- John Campbell, CHCIO, is the Chief Information Officer at Spaulding Rehabilitation Network, which specializes in post-acute inpatient and ambulatory care within its network of facilities. For the past seven years, he’s overseen the implementation of new health information technology (IT) systems at Spaulding Rehab as well as worked with other decision-makers in Partners HealthCare (of which Spaulding Rehab is a part) to select health IT technologies that will be adopted across the system.
We caught up with John recently to discuss what health IT means to a CIO and how future innovation is shaping how Spaulding Rehab and Partners HealthCare integrates new technologies in order to provide best care to their patients.
How do you choose a health IT vendor?
There are three models: all single-vendor or majority single vendor; parent-child relationship (parent with a couple of stepchildren); or best-of-breed. The larger, academic acute hospitals tend to go more best-of-breed because they have unique needs department by department; they also have powerful stakeholders department by department. They might have a radiology system from one vendor, a lab system from another vendor, billing from another, etc. That’s very expensive and messy to stitch together on the backend.
How much customization is needed to configure a new system?
Some of the vendors will deliver you a model system. They deliver you a system that’s built out and then you might do some customization on the edges. For our particular line of business, which is inpatient rehab, there’s no vendor out there that really specializes in inpatient rehab for all aspects — meaning labs, pharmacy, all those things. So any vendor that we would purchase, we would probably have to do a fair amount of customization just to fit the unique requirements of inpatient rehab.
How do deploy and implement new features?
We have continued to implement new features and new models as recently as last year. HIT has really grown up over the last decade, from being largely billing and financial systems to being full-blown advanced clinical systems, so you’re never really done. Most of the focus since I’ve been here has been on the advanced clinicals. That’s nursing and therapy documentation, a closed-loop medication administration system — that is, physicians doing order entry in the frontend and nurses doing medication administration with barcoded medications and wristbands on the backend.
What are the major health IT infrastructure needs for a large healthcare organization?
First of all, I would say bandwidth, both wired and wireless. The new hospital has really been designed to have almost limitless capacity on the wired and wireless infrastructures.
We have a 100% wireless coverage in the old hospital. The difference is: This is an old building. The building predates wired and wireless. Not all the rooms are wired. Every time you want to run a new data drop somewhere, it’s not easy. Because of where we’re located — even though we’re in downtown Boston — we don’t have fiber at this location; it would be very costly to run it to this location. At the new site, we’ll have a direct fiber connection to the network core for our parent company. On the wireless side, we’re using a distributed antenna system (AS). It’s a single-antenna system that basically consolidates all of your wireless traffic on to a single infrastructure.
The other thing that is important is what we’re calling ubiquitous computing. Virtually anywhere that a clinician wants a device to work with, there’ll be a device.
So how do you manage what devices are used?
For now, we’re still going the provisioning route. That’s a losing battle. We are starting to do work with technologies like Citrix that can provision applications on virtually any device.
How does a large healthcare system like partners go about choosing a vendor?
Partners set a goal of making a decision and finalizing a vendor contract within a year, which is almost unheard of for our organization. They narrowed the list early in the process to three choices. They had an accelerated process to vet those choices (do site visits to the vendors that were in the running) and get it down to the finalists. It’s actually been a very well-organized process. I would say there’s been an overwhelming clinical representation from across the various sites.
What does meaningful use mean to a ineligible organization?
We are not eligible on the inpatient side. Because we’re part of the Partner HealthCare System we’re more or less expected to be compliant, not necessarily to the letter of meaningful use. The major things that are part of meaningful use, frankly, we’re already doing because we’re part of this large sophisticated system, the rest of the system is doing, it’s the right thing to do, and even to have clinical credibility within the system. If all of our acute cousins are doing CPOE, eMAR, and all these things and we’re relying on them to send their patients to us, we need to be doing those things too to earn their confidence that we’re providing the same level of clinical quality. We are eligible on the ambulatory side. Our physicians are part of the PO, the Physicians Organizations at Mass General Hospital. We are eligible; we are compliant. And that whole effort is being organized by the Mass General PO.
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