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One-on-One with Lowell General Hospital CIO John Goodrow

May 29, 2009
by Kate Huvane Gamble
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Switching out manual systems for electronic documentation at Lowell required an organization-wide effort, along with new infrastructure

John goodrow

John Goodrow
Located about 30 miles north of Boston, Lowell General Hospital is a non-profit facility with 200 licensed beds, 38 bassinets, and two satellite locations: the Surgery Center and Patient Services Center at LGH Chelmsford and the Women's Imaging Center in Chelmsford. Five years ago, Lowell General brought in John Goodrow, a first-time CIO, to guide the facility through a dramatic IT transformation. Under Goodrow's leadership, disparate systems and manual process were replaced by nursing documentation, physician documentation in the ED, and CPOE, among other changes. Healthcare Informatics Associate Editor Kate Huvane Gamble recently spoke with Goodrow about what it took, from a both a cultural and an infrastructural standpoint, to bring about what he calls an “organizational” change.

KG: When you started at Lowell, what type of system was in place - was it mostly paper-based?

JG: No, we had a homegrown Web portal that we fed information into from disparate systems. So primarily, results of labs and things like that, and a handful of other things about the patient record that we were capturing electronically.

KG: And this is where you came in?

JG: Right. They brought me in to address a handful of things; address the departments, address the infrastructure, put in a new data center, put in a new wireless network, as well as a housewide system evaluation.

It was everything from refreshing the entire desktop environment, doing some standardization on what goes on the desktop, as well as putting in a brand new data center and doing a full evaluation for a complete HIS.

KG: What did you decide for the HIS?

JG: We went with Cerner. Our device strategy was multifaceted. We started with, obviously, the desktops. We also went with Motion Computing slate tablets on Ergotron (St. Paul, Minn.) as well as in carts and wall-mounted cabinets with full-sized keyboards and mice. This way, the nurses or physicians could use it outside of the room like a regular computer, or they could take the slate out of the docking station and bring it right into the room where they were going. In addition to that, we do have mobile carts, computers on wheels, and we also have roughly 200 Motorola MC70 handhelds, which we use for some nursing documentation, IMOs (inpatient medication orders), as well as closed loop medication, barcode scanning, medication checking.

So an array of different devices - those devices that are appropriate for each location.

KG: Was it a big bang implementation?

JG: It was, yes.

KG: How was IT able to pull something like that off, not having a huge pool of resources?

JG: It wasn't an IT project. It was an organizational project - that's what makes these projects successful. You do something like this, and it's driven from the top-down. The entire administration and C-suite drove the project. So it wasn't, ‘We're putting in a computer system.’ It was, ‘We're changing the way we're delivering healthcare to this community,’ and as such, we're looking at every one of our processes and workflows, and how we can leverage the technology to help streamline processes and provide enhancements to the care process as opposed to looking at it purely as a tool that we need to work around.

KG: How long was the process?

JG: From start to finish, the implementation itself was a little bit under 15 months. And that 15 months was from execution to conversion. So what we had prior to that was a system evaluation phase, and after that we executed an agreement, we put a lot of upfront time on planning the scope of what we were actually going to do.

KG: Once you went live, was it a smooth transition? Were there any serious issues?

JG: It was extremely smooth. We brought everything up, and 14 days after we went live, we closed down our command centers and it was business as usual.

KG: That's a pretty short time period. Was that less time than you expected it would take?

JG: I figured it would probably go for about a month.

KG: It's always nice when that happens. So to support all of these devices, what was required as far as infrastructure?

JG: We put in a whole, completely new wireless infrastructure. And the slate computers, the mobile carts and the MC70s are all running over that wireless infrastructure. The tablets are from Motion, and the wireless infrastructure is Extreme Networks (Santa Clara, Calif.). Motion did help us with a wireless evaluation, because we were investing so highly in their devices that we wanted to make sure that everything played well together.

KG: What did the evaluation entail? Were there concerns about connectivity?

JG: It really was just a matter of doing site surveys and making sure that we had access points placed appropriately and that we didn't have conflicting signals. So now we're using the three different radio bands - A, B, and G - for different devices, making sure there isn't too much bleed from one to the other. The basic things you do when you put in a wireless environment.

KG: Do you have CPOE?

JG: We do. We went live with CPOE in the initial implementation as well as physician documentation in the emergency department.

We have not finished rolling out CPOE housewide; we are in that project right now. We're in the planning phase; we anticipate starting the project phase this summer.

KG: Will you need to make any adjustments to ensure wireless coverage?