It’s been a decade of change for Peconic Bay Medical Center, from the organization itself — which has evolved from a community hospital to a health system — to its home, the East End of Long Island, which is one of the fastest growing areas in New York. A key component in this expansion has been a shift in how IT is viewed. As CIO, Artie Crowe has played an instrumental role in changing the perception of IT from the department that fixes what’s broken to one that helps shape the strategy of the organization. In this interview, Crowe talks about what it takes to lead an evolving IT department, why his team almost threw in the towel on MU Stage 1, why customization is sometimes the best solution, and the secret sauce to boosting clinician satisfaction.
- Peconic Bay’s growth from community hospital to health system
- Upgrading to Siemens Soarian
- Making “a leap of faith” with vendors
- IT as an investment strategy — not just fixer of what’s broken
- Weekly forums to improve clinician satisfaction — “They can go elsewhere.”
- Partnering with LG on Zero Client devices
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You make a leap of faith because they say they’re going to have it developed by the time we need it, but it’s still actually in the development stages. You sort of partner together and say ‘Okay, I trust you.’ Thankfully it’s all worked out.
If we don’t offer a really intuitive, friendly platform for caregivers to use, it does affect the business model. Physicians can go elsewhere. They get turned off.
Every healthcare dollar is hard to get and hard to hold on to. And for every dollar there’s two dollars’ worth of need, so deciding how to divvy up the dollars is a difficult thing.
It’s been through an ongoing, two-way process between the people who are deploying it and developing it and the users that we’ve been able to convince the higher-ups that this is an important thing for us to do with our dollars.
Running additional power to every room in our facility is very costly and disruptive because you have to shut rooms down. Having any room out of service on any day is not what I want to tell my CFO — ‘hey, we couldn’t fill a bed today because we’re putting in electrical components.’
Gamble: Hi Artie, thank you so much for taking the time to speak with us today.
Crowe: No problem, thank you.
Gamble: Why don’t you start off by giving us some information about Peconic Bay Medical Center?
Crowe: Peconic Bay Medical Center is a 182-bed acute care and rehabilitation facility located on the East End of Long Island in Riverhead, NY. We are a designated stroke center. We are an advanced center for orthopedics and bariatric surgery. We’re pretty much what used to be your basic community hospital that’s growing up into becoming an up-and-coming health system.
Gamble: As far as the geographical location, what is the area like?
Crowe: We’re the largest care provider on the East End. There are a couple of hospitals besides us out here, but we’re the largest. In our primary service area we serve about 71,000 to 72,000 residents, which is quite large, and then in our secondary service area, we serve another 140,000. So we serve a pretty large spectrum of the community. The East End of Long Island is one of the only growing population expansions still happening in the State of New York. Riverhead itself has grown about 21 percent over the last 10 years in population, and it’s predicted to grow another 5 percent each year over the next five. So we’re definitely needed to serve this up and growing community.
Gamble: And do you have physician practices that are either owned by or affiliated with the system?
Crowe: Yes, we have a primary care network that we’ve developed with both primary caregivers and surgeons in our managed services organization model. Those are located in satellite facilities in the town of Riverhead, and also out into Mattituck and down into Hampton Bays. We just recently opened our new Manorville campus, where we intend to expand even further off of our first building, which is doing primary care and urgent care to the community — it’s a little underserved there, so it’s a perfect fit. We also plan to expand to have some more surgical presence there and potentially even open an ambulatory surgery center on that campus. As I said, we’re developing into this health system. Our Manorville Campus is our newest addition, and it’s been really quite successful.
Gamble: Yes, definitely a lot of growth going on with you guys.
Crowe: There’s huge growth out here. The East End of Long Island was untapped for a long time. I’ve been here for about 12 years, and when I first got here in the first year or so, I drove through potato fields. Now that same road is filled with Home Depots and Targets and every big-box store you could think of. Just the growth and the development of this area here has been huge. And that stuff doesn’t happen unless people are recognizing that this is definitely an area that’s up and coming.
Gamble: Yeah, and all those people are going to need some care.
Crowe: All of those people need care, exactly.
Gamble: Okay, so tell us a little bit about the clinical application environment. What are you using in the hospital?
Crowe: We just recently upgraded — what used to have Siemens Invision. We had that for about 10 years as a platform, as our health information system. In our efforts to address Meaningful Use, we went to the upgraded Siemens offering, which is called Soarian. We deployed that about a year ago very successfully, and that’s house-wide. We went with CPOE very recently as well as part of that platform, and it integrates into the entire technological platform that we have here. Siemens is our primary provider for clinical applications. We’ve used other sources to kind of meld things together, but it’s that integration with Siemens as our defining vendor that’s really helped us to be successful.
Gamble: Not that it’s ever simple, but going from Invision to Soarian — what did that involve?
Crowe: You’re right, it’s not simple. That was probably two years in the making as we prepared to get there. In some cases you make a leap of faith because they say they’re going to have it developed by the time we need it, but it’s still actually in the development stages. You sort of partner together and say ‘okay, I trust you.’ Thankfully that’s all worked out.
As far as building up our resources, I don’t know how it’s been for other people, but IT was one of those areas that I’ll say the hospital didn’t intend to invest a lot in with resources. It was ‘when it broke, you replaced it,’ and that’s when they spent the money. That whole mindset has shifted into an investment strategy, and so we went out to find highly skilled people to join our team to help do the build and we interviewed the users, and that was really something unique — to bring physicians into the fold. We have physicians serving on our team because obviously it’s across the whole spectrum of caregivers. Developing that team and have them work collaboratively, all coming from different specialties, isn’t easy.
So that was one challenge, and of course there’s cost. Getting the money to do these types of things is never easy but we’ve shifted the mindset from IT being an operational expense to really being strategic. If we don’t offer a really intuitive, friendly platform for caregivers to use, it does affect the business model. Physicians can go elsewhere. They get turned off. Even our staff — if they’re not happy with what they’re using, you end up spending more money and you have user dissatisfaction, which always can affect patient care in the end. And so it’s an important thing.
Gamble: Was that a difficult thing to change that thinking from IT being seen as ‘we’ll fix things when they’re broken’ to really becoming a more strategic part of the organizational planning?
Crowe: Absolutely. I don’t want to pick on the CFOs of the world, but every healthcare dollar is hard to get and hard to hold on to. And for every dollar there’s two dollars’ worth of need, so deciding how to divvy up the dollars is a difficult thing. But I think we were able to demonstrate that unless we provided an investment in IT correctly — meaning that our whole business acumen is going to be based on having physicians be satisfied and being able to use the system easily and have our providers to do that — then that business can go elsewhere. They realized that, mostly through some focus groups that we did. And I hate to say it — it seems cliché — but we do have an open door with our users, whether it’s physicians, nurses, techs, you name it, to get feedback. It’s been through an ongoing, two-way process between the people who are deploying it and developing it and the users that we’ve been able to convince the higher-ups that this is an important thing for us to do with our dollars.
Gamble: So that was the impetus for forming the committee you have with physicians and specialists?
Crowe: Right. Ten years ago, we deployed whatever was the most economical or what, based on resource availability, we could get in the easiest, without giving much concern to how the end-user might feel about using it. Now, we go out and we survey the folks who are going to use it. We put them on committees, we put them on search teams, and we send them off to other facilities to do site visits so that they can be our cheerleaders not our detractors when it comes to deploying these types of applications.
We have an ongoing forum weekly where we talk about enhancements, process improvements — any number of things. And having that open line of communication is really helping us succeed because we have deployed quite a bit of technology in the last 12 to 18 months. For some people who had done everything on paper and pencil, it’s been an eye-opening experience. But we’ve kind of held their hand along the way and made it easier for them because we’ve listened to them about what they really need to be successful.
Gamble: That’s a major shift from the last decade.
Crowe: Big time.
Gamble: As far as things like the network infrastructure, was it pretty involved as far as everything that needed to be done?
Crowe: Yes. Obviously we had to have some network infrastructure to provide the prior system that we had, but our new model was going to call for us to put devices in every patient room. And that, again, came again from user feedback that they want caregivers at the bedside, and they want to be at the bedside. So to have them congregate at the nurse station and try and use computer technology was just not what we wanted. Now we have to deploy over a hundred-plus devices throughout the organization. So we have to beef up our network, we have to figure out how to power those devices, and you have noise concerns, maintenance concerns, etc.
It’s no big surprise that one of the big challenges we face is wireless technology, from bringing your own device to work and getting that on our network and is it secure and how are we going to control it? How are we going to contain it? And so we did an entire wireless infrastructure upgrade. We put devices in every room. We found a unique way to actually deploy those because running additional power to every room in our facility is very, very costly and disruptive because you have to shut rooms down. Having any room out of service on any day is not what I want to tell my CFO — ‘hey, we couldn’t fill a bed today because we’re in the room putting in electrical components.’
We found a very simple way. I shouldn’t call it simple — it’s very sophisticated, but it was simple for us, to deliver power over Ethernet to Zero Client devices. It’s a new technology that was developed. We partnered with LG on their Zero Client devices; we send about 60 watts of power down to them and we can power not only the computer, but the USB devices attached to it, from our single sign‑on tap‑and‑go device to the mouse to keyboard, in a very clean, efficient and cost-effective way. So again, we’re building up that infrastructure and putting power over Ethernet switches in our data closets. While it’s a big investment, it will pay off over the long haul. And it didn’t disrupt services. We never really closed a patient room to deploy any of those devices.
Gamble: Obviously, that’s huge right there, being able to show cost savings.
Crowe: The initial estimate was around $150,000 to $200,000 that we would have had to spend on electrical upgrades, because we wanted the devices to be on emergency power and a number of things. That was offset significantly by going with the power over Ethernet switches, and again, minimizing the disruption, because you do have to factor in lost patient bed days because you take rooms out of service. So at the end of the day, it was an incredibly cost-effective solution for us.