When Linda Shanley joined St. Francis Hospital in January 2012 it wasn’t long before the chief information officer was tasked with leading one of the medical center’s most complex projects in recent memory.
Just a few months into the University of Hartford MBA’s tenure, Shanley had to help develop a plan for re-wiring one of the state’s largest hospitals, a multi-year, $120 million project that would overhaul St. Francis’ health information-technology infrastructure.
The task: Take the 34 disparate health IT systems used within the hospital and convert them to a single platform shared by every department so doctors, nurses, and other clinicians can more easily share patient data.
The change included adopting a new electronic medical record and re-engineering each medical department’s workflow. Nearly 6,000 St. Francis employees are being impacted by the conversion, requiring significant training and project management oversight.
After nearly two years of research, planning, and implementation, St. Francis will go live with its health IT makeover in April.
“It’s been a massive undertaking,” Shanley said.
In recent years, hospitals in Connecticut and around the country have invested billions of dollars in new health IT that allows medical providers to more easily share patient information and better track patients’ conditions.
The end goal is to improve care coordination and communication and allow doctors to do a better job keeping patients healthy. The shift, however, isn’t simply about introducing new gizmos and gadgets. Technology is literally changing physicians’ daily routines, forcing providers — many of them gray-hairs long set in their ways — to adjust quickly so they can maintain productivity.
The IT investment is being spurred, in part, by the federal government, which is pressuring hospitals — through so-called meaningful use guidelines — to show they’re using medical records technology in ways that can be measured. Providers are eligible for Medicare and Medicaid incentive payments if they become meaningful users by doing things like electronic prescribing. Medicare payment penalties begin in 2015 for providers who fail to achieve meaningful use status.
For hospitals, health IT investment is a continual process. St. Francis’ $120 million investment, for example, will be made over 10 years.
Communication Barriers
Shanley said the hospital’s use of 34 different health IT systems was costly and inefficient. Each department had its own separate hardware, software, and maintenance schedule. Worse yet, not all systems could talk to each other. That meant departments were operating in virtual silos. Since the goal of meaningful use is to allow information to flow freely from one caregiver to the next, the hospital is converting to one IT platform — Epic — shared by every department within the hospital.
The integrated approach, Shanley said, will make it easier to manage patients, and also save the hospital $60 million over 10 years by allowing them to consolidate health IT operations.
Now all departments — emergency, pharmacy, radiology, and even scheduling and billing — can share patient information instantaneously. If a patient is released from the emergency department and sent to radiology for an X-ray, their health history will follow them more seamlessly.
That should reduce costs and improve quality, said Dr. Sudeep Bansal, St. Francis’ chief medical information officer, by arming physicians with a patient’s entire health record, allowing doctors to make better informed decisions about what tests or medications to prescribe. The goal is to reduce errors, duplicative testing, and encourage better health monitoring.
There are other changes too.
Once the new IT system is fully operational, St. Francis’ doctors will be able to dictate notes into a digital record using a microphone, allowing physicians to spend less time writing things down, and more time talking to patients, Bansal said.
Other new tools include patient check-in kiosks and an online portal that allows patients to access their health history at home.
Shanley said the health IT overhaul is a major upgrade, but she admits technology alone won’t improve health outcomes.
“The system is a tool,” Shanley said. “We have to work to improve workflows based on all the elements of the tools.”
Project Management 101
St. Francis Hospital’s re-wiring represents the largest project the medical center has undertaken since construction of its $184 million, 10-story John T. O’Connell patient tower in 2011.
The IT overhaul, however, is impacting virtually every department, creating a complex project management operation.
The planning process, Shanley said, started around October 2012. To get all stakeholders involved, an 18-member project leadership team was created representing all hospital departments, Shanley said. The team met weekly for two years, with strategy sessions lasting up to three hours.
Other subgroups were created that focused on specific tasks like revenue cycle management and workflow re-engineering.
“From the very beginning they involved all clinicians in the design of the systems,” said Pamela Manor, St. Francis’ clinical and nursing information officer.
New health IT technology has a significant impact on medical providers’ daily workflow, so it takes time for doctors, nurses, and other clinical staff to adopt.
More than 6,000 St. Francis employees are being trained on the system. The hospital has run training sessions six days a week from 7 a.m. to midnight since Jan. 6.
Shanley said she expects few glitches heading into April.
“We have a really dedicated team that has been working all hours of the week to get it right,” she said.
