It sounds surprising, but health care was one of the last sectors that used paper documents. For many groups, that didn’t change until the Affordable Care Act required them to digitize billing and health information to cut costs, improve care, and reduce errors. Others, though, were ahead of the curve. Deanna Wise, of California-based Dignity Health, says the health system had already started its five-year deployment of electronic health records when the federal mandate accelerated the process. As executive vice president and CIO, Wise—along with 1,100 IT employees—is helping one of the nation’s largest health-care systems harness technology to improve patient experience and deliver high-quality, affordable health services.
Wise, who came up through the ranks as an app developer and grew through leadership, has spent 17 of her 23 professional years in technology. At Dignity Health, she’s finding new ways for the large system (64,000 caregivers across 21 states) to focus on the human side of health care. The implementation of electronic health records will do that by improving care and safety. The deployment is about 50 percent complete, and Wise is pushing forward to make sure everything gets done well. “We have to get buy-in from patients and partners at every level,” she says. “An IT project starts to go bad when a team develops something and then rolls it out with no awareness or acceptance. We’re asking for feedback and participation from key players.”
A user-experience committee is helping Wise achieve her goals. The doctor-led team includes workers from the business side and others who participated in the initial build. They meet regularly to analyze the first 30 months of deployment and find opportunities for improvements or adjustments. Because there is a learning curve associated with electronic records, Wise is also dedicated to testing, training, retraining, and auditing.
At Dignity Health, three rolling teams follow Project Management Institute standards to simultaneously complete major projects. With the health records project underway, Wise is also leading a push to upgrade IT systems through a $1.83 billion investment. The far-reaching program will create a full wireless network and replace or upgrade computers and other devices. In such a large system, an effective CIO needs to gather requirements from a client and understand all expectations before building and developing. “If you provide a tool but don’t make it accessible, you only have half of the solution,” Wise says. “We work to make sure we get the right tool into the hands of the right person at the right time.” Dignity Health’s IT team never assumes one hospital is the same as another. Wise and her colleagues enter a facility with a standard but flexible tool set that changes to match each facility.
Dignity Health’s vision for the future—Horizon 2020—addresses quality, cost, growth, integration, connectivity, and leadership. It’s imperative that IT aligns all it does through that vision to drive internal goals alongside Horizon 2020. “Tech for the sake of tech won’t help you solve problems,” Wise says. “You’ll actually create more problems. IT is an enabler.” She encourages her team to think innovatively while deploying technology in a smart and sensitive way to provide business-driven solutions.
IT teams find the best solutions when they’re given the right work environment and then trusted to perform. Wise doesn’t believe everyone on her team needs to work from the same location and has built a strong staff by allowing employees to work remotely. The strategy helps her find, attract, and hire the best people regardless of location. She also looks for “bright and accountable” people who “listen, act, and understand what we are trying to accomplish.”
Wise’s other big project is understanding and adopting ICD-10 coding and reporting standards, which are new guidelines for hospital inpatient health-care settings. Dignity Health is also building out a data warehouse for predictive analytics. “It’s really important that we have all we need in place to collect the data that electronic health records can mine. With that, you can do population health,” she says. Not only can engineers use these systems to collect and disseminate data—they can also put the information back into the workflow of clinicians and physicians. By funneling critical information and digitizing data, Wise’s team can provide important information at the right time. In doing so, they will influence and change the quality of care in a positive way.
A lot has changed in the last five years, but the pace of technology is not slowing down. Dignity Health has started a pilot program through which doctors and patients interact remotely via teleconference. The next step is more fully integrating data. “Maybe if you go to an eye doctor and then a primary care physician, there would be a benefit of having these health records combined,” Wise explains. “We’re heading down the path of putting information into the hands of the patient.” She’s implementing a portal strategy that will allow IT staff to enter or collect data and provide it back to patients who access their health profiles much like they do with their finances in an online banking session.
Lastly, CIOs and IT teams across the industry are working to find ways to use data and technology to prevent problems or errors before they arise. Dignity Health has a product called AirStrip OB that provides mobility while combining electronic medical records and information from medical devices. An OB doctor, for example, could monitor a pregnant woman in labor from a remote location without relying on a nurse to relay critical data. “Information is at our fingertips in new ways each day,” Wise says. “It’s an exciting time to be a CIO working in health care.”