According to Dave Dully, chef technology officer of Baptist Health, a consortium of physicians and hospitals in northeast Florida, healthcare IT administrators fight an uphill battle in terms of securing capital budget money; new disk arrays are often at a disadvantage against money for a new ambulance or X-ray machine, he said.
However, he said, "There has never been a better time to garner support for healthcare IT, as we are in the midst of a public discussion about the state of healthcare in our country."
Even the most generous capital budget in healthcare won't allow projects to be completed all at once, Dully pointed out. And often, the process of training users or even convincing them to embrace the new technology is a bigger problem, he said.
"We went to an entirely paperless system, but it took us a full two years," Dully said. "The way we did it was to essentially 'provision' our project -- we divided up our business goals into smaller pieces and translated them into goals for IT. Then, we prioritized them in order of importance and put them in place one by one."
According to Dully, "There has been a lower level of IT innovation and advancements compared to other industries because medicine is considered an art as well as a science," Dully said. "If you ask 100 doctors how to treat a cold, you'll get 100 different answers -- it doesn't lend itself to automation or repeatable processes."
But, he said, there were signs things are getting easier. "When I introduced our latest improvements to our physicians, they immediately started asking what would happen if the system went down.". "Even a few years ago, these guys weren't using PCs, and now they're asking me about downtime. It's a sign things have changed," he said.
The largest storage project any healthcare provider will face, according to Dennis L'Hereux, chief information officer (CIO) of Rockford Health in Rockford, Ill., is implementing a Picture Archiving and Communications System (PACS). L'Hereux said the systems are expensive up front but encouraged healthcare users to document the return on investment (ROI) they can achieve by eliminating silver oxide-based X-ray film. L'Hereux estimated that in the first year his PACS system, including associated storage from Xiotech Corp., would save his company almost $400,000 in staffing, materials and physical storage costs; year two would see a savings of over $1 million.
"In the worst-case scenario, our PACS system, including storage, will pay for itself in 5.2 years," L'Hereux said. He added that there were other intangible benefits, such as a reduction in waiting time for test results and the perception that the healthcare provider was technologically advanced -- that would keep patients coming back.
In selecting both the PACS application itself and the Xiotech storage, which the company previously used for other applications, L'Hereux said his method was to involve his staff heavily in the decision-making process. His radiologists made the final decision as to which PACS product the company would use, and his IT engineers had been the ones to pick Xiotech, he said.
This type of purchasing process also helped smooth the training learning curve, L'Hereux said, since the employees who would be using the product had been part of the research phase of purchasing. L'Hereux said he had found appointing one employee a "super user," who could mentor other users, had also been effective. Finally, L'Hereux said, it was best to train physicians one on one rather than in a classroom session.
"Doctos in general don't like asking questions sometimes," L'Hereux said. "They don't want to look like they don't know something."
However, L'Hereux admitted, all of that -- from demonstrating ROI to the training process -- assumed other organizations had the means to implement such a system for themselves. And, he said, the majority probably did not.
"I'd say only about 20% of healthcare centers in this country have a PACS system right now," he said.
In that case, L'Hereux predicted PACS systems would soon be offered by vendors as a service or as a communal system shared by several healthcare centers in a given area.
"Not every company has a CIO," he said, "but every company has a chief financial officer who might be interested in the time and money that can be saved with a PACS system. Be persistent, and bring any technology that you think might make a difference to his attention."