Cindy Peterson, VP & CIO, Henry Mayo Newhall Hospital, Chapter 1

For today’s leaders, it really is all about collaboration — both with vendors and the executive team, says Cindy Peterson, who has been CIO at Henry Mayo Newhall Hospital since 2001. With vendors, it means engaging in ongoing communication and being involved in each other’s strategic planning processes, and with the executive team, it means earning trust by being consistent and delivering what is expected. In this interview, Peterson talks about how her team is working to deliver data more effectively to clinicians, the one question leaders should ask with any application, and what she has found to be the key in maintaining a successful partnership with Meditech.

Chapter 1

• About Henry Mayo
• Migrating to Meditech 6.16 — “We’ll be an early adopter.”
• Working with Web Acute
• The big question: “How does it improve patient care?”
• Pushing vs pulling data
• Vendor management — “It’s a two-way street.”
• Including vendors in IT strategic planning

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Bold Statements

It’s a lot of collaboration that’s going back and forth in trying to making this product the best it can be. We want to make sure that we’re not going backwards on any functionality, but only moving forward with additional functionality and improving processes, patient safety, and patient care at the hospital.

We’ve got to make sure that whatever we’re developing and rolling out is going to be what’s best for operations and improving patient care. That’s always the key component.

The key is providing information that they need to see, when they need to see it. Instead of having to click down through multiple pages to find the information you want, this is a system that’s more intuitive and knows what information you’re going to want to see in a particular page.

It needs to be a partnership, that there is no software out there that’s perfect. You have to understand that. And you have to have a relationship with that vendor where there is ongoing communication and ongoing collaboration, and there’s give-and-take.

We need to be engaged with them in their processes and their focus groups and maybe sometimes be early adopter, and they too need to be engaged in what we’re doing and understand our organization and understand where we’re going.

Gamble:  Hi Cindy, thank you for taking the time to speak with us. To lay some groundwork, Henry Mayo Newhall is a not-for-profit community hospital with around 238 beds?

Peterson:  Correct.

Gamble:  And as far as physician groups or affiliated positions, what does that landscape look like?

Peterson:  We currently do not own any medical groups or have any physicians employed. The only physician groups we have are contract services with are ER physicians, and we have some hospitalists. But when it comes to medical groups, we don’t have any of that in our facility.

Gamble:  And that’s not something that’s in the plans for any time soon?

Peterson:  No. Our strategy is really to work with multiple medical group organizations at the facility, but not actually to have an MSO or a foundation, because in California, you have to have a service agreement with medical groups or you have to have a foundation that was created.

Gamble:  In the hospital, you’re a long-time user of Meditech. What version are you on at this point?

Peterson:  Currently we’re on 5.66 client server. We’ve been on client server from the moment we went live with them in 2007.

Gamble:  Are there any plans to upgrade or go to a different version?

Peterson:  Yes, our plans are to go to version 6.16. We’re in the middle of the implementation right now. We’ll be an early adopter of that version, and we’ll be an early adopter for the new Web Acute application that’s in development.

Gamble:  And so in terms of being an early adopter for 6.16, what is the thought process there? I’m sure it can be scary not to have other organizations you can speak with about it. What was your approach?

Peterson:  We’ve been an early adopter before with Meditech, but it’s mostly been on various upgrades or new applications. This particular implementation is a little different because early adopter with this is a brand new technology that they’re implementing. It’s all web-based. So that’s very different. We have a lot of collaboration relating to testing and reviewing the product and submitting feedback and having modifications coming back, so it’s a lot of collaboration that’s going back and forth in trying to making this product the best it can be. We want to make sure that we’re not going backwards on any functionality, but only moving forward with additional functionality and improving processes, patient safety, and patient care at the hospital.

We have multiple physicians involved as well as informatics team, the analyst team, and Meditech’s developers, and so far, the process is going very well. But it’s not exactly the same as being an early adopter where it’s just an upgrade.

Gamble:  Right. And like you mentioned, there are a lot of different stakeholders involved, and a lot of people wanting to get this right. How does that work from a perspective of balancing all of these different opinions and preferences? I imagine that must be challenging.

Peterson:  It is. And I would say that Meditech is very open to listening to all of our suggestions and our feedback, but sometimes within our own team we don’t have agreement, and so you do have to talk through the various scenarios of how it would work so that everybody is understanding. We have to remember that from an analyst’s perspective, we might be looking at it like, ‘how do I support this,’ but we really have to look at it like, ‘how is the user going to use it? How is this going to affect not only nursing but the physicians?’ And so sometimes there has to be a consensus and sometimes there has to be a little give, but we’ve got to make sure that whatever we’re developing and rolling out is going to be what’s best for operations and improving patient care. That’s always the key component — how does this improve patient care? It might be a little more difficult for the user, but is it going to improve patient care? Those are the components that we have to really balance.

Gamble:  Right. And with the web platform the goal is to improve the work flows, but obviously, there is going to be a learning curve. How can that be dealt with?

Peterson:  What we’re trying to do is we’re trying to move more toward a mobile type of platform. And being a web-based application, it’s geared more toward iPads and your mobility. People are already used to a lot of swipes instead of clicks, and so I think the key is providing information that they need to see, when they need to see it. Instead of having to click down through multiple pages to find the information you want, this is a system that’s more intuitive and knows what information you’re going to want to see in a particular page. That’s the difference. With most applications today, it’s ‘Go fetch the information that you’re looking for. Go find it. Go onto this page. Click on this.’ And you have to do all of that to actually end up finding what it is you want to find. Whereas in the web-based application, it’s more intuitive. I’ve got the patient there and now I might just hover over something and boom! It shows me the information that I want to see relating to that particular case. So the information is being pushed to you rather than going out and trying to retrieve all the information. Does that make sense?

Gamble:  Yeah. It’s the ultimate goal of all these things, like you said, to have the push instead of the pull. That it’s just a process of getting there.

Peterson:  Right, right.

Gamble:  And with the web platform and the clinicians, I know you have user groups and things like that, but what type of interactions do you have with some of the users as far as getting their input and feedback?

Peterson:  For this whole project, because it’s a complete rebuild of every single application, we have core teams that include our stakeholders, analysts, and specialists from Meditech that actually work on each of those aspects relating to the build of the system. So that’s going on with every single application that we’re implementing.

Web Acute is a little different because it is the only part of the web-based application that’s being rolled out in the beginning, so there’s much more development and collaboration between Meditech. We still have the same level of core team. We have physicians. We have nurses. We have informaticists. We have analysts, and then we have various levels of the technical development team and directors from Meditech. They actually have weekly calls, and we’re also doing a face-to-face meeting. So Meditech may come out here, or we may go out to Meditech for development days and building days together so that you can actually see what’s going on and then they understand what changes need to be made. And then the following month, we’ll get a new revision and then we’ll go through all of that.

It’s a very complex, but very focused group on making the system a great one. We feel really good about the way that process is going. From an executive level, I’m sometimes involved on the calls, and I’m involved in parts of the site visits where we go back and forth. We have a vice president of Meditech and a project manager from Meditech who are also involved. And so we identify all of the items or issues that come up, we have them all logged, and then at the hospital level, all of these core teams report up to their executive sponsors and then to the steering committee. We have a steering committee that oversees the whole project that includes the vice presidents of the hospital and the president of the hospital, so that we have focus and prioritization for this project. That’s sort of how it rolls up and how the oversight occurs.

Gamble:  With the complete rebuild you’re doing, what is going to be next in that process?

Peterson:  Currently, our plan is to implement and go live next fall. The hardware for the systems is already in place, and the software for all the other applications has already been loaded. They’re currently in the process of building all of the dictionaries and the master files for the systems, and they’re starting to do the testing. So they’re further along than the other applications because the other applications aren’t a complete rebuild. They’re built on the new platform, but they have already been installed in other facilities, so it’s just the newer enhancements. And some applications have been rebuilt, but they’ve had extensive testing and they’ve been rolled out before. It’s the physician side, the web-based side of it that’s more of a development aspect. So the other applications are going through the normal build, the normal testing, the normal integrated testing, and working with the same type of process with those core teams where we have stakeholders and we have nurses pulled off of the floors to work on this implementation. We use that same methodology for the implementation of all the applications.

Gamble:  Henry Mayo’s obviously been working with Meditech for a long time, and during what it takes to successfully manage vendor relationships. It’s something that’s a challenge for a lot of organizations, so what do you think it takes for the IT executives and vendors to keep that relationship viable?

Peterson:  I think that the important aspect is that it needs to be a partnership, that there is no software out there that’s perfect. You have to understand that. And you have to have a relationship with that vendor where there is ongoing communication and ongoing collaboration, and there’s give-and-take. So when they ask for early adopters or they ask for people to participate on their focus groups or become involved, you need to take that responsibility to be engaged with them. The more you’re engaged with them, the more your relationship continues to build, and it becomes a partnership. For us, Meditech’s a strategic partner. They’re strategic because they’re one of the most important things that we have in relationship to making this organization operate efficiently, effectively, and be geared toward patient care. They’re strategic in that.

So we have to have that level of communication back and forth, and engagement on both sides. We include them when we’re doing our IT strategic plans and offsite meetings. We include our strategic partners to be engaged in that process with us. So it’s a two-way street. We need to be engaged with them in their processes and their focus groups and maybe sometimes be early adopter, and they too need to be engaged in what we’re doing and understand our organization and understand where we’re going. And when you have that two-way engagement, you build that relationship. I would say that we truly do have a strategic partnership with Meditech, and I would believe that they would say the same thing.

Chapter 2 Coming Soon…