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

And it could have been done either over the phone or at a mini-clinic. I recently read an article about mini-clinics that are staffed by caregivers like nurse practitioners, physician’s assistants that have prescribing authority, that have a very narrow band of illnesses that they look at and diagnose and treat effectively. Those mini-clinics don’t require all the trappings of a physician’s office. The mother I described could have gotten the same thing done for $35-40 and still been able to get to work for at least half a day.

GUERRA: How do CIOs prepare their organizations for this future state of healthcare you describe?

CHRISTIAN: Well, I’m doing a whole lot of listening because there’s a whole lot of stuff out there. One thing about information technology is that it used to be the mystical dark side of the hospital. Now, keep in mind, I’m an x-ray tech originally. I spent 14 years in radiology, and I’ve had about 25 years in healthcare ITs. That tells you how long I’ve been in healthcare. Technology is no longer all about bits and bites and twisting the knobs and turning the dials and the little blinking lights, like it used to be a long time ago. It’s about how you use technology appropriately to have an impact upon process, make it better, make it safer, make it have a higher quality. And so it’s going to take a lot of partnership and expertise to improve healthcare, and that’s one of the nice things that I’ve got to do is work with a much, much wider array of individuals in different aspects of healthcare, not just putting in an EMR or a PACS system and that kind of stuff but figuring out what’s the impact upon operations, patient care, and now that we have this data, what do we do with it.

And so I guess the advice is that most of the benefits we’re going to get from the technology, I call one-offs and that means you really don’t know what you can do with it until you get it. You have a pretty good vision and so you implement it, but only then can you say, “Now I got this, what else can I do?” And I’ll give you a couple of examples.

When we were putting in clinical documentation about 10 years ago and my team was working with nursing – they are all nurses and so they understood the intricate workflows and the accreditation requirements and the patient safety things that we had to do – they started looking at those processes and determining what we could do with the data. So we built protocols into our admission assessment where, depending upon a review of the patient’s skin, we asked: are they at risk of it breaking down to form decubitus ulcers, do they already have an ulcer, does the wound team need to look at that. It used to require the nurses to remember to make a phone call or send an order down to someone from the wound team to come and look at the patient we just admitted up in room whatever, or to have the nutritionist come and do a nutritional assessment with the patient because they may be malnourished. Maybe the patient said, “I’m dizzy,” or they have had vertigo, maybe they’re at fall risk and that kind of stuff – they had to remember to do all those things.

So now what we’re doing is making the data work for us. Depending upon how they score that patient when they’re doing an admission assessment, things happen automatically. The folks in dietary will automatically get a notice that there’s a patient admitted who met the criteria or fell below the threshold for the nutritional assessment, so they need to be reviewed. The same goes for the skin scoring and all that stuff. So how do you to make the data work for you. Some of those things can’t really be envisioned when you’re thinking about putting in clinical documentation, because when we were putting together the business case for clinical documentation, that stuff was never thought of. So it’s those one-off opportunities that you find once you start putting those tools in the people’s hands who really know the processes. That’s where you make an impact.

And so that’s why I say you need to have a lot of conversations and listen and be open-minded. I’m a lifetime learner, and it’s what I tell my children. Just because you get out of college doesn’t mean you’ve finished learning. If you’re not open to learning every day, you’re missing a vast opportunity. It may be a good thing, may be a bad thing, but I learn something every day.

GUERRA: So to be successful as a CIO today, your management and collaboration skills must be as polished as your IT knowledge?

CHRISTIAN: Yes, I absolutely agree. The only metaphor I can come up with is the architect and the contractor. The CIO has to be the architect. They have to have the skills to be able to communicate and listen to what the customer is wanting in their building and that kind of stuff. They need to be able to know enough about the pieces, parts that go into it, they know how to design it and how it all fits together, but then they’re going to let somebody else build it and maintain it and do that kind of stuff, and then they’re going to work with the interior designers to put the furniture in the right place and the color schemes and that kind of stuff.