Lee Powe, CIO, Hugh Chatham Memorial Hospital
Talk about hitting the ground running. When Lee Powe started as CIO at Hugh Chatham Memorial Hospital, he had just five days to familiarize himself with his new surroundings before kicking off a major system installation. Fortunately, it was the same ED system he had implemented at his previous organization. But still, it gave him a taste of how much work needed to be done — and how different it would be to lead a smaller organization. In this interview, Powe talks about the risks and benefits of using cutting-edge technology, Hugh Chatham’s approach to data exchange, the importance of having a true open-door policy, why it’s impossible to keep everyone happy, and what keeps him up at night.
Chapter 3
- Best-of-breed vs. consolidated systems
- Epic isn’t for everyone
- Going from a mid-sized organization to a smaller hospital
- Hugh Chatham’s IT push — “We’re showing where technology can take the organization.”
- Dealing with red tape
- Overseeing IT & HIM
LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED
Podcast: Play in new window | Download (Duration: 13:17 — 12.2MB)
Subscribe: Apple Podcasts | Spotify | Android | Pandora | iHeartRadio | Podchaser | Podcast Index | Email | TuneIn | RSS
Bold Statements
When you have a consolidated system, you get okay at everything, but you don’t become the best at everything. And so when we place more demands on lab or OR or ED, they want the best possible software with the best customer support that they can get.
I’d love to have a single-source system. When it comes to support, when you deal with one vendor versus 10, it’s a lot easier. But I don’t think we’re going to ever be going back. Once you start peeling off the layers, you’ve got it done and you’re stuck with it.
There were approximately four people in IT here when I arrived. Today I have 10. We’ve grown through the years, because we’re showing where technology can take the organization and how much more efficient it can be.
Once you have established a good history, your word really carries a lot of weight, because you’re not going to make a decision on implementing a new system unless it’s the right thing to do for the organization.
We look for different ways to make things efficient and maintain people’s privacy, and we do that. If I tried to go and do that in a large facility, how many meetings would it take?
Gamble: You talked about how you what is pretty much considered a best-of-breed environment at this point. Can you ever foresee trying to go with one system throughout, or is it just something where it’s just too hard to do when the lab has their specific needs and case management has the system that they want, etc. Could you see it where you just keep going the best-of-breed way?
Powe: I guess that’s going to probably depend upon a few things. CPSI actually has a consolidated system that has all the components. They focus on the small-sized facilities that probably didn’t have a lot of staff — just a few people for IT. That’s what their focus is. We’re in that in-between status — we’re a little bit bigger than the small facilities. Critical access, which is about a 25-bed facility, is their sweet spot.
With our people, more demands that being are placed upon them, and CPSI is not meeting all of their needs, so they’re looking for other systems to meet their needs. When you build a system and your purpose is just lab, you can get really gifted at lab. When you have a consolidated system, you get okay at everything, but you don’t become the best at everything. And so when we place more demands on lab or OR or ED, they want the best possible software with the best customer support that they can get. That’s where a lot of it is going.
Now the Epics of the world are extremely expensive and they are for large facilities. They can do those things in the large facilities but we’re not a large facility. We don’t have 800 beds. But that’s one of those things where you have to look down the road a few years from now to see if they go to a third-party PACS or a third-party ED system. Sure, I’d love to have a single-source system. When it comes to support, when you deal with one vendor versus 10, it’s a lot easier to work with. But I don’t think we’re going to ever be going back. Once you start peeling off the layers, you’ve got it done and you’re stuck with it.
Gamble: And like you said, it is certainly much easier to deal with one vendor. The big advantage is that the individual departments have the system that works best for them and so maybe not being able to deal with that pushback is worth it in some ways.
Powe: It benefits inside the department and it should benefit from a resource point of view. Technically, you would think it would be less people because it’s more efficient. But what usually will happen is the IT department will ramp up more people to have to support the software and hardware components of all the different systems. So as we’re ramping up, some of the other departments are using more technology to their advantage, so it will become better for them and they can do more. Now, not every software package out there does that. But the ones that do work very well; they do.
Gamble: Maybe they’ll be a day when the Epics of the world are more affordable and can cater to smaller organizations, but I don’t see that happening anytime soon.
Powe: That will be a long time down the road. We interact with a lot of different facilities and we know a lot of people, and some of them are actually pushing the Epics down to the smaller hospitals and it’s not working very well because the smaller hospitals just can’t operate in that type of environment. It doesn’t always work. It might not be the perfect software for the smaller facility, or it might be — I don’t know. I’ve never had the opportunity, so I can’t say.
Gamble: You talked about previously being at a large facility. That was Good Shepherd, correct?
Powe: Correct.
Gamble: Can you talk a little bit about the difference in being in a facility that size and what the IT staff dynamic was like, compared to what it’s like for you now working at a smaller organization, and I would imagine, a smaller IT department?
Powe: Oh yeah, much smaller. It’s changed there because it’s been several years now. But when I left there, I was the clinical systems manager. I was over approximately eight clinical analysts, which covered PACS and all the different clinical software components. We had a manager that was over all the finances. We had about six or seven people. There were probably about 27 to 28 IT staff members, from what I understand. But they also were over the phone systems and that staff wasn’t part of the IT staff but that included about 20 personnel in there, which were operators and phone people working on phones and cabling and stuff. So it was much larger. The big difference between there and here was that there were approximately four people in IT here when I arrived. Today I have 10. We’ve grown through the years, because we’re showing where technology can take the organization and how much more efficient it can be and how much better it can be here.
One thing I’ve learned about the difference between a large facility and the small facility is the politics of getting something approved. We would do a budget every year. We did a tremendously large job putting stuff together and justifying it when I was at Good Shepherd. Then when it was time to purchase, you went through the same process all over again. So there were many, many hours being put in just to get something approved.
When we were implementing the nurse module, we had to go into rooms that had 30 nurse managers in it and have conversations about how to do something and how to fix something — and that was how everything went with the presentations. Here, when you do your budget, you submit your budget and make your cuts before approval. Once it’s been approved and it’s time to purchase, you fill out your requisitions. You submit it to the board. The board signs off on it, and you purchase it. We have a planning committee that meets every month which includes department heads from every department so we can discuss issues that are going on — what they want to see, what’s happening and what are the issues. We get a chance to speak and cover all the different products that are coming or that we need. For example, we needed an EKG management system that worked well with others. Epiphany came about that way. But the process in the smaller facilities of getting something through the system — it’s a lot less politics and a lot less time, and it’s more efficient.
Gamble: I can imagine. I’m envisioning a whole lot of meetings when you talk about being at a larger facility; a whole lot of meetings and a whole lot of back and forth before anything is even close to being done. That can be a tough environment to work in.
Powe: It is a challenging environment. I don’t know what they’re doing right now, but when you’re doing about 90,000 ER visits a year, it’s a fast-paced environment and you’re just trying to stay ahead. And there’s always a meeting. There’s always something that needs to be worked on, and there were always a tremendous amount of people at those meetings. Here, once you have established a good history, your word really carries a lot of weight, because you’re not going to make a decision on implementing a new system unless it’s the right thing to do for the organization. The administrative team gives great support on this, and the board gives great support, so we’ve changed out and put in fabulous technologies here. We’ve done a lot of things, because there are no software packages that fix everything, so you have to go out and get people to design it for you.
We have specimen drop-off and it’s the same thing. It was a log. People would drop off a specimen and they’d fill out a log. You could see the previous person. We turned that into a digital process so you walk up to a touchscreen computer and it’s got a requisition — what’s the person’s name? What kind of test is it? And it shows up on the other side in the lab and it goes away. We look for different ways to make things efficient and maintain people’s privacy, and we do that. If I tried to go and do that in a large facility, how many meetings would it take? I’m not saying that it’s the same everywhere, but it’s a lot easier when I can speak with the lab director and say, ‘Hey, this is what we’re looking at doing. What do you think?’ And they say, ‘That’s a great idea. That would solve this,’ and then you do it.
Gamble: That’s a world of difference. It really is. I would imagine that with the IT staff that you have now — you said it’s about 10 people — you’re able to actually get to know them better so that you know their strengths. And I can imagine that that helps create an environment where the staff becomes more engaged and everyone has a role that fits them. I can see it unfolding that way.
Powe: Very much so. I’m actually over the health information management staff as well, so I’m over actually two departments. I have the IT staff, which is pretty much everybody’s custom fit. I have a help desk analyst, five analysts covering different areas. One’s a practice analyst who takes care of all the practices. One’s a data analyst. I’ve got an HL7 guy who takes care of all the interfacing. I’ve got a compliance/systems analyst, and I’ve got a couple of hardware techs and network administrator. But I also am over our health information management because it’s electronic records. In converting everything to digital, we needed to bring these two worlds together. We’ve done so, and I have a tremendous staff over there as well.
Share Your Thoughts
You must be logged in to post a comment.