Accused CIO Responds To Ethics Charges

The CIO caught up in an ethics scandal at Nassau Health Care Corp. claims she's a victim of poor training and that a state ethics panel has misinterpreted technology acquisition rules.

Further, says Christine Forman, the controversy is sapping efforts to deploy software designed to improve the safekeeping and accuracy of medical records at Nassau Health facilities.

Forman says she was "shocked" when the New York State Ethics Commission on Monday formally accused her of improperly accepting hospitality from IT vendors competing for a contract to build a medical ERP system.

"As far as I knew we weren't breaking any rules," Forman says.

The commission has charged Forman and other Nassau Health execs, including president and CEO Richard Turan, with accepting meals and payments for travel expenses beyond what's allowed by state law. The 1,500-bed Nassau Health organization operates the Nassau University Medical Center in East Meadow, N.Y., an extended-care facility in Uniondale, N.Y., and nine community health centers in the state.

The commission says that of seven Nassau Health execs named in the complaint, Forman received the most illegal hospitality--valued at more than $4,000. Turan is charged with receiving about $700 in illegal goods and services, including a trip to a New York Islanders hockey game. Turan says he has made reimbursements for the tickets and, in fact, all the vendors involved in the competition have been paid back, "even though we're still not sure we did anything wrong."

New York State places strict limits on what execs at publicly funded institutions can receive from vendors. Under most circumstances, they can't take gifts or payments in kind worth more than $75. Penalties include fines of up to $10,000 per violation and misdemeanor criminal charges.

Forman says she had never heard of those rules when, during the past year, she accepted meals and lodging from vendors vying for the software contract. "I've worked primarily in the private sector, and this is all new to me," she says.

The vendors listed in the state's complaint are Cerner, Fuji Film Medical Systems USA, Philips Medical Systems, Siemens Medical Solutions USA, and Eclipsys Solutions. The vendors are not charged with wrongdoing. Nassau Health ultimately awarded Eclipsys a $7.2 million contract to build the system.

Forman says she's insulted by allegations that she demanded favorable treatment from the vendors and that, in the private sector, accepting moderately priced meals and hotel stays from vendors is standard operating procedure. "It's not like I was going on golf trips; these were for legitimate business purposes," she says. Among the items on the state's complaint list is $2,399.84 in expenses related to trips Forman made to Siemens' data center in Malvern, Pa. "If you're going to buy a product, you have to go look at it and make sure it's not something running in a garage," Forman says. She adds that Nassau Health was hardly in a position to pay for the trips. "We're in a turnaround phase," she says. The company is expected to lose $9 million this year.

Forman says that she "received no training at all on this" during her new-hire orientation two years ago.

She also says the commission is incorrect in its assertion that she committed another misdeed by not putting the software contract out for open bid. "Our attorneys have told us that software is not biddable, and we bought the hardware from an existing state contract," Forman says.

The issue is delaying implementation of technology that Nassau Health execs say is vital to the organization's future. Turan says the $7.2 million system--which uses Eclipsys' SunriseXA software as a backbone--is essential if Nassau Health is to remain competitive.

The software, combined with wireless technology, is designed to provide physicians at Nassau University Medical Center with more convenient, secure access to medical data and patient records. It features a Web-based medical-record and clinical-data repository, computerized physician order entry, and clinical decision support with alerts and reminders.

Physicians using the system will also be able to access patient information, including radiology images, lab results, and medication orders, from their homes or offices. "We think this is going to catapult Nassau University Medical Center into being one of the most technologically advanced hospitals in the region," Turan says.

The ethics commission has sent copies of the complaint to the directors of Nassau Health, who will have a chance to respond to the allegations at a hearing. A hearing officer will then decide whether to send the complaint to the full commission, which can either accept the findings and levy fines directly, reject them, or ask for another hearing.