KH: What kind of timeframe are you looking at for this?
GC: The plan right now is for us to roll in out in chunks. We have pieces of it available now. That overarching piece of software, which some people want to call middleware or service-oriented architecture, that connects all the different components and brings them together to you when you’re buying the vitamins or using the concierge, is something that doesn’t exist today. We’re presently working with one other health system that has similar beliefs with ours, and beginning to try to formalize our design specifications to take that out to the industry to talk to big vendors about developing that software for us.
You’re hearing rumblings of this type of stuff when you hear people talk about integration, service-oriented architecture, middleware, stuff like that. But truly what needs to be done isn’t in the sights of anyone that’s developing any of this stuff. What really needs to be out there isn’t just the ability to integrate, but to parch through the information. It’s easy to put a patient’s information out on a portal, but if I’m a doctor who is only concerned about your liver, I don’t need to see the other tens of thousands of pieces of information I might have about you.
If I’m your primary care physician, I do care about all the information, but I can’t handle it all. I need tools that help me parch through that information and make it meaningful. That set of tools is just not out there today.
KH: Right, and that’s certainly something a lot of people would definitely value. You seem to have a very full plate at Christus. Has it been this way since you began your term as CIO? Have things always moved at this pace at Christus?
GC: Well, yes. Initially it was the combining of two organizations that had common roots but had evolved in very different directions — my job was to get them to work together and get people talking. Dr. Royer (Christus CEO Tom Royer), from day one, hammered on consistency and predictability in the organization; he created the concept of our balanced scorecard. If you’ve been on our Web site, you’ve seen what we’ve got out there from a transparency perspective. We’ve almost always had our financial information out there, but we now also have clinical, patient quality and safety information out there on the Web, as well as our community benefit. We’re one of very few organizations that has been that transparent for so long. So that was another step for us.
There’s a famous bumper sticker down here that says something like, ‘you’ll have to peel my 357 Magnum from my cold dead hands’. Prior to 2004, that was the attitude of some people relative to their vocal operations, including their information systems. One of our regional CEOs (at the time) even said that; he was very clear, he said, you’re going to peel my McKesson system out of my cold, dead hands. In 2004, the organization reached a tipping point and leadership came to us and said, what would it take for us to move to a single information systems platform? We said that it would take this amount of money. But to do it right and to get the benefit out of spending that money, what we would need to do is standardize a lot of what we’re doing.
So we put teams at work for almost nine months on generating a new business and clinical model for Christus. They standardized over 500 business and clinical practices across the organization, literally tens, if not hundreds of thousands of data items were standardized across the organization. Then, we started to put that into the Meditech system, which is what we decided to go with, and install it all across all of Christus. So 2004 was a real tipping point for us and ever since then, any new system that we’ve purchased is heavily scrutinized for its ability to be able to play fairly in this integrated framework.