Albany Medical Center encompasses the 631-bed Albany Medical Center Hospital, Albany Medical College and the Albany Medical Center Foundation, Inc. At the helm of this academic health sciences center is Senior Vice President and CIO George “Buddy” Hickman, who was recently named CHIME/HIMSS John E. Gall, Jr. CIO of the Year Award. HCI Associate Editor Kate Huvane, who was in attendance at HIMSS when Hickman delivered a presentation during a workshop entitled, “Introduction to Healthcare and IT Enabling Technologies,” recently had a chance to catch up with Hickman and chat about his work. KH: What are some of the projects you currently working on at AMC? What projects are on your radar?
BH: Siemens’ Soarian Clinician is an evolving EHR deployment for the hospital organization. We’ve leveraged it somewhat for the practice as well, but it’s very hospital-centric in terms of what we’re doing, and if you’ve tracked that development over the last few years, you understand the newness of Soarian and the promise it brings to the market. We’re finally seeing some traction with Soarian and are very hopeful that we’ll see some additional modules and go-lives in the not-too-distant future. The same goes for Allscripts’ TouchWorks for our practice, where we are positioning for our first go-lives of the full suite around the end of the summer. We’ve been undergoing a build process there and we’re right on the cusp of some early deployments and really, a staging of two years of active roll-out activities. It’s like, how many times do you come to the starting line on these projects where you’re going through the next phase and then followed by a next phase, and so on. But we’re right at the cusp of a two-year drill to get it spread across all of our various clinics and our faculty practice.
The integration work for these and many other things are high-end and continual works in progress. We’re also replacing our Novell operating system and e-messaging infrastructure with Microsoft suites, which is kind of like pulling the foundation out from under your house along with the wiring and plumbing, and shoving it all back in. While we’ve got all this application stuff going on, we’re at the front end of a legacy revenue cycle systems replacement. A number of the administrative systems for the college and otherwise will see improvements this year, having just completed replacing the fundamental package systems that support all the college administrative functions. There are numerous infrastructure projects and deployments underway that include additional waves of mobile and point-of-care devices, new security tools, intranet and extranet improvements, also having just replaced the innards of that. And also an upwards paradigm shift in how we’re looking at business recovery capabilities. So we’ve got a lot of stuff going on.
KH: It certainly sounds like it. So with all of these projects on your horizon, how do you meet the challenges with budgeting?
BH: The way that I think most people do — very courageously. I think that the way we process that here is, as a CIO, you have to get a sense around knowing what you have to get done as mission critical, and go to the table with that base in mind, but also appreciating that it really has to be defined from the top of the organization and working in concert with executive sponsors. In other words, the top comes from the floor, and the floor comes from the top.
For us, we have processes that respect that whether it’s capital-intensive, meaning annual cycle approval stuff, or routine operational requests. We in both cases have ways of creating organizational participation and priority-setting. So very little is done in a vacuum, I’ll say it that way. It’s very much a vetting and advocacy process, and that’s what we intend to continue to do.
KH: You serve on several boards and committees. Can you tell me about some of the initiatives that you are involved with?
BH: These are things that evolve. As you may know, I spent some time on the HIMSS board and rolled off the board as the chair a year ago. So my current involvement with HIMSS is that — I’m glad to say — I’m a volunteer and a member; although I am serving on the board nominating committee now as well. I sit on the editorial review committee for ADVANCE for Health Information Executives, which is another trade magazine. We get requests quite often from the editor or publisher regarding the setting of topical priorities for publication for providing field CIO reactions to certain things that they’re looking for thought leadership or opinion leadership on.
The New York eHealth Collaborative — we call it NYeCE — is a body that’s been formed in the private sector to work cooperatively with various constituents around the state, and that includes public, private, government, and associational organizations in establishing enablers for HIT adoption. The efforts include advocacy relative to the capital legislature as well as the regulators, finding of grants, administering programs, and there’s a whole lot of working in tandem with the New York Department of Health, particularly our deputy commissioner of health IT, Lori Evans. HIXNY (the Health Information Xchange of New York) is our regional health information exchange. The organization is still in its early efforts to establish a working and sustainable clinical data exchange, and my role there is simply one of governance as a board member, and I’m the planning committee chair. That’s something that we’ll hopefully see some product coming from within the span of 2008. This is a critical year. Those are some of the things I’m working on. Oh, I just finished a draft of a book with a co-author, Herb Smaltz, who is the CIO at Ohio State University Medical Center, and we were fortunate to have a list of about eight of our closest friends as collaborators to also give us some case study content. Herb and I are indebted to them for their contribution to that. We’re thinking that’s probably going to hit the market about June. It will be an IT planning field book intended for C-suites or generally people who find themselves engaged in IT planning in some way for a provider organization. So those are some of my spare time activities.
KH: How does your involvement in these activities affect – or even enrich – your role as CIO?
BH: I learn constantly, because I’m challenged to have to learn when I’m sitting in these circumstances where you’re making decisions and/or trying to provide insight to others in some way. So you get the residual benefit of what you learn to bring it back home. Being plugged in helps your organization to be plugged in and better understand what’s going on in the environment as it may be impacting on or influenced by your organization. And I think in the end, there are just a whole lot of things that get brought home in that way that are beneficial to the organization because of the outside involvement. I tend to see a lot of things cross my e-mail or get telephone calls from colleagues or whatever, where the relevance of the conversation has direct bearing on what we have to understand about some upcoming FDA regulation or what the analyst view on what’s happening with a particular transaction in the health industry market or whatever, and those things can have causal affect with us, and it’s kind of neat to be out there doing this kind of work where you get that perspective and you can quickly translate it to what happens to the organization.
KH: So now, we have the million dollar question. How do you foresee the role of CIO changing in the next five years?
BH: I believe we’ll see a higher number of CIOs with clinical backgrounds in healthcare. At the same time, it will be really necessary for executive teams to keep an eye toward the business and technology-based competencies that the office also requires for CIO-role success. As to which competencies dominate a particular organization, that’s really going to depend on the C-suite’s point of view of importance. So as we see that changing role occuring, it will really be a matter of what that particular organization is thinking about, what it’s wanting to see sitting in that role in the sense of a competency set.
I don’t think the CIO of the future is really going to be a technocrat, though at the same time, we’re going to see an even increased demand for high-end technology architects, because you can’t bring together all this complex stuff without having that. It’s getting more and more difficult to understand how to keep all the pieces connected at this point.
I think in the end, CIOs have to find a greater sense of humor. It’s a necessity to keep your balance, given everything that’s going on with the constituencies and trying to align all the outcomes. You’ve already heard me paraphrase Dr. Uwe Reinhart, the healthcare economist, in acknowledging that we must really be the last of the great romantics in a world of cynical realists, maintaining our mission focus on delivering enabling technologies and in effect, chasing the windmills of these killer clinical applications is noble work among so many competing and conflicting healthcare industry agendas.
