The new healthcare is bringing together disparate elements of planning and activity as never before. Twenty years ago, building a hospital was a relatively straightforward process, based on decades of tradition and precedence. Certainly, pioneering hospital executives and clinicians were evolving toward a variety of concepts around the patient-centered hospital, improved clinician workflow, and other laudable innovations. But the core physical plant was fundamentally familiar to building contractors in the same way it might have been 50 years prior.
No more. Today's replacement hospital facility is fundamentally different from that of 10 or even five years ago, in at least one critical way: it will usually be a “smart” hospital, with a built-in technological foundation and capabilities that will change the delivery of patient care - and will require a new kind of construction planning altogether. No longer will the CIO be brought into the discussion after the building is nearly physically complete; instead, the chief information officer and her or his team are now increasingly at the table much earlier.
Just consider the following:
At the 675-bed Parkland Hospital and Health System in Dallas, Jack Kowitt, senior vice president and CIO, and his team, have been planning a total replacement for the 56-year-old facility. As planning proceeds for the 2.1-mill.-sq.-ft. facility (to replace the current 1.1-mill.-sq.-ft. one), it is becoming clearer every day how essential IT's involvement has been to the design and construction process, Kowitt says.
In northern Ohio, healthcare IT executive John Britton is helping manage two coordinated smart-room-based hospital construction projects, at the 99-bed Fisher-Titus Medical Center in Norwalk (where he is vice president of information services), and at the 25-bed Magruder Hospital in Port Clinton (where his title is consulting CIO). Both construction/IT projects are moving the hospitals towards virtual paperlessness, as well as a completely new room design, for both facilities. In addition, the planning will produce a first full implementation of electronic medical record (EMR) and computerized physician order entry (CPOE) systems at both hospitals, in anticipation of obtaining funding under the federal ARRA-HITECH Act, Britton reports.
In Boston, Sue Schade, vice president and CIO of Brigham and Women's Hospital, has been involved in three new construction projects in the past 18 months. Brigham and Women's Hospital has not only built a new 136-bed cardiovascular care center on its own campus; it has also been involved in two collaborative construction projects, one involving an ambulatory care center it is co-sponsoring with Massachusetts General Hospital, a sister organization within the Partners HealthCare system; the other, a collaborative cancer center involving the Dana Farber Cancer Institute and nearby South Shore Hospital and the Harbor Medical Group. While each of the three projects has been different, they share a common bottom line from the CIO standpoint. “The early planning and connections with the facilities people are critical,” Schade says. In order to achieve success, she says early work “You can't start talking about the IT needs too soon.” And, she says, early work must focus on patient flow and clinician workflow, in order to achieve success.
In Phoenix, construction is proceeding apace at Phoenix Children's Hospital, whose executives are building a new patient tower that will hold 626 beds, reports vice president and CIO Bob Sarnecki. The current patient tower (with 300 beds) will be used for certain specialized types of care once the new patient tower is opened next year, Sarnecki says. With the opening of the new tower, Phoenix Children's Hospital will be the largest pediatric hospital by bed size in Arizona, and one of the largest in the U.S.
At Northwestern Memorial Hospital in downtown Chicago, executives realized some time ago the great importance of coordinated planning for new construction and for IT development, so much so that last year, the hospital elevated Tim Zoph from vice president and CIO to senior vice president of administration and CIO, recognizing not only Zoph's personal talents and capabilities, but also the fact that it was his division, IT, that helped to seed successful project management strategies across many divisions at the 785-bed [CHECK] academic medical center. Zoph is now in charge of all new construction at Northwestern Memorial, which has been a pioneer in new construction among teaching hospitals in recent years.
“If you're even considering constructing a digital building, you must involve your CIO and IT people, because the infrastructure for a digital building is totally different, particularly in terms of the requirements for a very high level of built-in reliability.”-Tim Zoph, senior vice president of administration and CIO, Northwestern Memorial Hospital, Chicago