Praveen Chopra is vice president, chief supply officer and CIO at Children’s Healthcare of Atlanta, a three-hospital, 474-bed, non-for-profit organization that includes five immediate care centers and one primary care center. Since Chopra’s arrival two and a half years ago, Children’s has implemented several components of an EMR system and recently went live on CPOE. Chopra didn’t let the fact that he was a first-time CIO stop him from heading up a major IT overhaul that replaced best-of-breed applications with an enterprise-wide system.
KH: How long have you been at your position?
PC: I’ve been CIO at Children’s for two and a half years. It’s been kind of a different experience for me. I was never a CIO before this. Actually, I was not in technology at all.
KH: Really? What is your background?
PC: I have a management consulting background; I spent most of my time in business improvement and supply chain areas. So when I started at Children’s about three years ago, it was in supply chain as the chief supply chain officer. I made a lot of big changes to the supply chain, and when the IS/CIO position became open, and I was asked by the senior leadership to take this role in addition to my supply chain role. So I came into the CIO position in an entirely different way.
I have a computer engineering degree; I went to school to get my degree in computers, but after that I always worked on the business side in business improvement and process improvement, just in time. So the only correlation I could make with CIOs and myself was my degree — there was no other correlation.
KH: That’s very interesting. It’s certainly not the road most traveled. Can you tell me about some of your experience with supply chain?
PC: When I came into healthcare, I had a couple of preconditions before joining Children’s, because healthcare typically did not talk about supply chain. Even if you hear the words ‘supply chain,’ mostly it refers to materials management. It’s about buying things, and I wanted to change that thinking from buying things to a strategic enabler, so what I did was I moved buying to strategic procurement.
I instituted a system called logistics and distribution. I talked about inventory management. How can we engage with the customer in finding out what they actually need versus what they’re asking for; I talked about becoming a true partner with clinicians and operations to understand the need and engage with them to talk about fact-based negotiations.
So I was aware of that and I was doing that and in the last three years, we were able to take upward of $20 million in real costs out of the supply chain. The supply chain is not a cost center, it’s how do I improve my margins through supply chain.
KH: In that position, did you work closely with the CFO? What about the CIO?
PC: I reported to the CFO so I worked closely with the CFO. I really didn’t work a lot with the CIO because in the first year, my goal was that I didn’t want to ask for a lot of dollars. So I put together some processes, and just when I was getting ready to work with the CIO, this position became open. And out of the blue they asked me, ‘why don’t you take this job also?’ I said, ‘are you kidding me?’ It took me three months to finally make up my mind and say, okay, I might as well give it a try.
KH: I can imagine that entailed a lot of ‘learning as you go’. How did you deal with that?
PC: Actually, it was a very phenomenal experience for me and has been a very rewarding experience. The good thing and the bad thing is that I did not know what I was getting into when I signed up to be a CIO. But it’s been a very good experience because it was similar to what we had in supply chain; I began to think of it as an incident management organization. I was out there, not able to engage with senior leaders — there was no alignment to strategic differentiation. So one of the first things I did was build leadership governance and set the strategy as to what needs to be accomplished. We came to the conclusion working with the senior leadership that we are incident managing now, and technology needs to evolve as a strategic differentiator for Children’s in five years time.
So our goal was to develop a strategic plan to achieve that in the next five years, and we are in year two of the five-year processes.
In my first week in the role, we made the decision to go with an enterprise EMR system rather than going with best-of-breed. We chose to go with Epic. And in two years and two months timeframe, I’m very pleased to say that we have actually brought all the clinical functions electronic now. So right from the time a patient enters a hospital to the time they leave, every single thing is on computer right now.
KH: That’s a significant accomplishment, especially considering you had just stepped into the CIO role. Did that require a good deal of coordination with other departments?
PC: When I first got here, I said that what we have signed up for is not a technology implementation — it is a change management initiative for the entire organization. If I focus only on technology, I’ll be doing a disservice to the organization, so I have to start from the top. So we engaged every single person in the organization. On June 3, we completed the last leg of bringing everything electronic by going live with CPOE.
KH: Did the decision to go with an enterprise system versus best-of-breed impact your success?
PC: Yes, it has helped us a lot because it can also drive us toward creating one version of the truth. Now that we are automating all those activities in the hospital system, we have a lot of data. The next challenge is, how do I translate a huge amount of data into information which can be used to either improve quality or to improve process or to make quick decisions.
KH: Let’s talk a little bit about your clinical applications. Mobile workstations are used at Children’s, correct? What other applications have been implemented?
PC: We use workstations and mobile carts, and they are integrated with the EMR system. We have different ways of accessing the system. It can be a cart, it can be a laptop, it can be a desktop.
KH: So you offer clinicians multiple options instead of selecting one or two devices. How does this work?
PC: A lot of people try to think of these as different entities, whether it’s workstations or carts or laptops. But what I’ve done is, instead of focusing on the devices, I focused on the seamless experience. As a part of my change management, one of the things I had was seamless experience. How do I improve the experience of the clinicians and make them effective, irrespective of their location. So I really don’t care what they use, but the experience has to be seamless.
With that driving force, we went ahead with mobile carts. Mobile carts are one of the ways of accessing the system, but the key component is what we’ve created as far as the virtual work environment. For any user of a system, we’ve created a kind of virtual workspace, which means they can access clinical systems, financial systems, e-mails and calendars through that virtual portal. They have ability to activate that portal wherever they are; they can be close to the patient or they can be at their own workspace, and they can activate the portal.
There are three ways to activate the portal. Either they can use proximity badges, which is wireless, or they can use biometrics, or they can use a log-in to access the portal.
KH: Are clinicians able to access data from a home computer?
