Eisenhower Medical Center is a not-for-profit healthcare institution consisting of the 289-bed Eisenhower Hospital, the Betty Ford Center at Eisenhower, the Barbara Sinatra Children’s Center at Eisenhower, and the Annenberg Center for Health Sciences at Eisenhower. Situated on 130 acres in Rancho Mirage, the medical center has provided a full range of medical and educational services for more than 30 years for residents and visitors to the greater Coachella Valley. Recently HCI Editor-in-Chief Anthony Guerra had a chance to talk with CIO David Perez about his work.
AG: Do you think CIOs are still, mistakenly, being asked to 'own’ the implementation, rather than the clinicians that are going to use the technology?
DP: I don’t think it is set out to be that way in a lot of places. I think we all have the idea that we know it can't be labeled as an IT project. We set out that way. But I know the challenges going through this, even though we’re all doing what I describe; there are still those challenges once in a while, people might slip and call it our IT project. It’s the old way of thinking that if it’s information systems, therefore it’s the information systems department driving this. So I think what happens is, they start off with saying 'okay this is going to be driven by the clinicians or driven by radiology or laboratory,' and then we fall back because the IT people are the ones who have the knowledge on how to bring in a system.
Every day I need to remind myself and remind my staff that we are the engineers behind the scene supporting the front-end people. We are the builders behind the scene. We’re the plumbers, we’re the electricians, but we are not the ones driving this. We bring them their options, they need to make the decisions. We constantly have to remind ourselves to keep doing that. And it works, because you realize this after we’ve been doing this now for a year actually since we kicked off originally, that it takes a while to sink in on the other side — the clinical side — the clinicians or the end users, that this is their system; they need to make the decisions and so forth.
AG: And if they don’t want it, then it’s not your problem to make them use it.
DP: Right. We won’t do it. They’ve heard me say that. ‘If you don’t want to move forward, let me know,’ and I said I can pick up the phone and call the vendor and we won’t be going forward. And they are like 'oh no, no, no'.
AG: What percentage of the physicians at your hospital just have admitting privileges; they're not employed by the hospital? Is it all of them?
DP: They're not actually employed. We do have a hospitalist group but again, they're not employed by the hospital. It’s a management contract.
AG: How many hospitalists?
DP: Eight, I think.
AG: How many physicians have admitting privileges but are independent?
DP: We probably have a staff of 390.
AG: Those 390 physicians are the ones that you really need to embrace the CPOE solutions.
DP: Correct. CPOE is scheduled to be implemented in the summer of 2009.
AG: It’s such an interesting dynamic in healthcare where the physicians are not on staff; some of them can be very well known, renowned, respected, have admitting privileges at multiple hospitals in the area, your competition. So you have to be very politically savvy and gentle and ginger, is that correct?
DP: You just described my world.
AG: Tell me a little bit about some advice you could give to your colleagues, anything you’ve picked up on how to successfully work with physicians from the CIO role.
DP: Bring them into the fold. Bring them early on into the idea and thought process of where you're headed. When we chose McKesson, our vendor, we traveled the country with anywhere from four to eight physicians each time. We made them part of the team of knowing what is going on, where we want to go. Right now, the post-discharge medical record is electronic. So currently right now, on the floors, they're still manually paper charting. But once the patient is discharged, everything is either a code-fed or scanned, so the physicians post-discharge need to look up their patients records electronically, and they have to sign off on their deficiencies electronically.
During that process, we brought them in early on during the design, during the training. We know physicians don’t come to the classes to be trained. We have to go out and find and reach physicians individually. We had people going to the physicians’ offices. We had people set up in the physician lounge and medical records to always be there, explain to them, showing them where we’re headed, what we’re doing and that we’re there to help them. So I guess bring them into the fold early on and make them part of the team.
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