CentraState Healthcare System is a private, not-for-profit health organization headquartered in Freehold, N.J. The system consists of the
CentraState Medical Center, an acute-care medical center licensed for 271 beds; the
Star and Barry Tobias Ambulatory Campus, a 171,000-square-foot outpatient center opened in late 2007; and t
hree senior living communities. Recently, HCI Editor-in-Chief Anthony Guerra had a chance to chat with CIO Neal Ganguly (also head of HIMSS New Jersey Chapter) about his accomplishments, challenges and goals.
AG: What we’re talking about here is really CIOs taking an active role in facilitating adoption through these different techniques. To what degree do you think CIOs should be on the hook for actual clinical clinician usage of these systems, 50 percent, 80 percent, 20 percent?
NG: I would say if I was forced to pick a percentage, 50 percent would be realistic or reasonable.
AG: Who would have the other 50?
NG: Whoever the business unit owner is, the executive owner. So if it’s nursing, it would be the CNO, if it’s radiology or lab, it would be the VP of clinical services; whoever your counterpart is at that level who has the direct staff responsibility for that area. I think that CIOs can’t run from the fact that we are bringing change tools to the table, and that oftentimes our customers aren’t skilled in change management methodologies, and we have to help bring that to the table.
So early, I think the CIOs have to have a lot of accountability in that, maybe even more than 50 percent, let’s say 60/40. And then ultimately, you get to a 50/50 level, and then as the organization matures and your user base’s experience with technology and understanding of why the technology is in place matures, maybe we can even see that shift to 40/60, where the CIO has a little less accountability to the compliance and a little more shift to the business unit executive.
AG: I’m sure you’ve been in implementation situations where the person in that ideal champion role — the CNO or head of cardiology — was not a champion of IT. Have you experienced that, and how did you deal with it?
NG: I have, and it is a difficult situation. Ultimately, this has got to be a top-down exercise, so from the board to the CEO on down, the support has to be there to implement these technologies. And if it’s not, and you're at the same level as the CIO, let’s say with the CNO, who is resistant, you're going to face a huge uphill battle, because ultimately you’ve got to make sure that message is coming from the people above both of you that say this is the way we’re going to do it, like it or not. Now in the absence of that, it’s the traditional relationship-building things, you try and educate and get them to see why all this was done and communicate that.
One of the things we did in this implementation is we formed a specific committee that was called a change management committee, and we actually installed our VP at HR as a chairperson of that committee. We realized that there is a lot of change happening here, and we’re so wrapped up in the process of the technology, that if we don’t really do a good job of communicating, we’re going to overwhelm our staff, our line clinician. So this group was put in place, and we looked at even some professional change management services (very expensive), and we said we’re not sure we can afford to do that, but let’s at least take some lessons learned from them and look at some of the communication tools they put in place. We created a specific Web site on our intranet that was there for anybody to go and see what was going on and frequently asked questions and you can post questions and get your answers there, and we had newsletters that went out. We had events and fairs that were done to communicate things, in addition to the full scope of all the training that had to happen.
So this was run by HR, and myself and other executives sat in on the committee, but it was by the VP at HR and had some line participation as well from people in the nursing area and some of the ancillaries.
AG: If you were to name the top challenges that you think CIOs face today, would this be one of them — encouraging or fostering clinician adoption — and if so, what would be a couple of others?