With 4,000 team members, not-for-profit AtlantiCare delivers healthcare through more than 60 locations throughout southeastern New Jersey. The organization includes AtlantiCare Regional Medical Center, a 567-bed teaching hospital with campuses in Atlantic City and Pomona, along with an IT business called InfoShare. HCI Editor-in-Chief Anthony Guerra recently had a chance to talk with AtlantiCare CIO Dan Morreale, who also serves as CEO of InfoShare.
AG: I was looking on your site and I noticed something interesting — you are corporate CIO for AtlantiCare, and also CEO of InfoShare — AtlantiCare’s information technology division. Can you tell me a little bit about that?
DM: AtlantiCare, as a conglomerate, is six different companies. InfoShare is one of those companies, and it is the technology arm of AtlantiCare. We also sell some technology services to some community-based physicians as well.
AG: That sounds interesting. I suppose you’ve found that structure to be the best?
DM: No, I think it’s been a little bit of a challenge, and we’re trying to change that. We, at AtlantiCare, have our businesses set up in the following way: the five businesses are the medical center, which is two hospitals and a bunch of outpatient activity; InfoShare, which is the technology company; we are half owners in a partnership with Blue Cross/Blue Shield and that’s known as our health plans company. Behavioral Healthcare is set up as a separate corporation, and we have a division known as Health Services, which is primarily physician offices, gymnasiums, and some more storefront space. The health services run our childcare activities; we have a very large childcare program.
Those are the five major businesses, and we all interact. We’re all part of AtlantiCare. We’re all fully owned subsidiaries of AtlantiCare. AtlantiCare is our prime responsibility, but structurally we have these business units and each business unit is expected to maintain profitability and keep their staff happy and grow the business, and that’s what makes this job just a little bit different from an ordinary CIO position.
AG: Are you familiar with other healthcare organizations that are similarly structured, or do you think you’re fairly unique?
DM: This model was very popular back in the ’80s, where CIOs try to convince their CEOs that they can turn information technology into a profit center. I know there are a few models out there. I can’t tell you that Jack Wolfe (CIO) at Montefiore (Medical Center) has probably got the only model in this area that works effectively.
AG: Tell me about some of the specific challenges that arise because of the structure you have in place?
DM: I think some of the challenges really center around the way tasks need to be prioritized. From a business standpoint, I have external customers that I need to keep happy. I have internal customers that need to be kept happy. My medical center is my biggest customer and pays me the most money, and demands the most, but the other companies have just as important demands and the process by which we prioritize all of those things is a challenge. I want to keep my biggest paying customer happy, but I want to keep everybody else happy as well. How do you dole out resources, how do you keep everyone engaged? And the needs are very different across the platform. The needs of the medical center are a whole lot different than the needs of the daycare center, or the needs of a physician’s office. It’s what makes the day full and interesting.
AG: With most IT purchases, there’s an ROI discussion. But some of these patient safety implementations don’t lend themselves to that very well. Do those discussions take on a different tone when you are, essentially, an independent company that’s providing services? Is it basically, if you can pay, we will do it, like most companies?
DM: No, I don’t do that, because part of the challenge that I had when I joined AtlantiCare was getting each of the organizations to sing from a similar prayer book, all the AtlantiCare companies. Prior to my arrival, each company would go out and buy whatever technology they wanted, and then dump it on our lap and say, ‘Okay, now you guys figure out how to make this work.’
We really needed to change that model and establish some standards and help our customers to go out and make selections of hardware and software that we thought were effective and fit within the security and technical structure that was in place. That was one of the first changes that we needed to do. It’s happening, so we’re getting there. Officially, we have a rule at AtlantiCare that is, if it uses electricity, InfoShare needs to take a look at it before the purchase order’s released.
AG: Is there a minimum dollar amount?