December 2008 FEATURE ARTICLES
The Healthcare CIO
Edith Dees, VP/CIO
Holy Spirit Health System
Edith Dees is responsible for telecommunications and information technology (IT) at Holy Spirit Health System. Her division coordinates and oversees the continued development of IT services, including the implementation of a multi-million dollar clinical information system setting Holy Spirit Hospital in the top 5 percent of community hospitals nationwide.
Q HMT: What does it mean to be a CIO in healthcare today?
"Healthcare is a high-touch environment, and physicians at the bedside sometimes have a hard time seeing the applicability of technology, which is where the CIO comes in, to be able to sell the benefits versus the features of the technology. Traditionally, we talked about gigabytes and megabytes and 10 bit and 100 bit but those are features. Instead, we need to sell the benefits. If the physicians do ‘this’ they get an improved response time — that they can wrap their minds around."
Q HMT: How does it differ from being a CIO five or 10 years ago?
"I don’t think technology was affordable enough or fast enough to reach to the depth and breadth of care delivery as it is today and will be going forward. There’s more opportunity to see how technology can be an indispensable tool to direct patient care. In the last few years we progressed light years from where we were with technologies like single sign-on biometrics. Technicians are preoccupied with keeping up with their online security rights. We know that it’s a critical practice. But it’s also a fundamental barrier because end users don’t know how important this is, so we have to find ways to secure patient information but make it easily accessible to physicians that need to move from floor to floor."
Q HMT: Is compliance and security as important to a healthcare organization as an electronic medical record?
"Now you are getting me on my soapbox here, but if we are going to collect this information we have an obligation not just under federal law but also to our patients to be very protective, good stewards of that information in every form — electronic, paper, any medium. We can’t say we’re going to think through that and then not implement something. We have to secure the information before we start collecting it."
Q HMT: What’s the most important technology you’re currently implementing at Holy Spirit?
"Inter-disciplinary documentation. When we
embarked on this a couple of years ago we realized we had an
opportunity to literally transform our clinical delivery. What
we’re building is a patient-focused
database for inter-disciplinary team documenting that’s in one
area for all caregivers to see. This is requiring changes in
human behavior, in that where the Respiratory Therapy staff, for
example, previously wrote ‘in’ Respiratory Therapy, and had
information that was either passed verbally or read in a chart,
now that information goes into the system along with nursing
documentation, pastoral care, dietician notes and case manager
notes. Everybody gets a snapshot in one place of what’s going on
with each patient."
Q HMT: You’re referring to a universal medical record. Would it also include PACS and RIS data?
"Yes, and medication information."
Q HMT: So data interchange is your biggest project?
"Yes, and negotiating how to get caregivers to give up individual practices that made perfect sense to them before we had tools to accommodate everybody writing to one universal patient record. They never had to sit back and ask ‘What’s unique to my operation?’ It might be productivity scheduling or that sort of thing, versus ‘What is pertinent to other caregivers that I collect or that I’m closest to collecting. Do the caregivers need this information and am I their only source to get it?’ There is so much pressure now to know everything, with the patient information coming in from every direction to physicians. To take care of a patient in one visit means wading through 30 pages of a medical record. That’s the average. Providers can do that, but their abilities are limited if the information isn’t automated — if what they need isn’t right at their fingertips. The goal is to reduce any time waiting on patient information. It should be where we need it when we need it, in a legible format and up-to-date. At Holy Spirit we’ve elected to not print out 99.9 percent of all documents because we want to ensure that the caregivers are working with the most recent clinical information."
Q HMT: What are you preparing for in the future?
"Now that we’ve spent a couple of years
working through our processes, doing a transformation,
creating and designing our collection systems, the next step is
to implement analytics, where we have for every manager, nurse
manager, provider and administrator a real time clinical
dashboard, so we can track trends and see if we’re getting the
benefits that we anticipated, and if not, where we need to
focus. My vision is to totally transform the quality function
from a team of people retrospectively going through old records
and reporting data that’s six months old into a practice that’s
upfront, preventative and proactive. Analytics I think will be
our next step towards that."
Q HMT: How should CIOs prepare for what is inevitably going to come in healthcare?
"Get comfortable talking to technicians because that collaboration has to get tighter and tighter going forward. We’re very comfortable talking to the finance people and the accountants, now we have to get as comfortable or more comfortable talking to physicians and understand what their priorities are and really speak their language."