Health IT's True Mission: Baptist Health CIO Speaks
Baptist Health CIO Roland Garcia reflects on his career and what he sees as the primary goal of healthcare IT: to improve care and minimize suffering.
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Roland Garcia is not one of the healthcare CIOs who started out as a clinician. Garcia, the senior vice president and CIO at Baptist Health in Jacksonville, Fla., found another calling: improving hospital operations at faith-based health systems.
In town following a family trip, I had looked Garcia up as the most important healthcare CIO in the region. On fairly short notice, he agreed to meet me for an 8:00 a.m. appointment at his office overlooking the harbor, across the street from Baptist Health Medical Center, the flagship of the five-hospital health system.
Garcia cited a couple of personal experiences early in his career that made the need for improvement clear to him. "You want to know why I'm in healthcare?" he asked. "I don't often tell this story -- I'm not sure why I'm telling you," he continued, sizing me up before deciding whether to continue.
When he was in his mid-20s, Garcia was working as a project manager at one of the largest private, faith-based hospitals in the country. When a wing of the hospital was being rebuilt, the IT team was housed in close quarters with clinical units -- with patient care being delivered on the other side of temporary partitions. One day, while rushing to his next appointment, Garcia tried to open the door to the hallway and found it blocked. The object blocking the door turned out to be a wheelchair, and in the wheelchair was a patient who had expired sitting in the hallway -- alone and apparently forgotten. The patient was the first dead person he had seen up close, and even after getting over the initial shock, he was left with the thought: "How could this possibly happen in a world-renowned facility?"
In retrospect, he sees that as the beginning of a quest to do his part to improve hospital operations.
Garcia's second story explains why he has been drawn to not-for-profit, mission-driven healthcare organizations. "My father died in '97 at an early age: 66." His father was a strong man, but near the end of his struggle with colon cancer, he was crying out in pain as the younger Garcia kept vigil. "Here I was pushing the [call] button to get the nurse, and there's only one person in the whole [expletive] facility with access to the drugs to relieve his pain." Why? The for-profit hospital had cut staffing ratios to make money for Wall Street.
When I asked what he has done that makes him proud, the first thing he mentioned was implementing electronic pharmacy order entry, which collapsed a flow chart of manual processes that had previously taken about two hours and 40 minutes. "With technology, we were able to shorten that to about eight minutes."
Another example of IT speeding the delivery of care: About six months ago, the hospital system started using voice recognition technology to allow radiologists to dictate their reports. "From what used to be a process of many hours -- maybe four to six hours -- now with the voice technology and front-end editing, with the physicians doing the corrections [to the transcript], we can have a report ready in seven minutes and available to anyone with access to the EMR." About 88% of the hospital's radiologists have adopted the new procedure.
The change also cut about $33,000 of monthly manual transcription costs, but the time savings is far more significant, Garcia said, because it means less time waiting for test results before care can begin.
In discussing electronic medical records and electronic health records technologies, Garcia made a point of arguing that it's wrong to use the terms "EMR" and "EHR" interchangeably, as is common in the industry (and in my reporting -- mea culpa). As defined by the Centers for Medicare and Medicaid Services, which oversees the Meaningful Use incentive program, EHR is intended to be more than a rebranding. Garcia explained that EMR is the medical records technology "within the four walls" of an institution, whereas EHR is intended to stretch "across the continuum of patient care" for an integrated experience. So even though CMS designates some EMR products as Certified Electronic Health Records Technology,
David F. Carr oversees InformationWeek's coverage of government and healthcare IT. He previously led coverage of social business and education technologies and continues to contribute in those areas. He is the editor of Social Collaboration for Dummies (Wiley, Oct. 2013) and ... View Full Bio