With patient engagement such a hot Stage 2 topic, it’s no wonder CIOs are looking to ramp up the pace of their portal rollouts. And Bill Byers, VP/CIO, Western Maryland Health System, is no exception. But, more than that, Byers is also looking to get his staff and community docs up on an EHR as step 1, then facilitate a robust data flow as step 2. All of which he’s doing with an eye to keeping the interface picture manageable to promote scalability, thus also increasing the chances of long-term overall success. To learn more, healthsystemCIO.com recently interviewed Byers for our Podcast series.
- Opening a new hospital
- Lesson learned: Have someone at the construction site every day
- “It’s one thing to select it, but you also need to get it installed”
- Bringing in the Boy Scouts (seriously)
- Nurturing those vendor/partner relationships
LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO DOWNLOAD THIS PODCAST AND SUBSCRIBE TO OUR FEED AT iTUNES
… in a very short period of time, let’s say just under three years, we were able to form a plan, a vision if you will, meet with the different vendors, do some site visits, and actually get the systems installed …
I would say that if we really missed anything initially it was having resources, a person if you will, at the construction site every day the work was going on …
… we actually had a group of Boy Scouts, of area Boy Scouts come in and simulate our patient activities.
One of my philosophies, especially in a small community hospital like we have here, is that maintaining very good vendor relationships is key, because I can’t afford to be switching vendors every couple of months.
Gamble: We’ve covered a lot of ground. Is there anything else you want to touch on?
Byers: Well, I really don’t have a whole lot of other wisdom to share, but if you wanted to talk about our experience with opening the new hospital, I’d be happy to share that. I don’t know how many organizations are going through that now, but we learned a lot from other hospitals that have opened up new facilities, and we have hosted many, many site visits since we’ve opened up to share our experience, so if you think that’s a value, I’d be happy to share a couple points.
Gamble: Please do.
Byers: Well, the way it worked out, from an IT perspective, and, if you think about it, most of our work was infrastructure. We certainly had to prepare Meditech to consolidate facilities and our applications team did a tremendous job in getting Meditech set up, but most of our work revolved around the infrastructure pieces. We called it low-voltage systems, of which we had between 25 and 30 that we were installing in the new hospital, so if you think about the phone system, the network, the wireless, nurse call, you name it, it was an impressive list, and we had a group of a team, a low voltage team, that evaluated the different systems.
We would bring in subject matter experts, for example, when we talked about nurse call. We expanded it to include the nursing team, as well the clinical team, but this core low voltage team are working with a consultant. We hired Jim Burton & Associates. They did a great job helping us navigate the different vendors, the different options, to help us pick the right system. They also helped us understand what we could do from an integration standpoint because, I think I mentioned earlier, we have almost 10 different systems that can send information to the nurse’s Ascom phone.
Getting the value out of these disparate systems was really what a team like Jim Burton & Associates could help us understand, what the possibilities are, and so, in a very short period of time, let’s say just under three years, we were able to form a plan, a vision if you will, meet with the different vendors, do some site visits, and actually get the systems installed for the opening in 2009 — something that, at the time, I have to admit I wasn’t sure we could really pull off, keeping in mind that they were not all IT related. But certainly now that all these systems are converging, IT tends to be a big part of these different systems, but we were able to get it all together.
I would say that if we really missed anything initially it was having resources, a person, if you will, at the construction site every day the work was going on, because all we did was hire Jim Burton & Associates to guide us through the process of selection and deployment, but we didn’t have someone that could work with, let’s say, the cabling people and coordinate or answer questions, specific questions they may have regarding the plans. We didn’t have someone initially to coordinate something as simple as electronic door locks, and it was a service that we did not have the resources internally to provide, so we had to go out and hire some help, an expert, if you will, to do that, and that was her job for, I’d say, a good year and a half as the construction went on, to be there to consult with us and the different vendors that were working on these systems, to coordinate the installation of these systems and, without her, I’ll tell you, Kate, we would have been sunk.
So just learning from those experiences and understanding that it’s one thing to select it, but you also need to get it installed, and you can’t do it all yourself. You need to go out and get some help.
Gamble: Sure. So having somebody onsite to be that point person was really key.
Byers: You got it. At the construction site, so everyone had one phone number, one person to go to any time of the day and having that resource was very critical for us. Now, maybe a larger institution such as Johns Hopkins, the big players, had the benefit of having the staff, but we did not, and that was basically, as I look back now the two and a half years, that was our big “mess,” and we were fortunately able to identify that early on and get that person on board but, for some reason, we missed that.
Gamble: Well, I think that a lot of people might focus on the fact that they have a fresh start with a brand new facility and forget about having someone on site to handle all the little details.
Byers: Well, in the integration too, in the coordination. For example, you can say: “Install your nurse call system,” but how about making sure it works with all the other systems? That was piece that really we were missing.
Gamble: Were there a series of practice go lives or practice openings, things like that to make sure that things were connecting as they should be?
Byers: Yes, that’s a great question, and we actually had a group of Boy Scouts, of area Boy Scouts come in and simulate our patient activities. They actually came and were admitted to the hospital. We did a full test of every system, Meditech, nurse call, every low voltage system we have, the Ascoms, and we were able to do a run through a week before we opened to make sure that everything was working as planned. I’m glad we did because it identified some areas that needed to be addressed. In particular, we had some problems with our wireless coverage that caused some issues whenever under load, the Ascom phones would intermittently not work and we would not have found that out had we not done that type of load testing, so that’s a great question and something we were able to address for the go live that we would not have known without that type of testing.
Gamble: As you were getting close to the opening, this was November of ’09, were people pretty much sleeping in cots in the hospital?
Byers: There was no time for sleep J
Gamble: Maybe the naps, right? J
Byers: It was amazing because, for us, we have Opexa’s devices, and we even have a building automation system to control the HVAC, all on our network, and when we installed this network — it is a routed network — and so each closet has its own subnet, and that was very confusing to many of our vendors that came in. So it was not uncommon for me and some of my team members to be at the hospital well after midnight and, I can tell you, Kate, we ran into many, many of our co-workers at all hours of the day, so there was not a lot of sleeping going on, especially amongst the technical folks at the hospital, but it’s that kind of dedication that it takes to get it done right, because you really only have one shot at opening it successfully and we had to make it work, and I’m very pleased to say we accomplished that.
Gamble: So it was successful when you did have the initial opening?
Byers: It was, and I will say that we improved. To get back to the one issue that we had with the wireless, we were able to make improvements to it. We did not solve it a 100% but, to Siemens’ credit, to Ascom’s credit, they flew in engineers from Canada, from across the country, they had a team onsite within a day of us saying, ‘We’ve got this problem,” and they stayed until they got it fixed and, once again, it’s a 100% coverage very robust system, and we have that because we had great vendor partners.
Gamble: I’m sure it was key to have them onsite to iron out the issues.
Byers: Yes. It was critical, but they went not only beyond their go-live support, they brought in their software engineers. They really went above and beyond. One of my philosophies, especially in a small community hospital like we have here, is that maintaining very good vendor relationships is key, because I can’t afford to be switching vendors every couple of months. I don’t have the resources to do that, and so it’s important to have good partners, to vet them upfront, and to maintain these relationships, because it’s really paid off for us in the long run. We’ve got vendors that we’ve had relationships with for years and years. Meditech goes back to ’92, Siemens, even before that, and they’re great partners with us. They get what we do. They understand the healthcare business, and I’m very fortunate to have them. It’s what allows us to run as lean as we do in the IT department.
Gamble: So for people entering into agreements, it’s important to set those service level expectations …
Byers: Well, exactly. They have to match us culturally, they have to be in line with us, with what we believe as an organization, and I have had in the past, unfortunately — they’ve been smaller vendors — those that don’t understand the needs of a hospital which must operate 24/7. They wouldn’t have technicians available on Saturdays and Sundays. We’d say, “Hey, guys, we just can’t shutdown. We’re open all the time, holidays and weekends,” and if they wouldn’t say, “You know what, we understand that. We’re going to change our service model,” then we found a different vendor to work with. Some vendors seem to get it more than others, and the ones that do get it we try to maintain that relationship. It really is a two way thing that I think is very important.
Gamble: Right and you know going through anything as stressful as implementations or new facility openings, you really need to know that you can count on them.
Byers: Exactly, that they will roll up their sleeves and jump in the trenches with you and fight the good fight. You’re absolutely right.
Gamble: Well, that seems like that was a great experience for you to go through, something really beneficial.
Byers: It was. As I said, I’m very proud of what we’ve done, but I will tell you this: it is a once in a lifetime experience for me. I would not want to do that as part of my regular job, because it was very stressful, it was very time consuming, but the experience of having done that just helped me grow so much professionally, and it was just a tremendously good experience. If you would have asked me that question a month after the opening, I would have said, “Oh, I’m still tearing my hair out,” but having the perspective that I have now, 2.5 years later, yes, it was a once in a lifetime experience, so I’m very glad that I was able to participate.