The Evolving Role of the Hospital CIO

Not long ago, the head of technology at a hospital was mainly concerned with how data networks were functioning and whether workers could access the electronic files they needed. Other hospital department heads handled equally important but unrelated purchasing decisions, facilities management and medical equipment.

Today, however, we have seen the role of a hospital’s chief information officer (CIO) expanding dramatically. CIOs and their information services (IS) staffs are the nexus for a wide variety of major projects that require the involvement of decision makers from marketing, patient education, nursing, administration and human resources.

As a result of these changes, we see the CIO first to discuss patient-facing technologies like communications and television systems. Today’s technology-heavy hospitals contain information systems that encompass more than just computers and networks. CIOs and IS professionals are determined to drive the connectivity of electronic systems in every corner of the campus. CIOs are leaders in balancing technology needs with objectives of clinicians, executives, patients and families, while also tackling issues such as productivity, privacy, education and patient satisfaction.

Cooperation Across the Organization

As director for information services at Chicago’s Northwestern Memorial Hospital (NMH), Sue Lopardo is responsible for the hospital’s administrative systems, which have traditionally included human resources, finance, patient scheduling and accounting systems. Over the last few years, her world has expanded to encompass systems and tools that not only impact the bottom line but also reach out and touch the patient.

"Our application portfolio includes interactive patient systems such as way-finding kiosks, in-room Internet and on-demand educational services, patient tracking and service tracking systems, as well as state-of-the-art communications systems linked into nurse call," says Lopardo. "Although not traditional administrative systems, these patient and support service applications leverage the hospital’s technical infrastructure."

Annette Elchert has spent 12 years working on technology for the hospitals of the Blanchard Valley Health System (BVHS) in Ohio. In 2003, BVHS outsourced its technology services to CareTech Solutions, and Elchert transitioned to CareTech as client executive/CIO. She continues to work at BVHS.

In previous years, Elchert was involved in what she calls "low-hanging fruit" projects, typical of traditional IS. However, the opening of a new BVHS hospital put fresh emphasis on interdisciplinary communication and management.

"IS now permeates the entire system," says Elchert. "Clinical and customer service demands communication, cooperation and collaboration, turning both the CIO and IS staff into cheerleaders and politicians."

New Duties, New Skills

Elchert’s work in IS has benefited from BVHS’s "pillar" structure, which features five councils devoted to growth, finance, people, service and quality. Elchert, or one of her managers, sits on each of the councils, participating in strategy development, capital and operations budgeting and business planning for new projects.

"IS’ close involvement ensures that we’ll be informed and up-to-date about happenings throughout the organization," she says. "We realize that there are few technologies that fail to attach to a network or interplay with other systems."

According to Lopardo, as a consequence of the expanding responsibilities at NMH, the skills of IS professionals also need to expand in order to deliver a higher degree of patient satisfaction. To achieve success in supporting the overall world of care, a new partnership with business leaders has been evolving.

Lopardo and the other IS professionals at NMH have had to acquire an in-depth knowledge of hospital operations to facilitate installation of telephone systems, and tackle issues such as patient orientation, assistance, support and integration with hospitalwide equipment management and support.

Because Northwestern Memorial’s nurses are now more likely to engage in non-brokered patient and physician communications, the IS staff have also had to delve into call flows, call volumes and call escalation. NMH’s move to a central telemetry system has led Lopardo and the Northwestern Memorial IS team to participate in the creation of down-time procedures for emergency team use in the event of a system crash. As a result, IS now contributes to the roles and responsibilities that once belonged exclusively to hospital safety. "Such developments force you to think about how you interact with people throughout the hospital and systems outside the confines of IS," says Lopardo.

Process Improvement, Patient Satisfaction

IS at Northwestern Memorial is actively involved with the fulfillment of the hospital’s three-pronged mission: best patient experience, best people and exceptional financial performance. Patient satisfaction is a top-tier priority. When NMH rolled out its patient interactive system application in anticipation of the opening of its new women’s hospital, Lopardo was pleased to document the positive impact of technology on patient satisfaction through both in-room and post-discharge surveys.

NMH’s approach to process improvement involves the use of teams that frame problems and work through process improvement opportunities. IS prioritizes team service requests for the application of existing technologies by business lines. More significant projects are filtered through IS’ project prioritization group, which features a cross section of hospital directors who evaluate a project’s function, scope, benefits and fit with existing initiatives.

Transitioning into new technologies and platforms at NMH has also created the need for new educational programs, ranging from brown bag lunch-and-learn sessions to programs provided by the hospital’s academy. Education and training topics cover customer service and patient interactive systems as well as advanced topics in patient tracking and nurse call.

"Project management and process improvement are more important than ever at BVHS to IS analysts and staff," says Elchert. "Individual departments often harbor a narrow view of organizational strategy, but still have valuable technical expertise to share."

BVHS’s intense focus on patient service satisfaction has also brought Elchert into conversations with patients, family members and visitors, as well as physicians focused on issues such as CPOE and best order practices. Elchert has even reached out to the community to engage physician practices and connect with local technology boards and leaders. One of BVHS’s application managers now sits on an advisory board for graduating high-school students, while she advises a junior college on its technology curriculum. "You go out with a twinkle in your eye about what can be done and then uncover the broken processes in need of re-engineering," says Elchert. "You survive only if you can morph into a diplomat, game-show host or band leader."

Suggestions for CIOs on managing the new and emerging challenges of IS:

Look for vendors that provide what Elchert calls a "growth path to the future" and allow for implementation over time rather than an all-or-nothing installation.

Look for opportunities to introduce existing technologies into new areas. BVHS, for example, introduced a patient interactive system into its hospice unit.

Develop leadership expertise in new, emerging and existing technologies.

Consider bi-weekly partnership meetings with operational vice presidents to forge an understanding of IS rules of engagement, as well the goals of the organization and its annual implementation plan.

George Fleming is president of TeleHealth Services and CEO of its parent company, Telerent Leasing Corp., in Raleigh, N.C. Contact him at George.Fleming@telerent.com.