Driving Health IT Implementation Success: Insights from The Christ Hospital
Summary
In 2007 The Christ Hospital (TCH) desired to separate from a well-established, multi-facility healthcare network in order to become a leading independent, regional hospital. The network they had belonged to provided 100% of TCH’s Health Information Technology (HIT) software and support. TCH needed an HIT system to replace the shared network system they had decided to leave. Typically, a project of this scope would take years of planning to develop and implement; due to deteriorating relationships with the shared network, the TCH project team had eight months. Through a monumental effort, the project was a success in no short part to multi-stakeholder collaboration, motivated project champions and a “we’re all in this together” attitude adoptedhospital-wide.
Background
TCH is 555-bed, acute care hospital in Cincinnati, Ohio. It’s staffed by over 1,200 physicians in 30 departments that provide cardiovascular, women’s health, cancer and emergency healthcare. Their mission statement is to be “the leading hospital for the region, providing the finest experience in personalized health care while advancing clinical excellence, technology and education.”
In 2005, TCH senior leadership decided to separate from the shared network it had belonged to for 15 years. The shared network provided 100% of TCH’s HIT software and support (patient registration and scheduling, supply-chain operations, personnel, financial management, etc.), so a separation would require TCH to provide their own, and do so with a transition that would not disrupt the healthcare their patients depended on. When TCH announced their intent to separate, relationships with the network began to deteriorate, expediting the need to replace the shared HIT system with their own.
The Project
TCH partnered with a consulting firm, Accenture, and developed a diverse team of healthcare consultants. The project was led by TCH’s vice-president and Chief Nursing Officer. The project team identified three core IT implementation areas:
1) An enterprise resource planning (ERP) system for non-clinical business processes
2) A suite of clinical systems to support clinical processes
3) A state-of-the-art IT infrastructure to support new HIT application and processes
With an eight month deadline, decisions had to be made quickly and with incomplete data. No formal Requests for Proposal (RFP) were given. Instead, major vendors were invited on-site to discuss the project and describe how they would be able to meet the project’s goals. Vendor selection and contracting took less than 90 days.
Implementation started in October 2007 and the ERP system went live in April 2008. During this time, over 300 network drops, 600 workstations and PCs, 450 scanners and printers, and 3,000 RFID devices were installed throughout the hospital, demanding more than 36,000 man-hours from the vendor responsible for IT infrastructure. In addition to the infrastructure, more than 150 clinical processes were reviewed and revised. This included patient registration and scheduling, hospital billing, clinical documentation, surgery, pharmacy, radiology, and emergency care. These processes, and many other peripheral processes, required 157 systems with over 200 different interfaces.
All of these processes and systems would be for naught if no one knew how to use them, but no one would be allowed to log in to the systems until they were trained, including physicians. In just five weeks, 3,300 people were trained to use the systems for patient care and operations. Off-site training centers were used to train super-users who in turn trained everyone else. E-learning sites and kiosks were also available to help employees.
Why it Succeeded
Typically, projects with such a large scope coupled with such a short timeframe end in failure, but strong collaboration amongst all stakeholders was the key to success for TCH, its consulting partner and three vendors. Many other factors led to the success of the project such as:
1) Staffing—the project team was manned by consultants with diverse clinical, financial and technological backgrounds that complimented and strengthened each other. Normally with an IT heavy project such as this one, someone with an IT background would be chosen to lead the project. However, TCH’s vice president/Chief Nursing Officer was chosen to lead and became a strong champion for the project. His perspective and guidance, rooted in patient care instead of technology, lent itself to greater acceptance to all non-IT stakeholders.
2) Open communication with all levels and user “buy in”— “town hall” meetings were conducted with the physicians, nurses, hospital administrators and staff to articulate the projects goals and request feedback.The project team also met with representatives from all levels to take input on how the new processes should be which led to a sense of group ownership.
3) Internal marketing— hospital-wide there was a“We’re All In This Together” attitude. The project team developed time lines and project goals that were posted throughout the hospital in the cafeteria, breakroom and other locations that reinforced the need for their continual support and also kept track of the progress of the project.