Inside IT

Michael Ward

A hospital's IT capabilities can have significant clinical and business implications.

To be successful, a hospital must consider how its decisions will affect the IT needs of the organization and whether existing technology can support the organization's long-range plans. As a result, one of the most important management issues hospitals face is how to integrate IT planning within their strategic planning process.

Technology has become so pervasive within hospitals that it is hard to imagine a major decision being made by a hospital that would not have technological ramifications. At Anderson Hospital in Maryville, Ill., the formation of an IT steering committee has enabled the hospital's administrative team to more fully understand how its decisions have an impact on the organization's technology needs-and to turn lessons learned into processes that strengthen the organization.

Bringing IT to the Forefront of Strategic Planning

When I came to Anderson Hospital in 2003, there was no detailed or prescribed IT planning process at the hospital. As a former project manager, I was disappointed with the lack of a formal IT planning process, but viewed the situation as an opportunity to build such a process. It had also been several years since the hospital's last long-term strategic planning process had taken place, yet the hospital was not without formal planning. Each year, hospital administrators and department managers devoted one day to mapping out the hospital's priorities for the next several years.

In 2005, Anderson Hospital's board of trustees and administrative team launched an initiative to update the hospital's strategic plan. Development of the plan included market analysis; interviews with the board, administrators, and department managers; a review of the hospital's finances; and numerous other variables. Although some technology issues were considered for specific needs, a detailed IT plan was not part of the overall picture.

As Anderson Hospital's IT leader, I struggled to articulate the importance that technology would play in meeting the goals outlined in the hospital's new strategic plan. However, when the strategic plan was developed, the hospital's long-term IT needs were not at the forefront of the plan. For me, it was a personal failure; I believed I had failed to make clear the connection between technology and improvements in hospital workflows and efficiencies.

As time went on, I grew frustrated by the amount of work required on behalf of the IT department to meet the goals established in the hospital's strategic plan and the resulting shift in priorities for my department. IT resources were considered to be a dynamic entity, always ready to address the hospital's latest decisions/needs. For most hospital IT departments, resources are limited and must be scheduled and prioritized. Because there was no formal plan regarding how IT resources should be deployed to meet the hospital's long-term needs and what the priorities for the department should be, the hospital's IT department was not always able to implement technology completely or successfully. In an effort to bring the importance of IT resources and planning to the forefront, I approached the CFO with this question: "What decision does the hospital's administrative council make that doesn't impact technology?"

I challenged him to consider the impact of the administrative team's decisions on the hospital's IT department. I asked him to stop and consider what technology and processes were needed before making a decision. I also wanted to show that each decision the administrative team made had a cumulative impact on my department's work and priorities.

When a decision is made to construct a new building, for example, it's important to see past the building's hardware and network requirements, and look deeper at the expected improvement in workflows and efficiencies. Indeed, physical layout has a significant impact on workflow, but so does technology. It's easy to forget the hidden items, such as new documentation needs, workflow changes, data integration with other systems, and reporting needs.

The simple question of how administrative decisions impact the hospital's IT department and resources ultimately led to the development of Anderson Hospital's IT steering committee. The formation of this committee represented a breakthrough toward integrating IT into the decision-making process. It was a key component to opening lines of communication between the administrative team and my department.

Education = Knowledge = Progress

Anderson Hospital's IT Steering Committee consists of the CEO, CFO, chief nursing officer, and five other hospital administrators representing, human resources, legal, facilities, compliance, and our outpatient clinics.

During the early stages of development, the IT Steering Committee provided an opportunity for me to deliver a status report on current IT projects. Little discussion focused on the hospital's technology needs and priorities. There was also little focus on the hospital's ability to respond to changes in the industry.

After the initial meetings, it was clear I needed to further educate the administrative council on the complexity and magnitude of implementing and supporting technology throughout the organization. The council needed a greater understanding of my department before I could expect this group of leaders to understand the IT implications of its decisions. Although some viewed the organization's IT resources as simply a combination of computers, servers, and printers, they didn't realize these tools represent only a small percentage of what IT does.

Discussions around the ROI of IT resources and tools, efficiencies created by IT, and the ability to mitigate risk with the help of IT were much more useful than discussing the need for additional FTEs or using Gantt charts to illustrate the importance of technology and its role in the hospital's overall plan. I was able to demonstrate that many of my department's efforts are in process redesign, workflow automation, and IT functions had a positive impact on patient safety.

Over the years, consistently breaking the hospital's IT function down into manageable chunks enabled Anderson Hospital's administrative team eventually to fully understand how its decisions have an impact on the hospital's technology resources. It was then that the IT Steering Committee took an evolutionary turn, turning lessons learned into real processes.

Trust Is Paramount to Success

This year, Anderson Hospital formed a board-level IT committee to bring a higher level of understanding to the board of trustees. The board is now directly involved in determining how IT resources will be deployed to meet the hospital's strategic planning needs. To help board members understand IT's role in hospital operations, members of the IT department and I walked them through the hospital and showed them how technology touches patients throughout their stay. Seeing the hospital's IT resources in action has energized the board and provided the hospital's IT department with the momentum and respect to move forward with projects more easily.

With the implementation of the Health Information Technology and Clinical Health Act on the horizon, Anderson Hospital is forming a physician IT committee to help the hospital avoid some of the pitfalls associated with computerized provider order entry implementations. Communication, understanding, and education will be just as critical in working with hospital physicians as it has in working with hospital administrators and the board.

The breakthrough in demonstrating the importance of IT to Anderson Hospital's long-range strategic plan was the establishment of trust between the IT department-specifically, the CIO-and leaders and staff throughout the organization. One of the most important ways to build trust is through relationship management. This means being visible to the people in an organization and learning about what's going on. Working on hospital committees provides great insight into processes, issues, and customers' frustrations. "Walking rounds" also are important. As CIO, I regularly take the time to walk through an area of the hospital, talk with staff, and learn about their IT needs, expectations, and experiences. I also use the opportunity to let staff know about new IT developments in the organization.

Today, there are times when some members of my organization do not like what I have to say-and other times when I may not like what I hear-but people throughout the hospital trust that my message is well-founded, researched, and accurate, even when we do not agree on a specific approach to action.

Lessons Learned

The experience of integrating IT into the planning process at Anderson Hospital has been a journey-a fast-paced journey with constant change, headache, and, at times, heartache.

IT offers tremendous opportunities for healthcare organizations, but it must be integrated within an organization's decision making and strategic planning processes to maximize its contributions to the organization. Following are some of the lessons learned at Anderson Hospital regarding the development of a detailed IT plan for a healthcare organization.

Consider the organization's needs and have a detailed vision regarding how IT can effect change in the organization. For example, when walking through a department or unit, ask my customers what they are reading. This will help in understanding their issues, their stresses, and what the future looks like for their areas of expertise.

Be able to clearly articulate your customers' IT needs and potential solutions to the challenges they are facing. Otherwise, colleagues will second guess your understanding of their needs.

After a decision is made regarding a potential IT project, communicate the decision to key stakeholders. All too often, decisions are made without communicating the outcome to those who will feel the impact of those decisions the most. This is not a good way to build relationships and trust with colleagues and customers.

Tout the IT department's successes-and be open about its failures. When an IT project does not deliver the desired results, explain what didn't work and how the department will improve upon its performance. Such discussions demonstrate openness and bring additional focus to the IT department's work and capabilities.

Establish solid relationships with vendors and business partners. As a hospital crafts a vision for the future of IT within the organization, it should know that it can rely on its business partners to support this vision. Developing such relationships should be a continuous process.

Be familiar with the latest healthcare IT advancements and processes. Regularly read messages from listservs of organizations such as the College of Healthcare Information Management Executives and the Healthcare Information and Management Systems Society to find out what healthcare CIOs nationwide are experiencing and to learn from other organizations' IT successes and failures.

Understand that the more you empower others, the more empowered you will become. There is too much work to be done in healthcare organizations to waste time on a power struggle. Take the time to communicate effectively with stakeholders, both to understand their needs and to educate them on the opportunities technology can provide to enhance the quality of care or service
provided.

Be honest with yourself regarding your skills and limitations as a leader. Consider your strengths and weaknesses, and ask yourself who you can turn to for help in developing your proficiencies and improving upon your weaknesses. Ask yourself, as well, what your strengths are in
working with staff and customers-and where you need improvement. Unless we're honest with ourselves, we cannot expect to gain trust from others.


Michael Ward is director of information services, Anderson Hospital, Maryville, Ill. (wardm@andersonhospital.org).


About Anderson Hospital

Anderson Hospital in Maryville, Ill., is a not-for-profit, community-based acute care hospital with 144 beds. The hospital treats more than 33,000 people a year and has a medical staff of 220 physicians representing nearly 40 specialties. 

Publication Date: Thursday, April 01, 2010

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