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: Are clinicians able to access data from a home computer?
PC: Yes, they can access it from home, but there’s a certain level of security. We have different security profiles for the types of users based on what kind of activity they’re doing and from where they’re doing it.
KH: And are the carts, laptops and other applications all integrated with the Epic EMR?
KH: Before you started as CIO, was there a different EMR in place?
PC: No, there was nothing. We were in the process of bringing multiple applications in an electronic fashion and we made the choice to go with Epic, but we were buying one solution at a time from Epic rather than going up to an enterprise strategy. We also preferred best-of-breed solutions. With pharmacy, we already made a decision before I started to go with Epic on pharmacy, but that didn’t necessarily mean that for CPOE we would go with Epic. People were saying, maybe we should go with Cerner or someone else.
That’s what I changed; I said, ‘no, we have to make an enterprise decision.’
KH: You just recently went live with CPOE. Has that been a smooth process so far?
KH: How does that system fit in with the clinical applications that were already in place?
PC: CPOE is a component of clinical applications. So if you think about it, we have electronic documentation, electronic ordering, medication administration — all of those areas are now electronic, which means applications are end-to-end electronic.
When I say we have end-to-end electronic capabilities, I mean that we have electronic documentation, which means physicians as well as nursing documentation, CPOE, electronic medication reconciliation, pharmacy, and radiology. All those components are electronic now.
KH: Is it a goal at Children’s to go completely paperless?
KH: What needs to happen before you can accomplish that?
PC: Next year, we are going paperless with surgical services. We are already paperless with revenue cycle, but we’re going to switch systems from SMS to Epic by next year, and we’re going to go paperless in the ambulatory setting over the next 3-4 years.
KH: With everything going on and all the plans in the works, it seems like you’ve had a very busy first two years on the job.
PC: Yes, definitely. That is exactly why I said the good thing and the bad thing is that I did not know what I was signing up for. But it’s been very exciting; I’m very happy with how things are going.
KH: Knowing what you know now, would you do it all over again?
KH: I know you have a pretty full plate. Are there any other IT plans that we haven’t touched on?
PC: The other thing I’m trying to pursue is we just turned over all the clinical systems. We’ve got demand-set systems and supply-set systems. Now I’m talking about stepping outside the CIO role; I’m talking about my supply chain experience.
The demand-set systems are all the systems which directly touch a patient, that’s why only clinical systems will apply. The supply-set systems are all the systems that support the demand-set systems: all the financials, A/R, supply chain and human resource functions.
We’re also going to go live with a combination of virtual systems. I couldn’t find an integrated enterprise system in the healthcare space to address the needs, so we’re going with at least three different vendors to accomplish a coherent, comprehensive and cohesive strategy to have supply side system up and running by the end of next year.
KH: From your own experience with supply chain, do you have any advice for CIOs as far as management of the supply chain and the importance of effective collaboration?
PC: I think one of the biggest opportunities I saw is that technology represents between one-third and one-half of capital spent in healthcare organizations every year, and IS organizations are really not very effective at negotiating technology contracts. They could learn a lot from supply chain. But the problem is a lot of healthcare organizations don’t have supply chain; they have materials management. So they don’t have good contract management and negotiation capability to start with.
It’s a matter of, how do you negotiate contracts, how do you work with vendors in a very effective way. And what I found out is for some vendors, effectiveness is not a top priority. They just want to get something up and running as fast as possible, irrespective of what the costs constraints are.
The last two years or so, although our expenses have gone up, if I had not used supply chain efficiencies, it would have gone up much higher.
KH: It seems like you’ve already learned a great deal in your first CIO role.
PC: I have, but I think I have a lot to learn; I’m trying to do the right thing and focus on what needs to be done. I have a lot to learn still.The interesting thing is that I’m new to healthcare too, not just the CIO position. I’ve only been in healthcare for three years. I was at Home Depot before coming here. I actually started a supply chain within Home Depot, and before that I was a management consultant with Accenture. So I worked with companies like Wal-Mart and Walgreens. I’ve had kind of a different career path.