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Not Just 'Techies' Anymore

Gary Baldwin, for HealthLeaders Magazine, December 13, 2007
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Ed Martinez is not one to shy away from a challenge--and it's a good thing, too. The mess he inherited three years ago at H. Lee Moffitt Cancer Center & Research Institute might have made many a chief information officer turn tail. The center had been struggling for several years to implement a new pharmacy system. Worse, the IT department was not seen as much help. "One of the biggest morale issues I had was that the department was viewed as 'techies' going around fixing problems, not as business allies that can help drive the business," recalls Martinez, the CIO and senior vice president at the center, a 162-staffed-bed facility in Tampa, FL, with some 6,500 annual inpatient visits and more than 230,000 annual outpatient visits.

Martinez took the challenge to heart. Through a mix of reassigned tasks, painful elimination of obsolete positions, and good old-fashioned communication, he energized--and eventually grew--the staff. The pharmacy system that had been stalled was brought online in nine months, and Moffitt deployed additional systems for registration, scheduling and anesthesia within two years. Martinez's IT department now includes more than 170 staff--more than double the number he had when he began. "It was an uphill battle for the first two years," he concedes. "But now morale is high, and IT is at the table. Discussions don't occur without the hospital understanding what we can do to assist business decisions."

Martinez is not the only technology leader who has struggled to uplift the IT department. As clinical systems become more important in the modern hospital, so does the profile of technical staff--in theory, at least. In practice, many tech departments are hindered by a perception of their limited understanding of medicine. That PR problem is sometimes compounded by tech staff's lack of understanding of their own importance to the clinical mission. It's a national issue, one that is reflected in dwindling enrollment in once-hot academic IT programs. But through a combination of recognition programs, open communications and leadership by example, savvy CIOs like Martinez are taking aggressive steps to both lift the morale of their tech staff and raise their profile in the clinical setting.

For Martinez, spotting talent was the first step. Although he recruited new talent, Martinez also took steps to reassign existing staff. "My role was to find these individuals, mentor them, and get them to shine," he recalls. "At the same time, I had to bring in people from the outside." Building a new hospital Web site was a task Martinez's group immediately conquered, setting the stage for the pharmacy installation. "The new Web site was simple enough to think about, but difficult to implement," he says. "We were successful, and that gave us some kudos."

Of course, logging a few successful implementations is not enough to raise a department's profile. Some CIOs have turned to internal marketing campaigns to get the word out. "As CIO, you must communicate or die," says Edward Marx, former head of IT operations at Cleveland-based University Hospitals, a 2,200-staffed-bed academic medical center. "If you don't communicate, no one knows what is going on, and they will assume the worst."

Marx initiated several programs at University Hospitals that helped raise the IT department's profile. First, he began issuing monthly reports that provided IT department performance metrics. Second, he initiated a mandatory on-the-job shadowing program that put IT staff into the thick of clinical operations. Finally, he launched a blog, which gave him a platform to promote his views of how IT supports the clinical operations.

"My core message," Marx says, "is that even if you are just changing toner or answering questions at the help desk, everything you do impacts patient care."

Marx's efforts paid off. Internal surveys revealed an IT staff that felt more connected to how decisions at the hospital are made. The programs were so successful that Marx plans to institute them at his newest position as senior vice president and CIO of Arlington-based Texas Health Resources. "You need to connect people's heart to the mission of the hospital," he says. Toward that goal, Marx published essays on his blog that upheld the personal nature of healthcare-including one entry that recounted his mother's death. He also shadowed physicians and nurses on the job. "After shadowing a nurse, I was more worn out than after finishing a triathlon," he says.

Having the IT staff shadow clinicians had other pay-offs, as well. When IT managers and crew mingle with clinicians, it creates a personal bond that lingers, Marx says. After shadowing a group of residents, one of his vice presidents, for example, remarked to the physicians how she understood the need for portable devices.

"These stories get told over and over," he says. "It shows the IT shop is engaged."

Executive leaders like Martinez understand their own limitations in making it all happen, however. "My role is to facilitate and get out of the way," he says. "If you have the right people, and give them the right tools, you will be successful."

Gary Baldwin is technology editor of HealthLeaders magazine. He can be reached at gbaldwin@healthleadersmedia.com.


CIO Blog Makes Connections

During his tenure as CIO at University Hospitals, Edward Marx maintained a blog that became popular reading on the academic medical center's intranet. After Marx announced his resignation, an IT staffer came to him in tears, thanking him for the impact he had on her life. "She had only known me through the blog," Marx recalls. Here is an excerpt from one of Marx's most popular essays, "My Passion for Healthcare Expanded," in which he discussed his late mother's struggle with cancer.

Throughout my mom's fight, I'd spent considerable time in various care settings observing processes, evaluating technology and pondering generally how things could be improved to benefit caregiver, family and patient. Clinicians who treated my mom clearly lacked the communications and clinical decision support they needed to deliver the highest quality of care. The amount of paper utilized and manual processing was disappointing; I swore it would never be this way at UH in the future. This is why we are implementing an EHR and have a physician portal. This is why we are developing a patient portal so patient and family can be active members of the care team. This is why we are doing e-prescribing and why we will ensure we have a complete medication list for all patients. This is why we are investing so heavily into an infrastructure that encourages communication and the collaboration of care. This is why I am here.

It's this passion that drives me daily in my work. For this reason I have been tenacious in advocating technology that brings critical information to the clinicians. This is the heartbeat behind why I spend more time with my people on leadership, customer service, and passion than I do on bits and bytes. Bits and bytes will be limited until the people behind them have a heart for the patient and are in a position to empathize with their plight. The heart must be transformed before you can realize the full potential of technology in the delivery of high-quality healthcare.

Thanks, Mom, for strengthening my passion as a leader of healthcare technology.

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