With more than 30 years in the industry, Ron Sandifer has seen it all. But even Sandifer is amazed at how demanding today’s healthcare IT world has become. With Meaningful Use, ICD-10 and ACOs all either on his plate or radar, there isn’t a minute to spare. To ready his organization for the brave new healthcare world, Community Memorial is upgrading its inpatient Meditech environment from Magic to Client/Server 5.6, slapping on a PatientKeeper front-end to increase physician satisfaction, and rolling out Allscripts in the ambulatory environment. To learn more about how Sandifer is managing it all, healthsystemCIO.com editor Anthony Guerra recently caught up with the California-based CIO.
Dealing with healthcare IT’s perfect storm (Meaningful Use, ICD-10, ACOs)
Grappling with the workforce shortage
Finishing bedside bar-coded administration
Life as an interim CIO
From the provider side, to the consulting world, to a hybrid role
The best of each world
“I’ve never seen a time when we’ve been as busy as we are now, have as many things on our plate, and have such a shortage of qualified individuals to assist us with what we have to do.”
“We have a substantial backlog of physicians in the community that want the product. We’ve talked internally about how we’re going to find the staff to be able to support the roll-out… some of the discussions we’re having involve possibly training people ourselves and working with other organizations here on the west coast in trying to centralize some Allscripts training.”
“They really don’t even look at me as being contracted. It’s as if I’m an employee. I don’t think anybody looks at it like, ‘Well he’s only going to be here a certain amount of time.’”
“When you actually work for an organization, I think you probably get more involved in the political things that go on, and you sometimes temper some of your recommendations because you understand the internal workings.”
Guerra: You’ve been in the industry for a while; have you ever seen such a confluence of major projects, and does this all seem manageable and doable to you over the next three to five years?
Sandifer: No. I guess it’s about 37 years now that I’ve been in healthcare IT, and I’ve never seen a time when we’ve been as busy as we are now, have as many things on our plate, and have such a shortage of qualified individuals to assist us with what we have to do. So it’s certainly a trying time for us, but we see the benefit, and I think the organization realizes that this is what we’ve got to do. And luckily, here at Community, the organization has seen the need and has backed the IT initiatives and funded it to the maximum. And we’re confident that we’re going to get there, but it’s certainly an interesting time for us, and it will be for the foreseeable future.
Guerra: You mentioned on your LinkedIn profile that you’re looking to hire two Allscripts analysts. How is that going?
Sandifer: It’s been difficult. We’re working with a number of different search firms, and we’ve got interactive ads and we’re going to one of the Allscripts user group meetings at the end of the month, but it’s very difficult to find qualified Allscripts people. We have a substantial backlog of physicians in the community that want the product. We’ve talked internally about how we’re going to find the staff to be able to support the roll-out, and some of the discussions we’re having involve possibly training people ourselves and working with other organizations here on the west coast in trying to centralize some Allscripts training out here, because the resources are very, very difficult to find.
Guerra: I guess it’s going to be more expensive than you might like.
Sandifer: Oh yes, that’s for sure. I think most of us—and I said this to a couple of the focus groups back at HIMSS—have realized that our salary ranges and positions have had to be pushed aside to look at what’s available and what’s being asked for and see how we can meet the needs.
Guerra: Right. Let me ask you an open-ended question before we talk a little bit about your career. Are there any other projects you’re working on that we didn’t touch on that are equally important?
Sandifer: We just went live with bedside medication verification in the Meditech space in our inpatient network. We’re still rolling it out; we’ve got a couple more floors to do and then we’re going to go up to our smaller facility at Ojai. So that’s been going on in the Meditech environment along with the planning for the new hospital, which we hope to break ground in the June timeframe. So we’ve got a number of things going on concurrently.
Guerra: You’re a busy man.
Sandifer: Yes. We’re a busy organization.
Guerra: Right. I see that you’re on the third year of a five-year contract, so tell me a little about that. You’re not staying there forever, or maybe they’ll re-up your contract?
Sandifer: Could be. I came here in an interim role when the CIO at the time decided to move on, with the idea that I would stay for three or four months while they recruited. We interviewed a number of people, and then they approached me and asked me if I’d be interested in taking the role. So we discussed it and we came to terms on a five-year agreement to basically outsource the management of the department to me, and we will see when that comes a little bit closer to ending whether we’ll go further.
Guerra: So you’ll both take a look at it at that point.
Guerra: I looked at your profile and I don’t think you’ve been through this specific type of scenario before, and I’m wondering if during the last year, things get a little strange; I’m thinking of a lame duck congress. I mean, do people say, ‘Ron’s gone next year, so you don’t have to listen to him.’
Sandifer: No, not at all. In fact, they really don’t even look at me as being contracted. It’s as if I’m an employee. I don’t think anybody looks at it like, ‘Well he’s only going to be here a certain amount of time.’ Prior to starting here, I was consulting for almost 15 years, initially with Superior Consulting, which became ACS. And I had an assignment in South Dakota as an interim vice president CIO for seven and a half years, so it isn’t something that is really unique to my career. I’ve done this before, and really in none of the cases have I felt that people looked at it like, “Well, he’s only going to be here a short time,” or anything like that.
Guerra: Right. I see you started or joined the company called El Dorado Health Consulting for about nine months. Tell me about that.
Sandifer: That’s my company that I formed when I left the consulting arena. I actually formed an earlier company, and then with this engagement, some of the other individuals that I’ve got working with my company decided that we had kind of outgrown what I set up originally. So this company was set up about nine months ago.
Guerra: Is that company still running? Are you able to still do things with that company while you have the CIO gig?
Sandifer: Yes. I’m not really involved in the day-to-day affairs of the company. I have two other individuals that are basically in the marketing arena and are finding assignments for other individuals that we’ve got on board while I’m sort of dedicated to this role, really 100 percent of the time.
Guerra: You mentioned you were with Superior from 1995 to about 2004 when it was acquired by ACS and then you were with ACS for another four years.
Sandifer: That’s correct.
Guerra: So that’s a long time with Superior, and before that you were with Cedars Sinai. What did you do over at Cedars?
Sandifer: Well actually, before Superior I was with Eisenhower Medical Center in Rancho Mirage, Calif., where I was director for IS for almost five years. Prior to Eisenhower I was at Cedars Sinai. I was there for almost 15 years, and when I left that role, I was assistant vice president of IS.
Guerra: So you were on the provider’s side and you went into the consulting world for a long time. Tell me about that decision.
Sandifer: When I left Eisenhower, I did not want to really relocate. I had been talking with colleagues and individuals that I’ve come into contact into my career, and it was suggested that I try consulting. They said, ‘You can live where you want to live, as long as you don’t mind being on the road.’ So I spoke with Superior and went to work for them, and I enjoyed the time that I spent with them in the consulting world.
Guerra: How did you find the travel? A lot of people would say that’s really the key; if you’re going to be able to thrive into the consulting world, you have to deal with that.
Sandifer: Travelling really has never bothered me. Like I said, I had a seven and a half year assignment in South Dakota and an interim period where I was living in Palm Desert, Calif., so I was flying into Palm Springs every weekend and back every week. And luckily for whatever reasons, I’ve been able to catch a flight just about when I wanted and haven’t had too many bad trips. The travel doesn’t really affect my life; it just worked out well.
Guerra: I think that we have CIOs that look at the consulting world, especially now, and I think we have consultants that look at the CIO world. Can you give your take from each scenario? You’ve been on both sides, so tell me your advice first to a CIO who’s thinking of going into consulting.
Sandifer: Well obviously, they have to be willing to travel. I think one of the things that you see in a consulting world is that they bring you in for your expertise. You can make a recommendation after reviewing the area and coming up with whatever they’re looking for you to do, and if they take your recommendation, that’s great, because that’s what they paid for. If they decide not to take your recommendation, that’s not all bad either, because you’ve given them the benefit of your expertise, and it’s their decision and their right to make that decision. When you actually work for an organization, I think you probably get more involved in the political things that go on, and you sometimes temper some of your recommendations because you understand the internal workings, and you may not make what in the back of your mind is the right decision.
Guerra: Right. Now let’s take it the other way—a consultant looking at taking an in-house CIO role.
Sandifer: Well, I think those that want to get off the road and those that see the idea of a benefited position—the idea of being part of an organization and looking for long term relationship, it’s definitely a positive experience.
Guerra: So you’ve been in the industry since 1974, correct?
Sandifer: That’s correct.
Guerra: And it’s been good to you?
Sandifer: It has; it’s been very good to me.
Guerra: Well it looks like with what’s going on today, you’ll have employment for as long as you want it.
Sandifer: It’s an exciting time for all of us. For a number of years, I think IS was looked upon as a something that you had to have, but wasn’t always financially beneficial to the organization, and did not always show a payback. And I think now we’re so independently involved in patient care and helping an organization get some of the funding that’s available to us, that IS looks a lot differently than it did 10, 15, or 20 years ago.
Guerra: Ron, that is all I had for you today, is there anything you want to add?
Sandifer: No, I don’t think so I’ve enjoyed our discussion.
Guerra: Thank you so much for your time, and I’ll speak to you soon.