Chad Eckes faces what is perhaps an unusual set of challenges and opportunities. As CIO of Schaumburg, Ill.-based Cancer Treatment Centers of America (CTCA), Eckes oversees IS operations at a national patient care organization with four cancer-care hospitals scattered across the country. Since obtaining care from CTCA often requires patients to travel long distances, the organization has more challenges to deal with than the average community hospital.
To that end, CTCA has found success in building a care service model that is intensely patient-centric and service-oriented. And its for-profit business model, Eckes says, translates into a greater willingness to invest in technology, facilities and other areas. For one thing, such investments reap large marketing rewards. Take for example the all-digital hospital that opened in December in Goodyear, Ariz., a suburb of Phoenix. That hospital (known internally as the CTCA at Western Regional Medical Center), was designed as a state-of-the-art showcase for IT and facility design, in keeping with CTCA's marketing as a company on the cutting edge in cancer care.
“We did an extremely expensive nationwide electronic health record project that came to culmination on March 28 of last year,” Eckes says. “We implemented 22 modules, everything from the front-end registration, across all phases of clinical care, to the back-end revenue cycle management.” The organization also deployed CPOE, closed-loop medication management, and physician documentation. He and his colleagues are using core clinical systems from the Atlanta-based Eclipsys Corporation.
Naturally, Eckes and his team in IS consulted with the organization's clinician leaders, among them Edgar Staren, M.D., Ph.D., senior vice president for clinical affairs and CMO. Only through such collaboration, Eckes says, can systems be implemented that will be fully adopted by clinician end-users.
In fact, he says that using the HIMSS Analytics “seven-stage” model of clinical IT development, the three existing CTCA hospitals are already at stage-six, while the newly opened one is at stage-seven. “We actually designed the hospital in the architectural blueprint around the technology,” he says, “so there's no physical medical records department. Our HIM is two people in a room with a computer and a big scanner for when paper documents come in through the door.” Eckes adds that there are no nursing stations in the facility, which is designed to help keep nurses as close as possible to the patients. “This is the first ground-up build of an all-digital cancer specialty hospital,” he says.
The return on investment (ROI) for all of this is obvious from first glance, Eckes says. “Things like CPOE are a given, because we have an extremely complex model of care that needs to be driven by systems,” and in which multiple clinicians need access to the patient chart in rapid order, and sometimes simultaneously. Given that patients are flying in from all over the country, time must be optimized. What's more, the implementation and upgrading of core clinicals that took place across the existing three CTCA hospitals between October 2006 and March 2008 was accomplished on time and under budget for $15 million (excluding the new hospital's IT costs).
The key to success in investing, Eckes says, is coordination with clinicians in the planning and rollout of such implementations. But he says he does not doubt the ROI of technology for any care organization that wants to offer top-notch services.
In common: strategic approaches
Nationwide, pioneering CIOs are moving to implement clinical information systems to cope with demands for transparency and accountability, pay-for-performance and accelerating consumerism. All these trends require IT to keep pace.
Among the many examples of ROI-friendly initiatives:
At the 400-bed Heartland Health in St. Joseph, Mo., CIO Helen Thompson has realized $47.5 million in hard-dollar savings to the bottom line from a $54 million EMR implementation (Heartland is using the Kansas City, Mo.-based Cerner Corporation as its core clinicals vendor). Five years into an eight-year deal, she says, the organization has experienced a 50 percent reduction in medication errors; a 24 percent improvement in MRSA infection notification; and an increase in clinician access to advanced directive information from 5 percent to 100. “This is about discipline,” says Thompson, “a discipline that emanates from the entire executive leadership of an organization that encourages measurement and deriving value.”