Hackensack (N.J.) University Medical Centers electronic physicians aide, "Mr. Rounder," made the cover of Business Week in 2005, acting as the national face of "The Digital Hospital."
Three Mr. Roundershuman-size robots with wireless links to the Webroam the halls of the 781-bed hospital. Theyre the eyes, ears and voice of remote physicianswhether theyre out of town, in their offices or just stranded at home by a snowstormas they check on their patients and clear them for discharge. Kids especially get a kick out of seeing their doctor on the screen that is Mr. Rounder's "face," and being able to tell him how they're feeling.
But there would be no Mr. Roundersnot to mention the information technology infrastructure that makes them possiblewithout the vision and drive of Hackensacks long-time president and chief executive officer, John Ferguson, 58. For that vision, for the commitment that made it a reality, and for the quality improvements the medical center has experienced as a result, Ferguson has won one of three 2007 CEO IT Achievement Awards from Modern Healthcare and the Healthcare Information and Management Systems Society.
"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 year's award winner and one of the judges for this year's 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 has been evangelizing for IT since the mid-1990s. He modestly credits his chief information officer, Lex Ferrauiola, with making him a believer when he came onboard 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.
Hackensack's chief medical officer, infectious disease specialist Peter Gross, admires Ferguson's unerring sense of what to doand what not to do.
"When everyone was buying physician practices, John, with his characteristic humor, said he wasn't interested in improving doctors' golf handicaps," Gross says. "Once you buy someone's practice, they won't work as hard and you won't 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 people's 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 Hackensack's 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."
Ferguson is one of three recipients of Modern Healthcare's fifth annual CEO IT Achievement Award program, co-sponsored by the Healthcare Information and Management Systems Society. Alan Aviles and Michael Murphy were also recipients. Murphy will be featured in an upcoming edition of Health IT Strategist.
This story initially appeared in this week's edition of Modern Healthcare magazine.
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