NEW ORLEANS – Mapping out prospective savings in specific service lines has helped Salem (Ore.) Hospital executives make the case for a significant deployment of information technology.
The executive staff was able to project conservative savings in top DRGs, such as those for cardiology, gynecology, medicine, orthopedics and surgery, estimating annual savings ranging from $2.6 million to $7.8 million.
That was part of the reason Salem Hospital’s board committed to a $38 million investment in IT. However, the hospital’s leadership understood that simply installing IT alone wouldn’t guarantee a return on investment.
The facility integrated IT into its larger strategic vision and took a number of steps to engage employees and devise new ways of delivering care, according to Salem executives who spoke at an educational session at February’s annual conference of the Healthcare Information and Management Systems Society in New Orleans.
Executive support and careful planning exemplified the collaboration between IT leaders and financial executives at Salem Hospital. Such cooperation is essential in ensuring realistic and successful IT implementations, they said.
Both Aaron Crane, Salem’s CFO, and Dennis Y. Sato, vice president and CIO, played instrumental roles in the choosing and installing clinical information systems at the 450-bed community hospital.
Even though the facility was strong financially, physicians and employees had a history of not getting involved in IT decision-making. Two previous attempts to implement clinical information systems were unsuccessful, 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, he said, when people, processes, knowledge and technology are aligned to achieve high safety, top quality, efficient care and maximum productivity.
The hospital developed an integrated strategic plan in 2003, including an initiative to improve quality. That would require several technologies, such as an electronic medical record, wireless technology and decision support systems.
That required cooperation between the CIO and CFO. These executives often have different concerns, but for a challenging implementation they must find ways to collaborate so leadership 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 help “sell” the system to the governance board.
In addition to clinical systems, Salem Hospital implemented several patient financial systems, such as billing, scheduling and admission-discharge and transfer.
Before implementation, the hospital surveyed staff about the facility’s readiness to move to a new clinical information system. That survey showed a lot of work was needed 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.