Timing really is everything. When Bill Neil started as CIO at Indian River Medical Center in early 2011, his first order of business was to create a roadmap for the organization to become completely electronic. But just as they were get started to implement McKesson Horizon, the announcement came that changed everything. Neil and his team decided to take a leap of faith and go with Paragon, and it’s a decision he’s never regretted. In this interview, he talks about what it was like to hit the ground running as IRMC’s first CIO, the challenges he faces in managing a patient population that fluctuates by season and is heavily Medicare/Medicaid, what his team is doing to cut costs, and his advice for new CIOs.
- Preparing for Stage 2
- Looking for ways to cut costs
- Staff retention challenges — “The pool isn’t growing.”
- Benchmarking against other orgs
- From large IDN to community hospital
- Advice for new CIOs — “Get on the CEO’s radar.”
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Part of that preparation is freezing any major new initiatives, because we have quite a bit on our plate already. Just getting through this next year is going to be a challenge.
They’ll go to a different hospital or clinical setting or they’ll go work for a software vendor, or they’ll go out there become a consultant, but it’s the same people — the pool itself is not necessarily growing.
They were instrumental in waking this organization up to the need for someone in a higher capacity to overlook the IT department and to help them strategically transform the hospital the way we have been doing it today.
The people that are here and some that have gone — for a lot of them, this is the only job they’ve ever had, and so bringing in that outside experience working with different organizations has helped a lot.
Get on their radar and understand what they feel the issues are in the organization — not just with IT, but overall. That would be my first advice — to get out there and understand the lay the land.
Gamble: Is there anything we haven’t talked about as far as some of the other major initiatives you’re working on or looking at?
Neil: In terms of some of the major ones, of course we’re getting prepared for Stage 2 Meaningful Use. We have some Paragon releases we need to put in and start testing and getting in production. And of course we’re all getting prepared for ICD-10, which is coming up in October of next year. We know we have that to do, and so we want to make sure we’re well equipped and ready for that and prepared, because that will affect us financially as well. Other than that, this year is going to be just major upgrades to our systems. I’m looking at different items like telecommunication where I can get some savings and get on the county’s fiber — maybe work on a better relationship with AT&T and get discounted rates and so forth.
With healthcare reform, hospitals are going to take a significant cut in some of their Medicare/Medicaid programs, and so we’re preparing for that. We did a RIF (reduction in workforce) and we looked at some services that maybe we should not be in. And so we’ve done a pretty good analysis just preparing for this coming year. Part of that preparation is freezing any major new initiatives we have, because we have quite a bit on our plate already. Just getting through this next year is going to be a challenge for all of us.
Gamble: You mentioned staffing — that’s another challenge that obviously a lot of CIOs are dealing with in terms of having the right people in place to help lead through all of these changes. Has it been an issue to hold on to some of the really strong talent?
Neil: It has, actually. In the IT world right now there’s a small group of good, talented people. They’ll go to a different hospital or clinical setting or they’ll go work for a software vendor, or they’ll go out there become a consultant, but it’s the same people — the pool itself is not necessarily growing. But we’ve been very fortunate. We have lost some key talent, but at the same time we’ve picked up some good, young, strong key talent as well.
At Indian River Medical Center, we benchmark ourselves with other organizations, and we’re holding our self to the 25th percentile. Of these other organizations that we compare ourselves to, there are basically only 25 that do better than us as far as labor. That’s what we’re holding ourselves to — that 25th percentile.
Gamble: Are there any measures you’re taking to try to either recruit or hold on to the good people by offering education or flexible hours, anything like that?
Neil: Not necessarily flexible hours, but just reinforcing their value here to the organization and offer additional training where we need it. I think a lot of it is based on location. There aren’t a lot of other opportunities here locally; it’s not like there’s another hospital that’s two blocks away. We’re blessed by that — if you do leave, you’re probably going to end up moving.
Gamble: It probably doesn’t hurt being in a nice warm area.
Neil: It does not. It helps us with recruiting.
Gamble: I imagine.
Neil: We show them the sunny beaches.
Gamble: Now I was looking on your LinkedIn page and saw that before coming to Indian River, you held director-type positions at some larger organizations. I wanted to talk a little bit about what brought you to Indian River and how different it’s been to this point.
Neil: Prior to Indian River, I was in Albuquerque, New Mexico. I was working for Presbyterian Healthcare Services, which is a large IDN. Today I believe they have eight hospitals — there are three in the Albuquerque area and five outside the area throughout the state of New Mexico. Between the provider side of it and the health plan side of the healthcare business, at the time, if I remember correctly, Presbyterian had about 70 percent of the healthcare in the State of Mexico.
In my role, I was in charge of the five regional hospitals outside of the Albuquerque area, anywhere from Socorro to Clovis to Espanola. As far as what I did out there, they were a McKesson Horizon facility — the hardware and everything was simply located in Albuquerque, and so I started rolling out the products that they had in Albuquerque hospitals out into the other hospitals, whether it was meds management, the pharmacy systems, the radiology systems, etc.
I was there probably a little over five years, and I enjoyed it immensely. It was a great chapter in our lives. Prior to that I was at Jackson Hospital in Miami Dade County, and we missed Florida, to tell you the truth. It was beautiful out there. The desert is wonderful. They call it the land of enchantment. Some people call it as land of entrapment — I can understand why. But for us, we wanted to go back to the East Coast. Our family was here — our daughter and grandkids — and so we just made that change. I started looking for other opportunities and this one became available.
Gamble: There was not a CIO at Indian River previously, right?
Neil: No, there wasn’t. There was a director position, but not a CIO.
Gamble: That’s pretty unique being the first person to hold that role. What has that been like?
Neil: I’m the vice president and CIO here. Prior to my coming here, they did contract out for an interim CIO. It was an interim position with the consulting company. One of the roles and missions of the consulting company was to recruit for that position. They were instrumental in waking this organization up to the need for someone in a higher capacity to overlook the IT department and to help them strategically transform the hospital the way we have been doing it today.
Gamble: I can see the need for having somebody who isn’t holding the interim CIO and having a regular, staffed position by somebody who’s in the area and is going to be around for a while. I can see the need for that and wanting to say that we have a CIO on staff. I would think that that would help in some aspects.
Neil: Yes, it has. The people that are here and some that have gone — for a lot of them, this is the only job they’ve ever had, and so bringing in that outside experience working with different organizations has helped a lot too in terms of bringing a different perspective and a different focus.
Gamble: Right, especially since you worked for organizations that were larger in scope. I’m sure brings with it some value as far as the experience you’ve had there. One of the things I like to ask is what advice you would give for new CIOs. One person actually told me that his advice was buckle up. I thought that was funny, but I wondered if you had any advice for being new to the role, and if there was anything you wish you would have known at that point.
Neil: I would say my initial advice is to get know the organization. Get to know the C-level suite that can help you — you can help them as well. Work with the CEO and the CFO. Get on their radar and understand what they feel the issues are in the organization — not just with IT, but overall. That would be my first advice — to get out there and understand the lay the land.
The other piece too is to get to know your organization internally. What I found out pretty quick was with that the staff that I had that I inherited, these were the only positions they’ve ever had. They didn’t have a broad bandwidth of experience. They’re very good at what they do, but they needed a lot of structure, and I think that’s what I brought to them.
Gamble: Okay, great. We’ve definitely covered a lot. I don’t know if there was anything else you wanted to touch on, but this has been great and I feel like I’ve learned a lot about the organization and you as well.
Neil: No, I don’t have anything else but thank you. This has been interesting. I can’t wait to see what you write up and everything.
Gamble: I will certainly keep you posted. Thank you so much, and best of luck to you going forward.
Neil: Thank you.