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One-on-One With Norwalk Hospital CIO Jamie Mooney, Part III

December 17, 2008
by Anthony Guerra
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In this final part of our interview, Mooney says that having a guiding principle makes budget-cutting decisions easier.

Founded in 1892, Norwalk Hospital is a 328 bed not-for-profit community hospital located in Fairfield County Conn. The organization serves a population of more than 250,000 residents with approximately 2,000 employees, 500 affiliated physicians and 600 dedicated volunteers provide care. Recently, HCI Editor-in-Chief Anthony Guerra had a chance to talk with CIO Jamie Mooney about her efforts to empower clinicians with information management tools.

AG: In this tough environment where you have to make some cuts, how do you decide which projects to fight for?

JM: I read this fabulous book about the Mayo Clinic that was written this year. It’s called Management Lessons From Mayo Clinic. And one of the things that struck me is that every decision they make is about what's best for the patient. So when I look at decisions I have to make internally, even deep down in the technology, the first thing I say to myself and to everybody else is if we have to make a decision here, which decision is best for the patient. So that’s one guiding principle that helps me make those types of decisions.

But again, I will go back and say the thing I need to be able to do is to articulate back to senior leadership why something — especially when it’s a technology dollar to be spent, not an application dollar to be spent — is important. The applications are clear to the non-technical people, but the infrastructure upgrades and that type of thing are more difficult to articulate. So I have to be able to go up and say this is why we really needed the fast recovery plan, for example. So for instance, that is a project we can't let go. Can we spread out the cost, can we focus right now on just getting the plan done and then have several steps to how we get the hardware, sure. But that type of thing we can't stop.

So I think if we’re able to put the case together in a way that other leaders in the hospital can understand it, that helps us to get things pushed forward that we really know we need to do despite what the budget cuts are.

AG: Any additional thoughts in terms of scaling back strategically to avoid long-term damage?

JM: Like a lot of things, you never want to cut into bone. So you really have to think through the implications of doing and not doing things. But I think, again, back to our discussion from a couple of minutes ago, taking this time to strengthen what you have to get people trained on things, maybe there is training people haven't been able to go. Well guess what, it’s less expensive to send somebody to training than to implement a new component of a nursing documentation system, for instance.

So if you take advantage of the time you have and the limited resources and shore up your foundation, I think then you're put in a position that when the funds do free up and you can move forward, you’ve got yourself at that starting gate versus not. So I think really trying to not only optimize what's in place, but help get your staff retool if necessary, those are the types of things that you can really take advantage of in a more scarce time.

AG: Do you want to quickly touch on maybe one or two of the major projects you're currently working on?

JM: First of all, we’re putting together a disaster recovery plan. We’re really very deficient in this. Again, many years of saying “no money, no money, no money…” this is not acceptable anymore. We have residents coming in who have never documented on paper in terms of physicians doing CPOE. So everything is so technology focused in terms of patient care that it’s no longer an option to be down for several days. So we really are very focused on making sure that the disaster recovery planning is very important. So that’s moving forward.

Other projects that we did get approved: We just got a quality system approved — Midas QM. We feel that was an important thing to move forward with because it’s standard of care and we don’t have it. So that just recently got approved and we’re very excited about that. We have the McKesson performance analytics. It’s the equivalent of the analytics tool that does cost accounting and advance reporting and such. There is a whole clinical component that we have not implemented yet. We are quietly moving forward with that now because being able to get cost and quality and clinical data altogether in a single database and report in a very clear manner is important as we get into these more difficult financial times. So that’s another thing that we’re quietly moving forward with. That just gives you an idea that in these financial troubled times, those are the types of things we’re looking at, that we think are very important.