By design, hospital CEO Mark Peters, M.D. wasn't the only physician in the room as he approached his board asking for approval to spend upward of $35 million on an enterprisewide deployment of clinical and financial computerized information systems and hardware.
Cardiothoracic surgeon David Kastl, M.D., was an ally as chairman of the board at 450-bed East Jefferson General Hospital in Metairie, La., during the past two years when the critical decision was researched and made, Peters says.
"Obviously, it's a big number to swallow," Peters says. "His support was very helpful in the boardroom."
So was that of the five physicians on the hospital steering committee and another 15 physician champions who served on various ad hoc subcommittees that were tasked with system design and selection.
"We brought them into the process very, very early on," Peters says. Those physicians not employed by the hospital were paid for their IT committee work. The compensation was nominal, about $1,000, reflecting the hospital's appreciation, according to Peters, for work done performed for the greater good.
"We realized we couldn't make up what they were going to lose in their practices, particularly the specialists," he said.
The hospital chose Cerner Corp. as its vendor, purchasing a hospital-wide CPOE system; an emergency room registration, electronic records and patient tracking suite; a pharmacy management system; a specialized cardiac care system; and a financial system with a data warehouse. The contract was announced Tuesday.
The Cerner software will replace a hodgepodge of aging systems, Peters says.
The cost of maintaining and upgrading those systems gave Peters some numbers to play off in looking at an integrated system from a single vendor, he says. Peters says the financial system will be deployed first with the clinical systems following in about 15 to 18 months from now.
"We're looking for the rollout to happen over a two- to three-year period," Peters says. The hospital will spread out the expected $30 million to $35 million in total costs over five to seven years, he says.
To put the East Jefferson deal in a national perspective, a spokeswoman for the Leapfrog Group says 1,136 hospitals have completed its survey, but only 40 hospitals have CPOE systems implemented to its standards. Another 153 hospitals that have committed to meeting Leapfrog criteria by 2005.
Claire Turner, director of communications at Leapfrog, says the business healthcare coalition requires 75% of orders within a hospital to be placed on the CPOE system to qualify as fully implemented.
At the Association of Medical Directors of Information Systems symposium Sunday in Orlando, Fla., IT consultant Mark Frisse, M.D., advised about 250 physician informaticists on how to sell a CPOE system to their boards of directors.
Frisse, vice president of clinical transformation with First Consulting Group of Long Beach, Calif., advised the physician executives not to obsess over proving return on investment, adding, in his experience, no board ever hung up a purchasing decision for a CPOE system on an ROI assessment.
"There are about 10 (ROI) studies and they all reference one another," Frisse says. "Once they (board members) get it in their gut, any study will do. Most of these decisions are based on emotion. They are gradually deciding it's the right thing to do."
Physician leaders, he says, should therefore provide what he called both factual proof, improvement in billing accuracy or "the number of people you won't have to hire in the next five years," as well as "emotional proof," estimates of how the system will improve quality.
"Do some observational work in your own places and tell your own stories to your board," Frisse says. "If you make it personal, you can pull your board in."
"I think it's very good advice," Peters says. "I think it was very telling and helpful when clinicians besides myself stand up and say it's the right thing to do, it's going to be a driver of the quality we already have. It resonates with the board."
Aside from being sales representatives for CPOE to the board, physician leaders involved in early in the process have another important roll, Peters says.
"It's very, very helpful with board discussions, but also, these physicians will be leaders and champions when we move to implementation," Peters says.