December 17, 2012

Technology: Just One Piece of the HIT Puzzle
By Annie Macios
For The Record
Vol. 24 No. 23 P. 8

Ten years ago, a hospital’s chief information officer (CIO) might have focused mainly on the “T” in HIT. However, today’s CIO must be more versatile than ever, with the technology aspect of the job often taking a back seat to the other skills necessary for success.

The need to stay current and possess “the right stuff” to succeed as a healthcare CIO is more important than ever in today’s demanding, ever-changing HIT environment. In fact, it’s so vital that the College of Healthcare Information Management Executives has developed a CIO boot camp to give these professionals a leg up on gaining an understanding of the critical skills and intrinsic characteristics necessary for them to perform at their best.

On the Front Lines
Joanne Sunquist, RN, MS, FCHIME, CIO at Hennepin County Medical Center in Minneapolis, and Mary Horan, MD, chief medical information officer at Seattle’s Northwest Hospital, serve as examples of how it has become necessary for CIOs to possess a range of skill sets as they navigate the challenges of successfully implementing IT projects.

Sunquist, who has been in her current position since 2004, says the job has evolved as the healthcare industry redefines itself. “Issues including healthcare reform, mobile technology, social media, security risks, and increased customer expectations and roles have all changed,” she says, adding that a successful executive must be a strategic thinker and a visionary capable of adapting to changing technology.

Because today’s CIO wears many hats, the skill sets needed to thrive are equally diverse. Sunquist says that while technology concerns are important, business strategies and process requirements to meet customer needs and deliver on a broader vision are just as vital. “The technology part is actually easier,” she says. “CIOs must become bigger thinkers. What seems counterintuitive is the fact that to be successful, a CIO may actually delegate the more technology part of the job. In relation to that, you must keep on top of industry trends. Change management has become an increasingly important quality over time as well as understanding how to impact change.”

Sunquist believes the ability to deliver care on time and on budget and create a positive return on investment is paramount, while citing strong contract negotiation skills as another necessity.

Horan says a more complex healthcare environment has made a CIO’s role more complicated. A high demand for information and the lack of a single IT solution require creativity, planning, and teamwork, she notes.

On a technical level, Horan finds interoperability failures to be the source of numerous headaches. At Northwest and other organizations that have merged with facilities within a network, it is common to have several HIT systems trying to communicate to deliver the right information at the right time.

“There has been a lot of talk lately on the topic of why vendors have yet to develop technology in a way that makes things easier in IT, offering a complete solution for the information needs across a health system,” Horan says. “One of the biggest challenges is finding a reliable system that provides physicians and clinical staff with the information needed—no more, no less.”

Horan notes that the skill sets for those in her position can vary based on a CIO’s background, but that continuing to receive proper training in many facets beyond technology is advisable. “While some began as programmers, most were and are clinicians, so technology was a way to integrate their skills in achieving success on the clinical side,” she says. “And it’s not just on the technology side but areas such as leadership and finance, for example. The focus on training isn’t just a priority germane to our facility; the University of Washington, the parent organization to our health system, is encouraging better training particularly in leadership across the entire organization.”

Balancing Act
Balancing life with work is a tricky proposition for CIOs, especially in light of how smartphones and other technology make it difficult to ever get away entirely from the office.

Sunquist admits that with 10- or 11-hour workdays, leaving issues at the office can be a challenge. “A big help is the use of mobile technology, but it can also shackle you because you can allow yourself to never really get away from your work,” she says.

To help maintain a positive work/life balance, CIOs can apply several strategies in addition to keeping an eye on good nutrition, exercise, and rest.

Delegating is one way to help maintain balance, but Sunquist cautions to be very clear about what’s expected of the staff. “It’s important to have solid project management in place so that when you need to delegate, you have a high level of confidence that things are as they should be,” she notes. “It also might be good to delegate the things you are not as good at so that you can focus on the strategic plan and direction of your facility.”

Horan agrees: “Having the technology to communicate 24/7 can be a blessing and a curse if your availability is not managed well. You just have to turn your mobile device off and trust that the people you know can handle the situation. Now if I only do as I say.”

Getting Help
Horan says IT efforts need to be prioritized and delegated in line with the facility’s goals and objectives. “Patient safety is a huge driver, naturally, and business needs must be met, but ultimately it comes down to what technology can make it most efficient for the healthcare provider to take care of patients. It is usually a group effort in carrying out the things that need to be done when there are so many projects and not nearly enough time to do them all at once,” she says.

It also can be helpful to use the support of outside vendors or services to help maximize efficiency. For example, like many hospitals, Northwest identified clinical decision-support (CDS) technology as a vital tool for improving patient outcomes, reducing costs, and meeting meaningful use requirements. Northwest determined it was necessary to emphasize going live with the technology quickly, which meant finding a way to not overlook important foundational elements within CDS.

Due to limited resources and staff time, the facility found it difficult to consistently maintain and optimize its CDS to ensure all clinical processes that improve mortality, readmissions, and costs were included. Fortunately, a third-party audit conducted by HIT vendor Zynx Health shed light on how Northwest could employ CDS to improve care for some common conditions. Based on those findings, Northwest made substantial changes to its CDS.

On and On It Goes
CIOs must keep in mind that the very nature of their position dictates a seemingly infinite cycle of new projects and challenges.

“No matter how much you’ve done or plan to do, the thirst for technology and support is never-ending, so you work with your [administration] to prioritize,” Sunquist says. “Sometimes you feel like it is a black hole because people want more, but you can’t afford to fall into the trap of thinking you haven’t accomplished anything, because you have. It’s just a matter of prioritizing and moving forward as technology evolves.”

— Annie Macios is a freelance writer based in Calgary, Alberta, Canada.