Saint Clare’s Health System — with four northwestern New Jersey hospital campuses — is one of the largest employers in the area, with 3,500 total employees, over 700 volunteers and a medical staff of over 700. In April, the system began a major transition, as it was acquired by Denver-based Catholic Health Initiatives (CHI), the nation’s second largest Catholic health system. Recently, HCI Editor-in-Chief Anthony Guerra had a chance to chat with CIO Richard Temple about how the transfer will affect IT.
AG: In reviewing your Web site for our interview, I noticed that you recently got a new CEO.
RT: We got a new CEO on May 19, as Saint Clare’s Health System became part of Catholic Health Initiatives. We are going to be their New Jersey outpost. They’re in 19 different states, but not much on the East Coast, but they’re starting to expand their horizons.
Just as an aside, in terms of what’s going with IT, there’s an IT restructuring that’s going on at CHI as well, so as we move to get a new corporate sponsor, we’re going to become part of an organization that’s undergoing a restructuring. So, we are in the throes of change in a big way.
AG: Are you moving forward with things you’ve budgeted, or is everything on hold?
RT: Well, we currently (March 25, 2008) are on October 1 fiscal year and CHI, our soon to be corporate parent, is on July 1 budget. So, what we’re doing is we’re going to emulate a year-end close from March 31, and we’re going to prepare all the numbers as though we were closing, but we’re going to let the year run through to June 30, and we’re going to change all our systems to pick up July 1 fiscal going forward.
AG: Tell me a little bit about what kind of IT shop you have.
RT: Let me start by saying that Saint Clare’s is a four hospital system, but we really treat ourselves as one entity with several different campuses and one IT shop that supports the totality of Saint Clare’s. On the financial side, we have McKesson Series as our hospital information system. We have a lot of McKesson products on the financial side. On the clinical side, we have Cerner Millennium, which we went live with back in November 2006. We were named Project of the Year by the Cerner Solution Center for that. It was a successful, very stressed way to implementation. There were bumps in the road, post going live, as there often are. But, on balance, it really went very, very well. So, we big-banged our clinical information system, took four hospitals, 17 applications, simultaneously live on November 6, 2006. So that’s kind of exciting. We do pretty much all the maintenance of the application in-house here and it’s been quite a journey, let me tell you.
AG: So, you’re McKesson on one side and Cerner on the other side?
RT: Primarily, yes, and there are interfaces between the two systems. The ADT transactions, after discharge transfer transactions get passed from Series into Cerner and discharged transactions are done and passed back to Series.
AG: What’s CHI’s attitude toward your existing IT investment? Do they want to leverage that or put you on their systems?
RT: Even as we speak, that’s all being worked out, because there is an understanding that CHI does have a Cerner implementation, but they have a centrally managed Cerner implementation; they run it out of their National Information Technology Center in Denver, Colorado. Whereas we are remote hosted at the Cerner Status Center out in Lee’s Summit, Missouri. We administer the Cerner system here. We have a much different solution set than CHI has, and we are actively discussing how we might be able to leverage them and how they might be able to leverage us, because we have a more level and a more mature installation. We have more solutions deployed, and we’ve been able to address a lot of the pain points that CHI’s experiencing because we have a very integrated solution.
So, they’re looking at how they can leverage that for themselves, not just to say that, but we’re also looking at how we might be able to bring some of the wisdom that they’ve accumulated over the years, with regard to Cerner, to us.
On the hospital information systems side, we have Series. Their hospitals don’t have Series, and there really hasn’t been a decision as to what we do. CHI is moving to standardize a lot more, and to gain efficiency that’s both operational and economic that you typically get when you standardize. But, I think they don’t want to throw a lot of money, hours and resources into something that’s not going to have a tangible benefit of the standardization, but the idea is that we’d like to somehow jump over to what CHI is actively supporting. So that’s another thing that we’re going to decide some number of months after this deal closes.
Nothing is going to change on April 2 (the day after the deal closes). Discussions will continue, detailed analyses will be done, but we’re going to try to be very rigorous in making enlightened decisions. We’re not going to make those right away.
AG: Who is the corporate CIO of CHI?
RT: The interim CIO’s name is Michael O’Rourke.
AG: Have had discussions with him personally?
RT: Yes. I know him pretty well.
AG: Do you ever feel like you’re defending your shop from an invader?
RT: Not at all. They’re very good about engaging us as a resource. I mean, there’s no doubt that they are way bigger than we are, and we are going to need to migrate to the CHI paradigm, but there is no implied or explicit coercion at all. We all want to come up with the best solution. I’m speaking in terms of CHI speaking to us — ‘If you guys are doing things that are working for you, we don’t want to throw that away, we want to be able to tap into that, maybe we can nationalize those things. Maybe we can find a way to let you maintain that and still somehow fit you into our structure.’
It is a very interactive, constructive dialog I have with them, I really can’t say enough good things about how they’ve welcomed us into the fold; how they’ve listened to us; how they’ve solicited our input.
They have a lot of good ideas, they’re going through, like I said, a significant restructuring of their IT function, and they are doing it with an eye towards really trying to glean efficiencies, do the right thing, provide an even better level of service than they were providing previously, and being able to tap into the collective wisdom that’s out there. When we come onboard, CHI will be in 20 different states. There’s a wealth of knowledge, there’s a wealth of expertise, there’s a wealth of innovative ideas that are out there and the notion of what CHI is trying to do, it’s called One IT, is to make all that available to everybody.
At some point, in the not too distant future, all the various IT departments from within the various markets of CHI are actually going to become CHI employees. That’s not the case now. There’s going to be an alignment of IT out of this new enterprise-wide IT structure.
AG: You mentioned that you both using Cerner.
RT: CHI’s larger entities run Cerner, their smaller entities run Meditech.
AG: You would fall into which of those categories?
RT: We’re larger.
AG: So, you’re larger, so you are on Cerner.
RT: As far as I could imagine, we will somehow fuse what we’ve done with Cerner with what CHI has done with Cerner for their larger organizations, and come with an optimum delivery system that makes things better for everybody.
AG: Now, in your system, you’ve got four hospitals and you have an integrated database for all patient records?