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: You mentioned that you’ve got McKesson and you’ve got Cerner — it sounds like a best-of-suite approach. Tell me about the data flow between those two main systems.
RT: We’ve had McKesson for a very long time. We had McKesson way before we had a clinical information system. We went out to bid on the clinical information system and we solicited bids from a number of different vendors and we wound up going with Cerner. Cerner came to us with a very integrated-type solution. We wanted to have a best of suite, as opposed to a best of breed. We wanted to have a common look and feel to the extent possible for a clinical application, so that would really engender the kind of uptake by clinicians that we wanted. We figured the uptake would be stronger if you didn’t have to learn 10 different applications, if you didn’t have to have 10 different user IDs or passwords, things like that. So, the integrated nature of Cerner was a big plus. We didn’t try to move the financial systems over at that point.
We just figured that taking on the clinical system was big enough and, thank you very much, let’s just do that. Implementing a clinical system, as you can imagine, is one of the most complex and intense things a hospital can ever do and, in order to do it right, it truly has to be transformational in terms of how everybody in the organization approaches their jobs. To bite off a financial or patient accounting system at the same time just seemed like that would be more than we could handle.
The two systems, the McKesson side of the house and the Series side of Cerner, they are interfaced, but that interface works very well. I don’t like to have 90 zillion interfaces going in and out of places, but that interface happens to work very, very well.
AG: Did you look at McKesson for the clinicals?
RT: We did.
AG: So you went with Cerner there.
RT: There were a couple of drivers for that.
AG: Do you want to get into that?
RT: Is it getting published?
AG: All of it is getting published (laughing). We’re doing an interview, it all gets published.
RT: That’s okay. One of the key things we were looking at, as I mentioned earlier, was a truly integrated solution, and what Cerner was offering looked very, very integrated. It was actually priced more competitively than one might think, and I think they were able to clearly articulate the vision for how our clinical world would look.
AG: If you had such a strong focus on integration, why not just go with McKesson, as you were already working with them?
RT: But McKesson’s Horizon suite of products doesn’t necessarily integrate a whole lot better with McKesson Series on the patient accounting side, in point of fact. Even though McKesson has an awful lot of good solutions, not all those solutions sit on a common database.
AG: Is that because some of the large vendors have grown from acquisitions?
RT: A lot of them did. It wouldn’t be that much different in terms of the relative levels of integration on both sides of the fence. We still have to build those interfaces.
AG: How can you make sure, as a CIO, that products from one vendor are really integrated?
RT: Just by using McKesson as an example, McKesson’s made great strides in integrating their clinical suite. I think the financials are still somewhat of a different animal, but they’ve really come a long way, even since we were going through the RFP in terms of actually integrating the various components of their Horizon suite.
First, I think, you have to make the decision, 'is integration the path that you want to go?' I mean, there are a lot of incredibly nimble organizations that have gone for a best-of-breed approach. For example, ‘I want to get the best lab system; that might be from company X; I want to get the best radiology system, that might be from company Y; I want to get the best tax system, that might be from company Z; and we’ll make it all talk to each other, we’ll do that.’ There are standards, which aren’t really standards, they’re more suggestions, but it’s some kind of a base line, and we’ll make it work. You look at an organization like Partners Healthcare up in Boston, and they really go for best of breed, and they’re not averse to building things themselves.
We felt, organizationally, that we would be best served by having a common database, by having a common look and feel, by having one throat to choke, if you will, if the implementation was going south. But if you have 10 different vendors that are participating in trying to roll out a robust clinical information solution, you get a lot of finger pointing. That was something we had made a decision about — we didn’t want to go down that path. So, I think there are many, many good arguments for if you have the fortitude to do that, try to do the best-of-breed and interfacing things. It’s very doable, many highly successful organizations have done that. I think, in our environment, we felt that wasn’t the path to take.
AG: As a final question, what are the most important skills to be a successful CIO today? Also, what is the hardest part of your job?
RT: I think the most important skills for a CIO to have are to be a leader, be a visionary, be able to obtain buy-in of the value proposition of technology through all quarters of the organization. I think that’s a really important thing to do. Be able to get people to think of technology as a strategic asset. How can we bring technology to bear to fulfill our strategic goals? We always have people thinking of that, that’s something which I think is very, very important. And to be able to lead, like I said, to be able to be a visionary and see where things are going two, three, four years out, to see clever ways to be able to address issues. I think those are things that are really important for a CIO.
And the challenge is to be able to do all the wonderful things that we all know we can do with technology in the face of shrinking budgets, in the face of challenging fiscal environments, and in the face of having to compete with many, many other absolutely vital capital needs that come down the pipe. Even in the most robust of organizations, there is only so much money to go around, and you want to be able to make sure that you’re able to get good capital dollars for technological investment that will actually produce something tangible. I think those are the challenges.