CCMH Turns IT Department into a Hybrid Shop

by HCE Exchange on March 25, 2016

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On April 1, 2014, Comanche County Memorial Hospital (CCMH) in Lawton, Okla., took a bold step with its department of information technology.

Once a fully outsourced shop primarily devoted to McKesson, the largest hospital west of Oklahoma City brought its outsourced personnel entirely in-house and implemented a remote-support model, mixed and matched from a few different vendors.

As James Wellman, chief information officer and senior director of IT, said, this move created a tremendous amount of savings for the hospital, increased customer satisfaction, and streamlined the department’s workflow.

Diversifying its IT infrastructure

For 15 years, CCMH had a productive relationship with McKesson, fully outsourcing even its local IT staff to McKesson Support.

However, in recent years, CCMH began diversifying its IT infrastructure and lessening its devotion to one particular company’s products. For example, the hospital had switched from the Horizon EMR platform in 2013 to the Paragon platform and also contracted with eClinicalWorks.

Because of these changes, CCMH’s leadership decided that its top IT person should be a hospital employee, not an outsourced corporate representative. In other words, the leadership wanted a fresh perspective from someone who wasn’t locked in with a product, Wellman said.

Wellman had been a McKesson employee since he arrived at the organization in December 2010, but he knew upon being hired that the McKesson contract was already under review. What he didn’t know was that CCMH was interested in offering him the opportunity to be the organization’s first CIO.

Restructuring the IT department

Wellman’s first project as CIO was to determine the positions he could fill for the hospital and the degree to which he could expand the IT program. He then began to build his department, hiring various network people who were already at the hospital as McKesson employees. He was also able to hire some former Haliburton employees after the company’s international IT group relocated to Houston, as well as some personnel from nearby Fort Sill.

When the dust settled, Wellman was able to bring all infrastructure and informatics in-house. For cost reasons, specialty applications that required 24/7/365 monitoring were still outsourced, including the help desk, which was contracted to Anthelio Services.

As the department was brought further in-house, Wellman noticed that a long-standing silo was beginning to crumble.

“When I first came in here, there was very much an ‘us and them’ mentality between the hospital and the IT department, even though the bulk of people in this IT department had been hospital employees years prior and they just transitioned over when the hospital contracted with McKesson,” he said. “We saw that aspect change a little bit. The IT staff has become more involved in a lot of the hospital projects and programs that are going on.”

When they were McKesson employees, the IT staff didn’t receive much recognition for their contributions to CCMH. For three months in a row after the restructuring, however, members of the IT staff were recognized for outstanding commitment to the hospital.

Under Anthelio, the help desk also improved its first-call rating, which had been very low. Wellman set a goal of achieving 50 percent calls closed on the first call. Within 120 days, the goal had been surpassed with 58 percent of first calls being closed.

Maintaining a local IT presence

Wellman said a restructuring of this magnitude demands a clear vision, and his vision was focused on being local.

“I had a goal in mind,” he said. “You see a lot of hybridization because a lot of people are going to the cloud, and you’ll read some articles that will tell you that this is the death of the local IT shop. From my perspective, it’s not. You still have to have a local presence.

“Regardless of virtualization, desktop support will still be there. Their roles and skill sets will evolve, but at the end of the day, there’s a physical device somewhere that’s in the patient’s room or on the physician’s desk or med cart and we’re taking care of those components.”

A local staff can also speak for the hospital, he added. That staff has the hospital’s mission in mind and in heart. And when a cloud system is implemented, they’re able to handle it because the department has been preparing for it over the course of many years.

“I wanted to be able to put a team into place that I could go in and transition to a new technology and still not upset the dynamic locally,” he said. “If we went completely cloud-based tomorrow, the team would stay intact.”

Instead of thinking short-term, you have to think long-term, Wellman said. What will your department look like three or four or five years down the road? Having an environment of constant, unexpected change as opposed to an environment primed for evolution doesn’t help anyone, including the hospital.

“I think that sends the wrong message to your administration and to your organization and definitely to your team because it puts them not at ease to come out and do their best work. I think they’re more worried about surviving sometimes, and we want our team to feel comfortable to make a mistake and know that there’s not the sword of Damocles hanging over their heads each day,” he said.

“At the end of the day, a good, solid dependable IT staff in your facility is a key component to your success.”

-by Pete Fernbaugh

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