Charles (Chuck) Colander has been around the health IT game long enough to know that choosing the most sophisticated system doesn’t necessarily guarantee high adoption rates. Colander’s experience — which includes time spent as both a CTO and consultant — has taught him the best way to get physicians engaged is to build an implementation strategy that focuses on improving the patient experience. In this four-part interview, Colander shares his thoughts on how he manages a varied application environment, the vast difference between being a CIO and a consultant, why it’s critical for the IT department to embrace its role as a service organization, and how he hopes to steer a smooth transition into a new building.
- Leveraging consulting experience
- The differences between consulting and in-house work
- “We’ll never be the superstars of this organization, but we can support the superstars”
- Best practices in using consultants
- Next up: more integrated communication
In those eight years of consulting I did, all of my exposure was at the C-level suite and board level, and it really gave me the opportunity to see the direction of the industry—how those folks think, what’s important to them.
The superstars of this organization are the doctors and the nurses. The best we can hope to be is the superstar support guys that really keep the systems going and put the things in place that help the true superstars of the organization. And you have to be comfortable with that.
This is a phased approach and there’s milestones associate with each of those phases. Part of the payment process with Merge is that they get recognized for achieving those milestones. And I frankly, I think that’s a great way to structure all your engagements.
For example, a nurse who is reviewing a patient record on Meditech wants to speak with one of the consulting doctors and they want to send a message to the pharmacist. Make that something that’s integrated directly with their computer systems so that with one or two clicks, they’re in a position where they can either call or send a text message to one of the folks on the care team.
This is technology that maybe was available in some form in the past, but now has really come together in combination to be able to allow us to change the way we deliver care and improve the patient’s experience.
Guerra: Let’s talk a little bit about your career. I see that you spent about eight years at a couple of places—Cap Gemini Ernst & Young and CSC Corporation, so you did some consulting. I speak to a lot of CIOs, and many of them have done consulting stints. Do you think that makes you a better CIO because you did a number of engagements at a number of different places and saw some best practices and some ways that things shouldn’t be done?
Colander: I think the variety of experience you get through an effective consulting career is can be very helpful. I think the exposure I received during those eight years with Ernst & Young and Cap Gemini Ernst & Young allowed me to develop an executive presence that just accelerated that development process. When I was in the director level at a number of different institutions, I did receive some level of exposure to the board level and to the executive management level. But in those eight years of consulting I did, all of my exposure was at the C-level suite and board level, and it really gave me the opportunity to see the direction of the industry—how those folks think, what’s important to them. And it allowed me to be able to develop those skills and understand more broadly the whole idea of the healthcare industry and healthcare delivery. So that’s certainly was essential to my career development.
Guerra: We see a lot of back and forth between the CIO and consulting roles. I know people who have done consulting then become a CIO, and I know some CIOs who’ve gone back into consulting. How would you compare the two worlds from your perspective?
Colander: Well, they’re very different. You’ve got to the lifestyle component of it, where you’re at the same place every day and you’re not hopping on an airplane, versus the lifestyle of the consulting practice. I think the other big piece is that when you’re a consultant and you come to an institution, you’re generally trying to solve a specific problem or address a specific challenge. And you have the focus of the organization while you’re there. They brought you in; they’re generally already pretty focused because they brought you in to solve a problem or address a challenge. And you can then quickly bring that group together around some type of process for how you’re going to help them get to their resolutions and implement their programs. As a CIO, that happens occasionally, but it’s not every day. So I have to remind myself that it’s not really true—I just know every day that when I was a consultant, frankly, I was the revenue center of the organization. I don’t generate any revenue here at Elmhurst.
Guerra: Yeah, you’re a big call center.
Colander: Yeah, unless you count the physician answering service. I’m a support organization. I have to rally my troops sometimes and help keeps us level-set that we’ll never be the superstars this organization. The superstars of this organization are the doctors and the nurses. The best we can hope to be is the superstar support guys that really keep the systems going and put the things in place that help the true superstars of the organization. And you have to be comfortable with that. When I was a consultant, I could be the superstar. Because I could sell the big job; I could deliver the big engagement, and that’s the core business that consultants do.
So it’s a different kind of mindset, and you have to get comfortable with it. I’m actually pretty good at shifting between the two, just because I recognize it.
Guerra: Has your experience as a consultant shaped the way you use consultants? Is there anything you look out for or a best practice you can offer your colleagues that maybe haven’t had some time on the consultant side?
Colander: I really developed some of the techniques that I use prior being a consultant when I worked with the team over at Advocate Healthcare. One of the things we did is we always tried to structure our engagements around milestone delivery to make sure that you can really manage yourself away from those runaway projects. Make sure that you can recognize that there’s a clear milestone around the engagement.
We talked a lot about this Merge cardiovascular system we’re putting in. This is a phased approach and there are milestones associate with each of those phases. Part of the payment process with Merge is that they get recognized for achieving those milestones. And frankly, I think that’s a great way to structure all your engagements. As a consultant I preferred for my engagements to be structured that way. So if there was a recognition that we’ve had some level of accomplishment, we can celebrate that level of accomplishment, and part of that is the fee structure associated with that. Stay away from the time and materials, no milestones, nobody knows when the project starts or when it ends except the invoices keep rolling in—those types of projects. Those are the ones that frustrate folks.
And as a consultant, if it’s not good for the client it’s not good for you either, because if you’re in that kind of situation, you might think, ‘This is great, I’m just cashing this check every month.’ But at some point, somebody’s going to step up and say, ‘What did we get for this money?’ And as a consultant, you might not be able to provide a solid response that allows you to feel good about your reputation.
Guerra: And then all of a sudden, you’re not referenceable.
Colander: Yeah. I established that approach fairly earlier my career working with Bruce Smith and some of the other folks over at Advocate. We found that approach to be pretty solid and I’ve carried it out both as a consultant and as a buyer of consulting services. I’ve used that same approach, and it’s worked well.
Guerra: Is there anything else you want to touch on that we didn’t bring up—any major projects or thoughts on anything going on in the industry that you want to talk about?
Colander: We’ve talked about a lot today. I think the other thing that we’re focused on right now is trying to develop a higher level of integrated communication within the facility. We use single sign on here, so even though we are a core vendor with Meditech, we do have the Sentillion system that allows us to provide access to multiple systems for our clinicians. And we really want to build on that to integrate communication more directly with that. So for example, a nurse who is reviewing a patient record on Meditech wants to speak with one of the consulting doctors and they want to send a message to the pharmacist who’s on call for that unit. Make that something that’s integrated directly with their computer systems so that with one or two clicks, they’re in a position where they can either call or send a text message to one of the folks on the care team, and be able to open up that dialogue more directly and more electronically.
So we’ve done a lot of things with our new building as far as integrated communications, and voice over IP wireless phones. I think we had 120 or 140 SpectraLink wireless phones over at the old facility. We’ve deployed 600 Cisco VoIP wireless phones in this new building. Now the building is somewhat larger, but that doesn’t account for the impact. The real impact is that now every nurse, every PCT, transport people as well as technicians—all are carrying Cisco wireless phones that we can access them immediately. We put in a new nurse call capability within the hospital here. It’s very interesting; it’s actually a call center.
So when patients press the pillow speaker button, they’re immediately answered by a call center person. And that call center person—who’s a clinically trained person—can do the triage to determine whether the patient needs a PCT, needs a bathroom assist, just needs water, or needs facilities because the room is too warm, or they need their nurse because they’re on a pain med. Once that triage is completed, that call center person can now make sure the correct caregiver is contacted. And we can get that person responding to the patients as quickly as possible. That’s a combination of wireless telephones and VoIP telephones as well as tracking. We have some capability for tracking our nurses and our PCTs so we know where they are on the units, and that can help the call center person identify the right caregiver who can respond quickly.
So this is technology that maybe was available in some form in the past, but now has really come together in combination to be able to allow us to change the way we deliver care and improve the patient’s experience. So we’re excited about it. Our patients move in three days, so it will be an exciting time for us and our patients and doctors.
Guerra: Well Chuck, that was about all I had for you today. Good luck with the move—I’m sure it will all go well, and good luck with Meaningful Use. I’d love to talk to you again soon. Thanks very much.
Colander: Thanks a lot, I appreciate it.