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One-on-One with HUMC's CIO Lex Ferrauiola & CTO Ben Bordonaro, Part II

August 5, 2008
by root
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Hackensack's IT chiefs explain that support comes from translating IT spend into clinical and business benefits.

Playing it safe doesn’t seem to be the most important concern for Hackensack University Medical Center’s CIO Lex Ferrauiola and CTO Ben Bordonaro. If that was the case, they’d almost certainly leave well enough alone, and Siemens and GE in place. But the duo has other plans — turning HUMC from a medical center held together with interfaces to a truly integrated organization, promoting data transfer across the continuum of care, from inpatient services to ambulatory physician practices. To make that dream a reality, the organization has settled on Epic. And while its vendor of choice comes with a high price tag, Ferrauiola and Bordonaro say you get what you pay for.

AG: Let’s go back to what you mentioned about the head of the ED, and how this person was able to understand what you were saying and compromise. Have you come up against other situations and could you give advice to other CIOs and CTOs that come up against an individual that’s not so amenable to reason; that sticks with a, “No, this is what I want, make it work because I’m bringing a lot of money into this hospital,” attitude?

LF: I don’t know if Ben is going to agree with me or not. We may see the world a little bit differently, but my experience here is that we've got some really dynamic, very colorful personalities, but the people really are very collaborative and they are team players. They do see the bigger picture. The people that I’ve worked with, particularly on this vision to move towards integration with the inpatient and outpatient community, they have been pretty agreeable to work with us. Would you agree with that, Ben?

BB: I do agree with that.

LF: The cancer center is a really great example. We have a world-class cancer center. We’re building a physical building, I don’t know if you saw the construction across the street, we’re building a five-story facility. It’s a dynamic group, and they have really wanted to have an EMR and practice management. They desperately need it, they’re a big practice. But they have been very, very willing to wait, work with us and partner with us so that they can be part of this vision, rather than going off on their own and doing their own thing.

AG: Ben, what are your thoughts on that?

BB: There has been no department that has said, “I am doing it,” and then actually has done it, because there are really good partnerships here, and we have a really good governance model. A department just can’t go out and buy something. We don't want to use the big hammer; sometimes we use the little hammer. They can’t just go buy something. We have a pretty good purchasing process here, where it needs to be cleared with finance and IT. I need to sign off on every requisition or Lex has to sign off on every requisition that gets processed here. When finance or purchasing sees software, computer anything on there, it comes to IT to get signed. You’d rather not use the big hammer. You’d rather have that taken care of with conversations first. But we have to approve the technology that comes in here because we have a pretty good governance model around that. So we try to work with them first on discussions and solutions, if they know what they want.

There has been no one who’s just gone totally off on their own. We consolidated under Lex. We consolidated all the IT so no one has little servers on their desks. We have our full data centers here. We offer so many more services to what they can do. So yes, there’s push back, like Lex said, with the ED, but everyone still wants the same goal and they see the better vision of getting it together.

LF: And leadership, strong leadership really makes the difference. We have a very strong president. He’s a brilliant guy. He has built this place into what it is over the last 25 years that he’s been president. He’s a very strong leader.

I’ve worked in institutions where the leadership is weak. And when you have weak leadership, it becomes very political and you do have territorial power. It’s very, very hard. I worked for New York University before I came here, not the hospital but the university. In academia, it’s all politics. Everybody has got their own little kingdom, and you can’t get things. If you have a strong leader, it makes all the difference.

AG: Let’s play off that. I like to ask CIOs and CTOs about the relationship with the CEO. Many have told me it really is very critical to them being happy and successful. They need to be supported. Tell me how important the CEO vision is and what you want and need from a good CEO.