PO Box 409095
Chicago, IL 60640
Length: 6 minutes, 6 seconds
Interviewer: Martopia Voice Talent
Interviewee: Alan Aviles, president and chief executive officer, New York City Health and Hospitals Corporation
[00:00:09.16] Woman's Voice: Welcome to this edition of Winners Playbook, brought to you by Modern Healthcare and powered by Martopia. With each edition of Winners Playbook, listeners hear directly from the recipients of Modern Healthcare's awards and honors programs.
[00:00:26.27] Martopia Voice Talent: We're speaking with Alan Aviles, one of the winners of the 2007 CEO IT Achievement Awards. Hello, Alan.
[00:00:36.21] Alan Aviles: Hi there.
[00:00:38.04] Martopia Voice Talent: When or at what point did you realize the importance of information technology to the delivery of healthcare services?
[00:00:44.17] Alan Aviles: Well, my first work in healthcare was on the healthnet side, where the ability to collect and analyze data related to patient care was significant, even 15 years ago. So when I arrived at the provider's side of medicine in the mid-1990s, I was immediately struck by the failure to use technology to more broadly manage and analyze patient-care information. We clearly have serious deficiencies across the healthcare industry in the form of relatively low adherence to evidence-based medicine for many common conditions, and a relatively high rate of medical error, especially in the very complex environment of hospitals. Most of those problems in both categories are a reflection, in my view, our failure to use IT to guide best clinical practices on the one hand, and to reduce the opportunities for medical error on the other.
[00:01:31.29] Martopia Voice Talent: What was the biggest challenge facing you and your organization in implementing IT in your healthcare facilities?
[00:01:38.09] Alan Aviles: Like many organizations, we had to do a lot of education and build the case for IT and healthcare over time. We started with a good deal of resistance among our clinicians, but we slowly made the case for how IT can help us improve patient care. As a result, today we have a highly demanding end-user community who want more and more functionality. The challenge now is to orchestrate that momentum and focus it in strategic ways to advance our agenda around patient safety and, for example, more effective chronic-disease management.
[00:02:11.09] Martopia Voice Talent: How did you and your organization overcome that challenge?
[00:02:14.14] Alan Aviles: Well, we're a large safety net system, and we serve a predominantly low-income patient population that often presents with complex medical and behavioral health needs, that often speaks a language other than English, and that's often uninsured, so our staff, by and large, has a high tolerance for tackling challenge, so long as it's clearly tied to our mission.
Nonetheless, with 11 acute-care hospitals and multiple academic affiliations, we've got lots of experts, and lots of opinions on everything. So we've needed to find ways to channel that energy in the same direction as we tackle the IT in; we've done it by developing project management teams made up of clinicians from across the system. So these experts work alongside our IT staff to develop functional specifications, pool that expertise and have created some robust functionality that we're really proud of. We actually now have advisory groups for nurses, pharmacists, and physicians, as well as technical teams who meet regularly, to share ideas and to help articulate our ongoing needs. I really think its this level of engagement with our physicians and other end users that's been a key to our success.
[00:03:24.07] Martopia Voice Talent: What advice would you give another executive in pursuing IT implementation in their facilities?
[00:03:29.26] Alan Aviles: Well first, think about data outputs as opposed to just data inputs. It's easy to focus on how data gets into the system, and how users react to the user interface; don't get me wrong, that's very important. However, the future of healthcare IT is really better workflow, clinical decision support and business intelligence. The ability to take the data into the system and reuse it repeatedly, to share it more readily with patients, to measure efficiency and quality, to communicate and collaborate with other health providersall that depends on being able to pull back the data back out, and that depends on careful data planning and data governance.
Second, I would say match product flexibility with your ability to control that flexibility. Standardization is often a bad word among physicians; after all, every patient is different. And that's true, every patient is different. But you can't build health information technology, at least not with the tools that are available today, if all stakeholders want this system to be highly individualized.
Finally, as with everything, it's always good to have a long-term plan, and to make that plan visible. People need to know when their particular area of interest or functionality is going to be addressed. They'll also be more patient if they understand the rollout schedule, even if what particularly interests them is several years down the road. We're currently developing a plan for the next seven years.
[00:04:50.29] Martopia Voice Talent: Do you think the nation will have a fully operational healthcare IT infrastructure in place by 2014, as President Bush instructed? Why or why not?
[00:05:00.20] Alan Aviles: I think that's highly unlikely. We're a long way from having the foundation of a fully operational healthcare IT infrastructure across this country. Implementation of IT in our industry remains a complex and expensive endeavor, and there's still a lot of risks. While there are very important short-term returns in the way of quality and patient safety; we are likely not to see significant monetary savings until we have broad interoperability. That's really the Holy Grail. But it will take much more leadership guidance and investment at the federal level to make it happen, and even then the end of the next decade is probably more realistic.
[00:05:39.16] Martopia Voice Talent: We've been speaking with Alan Aviles, one of the winners of the 2007 CEO IT Achievement Awards.
[00:05:46.21] Woman's Voice: Thank you for listening to this edition of Winners Playbook, brought to you by Modern Healthcare and powered by Martopia. Listen to other editions of Winners Playbook by visiting the multimedia section of Modern Healthcare Online at ModernHealthcare.com.
[00:06:06:03] Audio ends.