations to come together. We merged Transforming Healthcare in Connecticut Communities along with the eHealth Connecticut, so now we really are under the banner of eHealth Connecticut.

KG: Is the idea that it will get government funding?

SO: Yes, because as the federal funding guidelines have come out on these statewide HIEs, the ONCHIT folks make it very clear that they only wanted one HIE proposal from each state, so we needed to have one HIE that we could propose as the alternative for Connecticut.

KG: Will some funding come from the hospitals as well?

SO: Yes. Actually, the sustainability model was always based on the hospitals shouldering the major burden of the financing, and that really was a very important element in our planning because you needed to have some means of sharing the cost of this in order to make it affordable to the industry as a whole. Of course, we're hoping to make that cost as little as possible by using federal funding to help get it off the ground. And we're looking to find other means of funding these programs, whether it might be through taxes or fees or other ideas. The real expectation is that the hospitals themselves will carry the major burden of funding the ongoing cost of the operation.

KG: And that wasn't too tough of a sell for hospitals?

SO: I wouldn't say it wasn't, but I think everyone understood the need for it. They'd much rather someone else paid for it, obviously, given the nature of our business these days, but no. As a matter of fact, we had a meeting with about six of the CEOs of our hospitals in Connecticut, and they were all fully on board with the idea that they would be sharing the cost. And we have about 32 hospitals here in the state, so when you start dividing the number by 32, it gets pretty small. So we don't think this is really going to be a big burden on the healthcare industry.

And while it hasn't been mandated yet, this idea of being able to share clinical information is defined as part of the meaningful use criteria that ONCHIT has developed, so one way or the other, we need to be able to show that we can share clinical data. And the HIE really is the best way for us to do that.