CIO Roundtable: Technology Supports Key Hospital Initiatives in 2008


May / June 2008

CIO Roundtable

Technology Supports Key Hospital Initiatives in 2008

While healthcare information technology certainly isn’t new, today medical centers are deploying more sophisticated systems that directly impact the quality of patient care, patient satisfaction, and clinical processes more than ever before. And as healthcare technology has evolved and grown in importance, so has the role of the chief information officer (CIO). Today, hospital CIOs often are fluent in clinical workflows, and they serve as advocates for improving patient care and clinical operations.

Increasingly, hospital CIOs are directly involved in helping to shape the hospital’s goals and strategy — from process redesign to change management — leveraging technology to get the job done. “It’s hard to imagine a hospital without plumbing or electrical. We have to look at technology in the same way,” says William Spooner, CIO at Sharp HealthCare.

Spooner’s remark was part of a recent roundtable discussion of four forward-thinking CIOs. The panel, hosted by Picis of Wakefield, Mass., discussed the most pressing issues these executives are facing in 2008. Along with Spooner, the panelists — who collectively oversee 25 hospitals — were Richard McKnight of Novant Health, Joseph Sullivan of Saint Barnabas Health Care System, and Judy Middleton of William Osler Health Centre. Dave Garets, HIMSS Analytics president and CEO, moderated.

Clinical Automation
According to the panelists, clinical automation remains one of the top priorities in 2008. Specifically, automation systems that directly impact medical errors are critical.

“The most pressing issues I have are providing a higher level of automation for caregivers,” McKnight explains. The panelists discussed the challenge of medication reconciliation and how technology can play an important role in this process.

Part of the driving force is a pending Medicare deadline. In October, it will stop paying for certain preventable errors, including some hospital-acquired infections. “I think it has gotten us to focus on the adoption of technology and systems that are going to assist us in reducing medical errors,” Sullivan says. Clinical systems that can track and notify clinicians to these dangerous conditions before they happen could specifically help hospitals reduce preventable errors.

Quality Improvement and Scorecards
The CIOs on the panel said they are very focused on applying technology to assist with quality improvement initiatives, which is a board level priority for many hospitals in 2008. “The organization takes quality extremely seriously. We do a lot of reporting and put a lot of emphasis on improvement. Computers and technology are a big part of how we track it,” McKnight says.

Many hospital CEOs are regularly reviewing reports, metrics and targets with hospital leadership. According to McKnight, “One of the core competencies is reading and reacting to the scorecards.” Technology is used extensively to capture data and measure clinical and financial performance.

Advanced clinical systems are helping hospitals better manage the quantity of data collected during a patient’s stay. Physicians, nurses and executives are leveraging this clinical intelligence, mining the data, and retrospectively reviewing patient outcomes to improve processes.

Hospitals are also measuring business metrics, identifying areas that need more attention and ways of improving efficiency and performance. For instance, hospitals can access and interpret the medical device and electronic medical record data collected from operating rooms. Everything from physician performance to scheduling efficiency can be evaluated to help improve time and materials management across the surgical department.

Linking Clinical and Financial Systems
The linking of clinical and financial IT systems is a top initiative, according to all panelists. “In the near future, healthcare reimbursement may link more closely with clinical indicators, so conceptually it makes sense that revenue cycles ought to be tightly integrated with clinical systems,” Spooner says. Spooner, who has experience with California’s pay-for-performance guidelines, knows the value of thorough documentation to avoid leaving money “at the door.”

Clinical systems that help physicians document patient care more thoroughly are becoming increasingly sophisticated, integrating reminders about providing care in accordance with CMS and other performance metrics. From the consumer side, hospital systems such as Novant Health are linking clinical and financial systems so that the hospital can provide patients with a cost estimate for specific treatments.

However, the CIOs acknowledged that very few vendors are prepared today to provide this tight integration of clinical and financial IT. The panel estimated that it will be 3 to 5 years before it is completely implemented across the hospital.

The job of the CIO isn’t as simple as selecting and implementing technology. As the majority of hospitals have some level of automation, CIOs are focused on integrating disparate systems to provide a complete flow of data, so that clinicians have quick access to vital patient information. For example, patient information collected in pre-op should be available to surgeons, anesthesiologists, and nurses throughout the surgical care process, since it may impact and support their clinical decision-making.

Interoperability can also improve patient satisfaction because it prevents them from having to provide the same medical history and basic patient information to a hospital several times. Once the data is entered into a hospital’s technology system, patients expect that it should be available to clinicians as they need it.

These visionary CIOs are not just focused on reducing paper and creating a completely digital hospital. They are analyzing how technology can help clinicians and hospitals leverage a digital environment to help improve workflows, patient care, and patient satisfaction. As healthcare technology continues to evolve, it will be exciting to see technology’s integral role in the hospital of the future.

Carlos Nunez is chief physician executive at Picis, the leading provider of high-acuity care information systems. Nunez can be reached at 781.557.3360 or