One of the many benefits of HIMSS attendance is getting to hear stories from the trenches about implementations and policies. Panel sessions of CIOs, CMIOs and other informatics executives can offer new perspectives on challenging issues. So it is at HIMSS 2017 in Orlando. For instance, Thomas Selva, M.D., chief medical information officer for University of Missouri Health Care, and Seth Katz, associate administrator of information management at the Truman Medical Centers in Kansas City, Mo., will talk about how IT governance structures evolved at their institutions.
In a HIMSS preview interview, Dr. Selva said their presentation would be about how two organizations just two hours apart, and the only safety net hospitals in the state of Missouri have developed very similar processes for how they manage their IT spend. “Both have come to the realization that health IT is a key strategic enable for your organization’s mission, and although they are a little bit different, we have a very clearly delineated process for how projects are vetted, evaluated, and how to do value analysis of those projects looking for full return on investment,” Selva said. “Growth of governance has really been a byproduct of the cultures of our organizations. Because we follow this structure and are disciplined, we have been able to return several million dollars to the organization — money that did not need to be spent.”
Selva said problems might occur when software is purchased without much supervision or forethought. “You have laid out $250,000 for software that ‘can’ interface with the EHR but never has,” he said. “So you spend $500,000 to do that, only to find it is a product for one faculty member who decides to leave in nine months. That is why you need oversight of these decisions. They can be so expensive, not just the capital expense, but the ongoing operational expense down the road.”
The governance structure at MU has evolved over the last five years, Selva said. He added that one colleague described IT governance as being like the fingerprint of an organization. “It is always going to be unique, because the needs are going to be different, but it allows health IT to be seen as an enabler rather than the department you rely on to keep the lights on.”
At every level of governance at MU, the process is always led by a clinician and enabled by an IT architect, Selva said. “We don’t do IT projects here; we do clinician-led projects that are enabled by IT. That is our culture here.” (Their presentation is Wednesday, Feb. 22, at 4 p.m. in Room W307A)
Working on Patient Flow
In a separate presentation, the CIO of a community health system in Joplin, Mo., will detail how he developed a close innovation relationship with the vendor his organization chose for patient flow tracking. Skip Rollins, CIO of Freeman Health System, described how his team worked with vendor TeleTracking to craft a solution for its switchboard staff, who used to have to phone, page and text teams, while still handling a call about every six seconds. Starting last year, they worked together to automate the process so operators are less likely to get distracted.
“Instead of asking operators to stop what they are doing and page someone, we provide them a one-button touch tool. They have a dashboard and click on a team button and they are done,” Rollins explained “It also allowed us to push out all the on-call scheduling to the departments. The Cardiology Department can populate tits own schedule. We don’t have to know anything about it. We just page the STEMI team.”
Because that implementation was successful, Rollins began co-developing another solution with TeleTracking having to do with work flows with community physicians. Freeman said about 500 times per month physicians refer patients from rural communities who need admitting. Getting the patient admitted and following their progress was time-consuming and difficult. To help, Freeman has established a Community Access Portal, where physicians can enter information and it communicates with the hospital registration system and in some cases assigns a bed right away. “When they arrive at the hospital, they can do paperwork and then go straight to their room in minutes,” Rollins said. “There is no sitting around waiting for a bed, and the physician can see where they are.”
Everything Freeman is doing with TeleTracking is cloud-based. “The system interacts with our EHR, which is Meditech,” Rollins said. “We have created a roadmap of how TeleTracking’s applications will fit into our environment. Their analytics package is being integrated and we are using it to see opportunities for efficiencies in patient management solutions.” (Rollins will be speaking at the TeleTracking booth #923 at 2:30 pm on Monday Feb. 20.)