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One-on-One with Gartner Researcher Vi Shaffer

May 30, 2008
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Vi Shaffer says the most important tasks for a CIO are to attend to IT operations excellence and stay strategic.

Vi Shaffer is research vice president of the healthcare providers division at Stamford, Conn.-based Gartner, Inc. She was lead author of Gartner’s Top 12 Actions for the CIO, a report released this past spring in which the company presents its annual top initiatives that healthcare CIOs should pursue to stay strategic and improve business value. According to Gartner, these actions "are especially significant in a year of increasing IT infrastructure and operations pressure." Recently, she talked with HCI Associate Editor Kate Huvane about the key findings from the report.

KH: What are some of the most important takeaways from this report?

VS: I think the key finding is that in the United States, many organizations are down the road on their journey related to clinical investments and clinical automation. With that comes an explosion of demand and expectations and challenges to really be world class in IT operations, and so about half of the recommendations are around things we feel they want to give extra time and attention to this year to make sure that they are running a world class IT shop that the users — and now the physicians and nurse users — can be confident in.

And then the other half is that because we’re in the midst of many of these multi-year implementations, all the way from the start of databases to physician documentation, and because of all these related infrastructure and IT management demands, the CIO has to be very sure that they carve out time to stay strategic to build those executive relationships to demonstrate their business value as innovators. So that tells you that how they spend their time, what they expect and how they carve out the senior management team under them are all things that are very important. So our 12 actions are couched within the light of those two very important imperatives. Number one, attend to IT operations excellence, and number two, stay strategic.

KH: Those are both extremely critical, particularly the part about staying strategic. How can CIOs go about doing that?

VS: We spend a lot of time talking about making time. Some of these are simple things; they need to be very aware of how they are spending their time, because personal productivity is important as well — is the CIO finding him or herself to be a prisoner of email, that kind of thing. It sounds silly because you’re talking about very senior executives, but you can get sucked in. Also, as the organizations have grown and IT has grown, you have to scrutinize your direct reports and say, 'have I been developing them? Am I spending my time brokering and making decisions between two of my own managers because they don’t know how to resolve conflicts, because they don’t know how to mutually evaluate the situation?' Those are the kinds of things personally that they need to do.

Professionally, they need to become ever more understanding of medicine and medical technology, what nurses do, what physicians do, walk around, get out, and this is true of senior staff as well. Because a CIO who does not have effective relationships with medical and nursing leadership and does not effectively meet their needs cannot be successful.

KH: Can you run through the top 12 actions and tell me the key points from each?

VS: Sure. The first one is the core competence and care process management. Here, we’re acknowledging that the CIOs and CMIOs must still attend to this ongoing implementation and optimization of the use of computer-based patient records. We also remind them that competence and care process management means also investing in ongoing knowledge and content management for decision support, and also what some call clinical intelligence — the reporting and analysis to help understand the care processes. That is a closed loop system; a processed system with an active feedback loop.

The second, mobility and unified communications strategy, touches everything — all the caregivers. It’s a high priority for communications, it’s a high priority for nurses, it’s a high priority for physicians, and CIOs need to lead insuring that they’re pursuing a unified communications strategy; looking at skating to where pucks are going to be in wireless and PDA, all these different aspects across the enterprise.

And then we have nursing and nursing workflow support. In the document, we felt it was very important to put attention to nursing very high on the list of actions. It is usually true that we talk — very high on the list — about serving physician needs, and that’s always important, and there’s a lot of power there. We highlighted nursing overall in our report because there’s a lot going on with very complex nursing workflow. We have a group of professionals who are one of the largest components of one of your largest budget programs, labor. They’re in short supply, their workflow is complex, and we know for sure that they’re absolutely critical to keeping the wheels on patient throughput and patient quality and hospital settings. We know all that. And we know that IT can do things to help this.