A hospital's CEO doesn't typically do rounds at midnight, particularly to allay IT concerns. But that's what Salem Hospital's CEO did to ensure that front-line users felt comfortable with the facility's new clinical information systems.
Executive support and careful planning exemplified the collaboration between the IT leaders and financial executives at Salem (Ore.) Hospital.
Such cooperation in healthcare organizations is essential in ensuring realistic and successful implementations of healthcare, according to speakers at the Monday session entitled, "CIS Strategy Guide: A Roadmap for CFOs and CIOs."
Both Aaron Crane, Salem's CFO, and Dennis Y. Sato, vice president and CIO, played instrumental roles in guiding the decision-making process and implementation of clinical information systems at the 450-bed community hospital.
Even though the facility was strong financially, physicians and employees had a history of not being highly involved in some IT decision making. There were two previous unsuccessful attempts to implement clinical information systems, Sato said.
"One of the major challenges of our organization was transforming a culture of entitlement to one of engagement in order to have a successful implementation," he said. The organization is truly ready for IT when people, processes, knowledge and technology are aligned to achieve high safety, top quality, efficient care and maximum productivity.
However, in 2003, the hospital developed an integrated strategic plan, which contained an initiative to improve quality. Necessary implementations, such as an electronic medical record, wireless technology and decision support systems required interaction and cooperation between the CIO and CFO.
These executives often have different concerns, but for a challenging implementation they must find ways to align with each other and collaborate so the leadership team can show that it embraces the common goal of improving quality and patient safety, Crane said.
For example, the CFO expects the CIO to provide fiscal responsibility and withstand requests that increase the scope, and cost, of implementations. Conversely, the CIO expects the CFO to understand the benefits of clinical information systems, help develop a return on the IT investment and then help "sell" the system to the governance board.
In addition to clinical systems, Salem Hospital implemented several patient financial systems at the same time, such as billing, scheduling and admission-discharge and transfer.
Before implementation proceeded, the hospital surveyed staff about the facility's readiness to move to a new clinical information system. Its readiness assessment showed it had a lot of work to do in areas such as technical infrastructure, order set development and standardization, and workflow redesign and transformation.
In calculating ROI, Salem used a third party to measure system benefits, looking at savings as a result of reduced nursing time, decreased HIM processing, reduction of lengths of stay and revenue cycle enhancement. However, the board was most interested in increased patient safety and improved quality.