RANK: #2 (LARGE HOSPITALS)
Three years ago, when Genesis Healthcare System committed to EMRs, it meant big changes for the IT department.

"One patient, one record meant one IT department, too," says Genesis CIO Ed Romito.

As part of the transition to EMRs, Romito united IT staff scattered throughout system's various locations and hired additional staff. The result: The central IT department swelled from 40 to nearly 100.

"But we have figured out how to keep the small-department feel," Romito says. "We're a big department that operates as a small family. That's hard to find in a 100-FTE department."

Romito subscribes to the "management by walking around" philosophy. Even after his promotion to CIO two years ago, he still maintains his office in IT. He describes the department's structure as less hierarchical and more matrix, with managers working side-by-side their employees.

In five years, Romito's staff has more than doubled while the workload has tripled. He estimates they're backed up perhaps a few years on new projects, and Genesis' planned move into a new medical center means even more work to come.

It's made for stressful times at Genesis, but Romito watches carefully for employee burnout, offers some opportunities for remote work, and makes sure the workplace stays fun.

"We're jokesters," he says. "We don't like to rule with an iron fist."

One Friday this fall, the IT team gathered for a tailgate luncheon in preparation for the weekend's OSU vs. Wisconsin football game – a rivalry they've established with their Wisconsin-based colleagues at EPIC. They'll gather this month for their annual holiday party, and the team said goodbye to summer with a Hawaiian-themed cookout.

Shon Bender is an RN by training who's transitioned into Genesis' IT department. What he appreciates most about his workplace are the opportunities for open discussion and reciprocal acknowledgement provided by weekly meetings.

"Coming from the clinical bedside, time doesn't always allow for that," says Bender. "It's important to get together as a team to discuss where we are. I think that's unusual."

CEO Matt Perry also recently joined an IT meeting: "What you get from that is an incredible sense of teamwork," says Perry. "They are very engaged. Their job is not to install and support computers. Their job is to transform health care."

That philosophy forms the basis for Romito's Operational Owner Engagement (O2E) program, which formalizes communication between IT and the hospital's business, financial, operational and clinical functions.

As Romito tells his staff, "There are no projects that are IT projects."

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