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One-on-One with Sibley Memorial CIO Lorraine Fordham, Part II

April 25, 2008
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In this part of our interview, Fordham talks about how vendor M&A impacts CIOs, as well as her thoughts on the drive towards data standardization.

Sibley Memorial Hospital is a non-profit, full service 328-bed acute care community hospital serving the Washington, D.C. area. The hospital’s campus is also home to its assisted living residence (Grand Oaks) and The Sibley Renaissance which houses the Center for Rehabilitation Medicine, Sibley Senior Services, skilled nursing care and a residential Alzheimer's unit. Recently, HCI Editor-in-Chief Anthony Guerra had a chance to chat with CIO Lorraine Fordham.

Part I

AG: So you felt a good fit with Compucare/Quadramed in terms of the criteria you talked about earlier?

LF: We first started doing business with that company in 1984 when we bought our first order entry results reporting systems, our first ADT systems. The company itself has undergone a lot of different transitions. They were bought by Baxter, then they got bought back out, then they were bought by Qudramed, and now they are buying up some products themselves. They bought the Misys CPR product. The philosophy of the company has very much suited us. They have got an active user group. They listen to what we say. They try to accommodate our needs. That is the company that we have had the longest relationship with, but we use that as a model as we go to look at radiology systems, for example. When we were buy our radiology and PACS systems, our final two vendors were GE and IDX.

It wasn’t a hard choice for us because GE was too big. We didn’t like a lot of things we heard on our references in terms of how they supported their users. They have a good product, but they would come back and say no, that is the way it is. So we said ok, we are going with IDX. Well of course, little did we know that GE would turnaround and buy IDX. We were sort of sitting around waiting on somebody to buy Qudramed while they went and did that. Now we are waiting with baited breath to see which of the products they will continue to support. Right now, they are still supporting both. GE is still supporting the IDX product and the GE PACS, and we are probably going to look elsewhere if they discontinue the IDX PACS because we are not happy. We are not happy right now with our relationship with our vendor for imagining services, and we were very happy with IDX.

AG: Any more on the IT side, in terms of the way an application is constructed making it more or less attractive?

LF: What we will look at there really is: do they use standard interface technology. You hear about HL7 a lot, but I hesitate to ask if they are HL7 compliant because that means a lot of different things. It is not really as standard as we would like it to be, but it is the best we've got. So we will definitely look at the interoperability features and functions of these systems, and if they say, ‘Oh no, we can’t readily implement text data between our systems,’ we will look at that level. Do they use standard reporting?

I have a small staff. It is not that small, but it feels small with all the projects we have got. I can’t have people that are expert in five different database languages and six different report writers. Whether they are good, bad, or indifferent, the ones that we use the most are the ones that we are going to want the other vendors to also play with. And they are standard. They are things like Crystal reports, and SQL, and Oracle.

Most of them do, but if we came across one that didn’t, one that said, ‘Oh no, no we have our very own proprietary database,’ our alarms would go off. We would say automatically they were eliminated, if they had the best functionality and the entire team said they were head and shoulders above the rest, and we can’t possibly go to the other vendor that has what you are looking for, we would probably support them in it, but we would bring it up and we would talk about it. Usually it hasn’t been an issue. Usually we find the vendors that have the technical infrastructure that we are looking and also have the functionality that the users are looking for.

Now the big change, philosophically, in our system selection is that up until last year, we were pretty much letting the users be best of breed, go out and get whatever they wanted, whether it interfaces or not. That interoperability question has become a real issue particularly with the pharmacy, with the closed-loop medication management. I don’t know how much you know about that or have heard about that, but that whole piece brought us up short about a year and a half ago, when we realized we can’t really integrate our order entry systems to our pharmacy in such a fashion that it is going to work efficiently for our nurses. What we really need is a system that has the pharmacy built into it and that is one of the reasons we are going with the CPR product. So we are looking for clinical systems that provide integrated medication management as opposed to interfaced.