Innovation is tough amid today's regulatory checklists. These leaders are getting it done.
Gretchen Tegethoff CIO, Athens Regional Health System
CIO, Athens Regional Health System
After not quite 18 months on the job as VP and CIO of Athens Regional Medical Center in Athens, Ga., Gretchen Tegethoff is feeling comfortable in the role. Mostly.
The toughest challenge? "Having to balance organizational needs with federal responsibilities," she says.
It has been a hectic time since Tegethoff came to Athens in February 2012 after six years as CIO of George Washington University Hospital. Athens Regional has begun its 90-day measurement period for its first year of meeting Meaningful Use Stage 1 standards and plans on attesting this spring.
The IT shop also is installing a patient portal to its Allscripts inpatient electronic health record in preparation for Stage 2 and is selecting an ambulatory records system, while also preparing for the switch to ICD-10 coding in October 2014 and adjusting to other realities of healthcare reform.
Tegethoff took a patient approach to understand the job and organization. "After six to eight months, you probably have a good idea of what the job is like," Tegethoff says. "I'm glad I gave myself an extra few months and found clarity on roles and responsibilities."
Another major challenge is finding enough qualified talent.
Athens is a city with a population of about 115,000, and Athens Regional competes for tech pros with hospitals in the Atlanta area, 70 miles away. Tegethoff hopes to connect the medical center to the University of Georgia, also in Athens, possibly to educate students about health IT and tap into the school's work-study program, grooming candidates for possible future employment. "I'm encouraged every time I see a new [training] program out there," Tegethoff says.
Lucile Packard Children's Hospital has been around for more than 20 years, but it's facing major change to keep up with the times. The hospital was created as a very high-end inpatient and research hospital -- meant to advance pediatric medical science and manage very severe and complex cases. But healthcare is evolving to put more emphasis on accountable care and the full continuum of treatment before, during and after a hospital visit.
Ed Kopetsky arrived as CIO of the hospital four years ago as this change was gaining momentum. The hospital was addressing the needs of patients once they returned to their communities by partnering with other health systems and building its own physician community network. Kopetsky realized Packard Children's IT would become a problem in this new model, because the systems were geared toward inpatient care.
So the hospital decided about 16 months ago to overhaul the entire IT system. The restructuring includes adding new analytical tools and replacing human resources, supply chain software and billing software. It includes conversion from Cerner to Epic for clinical systems and electronic medical records. That will allow Packard Children's to better exchange patient data with other hospitals in the region, since most are now Epic shops, Kopetsky says.
It adds up to much more than a typical IT project. "It's complementary to and critical to the transformation of the overall business," says Kopetsky. The next step will include telemedicine capabilities so the hospital can monitor very sick children and pick up on early indicators that may signal the need for escalated care. "Getting to the right level of care fastest" is critical to achieve the best possible outcomes and deliver quality care, says Kopetsky.
Kopetsky is no stranger to such megaprojects. Prior to joining Packard Children's in 2009, he was a partner in IBM's services business, and executive VP with the consulting firm Healthlink. He has also served as senior VP and CIO for Centura Health and Sharp HealthCare.
Kopetsky and his team also plan to implement a personal health record system to let parents enter data about the patient as things happen. If families choose to share that data with the hospital, clinicians will have more up-to-the-minute data on each child's condition and needs.
-- Paul Cerrato
Michael Smith CIO, Lee Memorial Health System
CIO, Lee Memorial Health System
As CIO of Lee Memorial Health System, Michael Smith is in charge of more than just IT. He also oversees health information management, biomedical engineering and diagnostic technology for the public health system in southwest Florida.
Biomedical engineering means Smith oversees the operation of medical devices. "More and more CIOs are involved in the biomedical engineering side these days because everything needs to be connected," Smith says.
There's no shortage of conventional IT work, with an implementation of an Epic Systems electronic health record in multiple stages. "It's been all hands on deck with putting in Epic," Smith says, on and off for six years. Lee Memorial has had an Epic ambulatory EHR since 2007 and has been replacing legacy inpatient systems in phases since 2009. That project slowed as the health system completed two hospital acquisitions.
The organization now has nearly 1,500 beds across four acute-care hospitals and two specialty hospitals, and also a long-term care facility and a network of outpatient clinics. IT brought the new hospitals live with clinical documentation in stages. Smith is leading a "big bang" rollout of computerized physician order entry this month.
Lee Memorial plans to replace its children's hospital in 2016, and other facilities are under renovation. "There is more to do than there is funding or time to do it," Smith says. He also sees a shortage of qualified health IT professionals. "I think the tension is going to get worse."
Prioritizing takes strong communication among senior leaders and operational units. "The good news is, we're efficient," says Smith. "The bad news is, it's a fairly tight margin."
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