Arthur Crowe, VP of Support Services & CIO, Peconic Bay Medical Center
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.
Chapter 3
- MU & ICD-10 — “The process never ends”
- IT’s role in strategic planning
- Background in radiology/PACS
- Creating the CIO position — “If someone isn’t steering the ship, you can run aground.”
- Tried-and-true systems vs cutting-edge products
- Playing golf to “stay focused”
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Bold Statements
IT planning has become strategic. We’ve presented a five-year look at what do we have to be doing over the next five years — not just for next year.
As the government continues to evolve the healthcare mandates and what they need us to do, it will change ever more. So when we think we have it figure out, I’m sure there will be a new curve ball thrown at us that makes us shift directions.
As a new CIO, predicting the future and where we really need to be and where we should be focusing our attention has been one of the more difficult things, because a lot of these things aren’t completely defined yet.
You’d love to be able to satisfy your user’s needs and meet your patient’s needs as quickly as possible. It’s weeding through all the options and finding really what is the best thing, is it really going to be here, and is it really as innovative as presented.
Gamble: Now that you did get that attestation out of the way.
Crowe: We did.
Gamble: What are your big priorities?
Crowe: The unfortunate part — or fortunate, depending on how you look at it — is that this process never ends. We’re fully in throes of Meaningful Use Stage 2, and then the other big animal out there is this ICD-10 initiative that has to be up by October. ICD‑10 was taking a bit of a backseat to Meaningful Use because of our tight timelines but now it’s running neck and neck with our Meaningful Use Stage 2 attestation.
ICD-10 involves a whole new bunch of folks to join the team, from finance people to health information management folks to business office people and patient accounting. A whole new bunch of people are joining our team, but, similar to how we did MU 1, collaboration is going to be key. We have a lot of commitment from those folks and everybody’s working hard at it. But those two things alone both have to be pretty much operational by October, and it is definitely a challenge. It’s definitely, definitely a challenge.
Gamble: I would imagine that with having those two pretty huge initiatives, you also have to say, ‘Okay, what do we need to be looking at for two years out and three years out.’
Crowe: Absolutely. As I said before, IT planning has become strategic. We’ve presented a five-year look at what do we have to be doing over the next five years — not just for next year. That’s how it was five or 10 years ago. But we are part of the strategic planning process — what infrastructure do we need to build on? What will we have to reinvest in or upgrade over the course of time? The whole information exchange piece that’s going to become so important over the next two years — what does that mean for us? What kind of interfaces will we have to build? How do you get all these proprietary EMR systems to talk nicely in one way to everybody? Should we be thinking about interoperability much more than we ever thought about it? What will we have to change? And every specialty now wants to have their own clinical platform in technology, so how do we integrate that in?
It’s an ongoing evolutionary process for us, but yes, it’s definitely long-term planning now; short‑term successes, but very much a long-term plan. As the government continues to evolve the healthcare mandates and what they need us to do, it will change ever more. So when we think we have it figure out, I’m sure there will be a new curve ball thrown at us that makes us shift directions.
Gamble: It definitely seems like how things have gone. Now how long have you actually been at Peconic Bay?
Crowe: I have been here coming up on 12 years. I came as the radiology administrator, PACS administrator. We didn’t have PACS when I came here. I deployed PACS, so that was sort of my forte, and over the course of time it just evolved into more and more things. I put on a bunch more hats, and 12 years later now I’ve been anointed as the CIO of the organization, which is a new title for us. We did not have a formal CIO position. I won’t say it’s me, but I’d say the creation of that position has helped stabilized things for the IT resources. They look at me as the stabilizing force for direction and prioritization, and that was definitely lacking before. Our platform in enterprise is so large that if someone’s not steering the ship, needless to say, you can run aground at times. So the creation of that position has been very, very helpful to us.
Gamble: Sure. It’s all part of what we talked about with the shift of IT being seen much more strategically now just in having the CIO at the table.
Crowe: Exactly. My crossover from department head to now sitting in the executive suite and conveying that information back and forth and understanding both sides has been very helpful for me and I think it communicates well to my staff.
Gamble: And you also have the role of VP of Hospital Services.
Crowe: Yes, I have a lot of hats. I have a big hat rack in my office. I’m the VP of Hospital Services, and that encompasses all the support services, like operations, housekeeping, and dietary, and then a lot of the ancillary services like laboratory and radiology still report to me. We have a school of radiography that reports to me. So I have quite a bit.
But again, it’s good because for me because I have input from all those different areas. I’ll use housekeeping and transport as examples. Those are truly viewed as service functions, but they have technology. They use bed tracking systems and they use communication systems, all of which we try to integrate into our overall large enterprise wide platform. Even though historically they have been viewed as support, they’re very technological these days. And so my ability to have those folks in my ear and then take it to the table and take it to the other groups has helped me to bring all those forces together so that they’re being heard as well as the people out in the clinical floors — the clinical folks. So it definitely ties together.
Gamble: IT really does touch everything in the hospital now.
Crowe: Everything.
Gamble: Having the background you do in radiology, how do you think that affects your role now?
Crowe: Radiology is completely technological. Film is no longer. Everything is digital. We’re always looking for how our system is going to integrate with other systems, and so having the background of knowing we had PACS up in 2003 and knowing how that works and what the clinicians expect from a usability standpoint and making sure that’s incorporated into the system-wide platform that we deploy, was definitely helpful. I will say some of the loudest critics of our technological systems can be the physicians who need to see images, either on call or up in the ORs. That was sort of not being listened to before, but we have definitely done a great job of integrating that, and I think my having a radiology background was definitely helpful. Because I knew what their concerns were, and I was able to incorporate them into the things that we delivered, including 50-inch plasma screens in every OR room where they can see images in large scale and not have to move away from the surgical site to go look at what they saw yesterday on the CAT scan or whatever it was. It’s taking that input and then using it system-wide to make sure we meet their needs.
Gamble: You didn’t necessarily set out to become a CIO but you find yourself in that role now. I know this is kind of a blanket question, but I wanted to know some of your thoughts on where the industry is headed. We’ve seen such huge change in the past couple of years and obviously although it creates such a burden, do you think, in general, that things are going in the right direction?
Crowe: I think things are going in the right direction. I think for a lot of us, at least as sort of a new CIO, as I get myself acclimated to what’s expected, I think it’s still changing. I think that some of these things are moving targets, like Meaningful Use — will they move the deadlines? What’s really going to be covered in that? What’s coming down the pike in Meaningful Use 3? What will be making it to the final act? These health information exchanges and how we’re supposed to coordinate the sharing of data and how hard or easy is that going to be, to the continued healthcare reform stuff that’s out there and what’s that going to mean. And then you always throw in HIPAA compliance at the end of the day, because they’re definitely enforcing that much more. The threats of enforcement are now becoming the realities in that they are enforcing much more than they did, and how do I take care of bringing your own device to work and meeting the privacy needs of patients and physicians.
We’re delivering clinical information to all types of places outside the four walls of our building now — how do I control that? How do I know where it’s been? How do I know who looked at it? That still continues to evolve, so for me, I think the challenge is really staying ahead of the curve and trying to predict what’s coming so that you don’t invest in something that turns out to be not the ideal solution. For me, as a new CIO, predicting the future and where we really need to be and where we should be focusing our attention has been one of the more difficult things, because, like I said, a lot of these things aren’t completely defined yet. I find that to be a significant challenge.
One of the other things too is there is tons of technology out there and there are tons of vendors now coming out with the next greatest thing that’s going to solve your problems and it’s going to be great. All these types of new innovation are great, but I don’t know if they’re going to be around in five years. If I invest, will they still be here? So I’m careful to kind of figure out, how new is that company? How much experience do they have? I actually look at their business models and their financial performance to make sure they’re still going to be around so if I choose to invest in them, in 10 years they’re still going to be here. We’ve tended to — and I think it’s a smart thing — invest in tried and true, very proven technology performers, whether it be Siemens or LG or some of the other companies we’ve talked about.
Gamble: Right. And you also don’t want to ignore something else that could be a great solution.
Crowe: And that’s the trick. If you do your homework and you really do find the most innovative thing and you deploy something that’s fantastic, you don’t want to be the third person that did it. You’d love to be able to satisfy your user’s needs and meet your patient’s needs as quickly as possible. It’s weeding through all the options and finding really what is the best thing, is it really going to be here, and is it really as innovative as presented.
Gamble: That’s the challenge I guess.
Crowe: Absolutely.
Gamble: For the last question, I just wanted to ask, with so much on your plate and so much going on, are you able to get away? And if so, what’s something that’s a hobby or another way you spend your time besides CIO.
Crowe: Most healthcare managers and executives spend an awful lot of time in the hospital. I don’t actually live on the East End. I live more west and I have a fairly long commute here, but to me it’s almost like going on vacation every day because the East End of Long Island is so much different than where I live. I’ve really come to love it. And one of the nicest things for me is the recreational piece. I’m an avid golfer and there are beautiful golf courses within five minutes of our hospital to the north, south, east and west. And so my golf game, while I don’t get to get as much as I’d like, has definitely improved, and it helps me stay focused on personal needs as well as business needs. A lot of good business deals are made on the golf course as well. I definitely enjoy the golf that’s out there.
The north fork of the island has really become noted for its wine district. The wineries out here and vineyards are tremendous tourist attraction. They’re fun. They’re great. They’re very easy going. I’ve brought my wife and family out here a number of times to just go wine tasting and just to see the countryside. It’s just a different world for me when I come out here. So for me personally, I love coming out to the East End of Long Island. It’s been great. Even though it’s a long commute, I love coming here.
Gamble: It’s sort of a mini vacation.
Crowe: It really is.
Gamble: Okay, I know that we’ve covered a lot, so unless there was anything else you wanted to touch on, I wanted to thank you so much for taking the time to speak with us.
Crowe: I really appreciate the opportunity, and I hope we get to speak again.
Gamble: Me too. I’d definitely like to touch base down the road and see how everything’s going.
Crowe: Will do, thanks. I appreciate it, Kate.
Gamble: All right, thank you so much.
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