On March 1, Norberto (Bert) Robles assumed the role of Senior Vice President of Information Technology and Corporate Chief Information Officer at the New York City Health and Hospitals Corporation (NYCHHC). Robles most recently served as CIO for the State University of New York Downstate Medical Center, and is a member of the College of Healthcare Information Management Executives (CHIME).
NYCHHC is a $6.3 billion integrated healthcare delivery system with its own 350,000 member health plan, and is the largest municipal healthcare organization in the country. An early adopter of electronic health records, NYCHHC has more than 10,000 users online daily. It also has CPOE and electronic patient registries that monitor and improve the health of diabetic and heart disease patients across the 11-hospital system. HHC serves 1.3 million New Yorkers yearly and provides medical, mental health and substance abuse services through its 11 acute care hospitals, four skilled nursing facilities, six diagnostic and treatment centers and more than 80 community-based clinics and. HHC Health and Home Care. Healthcare Informatics senior associate editor Daphne Lawrence recently spoke with Robles about his new role.
Daphne Lawrence: HHC has such an incredible history of HIT, from its early Misys System, its Davies wins, and its high level of physician adoption. How are you planning to build on that foundation?
Bert Robles: I’m intrigued by the challenge. What I understood even before coming here was that we have an outstanding portfolio of information assets that is quite impressive. We’ve been early adopters of many of the technologies that support our mission. But part of the process is looking at business events like government compliance issues and the technology marketplace that will continue to move us through change — and we have to be responsive to that change. One of the many goals we are going to embark on, obviously, is assessing not only the current assets that we have but what do we need to do going forward: understanding the market, understanding the business events, understanding the needs and mission of the organization to deliver the patient care and outcomes we are trying to achieve.
DL: Is that going to include a new enterprise EMR?
BR: We already have physician order entry. We were an early adopter of Misys which is now Quadramed. What we will continue to do is expand the ability to capture more clinical information online, and we are enhancing it now. We also do have some departmental niche products. As part of this assessment and strategic planning we’re going to look at whether we’re going to continue that approach or have a totally integrated enterprise strategy for clinical documentation and CPOE.
I think it’s appropriate, given the needs and demands and also the regulations for the stimulus money. One of the major areas of focus is obviously to take advantage of the stimulus funds that are available, for both the acute side as well as the provider side for hospital-based physicians. It’s a significant opportunity for us to improve the technology and meet the demand on a national, state and regional basis.
DL: So would you say that ARRA and HITECH is affecting your technology strategy?
BR: I think that HHC has always been dedicated, looking at its past history, to using technology to improve the quality and the delivery of care. Given the amount of incentive money and the movement to further expand the EMR, we are going to focus vigorously on realizing those incentive funds. We are working very diligently to meet the meaningful use criteria.
DL: What stage are you at?
BR: That varies depending on how you interpret the HIMSS stages. What I’ve found is you have evidence of different stages within an organization. We meet those stages at varying degrees, it’s not a wholesale stage 2, 3, or 4. I think the criteria are an acceptable framework to strive for.
DL: What is your leadership style — hands on or corporate?
BR: My office is downtown near the president’s office but my style is more to meet and have an ongoing dialogue with all the locations where we provide service. I’ll be continuously meeting with the leadership and operational units of these areas.
I’ve been getting out to the hospitals already and I find the leadership and the operating units quite receptive. Just yesterday, as a senior leadership group, we agreed on various initiatives that the HHC hospital networks are supporting, including a timeline for the stimulus funds compliance. I found them quite supportive in my early tenure here, and I enjoy the level of support I’m receiving.
DL: So what is first on your to-do list?
BR: A couple of things: As a new member of any organization, you have to have a much deeper understanding of the culture, and develop strong relationships throughout the organization. There are varying needs from area to area that need to be supported, and I have to understand those areas. I’ve been focusing obviously on the IT talent, our business and user needs and making sure our IT organization is properly aligned to support the clinical service needs of our providers and patients. Those are the areas of concentration, and there are also some significant initiatives: obviously the stimulus fund, and the upgrades we have to the various systems. We are undergoing a significant major data center consolidation and construction for its expansion.
Those are projects that are underway currently, as is a significant upgrade to the financial systems and revenue cycle capabilities—among others. But while we’re looking at what we do going forward, we still have to make sure that these initiatives are completed on a timely basis.