Interview+Page

 This page is the conclusive context of the individual interviews by each team member. Some of the highlights from the interviews included the different perspectives between IT management and Business management. It is clear that IT is becoming more integrated into all business practices and that it is no longer just a segment of the company but it has deep impact for the entire company. Companies are moving forward or being slowed because of their IT systems and software. The responses from the interviews will be posted by the team members as they were written.


 * Caleb Kangas ** ** Interview Responses: **

Jeff Phillips – Black & Veatch, IT Manager Jim Doull - Black & Veatch, Estimating Manager

//** 5 Most Important IT Issues Currently **//

1. BV has shown progressive growth for the past 30 years with revenues topping 3.1 Billion dollars in 2008. The current strategic intent for the company is revenues of 5 billion by 2015. The IT infrastructure must support this growth. 2. Transition time to implement new systems is to slow and costly. 3. Integrate our BV systems with Extended Enterprise so we can better work with clients, owners, and Joint Venture partners. 4. Integrate all software systems between the 5 divisions. Currently BV has separate systems for each division for financial reporting, estimating, and document control. 5. IT system was built on a liner model that was outcome based. This is not good for Web 2.0 and remote access integration. This must be improved.

These are the top five issues facing Black & Veatch. I have been in the middle of a software integration for BV for the past year. We have been switching from an internal Microsoft Access estimating system to a Sage application, Timberline. The transition has gone very poorly and has now become over budget on money and time. The project is shut down now while they wait for more money to be approved. The initial budget was $1.2 million for software purchase and customization. The program was supposed to go live January 1, 2009. It is not July and there is no end in sight. So I am seeing first hand the effects of IT and system changes not going as planned.

A few other points Jeff made in the interview were good also. He mentioned how they are trying to create remote access ID’s for non-BV employees. We have external clients interfacing in our offices all the time. But they can not even get on our networks to access their email and the web because we don’t have separate security on our network. There is no way to limit their access to files on the servers that are internal. The BV IT group is trying to create digital passports for both employees and external clients.

The best thing I felt like BV is doing is their vendor partnership program. In the past 12 months they have gone to every major hardware and software vendor. Companies like HP, Oracle, Cisco, Microsoft, etc. and asked them how their systems could help BV become faster, leaner, and ready for the future. With each conversation they have told the companies they don’t want a, “Use our product and everything will be fine approach”, BV wants to know if a specific system will really work and if not they want the vendor to point them in another direction. After BV finishes their 1st round of evaluations they plan to get all the vendor architect in a room and meet to discuss different hardware and software options and solutions. I think this will be very interesting to have people for the major players in IT all chiming in on an answer. It could work very well or it could just go around in circles


 * Darin E. Jordan ** ** Interview Responses: **

David Printz - Central DuPage Hospital, CIO Lynne Bernard - Central DuPage Hospital. Clinical and Operational Nurse Manager

Presented below are 2 interviews conducted at Central DuPage Hospital (CDH), a non-for-profit organization in the Chicago Suburbs, by Darin E Jordan, MD. Mr. David Printz, Chief Information Officer and member of the CDH Executive Team, and Lynne Bernard, Clinical and Operational Nurse Manager of the hospital’s 6 urgent care facilities both offered perspectives on how IT is integrated into the hospital system and their specific job responsibilities. It is interesting to compare the 2 different interviews on how they relate to different areas of IT involvement, including governance and strategic initiatives. Mr. Printz emphasized the importance of supportive leadership and strong strategic planning on an administrative level. He also discussed how IT is measured and reported to not only the executive team, but to the hospital board. Several different areas of focus were also discussed, including IT security, education and resource allocation. Ms. Bernard, while sharing the importance of strong governance and strategic planning, tended to portray IT from a different viewpoint. Ms. Bernard tended to focus on how IT relates to improved clinical and operational quality, as well as patient care. Moreover, Ms. Bernard discussed some of the challenges that individual department managers have compared to leadership at an executive level Both viewpoints from Mr. Printz and Ms. Bernard however, both seemed to stress the importance of education and training, as well and investment in IT to improve the growth and service of the organization, both of which are strategic business goals of the institution. Moreover, a solid foundation of leadership and unified vision were essential to maintain a strong IT program within the institution.

**Interview with Dave Printz:** Upon interviewing Mr. Printz, he chose to discuss different areas of IT that were significant to CDH. He noted that the Executive Leadership Team at CDH has established strategic elements that each hospital department should focus on, including IT These elements include Quality, Growth, Strategic Initiatives, and Finance. Within each of these elements, each department must maintain projects with measurable outcomes and goals. IT projects are carefully planned and approved by executive administration, so projects meet strategic business models and goals. These projects are then implemented by the IT administrative team and monitored closely. Moreover, the IT department is measured by other metrics, including “IT Spending as a % of Revenue", "IT Spending as a % of Operating Budget", "IT Spending per Employee", and "IT Employees at a % of Total Revenue". It is also interesting to note that the CDH IT Department benchmarks itself against other industries. For example, CDH benchmarks itself using “average IT spending as a percentage of revenue” with other industries, such as banking and financial, telecommunications, other health care organizations, and transportation companies. In this way, CDH can compare and analyze cost structure with other corporations.

Mr. Printz also went on to explain other components of IT management that are essential to fulfill business strategy. He strongly promotes education and training among the IT staff, as well as among individual department end-users. Mr. Printz has initiated a system at CDH where all departments have an IT “liaison” that can train operational or clinical end-users on IT applications and hardware, as well as can integrate higher level and intricate communication to the IT department. With this liaison system, both the IT and individual departments benefit and are effectively more efficient. Continual educational IS opportunities, programs and support are also promoted and implemented throughout the institution and managed by the IT department. There is also reimbursement for many IT programs if employees wish to participate.

IT security is also an area of significant importance to Mr. Printz. With CDH operating as a hospital, Mr. Printz realizes the safety and security of health-care records is paramount. CDH has developed a security division within the IT department that specifically focuses on IT security. Security breech drills are regularly implemented to assure organizational IT safety and security. Moreover, there is continual monitoring and updated technology devoted to this area of focus. All employees are given training in the area of IT safety and security, as well.

Finally, Mr. Printz commented on the fact that CDH is unique to many other organizations with regard to IT. First, CDH has an executive leadership team with a respect and appreciation of how IT can significantly improve patient care, as well as growth, profit and market share. The executive team shares a vision, which incorporates strong IT involvement and unifies this business strategy with strong leadership. Moreover, CDH is in a position financially that they allocate significant resources into various IT projects and development, even with a depressed economy. This allows the institution to not only maintain its present IT system, but to promote development and improved technology, for the advancement of patient care and organizational growth. Finally, the leadership of CDH understands the importance of competency and expertise in IT staffing and has built an IT team that is superior to most other organizations. Several years ago, under new management, the IT department was reorganized and restructured to better implement new strategic initiatives and goals. The combination of these components has why CDH has received national awards for the past several years as the “Most Wired Hospital” as well as other awards for superior patient care and technology.


 * Interview with Lynne Bernard: **

** What are the 5 most important IT issues that you have to deal with at CDH? **   1. Staffing, training, and developing IS skills – Ms. Bernard noted that in the healthcare field, there are many disciplines (i.e. nursing, physician, technician, ect.) that are not experienced or comfortable on a computer. Thus, as the hospital implements more and more software uses for medical care, training and developing these skills becomes essential or patient care is delayed or compromised.

  2. Educating the IS staff about the business – The IS department at our institution is great at installing new computer hardware and software. The IS department, however, according to Ms. Bernard, needs education on how to implement this new technology without compromising care or patient flow. Both the healthcare team and the IT team must work mutually in this environment, educating each other on limitations and boundaries in the best interest of the patient. Without this team approach, cohesive, efficient, and advanced medical care is jeopardized.

 3. Incorporating the internet and electronic commerce into the business – Healthcare is such a competitive environment. Moreover, like medical information, IT technology is quickly outdated. With new IT technology being developed all the time, Ms. Bernard notes one must always be looking for new innovative ways to incorporate the internet and e-business applications to improve your business performance and revenue. This not only provides superior medical care, but keeps your organization ahead of other competitors.

 4. Managing systems development and systems project management – As explained in point three, CDH health system is always trying to implement new IT technology. With this initiative, managing the system and project development properly becomes essential. Mismanagement can not only cause installment delays and cost over-runs, but potentially compromise the safety and quality of health care being delivered to patients.

<span style="font-size: 11pt; color: #000000; font-family: 'Times New Roman', Times, serif;"> 5. Partnering with the executive level that runs the business – As with any new plan, Ms. Bernard emphasizes that partnering with the executive level is necessary to get not only the support for a project, but also to secure the funding. Moreover, integrating the executive level with business unit initiatives brings the entire organization closer to the team concept that organizations strive for. This also develops a greater efficiency throughout the entire system. <span style="font-size: 11pt; color: #000000; font-family: 'Times New Roman', Times, serif;">

Ms. Bernard points out that CDH’s health-care organization is quite large and IT funds are limited, so trying to convince the importance of an individual department’s IT project to both administration and the IT department, amongst other hospital departments becomes a significant challenge. Moreover, IT projects are sometimes are prioritized by different values (i.e. strategy, cost, revenue potential, technology advancement, ect.) that are not always agreed upon by different members of the organization. This makes it difficult sometimes to get your department’s project approved, compared to another’s project, merely based on a varied value system.
 * What do you like or dislike about the way IT is governed and managed in the organization? **<span style="font-family: 'Times New Roman', Times, serif;">

All new projects that affect CDH’s health care system must pass through not only IT and administrative approval, but must also be presented and approved through our health system’s multi-disciplined steering committee. This steering committee is governed by an executive from our health-care team and IT leadership. CDH’s steering committee also oversees the project implementation. Small intradepartmental projects receive approval from the direct IT supervisor and a direct report administrative executive. The IT department implements the small projects based on available staff and resources.
 * Is there a steering committee for new projects – who governs them? Who makes decisions about IT projects? **

Ms. Bernard noted that our health care system is planning to implement at unified EMR system within the next 1-2 years. This is a significant and costly project which will affect every aspect of our organization. Ms. Bernard says implementing the EMR, not only out of necessity to provide a more efficient and advanced form of health care delivery, but also to provide a strategic advantage against local health care competitors. To some degree, those health care systems with an EMR already in place have an advantage and other health care organizations are just trying to maintain a competitive equivalence.
 * <span style="font-family: Georgia, serif; msospacerun: yes;">What are the IT projects that are planned for the next 2 years? Are these projects implemented out of necessity or to provide a strategic advantage? **<span style="font-size: 11pt; font-family: 'Times New Roman', Times, serif; msobidifontfamily: Tahoma;">


 * Napoleon Knight ** ** Interview Responses **

//** 5 Most Important IT Issues Currently **//

1. Organizational structure of IT- In my organization the Chief Information Officer reports to the Executive VP and Chief Operating Officer, who then reports to the CEO, who then reports to the Board. There is a Chief Medical Information Officer who reports to the Exec VP and Chief Operating Officer as well. There is a combined IT oversight committee that oversees IT for both the Hospital and the Clinic and is responsible for ensuring ongoing operating stability, incorporation of new technology, and recommendation for new purchases to the hospital and clinic board. 2. Who manages IT budget? The IT budget is developed by the IT department, is overseen by the IT oversight committee, and then goes through the hospital budget review process with the CFO and the Exec VP and COO, and then goes to the CEO for final oversight, and then on to the Finance Committee of the Board, and then to the Board for final approval. IT has its own budget, but each department has an allocation for capital items, and IT capital items comes out of those dollars. Each department director or VP has to go through the Budget approval process to justify their requests. Decisions about IT projects that cost more than $25,000 must go to the Board for Approval, and projects that are less than that and are budgeted through the capital allocation process can be approved and authorized by the director or VP for purchase. 3. Do they outsource IT functions? We in the hospital contract with the clinic for IT services, and use the combined IT oversight committee for oversight. There is no outsourcing of IT functions unless we do not have the expertise in-house, or a critical project is needed and we cannot do it in house. 4. In thinking about an overview of a successful IT projects, I would have to say that one of our biggest successes was the implementation of our Epic electronic medical record. This was an $18 million dollar cost to the organization, minus some hardware and installation costs. It was implemented on time and on budget, and has made us one of about 4-6% of hospitals in the country to implement physician order entry. An example of a failure brings to mind on implementation of an electronic documentation system in our ED about 10 years ago. The system used templates, and was sold to us with the understanding that it would save us about $ 400,000 dollars a year in transcription costs. The system unfortunately did not work as billed, as it had multiple software bugs, and it went down frequently. When it did the on call tech would want the physician to stop seeing patients, and do trouble shooting on the system. Our IT department did an evaluation of the system, but did not load the software program with the number of patients that it needed to handle simultaneously, and so were not able to appreciate the impact on the system in use. We did not do a good enough job in our contract with the company to ensure performance levels and support of the system. 5. What are IT projects that are planned for the next 2 years? We will be implementing OpTime which is the electronic health record that will be used in the preoperative and operating rooms in the hospital. We will also be implementing an enterprise wide registration system. These will be implemented out of necessity, as the OR needs to be electronic, and the enterprise registration system is necessary as we are using a legacy system with poor support and recurrent downtime issues.


 * <span style="font-family: Georgia, serif;">Tyler Wilson Interview Responses: ** <span style="font-size: 11pt; font-family: Georgia, serif;">

**<span style="font-family: Georgia, serif;">Lynne Wilson - Perceptive Software, CIO: ** <span style="font-family: Georgia, serif;">

<span style="font-size: 11pt; font-family: Georgia, serif;"> <span style="font-family: Georgia, serif;">__//What are the 5 most important IT issues from your perspective?//__ <span style="font-family: Georgia, serif;">

Strategic linkage with the business - Ability to consistently meet or exceed key performance indicators (systems availability, customer satisfaction, first call resolution, completing projects on-time and within budget, etc.) - Security (logical and physical) - Disaster avoidance/recovery - Delivering effective and efficient solutions that meet the requirements of the business

<span style="font-family: Georgia, serif;">__//What do you like or dislike about the way that IT is governed (not necessarily at Perceptive Software...but in general)?//__ <span style="font-family: Georgia, serif;">

IT should be viewed as a strategic component of an enterprise versus just a cost center. This is sometimes hampered based upon where it reports within the organization (CFO / Finance versus CIO/COO) - Customers oftentimes view required structure as a challenge getting things completed from an IT perspective - without the structure it is challenging to maintain highly available, secure systems. It is also challenging to deliver technology projects none <span style="font-size: 11pt; font-family: Georgia, serif;"> **<span style="font-family: Georgia, serif;">Interview with IT Staff (paraphrasing from conversations with IT): ** <span style="font-family: Georgia, serif;">

1. Organizational structure of IT: CIO reports to CFO. I have two functional managers that report to me. One for the application/internal side and one for the external side (website, extranet, etc.). 2. Thoughts on outsourcing IT functions, being done? Not being done. We handle all of our functions internally. Not a fan of outsourcing - especially for internal IT functions. 3. Most successful IT projects: Roll out of Saleforce.com for sales team and now for other related department (support, development, administration, HR). 4. Failed IT projects: Haven't been around long enough to accurately answer this question... 5. Upcoming IT projects: Deployment of new enterprise email/web server and app. Application TBD.