You may have never heard of Henry Mayo Newhall Hospital (HMNH), but the 238-bed not-for-profit community facility is a model for how new innovations should be implemented in todayâs evolving healthcare environment. This is due, in large part, to vice president and chief information officer Cindy Peterson, her information-solutions team, and their processes for launching new technologies.
When Peterson arrived in 2001, HMNHâs IT department had a staff of ten, no enterprise-wide architecture or Internet, five interfaces, IBM AS400, two servers for a handful of stand-alone systems, fewer than twenty software applications, and a budget of $1.9 million. Today its operations have grown into a staff of sixty-five (including biomedical, compliance, and a full group of analysts and informaticists), more than 275 interfaces, 286 servers, 1,249 workstations, fully standardized institutional software (including MEDITECH for fully integrated electronic medical records) and a budget of more than $9 million.
This growthâand how HMNH achieved itâearned Peterson a spot on Beckerâs Hospital Reviewâs â100 Hospital and Health System CIOs to Knowâ in 2014. She modestly suggests that being under budget and on time in approximately 95 percent of its technology initiatives might have had something to do with being added to the list.
âWeâve been able to achieve that kind of success because of our planning and structured approach to project management and how we involve all stakeholders from the very beginning,â Peterson says. âThat way we arenât viewed as working on âIT projectsâ but on operational improvements.â
She points out that early engagement means stakeholders are involved from the very beginning in prioritizing and approving projects, as well as allocating funds. Once decisions are made, her technical planning approach then involves executives, department directors, and staff in project implementation. This includes planning, training, go-live, and follow-up analytics that rely on a matrix of specific goals that are used to measure success at six-, eighteen- and thirty-six-month intervals.
For example, when the hospital launched its computerized physician order entry (CPOE) system, physicians had helped develop order sets, reviews, and coordination with all medical specialties. Their âownershipâ in the project was also supported by technology âred shirtsâ who were available to provide immediate support, if needed, after the system was launched. As a result, CPOE use grew by 12 percent in the first month and now exceeds 80 percent.
Peterson uses a philosophy of âservice-enabling cliniciansâ to identify appropriate new initiatives. âWhat can we do to save steps, improve work flows, make processes more efficient, and create more time for physicians to spend with patients?â she asks. âFirst we gain a full understanding of how theyâre doing things today; then we look at alternative approaches so they can do them better tomorrow.â
This approach was applied to enhancing emergency-department work flows when a new emergency-department management solution was implemented in 2010. Having completed a full assessment of the current work flowsâprocessing and identifying areas needing improvement (such as 4 percent of patients who left the emergency department before being seen)âPeterson and her team decided to implement the new solution and other adjustments (including the logistics of how and where patients are greeted and triaged) in a single phase rather than the vendorâs recommended two.
This resulted in improved efficiency and patient experience, including an 80 percent reduction in patient time to triage; a 60 percent reduction in patient time from triage to room; a 63 percent reduction from room to physical exam; and an 83 percent reduction in patients leaving the emergency department without being seen, which resulted in an accompanying $2 million increase in revenue. The single-phase implementation also saved $363,000 in project costs.
Peterson oversees a strategic plan that constantly evolves through ongoing interactions with hospital executives, board members, clinicians, vendors, and organizations such as HMMS and CHIME to identify existing challenges and current trends.
âItâs all part of our efforts to make sure that whatever is rolled out has a positive impact on overall quality of care,â she says. âAfter all, that is our mission: to positively impact the care of our patients.â
Projects under the current strategic plan include a system for monitoring blood transfusions, a telehealth project, deployment of a smart-device initiative, and a community portal to improve communications between physiciansâ office staff, medical groups, and the hospital. Preparation is also under way for the February 2017 launch of MEDITECH 6.16, a totally redesigned platform for EMR management.
âThe new system is completely rewritten with a new OS fully integrated and requires all new hardware and software, so we canât maintain any of the old system,â Peterson says. âItâs a âbig bangâ approach, where everything has to change simultaneously.â
She is quick to point out the contributions of HMNHâs IT team to all of the hospitalâs past and future successes. âThey continue to surpass my expectations every time and deserve all the credit for operationalizing the strategic plan we create,â she says. âI donât make all this happen on my own.â