One CIO, divided by five

Lewis Hooper wants Ontario’s health-care system to get its act together.

On Wednesday, Hooper was named the CIO for a group of five organizations that will include Scarborough Hospital, Durham

Access to Care, Lakeridge Health, Rouge Valley Health System and Scarborough Community Care Access Centre. The partners said it was the first appointment of its kind in Ontario.

Hooper, a consultant who worked on the Ontario Health Services Restructuring Commission and the Ontario Third Party Review, says he is aware that dividing his time among the various organizations will be difficult, but he says he is ready for the challenge.

“”What we have to recognize is that local needs are going to be different,”” he says. “”We’re going to let them develop what they need to develop, and look for things where we as partners can help each other.”” spoke with Hooper about the nature of his role as CIO, and how he plans to improve IT service across the board. What’s the most important thing you’ve learned as a health-care consultant that you’ll be bringing to this position?

Lewis Hooper: What I’ve picked up is that in the health-care business, we don’t always understand the importance of knowledge transfer. It’s really part of the whole business of health-care. Think about what we do: We acquire knowledge from the patient — their history, diagnostic tests — we transfer it to somebody who can apply it with their own set of skills, whether it’s a nurse or a physio. They add to that knowledge trail, and they move it on to the next person in the chain. The part that I’m seeing here is that the partners that I’ve got — the three hospitals and two CCACs — see that as an important piece. They see that as a real opportunity to tweak the health-care paradigm a little bit. To move the information better in a way that meets the patient confidentiality, I think we can do that.

I’ve been fortunate enough to do some research on information technology in health care, and what you’ll find is those folks that have got good information systems tend to have lower costs than other hospitals. Not only that, they’re more what we would think of as operationally efficient. The cost per production unit is a little cheaper for those hospitals.

ITB: How did this opportunity come about?

LH: It was really the partners coming together and saying, “”We need to think regionally,”” as health care in Ontario moves into a LIHN, which is a local integrated health network. There’s an area that includes these hospitals that’s supposed to have some planning and operating responsibilities together. They took a look, I suspect, and asked where they could maximize the value of that. To help facilitate that change, and help consolidate some of our approaches. For instance, we haven’t started talking about this yet, but we could start scheduling patients from anywhere inside the LIHN. Our waiting lists for MRIs might be higher here, but we could move that over there. Or if you need this type of surgery and the surgeon that does that happens to be at Scarborough hospital, you could call up the times. Right now, what will happen is you’ll get that referral, you’ll call surgeon, who’ll say, “”I’ve got to call the operating room to find out when I’ve got time.”” You could consolidate that so that it’s very simple to do.

ITB: What kind of resources have you been given to work with. Does this mean fewer IT staff at the local organizations?

LH: At this point in time, I don’t know. One of the issues that I face is, the Ministry of Health, which is the ultimate funder of health care in Ontario, doesn’t really understand the importance of this knowledge transfer chain. When they fund hospitals, and the hospital’s funding a new building project, they don’t fund the IT portion. They’ll fund the other stuff, but if you want to put a network in, that’s not part of the budget. Fortunately, I think it’s starting to get some cache now. They’ve established a transformation team that has information as one of the key components of it. I’m hoping they’re going to come around and realize we need some resources to make this happen.

ITB: Why do you think it’s taking so long for that realization to occur?

LH: I don’t know. I suspect there’s several causes. One is the Ministry is fearful of funding anything because it turns into a black hole. I also don’t know if the field has realized that what we really do is that exchange of knowledge. The Ministry has found it difficult to grapple with the costs of IT. They’re doing some good things, now. They’ve started Smart Systems for Health, Canada Health Infoway. Historically, they haven’t done much of that.

ITB: How do you approach managing five different IT environments?

LH: It’s going to be a real challenge. I’m in a fortunate position of having senior-level partners, the CEOs, who are very cognizant of what this thing ought to look like. Even though we’re still kind of vague in our minds, they see the importance of it. And at the IT manager level, they’re also very good. I’ve got a core group of good people I can work with, especially at the IT management level, that are saying we could do this. The political barriers aren’t as prominent here as they are in other things, which is where this tends to fail. The other advantage I have is, the expertise of each of these organizations is different. Some of the hospitals have done really well with some sorts of integration for letting physicians see information from a Web-based portal. Others have done really well on telecommunications, or the network infrastructure to support these things. In the first six to a year, my suspicions is we’ll be looking for, “”Gee, you did that? Well, can we expand it over here?”” And we’ll bring each other up to the same level. And then in the next few years we’ll start looking at where we’re going to go from there.

ITB: How long before health-care organizations other parts of the country adopt the joint CIO approach?

LH: You know, other parts of the country are in a very different situation. What’s happened in most of their health-care systems is, they’ve regionalized. Our LIHN would be comparable to one of the regions in B.C. — Fraser Valley, or something even smaller than one of those things, although we’re the biggest LIHN in Ontario. What I see is really for us to go to them and see what they’ve done in overcoming these issues. I anticipate learning from them.

ITB: What would you identify as your first priorities?

LH: I mean, I’ve been here five days. I think I’ve got to get an understanding of where we stand — it seems to be pretty good. I’d like to get moving on sharing information, subject to patient consent — I want to put there, because that’s a hot topic — and dealing with some of the redundant systems if we can. What I see is my biggest opportunity is bringing everybody up to a higher level. We’re all the stars in some areas, so I’d like to see us stars across the system.

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