Calculated. RISKS My Survival and Success (?) as a Chief Information Officer

Transcription

1 Calculated RISKS My Survival and Success (?) as a Chief Information Officer Michael Restuccia February 1 st,

2 My Journey 30+ Years Healthcare IT Experience Health System, Consultant & Vendor Experience Unique professional experience includes Business Owner as well as employee in large scale Delivered Services healthcare organization as Interim Director Personal decision making often guided by trends of IS and statistics In 2001, 90+ percent of all new businesses fail in the first 12 months, primarily due to cash flow short falls; yet founded MedMatica Consulting Associates at this time Contract & Prestige of UPHS CIO After 5+ years in business, came to University of Pennsylvania Health System in managerial consultative role. Soon a CIO vacancy Recognizing that the average tenure of a CIO was 3½ years, I was selected and accepted the permanent CIO role 2

3 3 Penn Medicine Today

4 Penn Medicine 2007 State of Penn Medicine in 2007: 95% of IS Services outsourced In country and out of country support No IS Governance nor Project Management Office Disjointed Application Strategy (often 2 or more of each) IS Budget totally in expense control mode Minimal Partnerships Reactive Fire Fighters IS culture did not align with the world renowned Penn Medicine patient care and research culture Reasonable approach if expense containment, but if wanted to support growth. How much worse could I make it? 4

5 The State of Health Care CIO s VALUE Budget Enterprise Leadership Executive Support Digital Transformation Team Building EMR s Day- Day Support Services Innovation Geographic Expansion & Integration Cybersecurity HIPAA Leveraged my business & install background 5

6 EHR Implementation Headlines 8 hospitals' finances hurt by EHR costs MD Anderson blames EHR costs for 56.6% drop in income Brigham reports $53M shortfall after Epic transition Southcoast cuts 95 more jobs after $100M Epic EHR installation 50% of EMR installs fail to meet objectives EHR Rollouts Gone Wrong 6

7 Should I Stay or Should I Go? Took a Direct Leadership Approach: Learned From Successful Leaders In Business and Sports Mike Mularkey 9-7 George Karl Davey Johnson Yogi Berra Marty Schottenheimer 14-2 Lee Iacocca Ford to Chrysler Steve Jobs Apple and Back to Apple All Terminated Despite Success Many Reasons To Be Terminated Not Based Upon Performance Best Defense is a Strong Offense Do What is Right; not What Will Protect My Tenure There are very few permanent jobs/careers 7

8 Building a Culture of Team Listening Mission of Penn Medicine Energy, Attitude, Aptitude Prestige of Penn Medicine Experience with Leading Edge Technology Benefits Manager Location Compensation Other Items 8

9 Cornerstones of Information Services Culture Common Systems Integrated versus Interoperable (industry not quite there) Selected Common EHR Vendor Epic Corporation Phased Implementation Approach Natural Segmentation Risk Minimization Single Instance & One Build 30,000 Employees 200 significant influences & decision makers Penn Med a Quaker Organization Each major decision disgruntles 25% of decisions makers Only a short matter of time before all are against me Centrally Managed Single Point of Accountability All March to the Same Guidelines Complex Issues Centrally Addressed Budgeting Simplicity The 3 C s Collaboratively Implemented Team Install Approach (50% IS and 50% Operations) Operations Sacrifice to Provide their Best No IS Projects Governance, Governance, Governance 9

10 The EMR Journey (PennChart) 2008 Integration vs Interoperability (Battle Royale) 2009 Vendor Selection (Cerner, EPIC, GE, SMS) Pick your Battles! All or Nothing! 2010 Phased Implementation Approach (Ambulatory Only) & 2017 Extend EPIC to some Inpatient Settings Decision to completely integrate Ambulatory, Inpatient and Homecare ( PennChart ) Activation of Integrated Patient Record across Penn Medicine entities 10

11 Guiding Integrated EMR Principles Look first at Epic solutions when replacing existing or implementing new solutions Non integrated solutions are the exception rather than the rule Enterprise Commitment Integration supersedes niche functionality Implement solutions uniformly across all Penn Medicine entities Workflows defined and validated by Operations Prefer small, incremental change versus big bang approach Prioritization, sequencing and optimization are performed at a group/governance level; leveraging the capital and operating budget cycle 11

12 Health System Results First academic to completely deploy EMR in all ambulatory, inpatient and homecare settings Enabled improvement in key health system quality measures including Re-admissions, Hospital Acquired Infections. Avoided Healthcare Publications Headlines for Failed EMR installations Benefits Realization - $300 million in savings and cost avoidance over 5 years Attained HIMSS Level 6 evaluated for Level 7 Most Wired 9 years in a row #4 & #9 Innovation Leader per Information Week Invested in Benefits Realization along the way. PennMedicineIS/ 12

13 Corporate IS Results Team Chemistry Never Better. Average 4.75% unplanned turnover over 5 years All projects delivered on-time and on-budget 2016 CIO Award 2015 CXO Award First UPHS/Penn Med CIO to exceed 10 years tenure. Personally exceeded average CIO tenure by over 3 times (thus more vulnerable than ever!) 13

14 So What Do I Suggest Do IT Your Way Focus on Team Network, Network and Network Keep Track and Communicate Successes Anticipate the Un-anticipated Recognize that there are NO Permanent Roles 14

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