John Ferguson has assembled components key to enabling his organization to take advantage of health information technology, says Glenn Steele Jr., president and CEO of Geisinger Health System, Danville, Pa., last years award winner and one of the judges for this years competition. He has leveraged board involvement, allocated significant resources, and received recognition via external funding.
Ferguson has been on the job at Hackensack since 1986, and evangelizing for IT since the mid-1990s. He modestly credits his chief information officer, Lex Ferrauiola, with making him a believer when he came on board in 1996, but Ferrauiola says Ferguson was already a believer and only needed the details filled in.
Together they constructed a plan whereby Hackensack would become a hospital without walls, at least as far as its patient information was concerned, and would let physicians access that information and file orders from anywhere. Eleven years and $136 million later, the hospitals working culture has embraced the ubiquity of informationon rolling laptops that are wheeled from bedside to bedside, on BlackBerrys and Treos, on home PCs, and on Mr. Rounder.
Hackensacks chief medical officer, infectious disease specialist Peter Gross, admires Fergusons unerring sense of what to doand what not to do.
When everyone was buying physician practices, John, with his characteristic humor, said he wasnt interested in improving doctors golf handicaps, Gross says. Once you buy someones practice, they wont work as hard and you wont get what you expect out of it. While other hospitals were losing millions on physician practices, he was putting the money back into the hospital, and a large chunk of it went into IT. That was probably his most important gut instinct.
My role was bringing people together and making sure they stayed on target, Ferguson says. Not only were we making a huge financial commitment, we were making demands on a lot of peoples time.
The first IT strategic plan, launched in 1998, cost $40 million, and put in place the secure data/voice/video network the digital hospital required. The plan also re-engineered the IT department, turning it from a 25-person back-office operation with a $6 million annual budget to a 100-person entrepreneurial service organization with a $22 million annual budget.
I saw myself as the CEO of an IT company hired to serve the hospital, Ferrauiola says.
In 1999, the hospital debuted HUMCMD.net, a portal for physicians that lets them view radiology images, check test results, order medications, and electronically view and sign transcripts of their notes from their offices, homes or on the road. The portal also supplies such nonmedical perks as full Internet access, stock quotes and news.
At about the same time, Hackensack became one of seven institutions in the Pursuing Perfection project of the Institute for Healthcare Improvement. The accompanying $1.9 million grant from the Robert Wood Johnson Foundation allowed Ferguson to hire a chief medical informatics officer, trauma surgeon Gerard Burns, to bring the EMR gospel to the physicians, without whose full cooperation any clinical automation effort would be doomed.
Burns nursing counterpart, Terry Moore, has been administrative director of clinical informatics since 1992. Shed been drafted temporarily to help the IT department implement nursing order entry and results reporting, an early cornerstone of the EMR, but her role quickly became permanent and she now supervises a department of eight. Both appreciate their CEOs foresight.
Nowadays everyone at the C-suite level is talking about IT and looking to it to fix our problems with quality care and costs, Burns says. Mr. Ferguson was thinking that way 10 years ago.
Hackensack is now putting the finishing touches on the second stage of its IT plan, computerized physician order entry, and will spend the next few years in stage three, moving its various clinical systems to a single new platform that will produce an integrated electronic record. To that end, the hospital is an adviser to IT vendor Siemens Medical Solutions on the development of its advanced Soarian clinical information system.
Perhaps Hackensacks most cutting-edge effort to date is a pilot project to implant microchips in its patients. The chips contain unique ID numbers that tie back to a patient database. Board members, physicians and some patients have been chipped, and the system may have saved at least one life: a police sergeant rushed to the emergency room with head trauma.
Ferguson sees the chips as potentially part of a national health information network. For technology to work, you need a secure national network, but without destroying competition among providers, he says. Patients need transportable records that go from provider to provider. The patient is the point.