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A Chat with St. Joseph's New CIO Larry Stofko, Part IV

March 14, 2008
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In this final part of our interview, Stofko talks about his approach to approving projects, as well as his thoughts on consumer technologies impacting the CIO.

In October, Larry Stofko took the IT helm at St. Joseph Health System. Stofko — promoted into the senior vice president and CIO job at the 14-hospital, $3.7 billion not-for-profit Catholic health system — had been with the organization for seven years. Most recently, he served as vice president, IT strategy and innovation. So what’s it like to go from a supporting role to a true leadership position? Recently, HCI Editor-in-Chief Anthony Guerra chatted with Stofko about his new role, and what it takes to be a successful CIO in today’s environment.

Click here for Part I

Click here for Part II

Click here for Part III

AG: With 14 hospitals and eight teams managing those hospitals, what is the procedure for large software buys? For example, if I’m the head of radiology in one of the hospitals and I want a new PACS system, or I’m in finance and I want a new revenue cycle management application, how are those requests handled? How do you get control of 14 hospitals with countless departments where everybody’s got their own specialty, their own point of view, their own needs?

LS: I’ll give you a little background on this. It stems back a little bit towards Y2K when we really tried to do a lock down on inventory, if you will, on what systems we had in place then. Our first version was a little bit more flow-chart oriented with certain hurdles. So if the system, total cost — software, hardware, implementation, project manager, everything — was over $100,000, it had to get through our governance process. And there’s hardly any software system that you can buy that’s going to be less than $100,000 when you count all those components.

We do have local prioritization groups, prioritization councils, if you will, that are kind of the IT steering committees for each of those eight management teams. And those requests need to be approved by that group as a priority, and then sent out to our larger IT steering committee at the system level. So what will cause something to bubble up to that level? If it’s over that $100,000 hurdle; if it’s a new technology, something like RFID, even if it’s lower than $100,000, we would want that to come to this group; or if it’s a non-standard technology. So we did publish a first-cut portfolio, broken by these natural groupings — these are our standard systems in these areas, these are the ones where a standard is under consideration, and these are ones where there’s no standard (you are first out to market or you can pick between multiple systems that are out there). So I think that in our first version we tried to handle that through a flow chart-oriented governance process, and we tried to distill it into maneuvering and navigating through the system to make sure we knew about everything. And that was okay. I mean, it wasn’t a terrible process, and a year ago or so, that’s how I would have described how we did it.

But where we are now, what we’ve done this last year was we tried to flip it more towards the planning process. So last year, we formalized things, and in one of the boxes off to the side of business alignment (download chart below), you’ll see “IT strategy management.” Part of that process is doing an annual review and it is usually a full day off-site session with each of those management teams to do local IT planning. And what we do is we scour all of their existing initiative, and the ones they think people are talking about. We scour their business plans. We work with their local VP of strategic planning or whatever the title might be. And we try to uncover what their business direction is for that local organization, as well as pull out what we think are systems, IT systems, that will be required to support that local strategy. So that creates a list potential initiatives.