Healthcare // Clinical Information Systems
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Anthony Guerra
Anthony Guerra

Guerra On Healthcare: Have Faith In Your Clinicians

When you turn to your medical staff for help selecting e-medical record and other clinical systems, be ready to listen and trust their thinking.

While just about every healthcare CIO can hit the market and select a core clinical system that's architecturally sound and fiscally feasible, no one recommends they make such a decision alone. One of the cardinal rules of system selection is to include the clinicians--the ultimate end users of the product.

"From the beginning, we decided that the selection was going to be made by our staff and not by our administration," said Tom Ciccarelli, CIO at East Orange General Hospital in East Orange, N.J., of his recent selection process.

But what's to be done when the product the clinicians endorse doesn't match the one the CIO favors?

As an experienced CIO with more than 10 years at the hospital, Ciccarelli knows the good, bad and ugly of the major core clinical inpatient systems. Of course, he's also intimately familiar with the KLAS organization's highly respected compilations of end-user system reviews. And that's exactly why Ciccarelli was taken aback when the team of clinicians he had put together said they wanted the Centricity system from GE Healthcare IT.

"Their KLAS scores scared the heck out of me," Ciccarelli said.

As far as the KLAS reports tell it, GE's product has been at the bottom of the list for quite a while. So Ciccarelli was faced with an unpleasant decision: Either tell the selection team they were wrong and suffer the loss of goodwill attendant with that message, or investigate why the team preferred the GE product to see if he could reconcile himself with the decision.

"We had a dilemma. I told these guys, 'Go out and do your job and tell me what's best,' and they came up with a turkey. I said, 'My God, what did you do to me?' "

Showing the courage of his convictions, Ciccarelli went with the trust but verify model. In fact, he went hard at GE on those KLAS scores, their commitment to future development and the proposed pricing. "So what we did is our senior management got together with GE and said, 'Talk to us about those scores. Tell us why they're so low, and tell us what you're doing to fix them.' "

In the end, Ciccarelli was comfortable enough with GE's answers to sign off on the purchase. "We bought their rationale and moved ahead with the decision," he said.

As we move further into a new era of clinical system implementations brought on by HITECH legislation, and clinicians are embraced in the process more than ever before, countless situations like this one will arise. How many CIOs will make the mistake of overriding their selection team and going with the "safe" choice thinking they would never be second-guessed for going with the vendor that consistently ranks number one?

But Ciccarelli's example should serve as the model of how to deal with a situation when users and CIOs don't agree on the best product. In the end, he stood with his selection team and supported their choice after sound investigation. CIOs who dismiss the clinicians' choice as too risky are playing a dangerous game, because even the top rated systems don't score well if they're not used.

Anthony Guerra is the founder and editor of, a site dedicated to serving the strategic information needs of healthcare CIOs. He can be reached at

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