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One-on-One With Capital Health CIO Gene Grochala, Part II

September 1, 2009
by root
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In this part of our interview, Grochala says successful CPOE requires training physicians with a personal touch.

Mercer County, N.J.-based Capital Health – a two-hospital, 589-bed regional health network, including an ambulatory facility – recently completed the implementation of an EMR from Boston-based Keane. Comprised of Mercer and Fuld hospitals in Trenton, N.J. and the Capital Health in Hamilton outpatient facility, the organization is expanding, with construction underway for a new hospital in Hopewell Township, N.J. as well as an expansion of services at its Fuld hospital, both scheduled to be completed by 2011. Add to all that the goal of qualifying for HITECH stimulus funds and it’s no wonder CIO Gene Grochala has his hands full. Recently, HCI Editor-in-Chief caught up Grochala to talk about how he’s managing all these challenges.

(Part I)

GUERRA: You mentioned you had worked with Beacon Partners back in 2006-2007 to help you with the system selection process. Did you get help with the actual implementation?

GROCHALA: It's us and Keane. There are no third parties involved. We had formal training classes for all the staff, and we did four hours sessions, two sessions a day, five days a week. Keane flew in here for three days a week and helped supplement the manpower for all that training. Physicians were trained completely one-on-one. We did not do any classroom formalized scheduled training with them. We had a team of nurses. They wore a lot of peach-colored stuff that they’d be recognized in, and they were called Peachy Keane. They actually chased the doctors, physically chased them down the hall and said, “Hey, let me show you this.” And then we kept a massive list of who was trained, how many hours, what the comments were, and all that kind of stuff.

The same thing with follow up, after we went live, we still ran around on the units grabbing the docs and showing them and teaching them. They understood the transition. It was amazing. I’ve been in this business for 30 years and I was amazed at how smoothly this thing went, how little resistance and screaming we got from the medical staff or the nurses and the ancillaries, too.

GUERRA: What do you think it was about your approach that was so successful?

GROCHALA: We put a lot more money in people than we did in hardware and software. The actual roll out and the cost of Keane was $1 million, and we licensed three facilities with that. We licensed Mercer Medical Center, Helene Fuld Medical Center, and then we have a huge outpatient facility in the suburbs, and all three of them came up at the same time. We’re taking about 120 people.

GUERRA: How many people are on your IT staff?

GROCHALA: In total, we have 38 people, full time.

GUERRA: Did you take on more people temporarily for the implementation?


GUERRA: Is 38 the right number or did you feel strapped?

GROCHALA: I could use 38 more, absolutely. But see, the Keane product runs on the IBM iSeries. So, what we get out of that is integration simplification because it does everything for us. It does the database administration, so we don’t need a database administrator. The operating system that people look to for virtualization today, the iSeries, has had and does have it today. Everything is streamlined. It has its own SANS system, so we don’t have to contract and buy a different SANS system. It’s never had a virus, never had a single incident. I don’t have a lot of spamware, the malware kind of virus protection on that, so I don’t have to think of hiring a systems administrator or a security administrator. The database is all integrated to the operating systems called DBX-400, 64-bed power processing. It’s a single level object storage. It’s such a beautiful box and Keane runs on it.

Here is an example – I did a Meditech installation one time and all of the vendors have their strengths and weaknesses, and Keane and Meditech are the same in that they started with a patient account number. That was their database and they grew it out. So, it’s still one monolithic port. By contrast, McKesson is a company of purchased products, so it’s a nightmare if you ever try to interface all those different products, operating systems, database systems. McKesson bragged that they have the largest R&D development of any software company, right? But when you look under the covers, most of it was spent trying to get their different products to talk to one another seamlessly, but they always seem to be working on that.

With Meditech and Keane, like I said, it’s one system underneath the covers where you could encounter a lot of those complications for the IT departments trying to get information flowing back and forth. We don’t deal with it. We don’t have that headache. It does come with an interface engine built into it for that $1 million. So, I don’t have two to three interface engine analysts over here. I just pull it up from my regular programming staff. There you are again, a lot simpler, a lot easier. If I want to shoot ADT information all over the place, I read it one time in some format and if I knew the lab system, I knew all other systems. I just shoot it back out into the trash cans through the same way. It’s pretty standard. So, that eased a lot of the pain and a lot of the work and management on our side.