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Lessons from a Pioneering Journey

September 29, 2010
by Mark Hagland
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An Interview with Jim Venturella, UPMC

Jim Venturella has spent three years so far in his position as CIO, Hospital and Community Services Division, at the 20-hospital University of Pittsburgh Medical Center (UPMC) Health System. In that time, he has been a key player at the massive, integrated health system, collaborating with colleagues to help lead the ongoing clinical transformation of that organization.

Jim Venturella
Jim Venturella

UPMC has been recognized as a national leader (including by this magazine) in clinical IT innovation. What does it take to help lead an organization forward and maintain its standing as a steadfast pioneer among health systems? Venturella spoke recently with Editor-in-Chief Mark Hagland regarding UPMC's ongoing progress, and his perspectives on lessons learned along the way.

Healthcare Informatics: What lessons have been learned so far at UPMC from your advances to date in clinical IT?

Jim Venturella: I would say that the biggest lesson is that all the initiatives are a major journey. Within IT, we tend to focus on the particular initiatives, and on moving from hospital to hospital on the implementations. But all those elements are really just pieces of the bigger journey. What we're beginning to be able to focus on really is the value that we're getting out of the systems, the benefits. One good thing is that the adoption has gotten increasingly easier over time; in terms of CPOE [computerized physician order entry], for example, we've achieved 80-percent adoption right off the bat.

And, as we've moved forward over time, many things have happened. First, the hospital executives have been able to be more firm with the physicians on CPOE; and the medical staff leadership has gotten firmer around this. And the clinical informaticists, the nurse and physician informaticists, have really gotten much more comfortable doing the implementations. So we're fortunate, in that we've got a well-oiled machine working now.

HCI: Are all 20 hospitals live on CPOE now?

Venturella: They will be by next May; I have four facilities left to go-one in Allegheny County here; and the other three are smaller, regional facilities.

HCI: Tell me about getting the value out of CPOE, and about optimization of clinical IS, post-rollout?

Venturella: Once we've got the physician order sets out there and we're getting the physicians to use them, the next challenge is how we build the other reporting requirements we have to meet, into the order sets, to drive improvements in practice. Because anytime we deliver order sets to the physicians, they just want to get going and use them. But we've got the health information management people, including coders and billers, who have things that need to happen. So how do you incorporate those new elements into it? We've developed what we call an E-Practice Guidelines Committee, composed of 12 to15 physicians, who meet regularly and discuss these things. And then we've built a repository of all our guidelines. We download from [the Kansas City-based] Cerner [Corporation], and customize our guidelines. And it's a way to track the changes and the tie to evidence; and we use the same database to track order set utilization, and we analyze the physicians’ utilization. And so we use the process to help give feedback to the physicians on that.

HCI: One constantly hears that community hospitals and teaching hospitals are completely different from each other, culturally in general, and in terms of IT implementation. What are your thoughts?