Healthcare Business News
Edith Dees, CIO, Holy Spirit Health System

Prioritizing competing IT priorities

By Edith Dees
Posted: December 26, 2012 - 1:15 pm ET

Last month, our hospital attested for Stage 1 meaningful-use incentives. Years of work, requiring the focus and determination of the entire organization, were integral to meeting this big milestone.

According to the Hospital Association of Pennsylvania, as of the end of October, only a third of Pennsylvania hospitals had attested for Stage 1. I hope that trend accelerates this next year; healthcare in Pennsylvania is improving exponentially. Our state is implementing statewide high-speed communication networks as our robust regional and state-sponsored health and insurance information exchanges continue rapid growth.

Now that Stage 1 is under our belts, there is a recent uptick in invitations to what I call "ambush meetings" for our IT leadership team. These meetings are typically organized by a group of stakeholders, supported by management. The group calls a meeting to invite someone from IT leadership with the intent of launching an initiative, bypassing IT governance and prioritization process and moving their initiative to the head of the line.

Don't get me wrong: These proposed initiatives offer the potential to increase staff productivity and satisfaction, and offer opportunities to better manage patient care proactively. The problem lies in the resources they require and the prioritization demands they make.

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Our IT department has grown significantly in the past seven years, exceeding all industry staffing benchmarks and outgrowing our office space. Our clinical information support team has relentlessly focused on rapid implementations, originally to address competitive pressures but more recently to achieve CMS incentives with only a little wiggle room available to accommodate the uncertainty of vendor readiness and resource availability. This team is supported by one manager who is responsible for vendor/contract management, staff development/coaching and contractor oversight. Of his 16 direct reports, only four are employees, while the others are experienced contractors. We recently received approval to create a second clinical information system manager position; that person will manage the day-to-day support needs and the requests that do not qualify as strategic requests but rather minor enhancements to existing functionality. Splitting this off will enable the MU team to remain focused on the heavy lifting of meaningful-use implementations. I could go on to detail how all the other IT teams support our meaningful-use commitment. Suffice it to say that achieving meaningful use requires the talents and commitment of the entire organization. IT once had to use all of its powers of persuasion to sell stakeholders on the concept of electronic health records, workflow redesign and a world that made minimal use of paper. Now, we are the ones being pursued. Our stakeholders are excited about the possibilities of moving to a formerly unimaginable world of real-time quality information. Clinical staff routinely are working toward the apex of their professional abilities rather than simply performing repetitive and clerical tasks to ensure adequate communication between caregivers and ensure patient safeguards. Many of the specialty areas that had been resisting IT initiatives are clamoring for attention—they now recognize that the paper processes or departmental systems that they used in the past are not the best way to move forward. Dual data entry from stand-alone documentation systems and data captured through a paper process cannot compare with the quality of data captured in real-time in our legal electronic record. These areas cannot afford the additional staff required to meet the same standard, nor would they have the space to house a larger staff. That's the back story behind the increasing requests for ambush meetings. Our IT leadership team is skilled at gracefully declining requests for these meetings, and they are now being forwarded to me as a CIO or to my boss, the COO. When I learned that he, too, was invited to learn about how the system could be modified or new systems purchased to support more paperless processes, he shared one of these conversations. He used the analogy that it's as if the organization has purchased a chest full of toys but now cannot afford the batteries. While all of the toys can perform better with more energy, we simply do not have enough supply to go around. We are not finished, so we have to maintain our focus and determination to achieve all CMS incentives. In my conversations, I assure other department leaders that their ideas are great and would provide increased value, but not as much value as implementing the prescribed CMS meaningful-use functionality at the same time as other hospitals throughout the country are and receiving incentive payments for doing so. This unprecedented opportunity could not be achieved by any hospital singularly—together, we are all greater than the sum of our parts. Common technology, terminology and functionality raise quality standards while ensuring the best use of our most scarce resource, our highly trained and educated staff. Without technology, we could not even imagine the heights we will achieve with patient engagement. This is an exciting time—one in which most hospitals share the same vision for workflow redesign, data capture and reporting, patient engagement, and real-time communications across the care continuum. So Virginia, this year you may not get many more batteries, but you will soon. We are beginning to see the future that is nearly within our grasp.

Edith Dees


Holy Spirit Health System

Camp Hill, Pa.

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