NCH Healthcare System: Susan B. Wolff, Vice President and CIO

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(Editor’s note: As of Sept. 30, 2011, Ms. Wolff retired from her role as vice president and CIO of NCH Healthcare System.)

Information technology touches all aspects of delivering healthcare these days, and like most areas, hospital IT departments are asked to do more with less money. As technology advances, more space is needed to house servers, cables, and other hardware, not to mention more staff to oversee the new technology. This creates challenges for any organization as they seek to cut costs and find a balance between budgets, clinical care, and technology.

NCH Healthcare System in Florida found a solution that may be a growing trend in healthcare – outsourcing.

A difficult means to a quality end

“In 2009, I was faced with needing to cut costs in the midst of a higher demand for IT services,” said Susan Wolff, vice president and chief information officer . “Our infrastructure for our data center was more than 20 years old and needed to be replaced. Plus, our area of Florida attracts retirees, but not a lot of technical, qualified staff. We chose to outsource our entire IT department.”

This was not an easy decision and required an extensive selection process. NCH chose Cerner as their vendor and was Cerner’s first client to outsource the complete IT solution. Since then, Cerner has seen more hospitals make the same decision.

From an economic standpoint, NCH’s choice to outsource saved money and cut costs, Wolff said. All hardware was migrated from the hospital to the outsourcing company, eliminating the need for an upgraded data center. Furthermore, Cerner has a much larger pool of talent to draw from.

But, she added, the human element was the hardest part of the decision. The IT department had more than 65 employees, but only about 35 were retained by Cerner. NCH helped employees who lost their jobs find new opportunities.

“The choice to outsource was a tough decision for all of us, but it was supported at the board level, and it has been a good decision for the organization,” Wolff said. “We have increased stability and gained a deeper pool of talent to draw on. We have probably accomplished more in the past year than in any year prior.”

Wolff said she is not sure if outsourcing is a trend in healthcare IT, but it may be the best choice for some organizations, especially ones as large as NCH. The system consists of two acute-care hospitals totaling 680 beds and has recently acquired numerous physician practices. It has a group of 14 cardiologists and a multi-specialty group practice with about 50 providers.  Excluding physician groups, the system has about $400 million in annual revenue.

Leading the way in technology

NCH has long been a leader in healthcare technology. The system began using nursing documentation in 2001 and is now looking at tools that talk to the medical record. Four years ago, the system adopted a closed loop of medication administration using barcodes.

Wolff sees the future of healthcare technology being in the ability of different devices to talk to the medical record. NCH has hemodynamic monitors that record information directly into the patient’s record, rather than a nurse manually entering the information. The system also recently purchased infusion pumps that have a two-way communication with the record.

Wolff said the excitement for innovation is found at all levels of the organization.  The administrators, physicians, nurses, and other personnel attend conferences and come back with ideas of how they want to use technology.

“We have a motivated group of people,” she said. “More than 10 years ago, our philosophy was that we were going to push for quality, and the rest will follow.”

Technology has provided a great way for the hospital to improve quality. The organization is heavily involved with the Institute for Healthcare Improvement (IHI). Wolff said she noticed many presentations given at a recent IHI conference by NCH employees all cited IT as part of the quality initiatives. The organization has already seen improvements in quality by using EMR rules to fire alerts for various measures.

“We have used these tools to help comply with CMS core measures and other federal and state quality measures,” Wolff said. “We have lowered our pressure-ulcer rate to close to 1 percent by using alerts. We have also won many quality awards.”

NCH has qualified for Stage 1 of meaningful use and completed the attestation in September of 2011. In 2009, NCH received recognition from HIMSS Analytics for achieving Level 6 of the EMR Adoption Model.

In the future, Wolff believes that IT will remain an integral part of clinical care, requiring a new skill set for the chief information officer.

“I think the role of CIO is going to be more focused on getting people to collaborate,” she said. “Medical staff, nurses, laboratory staff, they’re all interested in IT and have a certain level of expertise. The CIO will need to help everyone make the right decisions about what they’re going to do and provide support for those decisions.”

-by Patricia Chaney

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