Northeast Hospital Corporation (NHC) represents the acute care hospitals of Northeast Health System, Inc. (NHS), an integrated network of hospitals, behavioral health facilities, long-term care and human service affiliates offering Massachusetts North Shore residents general and specialized medical care. NHC hospitals include: Addison Gilbert Hospital in Gloucester; BayRidge Hospital (psychiatric) in Lynn; and Beverly Hospital in Beverly. There are also two outpatient facilities in the corporation: Beverly Hospital at Danvers, Medical and Day Surgery Center; and Beverly Hospital Cable Center in Ipswich. Recently HCI Editor-in-Chief Anthony Guerra had a chance to talk with CIO Robert Laramie about his work to strengthen NHC’s infrastructure so point of care applications are always available.
GUERRA: You’ve been the CIO there for just over two years. Were you promoted from within the organization or did you come from outside?
LARAMIE: My role is brand new at Beverly Hospital. Previously, there was not a chief information officer in the organization. I’ve been in healthcare IT for 15 years in various roles such as working for a vendor, being a consultant, and also working at a large institution, which was Lahey Clinic, before I came here. So I think I’ve seen all sides of the fence with regards to healthcare IT, the ways that it’s implemented all across the nation in large and small organizations. As the organization looked at what was happening in the industry and was finishing up a five-year master facility plan, they decided that strategically they needed to create this position which I was recruited for.
GUERRA: What was it about the position that attracted you?
LARAMIE: It was two phases for me. One, I had my own consulting firm for eight years, which I sold because I didn’t want to live on a plane anymore. The other factor was that I think, over the next five-10 years, healthcare is going to have such dramatic changes, and IT is now going to be, I think, one of the driving factors to support what’s going on. So I just saw it as a truly exciting opportunity to get back involved on this side of fence and really have a dramatic impact on the patient care process.
The other part was that having lived in Massachusetts for so long, I knew a lot of the executives here and I knew what the organization was about, so I had a lot of confidence coming in that this would be a great place to work.
GUERRA: Did you do an inventory of the organization’s software systems before you took the job? Did you investigate the administration’s attitude toward IT?
LARAMIE: I had the luxury of having other executives in other hospitals that I could talk to because I had worked with executives here in their past careers. So, I had some capability to get insight that other people wouldn’t have had, insight about where the individuals had come from and how they were to work with. We did have conversations throughout the process that confirmed this was a very entrepreneurial thinking, forward-thinking organization. That analysis has been supported over the last two-plus years that I’ve been here.
The other part of it was that during my interview process, I spent half a day with the IS staff walking through what they do, the things that they have challenges with, really get the lay of the land for the department and what I was taking on.
GUERRA: What are the main things you want to know before taking a CIO job? You mentioned the culture; would it also be the IT budget you’d have to work with? I would assume you want to make sure you’ll be given enough resources to do the job, and the budget says a lot about an organization’s priorities.
LARAMIE: That was the most important thing to me. I sat across the desk from the CEO and said, ‘Where is IT in your priority list?’ The response I got, across the board from all executives, is it’s in the top three for the organization looking forward. They had spent strategically on facilities and a new ambulatory care center, so they knew they had to start investing in IT, as it was now a strategic objective for the organization to implement the type of systems that will improve the patient care process.
GUERRA: I understand you’ve made some changes to your IT environment. Tell me about that.
LARAMIE: We’ve changed the whole technical infrastructure that supports Meditech here. When I came here, I knew that to accomplish our clinical system strategy of improving patient care with the modules that were being discussed and prioritized the infrastructure had to be solid, and it wasn’t to where it needed to be to support these point-of-care applications.
So we replaced completely our storage area network and our server environment to support Meditech. We built our wireless capabilities to be 100 percent across all of our campuses, so that we would be able to support the type of form factors that clinicians might want to utilize to treat the patients. We also wanted, obviously, to offer them mobility throughout the organization. We’ve done the significant infrastructure changes to prepare ourselves for CPOE implementations, for bedside medication verification, for electronic medication administration records, and the list goes on for us, as far as our clinical strategy.
GUERRA: So you saw that the underlying infrastructure would not support what you wanted to do with the software applications?
LARAMIE: That is absolutely true. The thing that I always say to my colleagues here is that it can’t be slow and it can’t be down. We were in a situation where we needed to improve the performance of our infrastructure and expand the capability that governs our infrastructure.
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