I met Chris 12 years ago when he managed IBM's U.K. help desk, and one day, he asked me what it is like to be a healthcare chief information officer. Before I could respond, he went on to say that I must support a workforce that's predominantly IT-challenged because most of them don't use computers in their daily duties. He thought for a moment and then offered up his own conclusion: "Healthcare IT supports 24/7 mission-critical systems for a predominately computer-challenged workforce. Wow, this must be a tough job!" I smiled and quickly replied, "By Jove! I think he's got it!"
CHIME Time: Health IT transformation about more than technology
I have spent my entire career in healthcare and never reflected much on how my IT duties and responsibilities differed from those of colleagues in other market sectors. For example, few healthcare organizations can afford to write their own mission-critical applications; the vast majority of hospitals rely on a few healthcare IT vendors to provide application development and support. To many IT professionals outside of healthcare, IT is not IT without programmers. Colleges and recruiters struggle to understand what is different about healthcare IT and why there is a national shortage of this talent when we are currently experiencing the worst economic downturn since the Great Depression.
In other market sectors, I imagine that IT has more latitude to work from customer design specifications for a specific functional business unit under less time pressure. By contrast, in healthcare, applications are highly integrated, and even small software changes generally require large-scale corporate work-flow redesign and staff education. At all times, customers challenge IT to meet regulatory and strategic deadlines, to tailor more-intuitive user interfaces and to make technologies more interoperable.
Few market sectors require a workforce as educated or as specialized. Healthcare offers a unique opportunity for these individuals to be part of something bigger than themselves. This may explain why these professionals choose to bring their coveted talents to healthcare, frequently while receiving salaries that are less than they could get in another industry. All healthcare employees, ranging from those at an entry level to the most highly skilled and credentialed, share a common mission—to provide the best care possible for their patients. Universally, a hospital's primary mission is to create healthier communities, one patient at a time.
The personalities in healthcare seem more relationship-based rather than task-oriented; these are people who love people. Leaders rely as much on instinct as they do on data. In light of the interdependence of decisions, collaboration is required in healthcare, whereas workers in other sectors may have the latitude to empower a few individuals to make quicker decisions. Furthermore, there are a number of personalities in healthcare who are easily distracted from the mundane tasks that do not involve life-and-death decisions. This particular aggregation of personality traits, when healthcare organizations face aggressive timelines and tight budgets with which failure is not an option, challenge even a seasoned project manager.
These cultural nuances help explain why it is that, in healthcare, if you simply build it, they will not come. To receive the anticipated benefits, healthcare organizations must step back and holistically re-evaluate current processes and work flow, write or rewrite policies, establish structure to ensure staff compliance to new expectations, and a number of equally important tasks. Organizations that believe a successful transformational change rests solely on IT skills and services are doomed before they start.
Health IT professionals can serve as catalysts and facilitators to move from the current state to the desired state. All change is difficult, but it does not have to be traumatic. In light of the specialization required in healthcare, IT is in a unique position to see the bigger picture and how a work flow change in one area may affect other areas with intended as well as unintended consequences.
I believe that a healthcare CIO's primary duty is to enable the organization to move as quickly and painlessly as possible from the current state to the desired meaningful-use state. I spend considerably more energy strategizing how to move leaders and staff toward this common goal than I do contemplating new and emerging technologies.
Healthcare is in the midst of a historic transformation. I believe our ability to meet this challenge hinges on the strength of the collaboration between IT and its customers. The current challenges in healthcare require all of our collective skills, experience, leadership, imagination and energy. We are all in this together.
Edith Dees Chief information officer Holy Spirit Health System Camp Hill, Pa.
Chief information officer
Holy Spirit Health System
Camp Hill, Pa.
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