In 2005, after 13 years in the financial services industry, I migrated into the healthcare industry. I was about five weeks into my new career when a major network downtime occurred.
From my history, I was waiting for people to start scrambling to get the systems up and running. In the financial services industry, "time is money." What I found was disconcerting to say the least, my team was taking a very lack-a-daisy approach to restoring network operations. I immediately started pushing the team to quickly restore at least partial service while they figured out root cause and a long-term solution. Obviously, they recovered. However, I was left with some unanswered questions.
Confused, I started to peel back the onion to understand their reaction. Could it be that we're more concerned about losing money in the financial industry than losing lives in healthcare? The answer I derived fascinated me - it wasn't lack of care, they didn't understand the link.
The healthcare industry was so immature with technology that the core IT processes and philosophies had not caught up with the new technological capabilities. If you think about it, banks had been highly automated since the late 60's and could not operate without IT. Healthcare on the other hand had been highly paper-based. That's not to say systems did not exist; however, the users could function effectively without them if they had to. As a result of this reality, CIO's and senior IT leadership in the past did not enforce the direct link between system downtime and an impact on patient care.
Times have certainly changed. Electronic health records, nurse call systems connected into voice-over-IP, medical equipment interfaced to information technology, overhead paging replaced by Cisco Informacast, and wireless capabilities have all raised the stakes. The adoption of these technologies has now given IT the ability to positively or negatively impact patient's care, to the extent of saving or taking a life!
The CIO must accept the responsibility of building a culture that informs IT employees of their potential impact, ensures a sincere appreciation of the responsibility, and finally ensures that acceptance of the responsibility. This responsibility goes far beyond paying lip service to the patient care and safety link. CIOs must ensure adherence to proper change management, testing, redundancy, and constant communication of the potential impacts on the patient. They must also keep fully educated on the clinical impacts by being closely aligned with key clinical leadership.
I recently facilitated a discussion where I explained this link between IT and patience care. Here's the very simplistic example I used:
As we all know, Cisco has a stronghold on the healthcare network environment. I took the discussion participants on a virtual walkthrough of one of my hospital's network environment. The participants began the discussions thinking that the network and phone system was one of those core infrastructure things completely unrelated to patient care and safety.
1.) We discussed our electronic health record which runs in the corporate data center 1500 miles away. If the network is down, guess what - no EHR!!!
2.) We spoke about the hundreds of mobile devices that exist to bring data to the patient's location. No wireless, no mobility!
3.) We discussed the Informacast system. Informacast runs on the Cisco VOIP CallManager. Cisco VOIP runs on top of the network. If the network goes down, the phone system goes down, and ultimately we have no paging. I then provided the team the vision of a code blue with no paging. Scary thought, isn't it!
4.) No network = no video-conferencing. Telemedicine is now impossible. Needless to say, the participants in the discussion very quickly obtained an appreciation of the patient care and safety link! Furthermore, the good news is the solution is very simple including solid IT processes, redundancy being architected in, and finally building a culture of being satisfied with nothing less than 100 percent uptime.
As the technology adoption continues to increase, CIOs will be faced with the responsibility of communicating and enforcing this responsibility of patient care and safety to their teams. This thought process is not natural to IT employees. They are not taught to think this way in school and if they come from another industry, they're also not taught to think this way. In most industries you can easily state "Don't worry if you make a mistake - no one will die..."
The CIO must be the one to make this understanding and responsibility a cultural norm. If you struggle with this message, try my secret and begin your discussion with "imagine your mother/father, brother/sister, or son/daughter being cared for in our facility when a system downtime occurs!"