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HCI's November Lineup is Here: CIOs Wanted

August 26, 2008
by aguerra
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At HCI, we rely on our readers to help make our stories deeply useful and effective. Please take a close look at the lineup below. If you are a C-suite technology leader, consultant or analyst interested in participating, please send me an e-mail. Inquiries regarding these stories are welcome until Sept. 15.

And, as always, if you’ve got other story suggestions for us, let me know.


Anthony Guerra, Editor-in-Chief



The Nurse Factor and IT Implementation Success

Nursing executives, managers, and nursing informaticists are becoming more and more critical to the success of all types of clinical implementations, from core EMR rollouts to medication management go-lives, to IT-facilitated patient safety and patient care quality initiatives. Smart CIOs have always understood this; but pioneering organizations are putting the concept into practice. The main focus of this cover story will be the IT/nursing relationship, in particular how smart CIOs are successfully cultivating strategic partnerships with nurse executives and managers for ultimate clinical IT implementation success. We’ll ask how smart CIOs can best work with nursing to be effective. The main sidebar will look at the CNIO role, one with growing importance.


Laboratory Information Systems — Connecting the Pieces

Anyone who’s ever been in a hospital or physician practice knows that the first thing that’s ordered is lab tests. But are those results getting back in to the electronic patient record, and to the doctor, in a timely fashion? Healthcare Informatics will take a look at what innovations are available in laboratory information systems — and find out who’s using them. How can a LIS integrate with the electronic record, improve physician workflow, and help ensure safe and accurate care. And what happens what an ED doctor needs lab results — fast?


Budgeting for Mandates

CIOs are facing a slew of new government mandates like the ICD-10 codes and mandatory CPOE in the state of Massachusetts. While it may be tempting to push those items to the back burner when it comes time to prepare a strategic plan, what’s the impact on the budget? Are CIOs prepared for the expense of training new coders? And what about implementing CPOE? How can CIOs prepare for mandates in order to keep from surprising their CEOs and CFOs at budget time. Healthcare Informatics will get ideas from CIOs who are not being caught unawares, and speak to industry organizations to learn their best advice.


Disaster Recovery

As critical care becomes increasingly reliant on electronic systems in today’s technology-saturated environment, data protection and disaster recovery planning are becoming a higher priority. Health systems have too much to lose — literally. Therefore, CIOs are employing innovative strategies to assess the current level of readiness in their institution and developing procedures to enable continued operations in the event of an interruption. In this article, we will examine scenarios for which every CIO needs to be prepared and, based on that, determine what types of technologies can be used to maintain continuity; what plans are in place to upgrade and enhance data back-up and recovery options; and how executives can ensure that they are doing enough to be prepared for the worst-case scenarios.


How Much is Enough?

Among many hospital executives, going paperless is the ultimate goal; but what about going wireless? As wireless technologies become more sophisticated and hospitals become increasingly wired, the question arises of just how wireless hospitals should be. In this article, we will explore what the desired level of wireless is for most healthcare systems, how the benchmarks may vary from one institution to the next, and how these goals can be achieved. We will also look at how clinicians fit into the strategy, specifically how important an effective wireless plan is in attracting clinicians and keeping them satisfied, and we will examine effective strategies for being as appropriately wired as possible, while still maintaining a high degree of safety.


Surgery PACS and IT

With market competition heating up, and reimbursement straitened, CIOs are in the hot seat as never before to help their organizations optimize surgery workflow. This means providing surgeons with images in real time, and also optimizing patient flow across the perioperative, OR, and post-operative suites. We'll look at how CIOs are strategizing to put their hospital organizations on top in their markets, and satisfy the needs and demands of the C-suite and clinicians, while ensuring that their organizations survive and thrive.




Regarding the disaster recovering issue, I have found it surprising how reluctant some healthcare clinical application vendors have been to assist their clients in developing effective DR schemes. Healthcare organizations have worked directly with hardware vendors on various strategies to reduce recovery time particularly using virtualization technology for server restoration at a secondary site, continuous or near-continous replication of data across wide area networks to support recovery. But you often hear that the vendors of the clinical system are mum on the subject and that the hospitals and clinics are proceeding without specific endorsement from the vendor. It would seem like ensuring the reliability and recoverability of critical clinical data would be a key selling point for an application vendor.

Kate - you are welcome. Glad I could share.

Anthony, I look forward to read "WIRELESS, How Much is Enough?"

I wrote on this topic a few weeks ago with similar emphasis and provided some key business drivers and questions for a wireless strategy.

"By validate your current infrastructure requirements, involved your clinicians and layout a detailed design upfront, the time spent later making adjustments or fixing wireless implementation mistakes can be greatly reduced, especially if you have a complex integration."

Some of the business drivers for hospitals to go wireless are:

- To improve responsiveness and consistency of patient care,

- The reduction of medical errors and litigation risk stems from paper-based manual processes

- An ever-increasing number of patients needing timely/critical care,

- Visibility and accountability for patients in real-time,

- And to provide anywhere high-speed access to critical information across the clinical environment.

Before jumping in a wireless solution mode — spend as much time as possible up-front to formulate a correct strategy, validate your current and future infrastructure requirements, and then layout a detailed design. The time spent later on making adjustments or fixing implementation mistakes can be greatly reduced, especially if you have a complex integration.

It is prudent for clinicians to get involved from ground up of developing and wireless/mobility strategy. The questions below can be used as a guide to CIOs and clinicians to help determine a wireless strategy and implementations.

1. Can you realistically improve your clinical staff productivity by providing anytime, anywhere access to key medical and patient information?

2. Do you currently have a secure, integrated communications environment that allows your staff to efficiently locate resources and collaborate to provide faster, higher-quality services to your patients?

3. Do you currently have any challenges in delivering key applications that will need to leverage a wireless network?

4. Do you have visibility into the location of staff and medical equipment to ensure availability and security?

5. Do you have a need to integrate your disparate communications systems into a more cost-efficient network?

6. Can your clinicians and caregivers now reliably access critical information using your current devices and equipment?

7. What challenges currently exist in managing your end-user environments

So, if you have not already gone down this road, please ensure that your nurses, doctors, and system vendors gets involved and that you clearly and timely explain the requirements, budget and integration that will be involved?

Give all stakeholders enough lead time to provide feedback, recommendations, changes, update, etc., which may be required for a smooth wireless and mobility implementation.

Hi Michael,
Thanks so much for providing your input on this. As the person who will be writing the article, I really appreciate any suggestions on what direction to take with this article and what points to highlight.
I find it interesting that your take on the issue focuses heavily on formulating an effective strategy prior to going wireless, involving clinicians and making sure this is something they really want (and need), and ensuring that right infrastructure is in place to support wireless applications.
I think that with so much emphasis on hospitals being 'wired', I think we really need to step back and look at this issue from a very rational, strategic viewpoint. Is implementing every wireless application on the book being done for the right motivation and is it feasible from a support standpoint? These are the points I want to really explore.
Thanks again for your insights.

Re: The Nurse Factor and IT Implementation Success

Vi Shaffer (Gartner) has been articulating the evolution of CIO relationships with others, including CTO, CMIO. I can't recall specific treatment of CNO, CNIO or CNEs. The parallels are obvious, and the implications for CIO and the whole C-suite are substantive. The biggest is evolution to a fiduciary responsibility to manage with the newly available, electronic process data ... and, who is being accountable for that.

I've seen a few other folks who on the leading edge, but Vi's got the most balance, insight, and forward thinkingness that I've seen. She's also the most fact-based.