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One-on-One With Good Samaritan Hospital CIO Chuck Christian, Part I

December 4, 2009
by root
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Chuck Christian says healthcare will never improve until the fee-for-service model is dead.

On first blush, you might think Vincennes, Ind.-based Good Samaritan Hospital is just another small community healthcare provider in the heartland of America. At 232 beds, how much could be possibly be happening on the IT front? But upon closer look, it’s clear this organization is different. Good Samaritan offers a range of medical services, as well as some of the most progressive technology available today. Of course, it doesn’t hurt when your CIO has been chairman of the HIMSS board. To learn more about what’s going on at GSH, and pick the brain of a top CIO about HITECH, HCI Editor-in-Chief Anthony Guerra recently talked with Chuck Christian.

GUERRA: I was looking at some information about your hospital online. I would call it a community healthcare facility on steroids – you’re doing some pretty interesting things on the IT side for a small organization.

CHRISTIAN: Yes, you’re absolutely right. I think you would not expect to have the facility that we have, and the services we have, in the size of community that we have. Our market area is about 250,000 people, which is about six times the population of our county, but we’re the only facility in the county, so it’s an interesting place. It was not what I expected to find here 20 years ago, and I guess that’s why I’m still here.


GUERRA: So would you say it’s not a super competitive environment where you have to bend over backwards to attract physicians?

CHRISTIAN: Well, that is true. However, to say we have no competition would be inaccurate. Because of technology today, and the fact that people are used to going for specialty services and stuff, they don’t get in the car and drive an hour. An hour north and south of us are Terre Haute and Evansville, and Indianapolis is only two hours away, so they have a variety of very large hospitals and stuff up there, but technology is also allowing our medical staff to compete as far as moving services and things that would be profitable for them to be done in their offices.

There’s also a free-standing surgical clinic that we now own that was put up by several of our physicians and an investment group. And then we have a radiology group from Evansville which is about 45, 50 miles south of here that put in a free-standing imaging center. So technology and entrepreneurism, if you will, creates a level of competition that we have to be aware of.

I was over in Peoria at Methodist Hospital. Right across the street is another facility called The Order of Saint Francis, a very large hospital, both of them are, and the thing I found very interesting is that in the boardroom at Methodist Hospital one wall is all windows. There are no curtains, and the view outside that window is The Order of Saint Francis Hospital.

So, on our end, we have more of a virtual view of who our competitors are. Sometimes I think we compete against ourselves as well because we don’t have another hospital that is sitting across the street or down the block, so it’s important we don’t get complacent with our strategic thinking. That’s just Chuck’s opinion and that, and $1.65, will get you a cup of coffee in most Starbucks in this country.


GUERRA: Hey, come on, you’re a big player in this space, don’t kid yourself.

CHRISTIAN: Well, I don’t know.


GUERRA: So sometimes the independent physicians that really drive your revenue, and bring the patients in your door, become competitors. Do you wish you’d seen that coming? Was it a service or something you could have done for them?

CHRISTIAN: Well, to tell you the truth, you have to remember that these guys are independent businessmen. These are small businesses and their reimbursement is still a volume-based business – the more stuff you do, the more money you generate. They go to their conferences, just like we go to ours, and they get presentations from consultants about how to make their practices more efficient, more profitable, “Here are some services you could bring in … oh, by the way, did you know that if you’re a urologist and you want to do PSAs in your office, you can earn another X number of tens of thousands of dollars.”

So those are the kinds of things we have to be conscious of. The other thing is I think we have to keep the relationships close enough so we can have conversations about those kinds of things. “There’s something that needs to be done, so let’s do it together rather being competitors.” How do we cooperate and create win-wins?

Have you read the book by Clayton Christensen called, The Innovator’s Prescription? It’s about disruptive solutions for healthcare. I highly recommend you take a look at that because I think some of the things he’s talking about, we’re starting to see come to fruition, specifically in organizations like Mayo and Cleveland Clinic, Kaiser and a few other places that have taken that clinic model and really done a really good job with it.

I think that 10 years from now we’re going to see more and more of that, that’s just Chuck’s prediction anyway. We’re going to see more organizations start forming these kinds of cooperative efforts between the medical staffs and the physicians. Rather than being separate entities, we’ll be doing more and more together. If you look around the country, more and more physicians are asking to be acquired by the hospitals because they want to practice medicine and they also want to have a life.