Somerset Medical Center is a nationally accredited, 355-bed regional medical center, providing a variety of emergency, medical/surgical and rehabilitative services to Central New Jersey residents. The organization’s 650-member medical and dental staff represents all major medical and surgical specialties. To learn more about the novel governance structure at the hospital, HCI Editor-in-Chief Anthony Guerra recently spoke with CIO & Director of Strategic Planning Dave Dyer.
GUERRA: When I noticed you were “director of strategic planning,” in addition to CIO, it caught my eye. Did you always have that title and, if not, why was it added?
DYER: Back in March of 2008, our CEO came to me and said, “Would you like to expand your role?” And I said, “Well, what do you have in mind?”
This was all based upon some innovative things we’ve been able to do from an IT perspective, such as running a data-driven organization and basing decisions on that data. So he suggested we put together a planning and physician support department under me, and then expand my role to assist him in working with the board to put together strategic plans for the organization.
So with that, we also hired a director of planning underneath me who knows the specifics of New Jersey certificates of need, and we went on a search and hired a director of planning that reports to me and a decision support manager and a decision support analyst, they report to her. So I’m supporting the planning team on one side and doing the traditional IT components on the other, which include biomed and communications.
GUERRA: Has the arrangement prevented you from missing some opportunities?
DYER: In terms of things we might have missed, I really can’t think of anything. I mean, traditionally, the planning department VP reports directly to the CEO or the COO. I think what our arrangement has been able to do is allow us to craft a process for the organization where we can create sound objectives and goals. Obviously the benefit to that, from the IT side, is IT is completely aligned with the strategic planning process within the organization.
We’re a fairly wired institution. We have CPOE up and running and we have an EMR connecting us to physician practices, but when you look at some of the disruptive innovations that are out there – such as accountable care organizations or medical home models – a lot of that is also driven off of IT, but with decision support. We’re in the process of implementing a new decision support tool as well, which will give us the ability to do a product line analysis.
So this has also been very helpful in terms of looking at health information exchange initiatives within the state. We have a full understanding of our demographics here in Somerset County. Also, I’ve worked very closely with lobbying firms in Washington, D.C., and we’ve been able to obtain about $1.5 million in federal grant funding, particularly for electronic medical record implementation, through lobbying our senator.
So it’s been a nice mix having the two together, albeit, it’s quite different than what you typically see in a hospital.
GUERRA: Would you call what you’ve done, structurally speaking, a best practice?
DYER: Yes. We’ve just kicked off a new process with the board in which we established an ad hoc strategic planning committee. We’ve been working closely with that board committee and the chair of that committee to develop a process for Somerset Medical Center. It’s a fairly traditional strategic planning process. We’ve got the process and the timeline together. We are in the midst of doing the environmental assessment right now and we’ll then be reviewing our vision, mission, goals and values and developing the goals and strategies that map back to that. So we’ve gotten much more closely engaged with the board of directors on this as well.
This is a different model, and we’ll have to see how it turns out over the next nine months.
GUERRA: Should CIOs view governance as something that can be changed if it’s broken?
DYER: The important thing is that the CEO is engaged and understands the importance of it. For one, having the CIO report to the CEO is extremely valuable. I was fortunate in that our CEO used to be the CFO, and when I first got here, it was a traditional CIO reporting to the CFO level. Our CFO was then promoted to CEO and that relationship stayed.
Governance is a fairly complex structure that you must have in place and, at least from the IT side, if you can have a board committee with CEO involvement and executive team involvement, it makes life much easier to move forward. Then you focus on getting your high level strategic plan approved which is aligned with the organizational plans. It just makes life a lot easier to move forward and there’s less friction associated with it, and less questioning of why things are going on.
On the IT side, it’s a very complex structure because you must have change management committees, you have to have oversight committees, you have to have project implementation committees, and then also informatics committees. They cross multiple lines. So it’s a fairly complicated structure to implement, particularly around clinical technologies. Having an understanding of governance, and how the board operates and what the board likes and doesn’t like, helps make that process a lot easier.
GUERRA: While titles are important, the person is as well. You could report to an IT-friendly CFO or a numbers-cruncher CFO who sees you as a big cost center.