El Camino Hospital, a not-for-profit organization in Mountain View, Calif., is located on a 41-acre campus in Silicon Valley. Operating statistics show the hospital has almost 400 licensed beds, more than 2,200 employees and a medical staff of 830 physicians. The organization is also one of the first in the country to go live with computerized physician order entry. Recently, HCI Editor-in-Chief Anthony Guerra had a chance to talk with CIO Greg Walton about the current state of affairs at El Camino.
AG: You mentioned the replacement hospital as a situation where you were able to do some interesting things. Can you go into that a little more and talk about how going into a new facility lets you be a mad scientist or frees you from an existing physical structure?
GW: Certainly the first thing that anyone should think about is a wired and wireless infrastructure. You’ll never get a better opportunity to prepare a building for electricity and for communications than when you’re drawing up plans. In my case, as I mentioned, we have a distributed antenna system.
A second thing is in-room amenities and the patient experience. So we’re going to deploy the largest flat screen that will be eligible for deployment in a hospital. By the time we have to pull the trigger on the decision, whether it will be a 46”, a 52”, or however large it will be, it will be the largest screen we can deploy because that real estate that we create with that monitor is probably the most valuable real estate we have. So the second thing you can do, once you have your network in place, is you can then use your glass, as it were, your monitors, your video displays, to really communicate in ways that before were difficult, particularly with place constraint. So whether its bed boards or anything that relates to patient throughput or air traffic control systems, our video communication tele-presence from room to room, those kinds of things are possible and those are the kinds of things that we’re getting ready to deploy.
AG: It just struck me when you were talking about the infrastructure issues that no CIO is going to be incredibly strong in every area: applications, infrastructure, managing a huge staff, budgeting. Where would you say your strengths lie and is it important for CIOs to understand their weaknesses and then to deal with that either through staffing or hiring consultants?
GW: I agree that it’s important to recognize your shortfalls and deal with that with staff. I’m not sure I would often supplement with consultants, but that’s a personal preference. In terms of what I think I do well, I think I’m pretty good at figuring out where the organization needs to go, describing that in a way that’s understandable both from the board and the physician level and to the individual staff member and, then constantly reinforcing that with effective communications and participation. So I tend to be stronger on helping people realize a vision and then I need people to help me with the details of how to put certain pieces together. So for instance, I knew the distributed antenna system was a great thing because I’ve done it before, and when I came here, they hadn’t heard of it. I was able to describe the concept and bring in some companies to show the idea, there were lots of engineers in Silicon Valley that could help figure that out and help the IT team figure it out. So again, what I think I do is try to articulate where we’re headed and help get the momentum and keep the momentum once we start out in a direction.
AG: So would you say that having the vision and being able to communicate it is paramount?
GW: For me, it’s been the topic I would point back to and say, “That was why I was able to do what I was able to do,” so here for instance, at El Camino, here’s a hospital with 40 years of healthcare IT experience, basically invented it, or invented a part of it. So I came up with this idea that we should call our next phase of existence El Camino 2.0, and so El Camino 2.0 is all about building a digital enterprise. Now I’ve invented that phrase, I have gone about describing it in more detail, getting momentum, beginning to get funding for that and beginning that digital journey. So that’s an example of just something that came out of the ether, because it makes sense for this place. We are the founder, if you will, we are the Kitty Hawk of healthcare IT, this is where it happened for the first time and so we grew. But now it’s time to grow in an even more dramatic fashion and El Camino 2.0 is about that.
AG: Tell me about when you started at El Camino, where you came from. My idea is this: I would like to give our audience some insight into when to move to a new position, to a new organization. You said that El Camino was very advanced, to many that could have been intimidating. So what are your thoughts on that?
GW: I think it is very important to understand where you are in your career and where the organization is in its evolution. That will help you decide if you get to the end stage of the interview process and the CEO makes you an offer, whether it’s really right for you, or for you to continue in that interviewing process. So knowing where the organization is in its evolution and where you are personally is really key.
I would also say to you, however, that no matter how advanced the place is, it can always be more advanced, and the nice thing about here is that they had gone over the CPOE hill, but I’ve known for a long time that once you got over that hill, what remained was another mountain chain. A lot of people are spending their energy trying to get over the first CPOE hill. To me, this was a place to jump over that, the systems were already accomplished, and to focus on even more advanced ideas.
So again, understanding what you want to do and where it is in time is so important because, like you said, I think Drex (DeFord) described himself as a turnaround expert and, to some degree, every organization needs a turnaround. The question is, what type and is that something you’re interested in?
AG: Where were you before this position?
GW: My last CIO position was at the Carilion Clinic, and the Carilion Health System in Roanoke, Va.
AG: When did you switch over?
GW: I’ve been here 10 months.
AG: Okay, so fairly recent.
GW: Yeah.
AG: You said something very interesting and, I think, very perceptive about that next mountain chain. One of the things we’ve observed is that the more advanced CIOs are moving beyond implementation into deeper usage. Is that what you would see as that second mountain chain?
