Medical centre CIO uses strong dose of guilt to ensure vendor due diligence

A CIO might receive an MBA to master the finer points of IT management, but one tactic not learned in business school, inflicting guilt on vendor reps to make sure their technology functions reliably, can be effective, too.

Ask Walter Fahey, the CIO at Maimonides Medical Center in New York. The 705-bed facility has undergone major network upgrades in recent months, using the services of longtime vendor Verizon Communications and its new Connected HealthCare Solutions group.

The network upgrades are designed to support electronic health records software that’s being upgraded in coming months and the transmission of patient data to smartphones and other wireless devices used by doctors, he said.

In an interview, Fahey said he frequently brings vendor sales representatives, including those from Verizon, into a Maimonides operating room and delivers a little speech. Fahey explains how complex applications must run reliably on robust networks to provide critical electronic patient information at the proper time to doctors and nurses who are using sophisticated surgical instruments on patients.

“I bring the vendor reps in the operating room and tell them, ‘Imagine if one of your relatives were here in surgery. Serious stuff. All this information has to be read, and it’s really, really important stuff,’ ” he said.

Fahey isn’t kidding. He said it can’t hurt to inflict a little guilt on vendor reps to make sure they install technology properly and keep it running when needed. “Guilt works, because it’s logical,” he said.

Aside from his frank management style, Fahey has earned a reputation during his 14 years at Maimonides for being thorough and adept at the range of difficult tasks facing IT managers in hospitals. The biggest chore hospital CIOs face lately is wending through the administrative maze associated with recouping federal reimbursements under the stimulus bill for technology investments made by medical centers and doctors in electronic health records technology.

Most of the federal money won’t be be seen until 2011, and CIOs as well as doctors are still waiting for federal officials to issue the rules for qualifying for the stimulus money, Fahey said. “It’s frustrating work,” he said. “But in the long run it’s going to be beneficial.” In all, he estimated the center has invested $100 million in electronic health record technology going back to 1996, but the reimbursements will cover on a fraction of that total, he predicted.

Fahey, who holds a master’s degree in business, sees his job as incorporating elements of management, accounting and technology.

For the technology portion, he has overseen Maimonides’ upgrade of a Verizon fiber optic network connecting two dozen buildings over the past two years, giving the center more bandwidth to handle patient records, including medical images.

For years, the entire network has been used, for example, to help doctors remotely diagnose stroke victims in emergency rooms via video streams. That way they can detect if a stroke has occurred based on patient speech and movement, which can help the doctor quickly administer the proper medications.

That kind of video application is bound to expand with increased use of electronic health records. Today, high resolution images are passed around the 800 doctors associated with the center. Up to 500,000 images are already viewed per month, all using a variety of networks.

A new eight-story care center is equipped with wired and wireless communications, including portions running 802.11n wireless LAN access points from Cisco Systems Inc., Fahey said. A doctor can pull a wireless cart next to a patient to gain access to his records and order medications and procedures, reducing paper and the need to move the patient.

The technology investments have “definitely improved patient care,” Fahey said, partly because the patient doesn’t need to be moved as much, and because the records are easily available, fewer tests are needed. The network will help support an upgrade to the primary medical record application, from Eclipsys Corp., used at the center.

Also in coming months, Maimonides will rely on Verizon’s Connected Healthcare Solutions group to conduct a comrehensive audit of its network infrastructure to assess patient data privacy requirements under the federal Health Insurance Portability and Accountability Act (HIPAA). In addition to the security assessment, Verizon this week also announced a Health Information Trust Alliance designed to help health care providers design security practices for sharing and storing patient information.

The recent network improvements have coincided with new IT management practices at Maimonides as well, Fahey said. For one, the center tried to outsource its help desk, but brought it back inside after users found they couldn’t get the fast assistance they needed over the phone from outsourced help desk workers working abroad.

The help desk at Maimonides supports many areas, including desktop and smartphones, which are primarily BlackBerry devices. Some doctors have insisted on using iPhones, but Fahey said those devices can be used by doctors for many functions, such as keeping their calendars, but not to view or store patient information, because of privacy and security concerns.

One way the center has helped end users adapt to new technology, including smartphones, is by promoting the use of peer experts, called “super users,” who can help their co-workers with applications or hardware tips and fixes. “We have a good relationship with our vendors and staff, and we have a good quality IT staff who have a good relationship with end users,” Fahey said. “For that, training is critical.”

One third of the Maimonides IT staff includes a group of doctors and nurses who work full-time in IT, which helps the IT department work better with medical end users, he said.

Ultimately, being a CIO at a major medical center requires elbow grease as much as anything, including inflicting guilt on vendors, Fahey said. “It’s not an eight hour day. It requires a lot of maintenance, a lot of monitoring and a lot of working with my colleagues,” he said.


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