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Perspectives on OR Automation

September 29, 2010
by Mark Hagland
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Interview: Rick Corn, Vice President and CIO, Huntsville Hospital

This summer, the Alpharetta, Ga.-based Surgical Information Systems LLC released the findings of a survey of healthcare IT and healthcare executives regarding issues around efficiency and effectiveness in the operating room (OR) and perioperative areas of the hospital. CEOs, COOs, CFOs, CNOs, OR directors, and CIOs (16 percent of respondents were CIOs) responded to the survey, which found that quality outcomes and financial results, in that order, were the largest concerns of those surveyed. In addition, 91 percent of respondents rated the success of the perioperative department as either extremely important or important to the overall success of their hospital organization.

The most negative trends identified by survey respondents were government initiatives and declining reimbursements, while the most positive trends identified were government initiatives, better physician relationships, new technology, and increases in patient volume, in that order.

Against that backdrop, HCI Editor-in-Chief Mark Hagland interviewed Rick Corn, vice president and CIO at Huntsville (Ala.) Hospital regarding the findings of the survey and their implications for CIOs and their teams. Corn’s organization is an SIS customer.

Healthcare Informatics: According to the survey, 91 percent of hospital executives rated the success of their perioperative departments as extremely important or important to the success of this hospital. What does that result say to you as a CIO?

Rick Corn: What it tells me is that that needs to be an area of focus from an IT perspective, so that we’re able to help facilitate efficient running of that area. From there, you cascade down to a whole raft of issues—trying to identify ways to reduce costs, and ways to help better document the care; and in some instances, that would translate into better reimbursement [through improved charge capture].

HCI: When you consider that the majority of hospitals still don’t have perioperative information systems, what does that say to you?

Corn: Hospitals have evolved based on the perspectives of the executives and the folks who lead those institutions. Historically, you go back a number of years, and everything was financially oriented; and it’s only in recent years that clinical applications have really come together into anything other than separate, stovepipe ancillary applications.

HCI: And now you’ll have to drill down into some of the core care delivery processes of the hospital in order to become more cost-effective in this era, right?

Corn: The question that was posed was around perioperative, though I’ll bet you that the percentage of hospitals that have a surgery scheduling system is much greater. And so there are stovepipes within stovepipes, among systems right now. And so you’ve got the scheduling stovepipe, and then the perioperative care-related systems, and then the anesthesia systems that are separate, and then the PACU [post-anesthesia care unit] and recovery areas, and the systems to support those functions. And the nature of those ancillary systems is that they’re developed separately, but now we’re looking to integrate those systems.

HCI: So it really falls to you as the CIO, working with clinician and other leaders, to strategize around all this, right?

Corn: In the broader sense, yes. And it’s not like we’ve got everything figured out. While we feel like we have done a pretty darn good job with efficiency and patient flow, we’ve still got a ways to go. We’re now trialing an analytics from SIS, in order to figure out where opportunities remain to improve operations within the surgical arena. So with that, I think we will find ourselves sitting around with IT, anesthesia, and OR management, and strategizing, and figuring out, OK, with all the opportunities we have here, where do we think we can get the most bang for the buck, in terms of incremental investment?

HCI: The OR is a key financial driver for the hospital, generating up to 70 percent of the revenue, 60 percent of the operating margin, and 40 percent of the supply costs, on average, for hospitals; clearly, the OR is a rich parcel of land to plow for opportunities, right?

Corn: I think so. Along the continuum, when I think of financial and quality issues, I think of them as being along a continuum, if you will.

HCI: So when you drill down into care delivery processes, you will find the cost and quality issues in the same places, right?