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CEO Outlook: Leadership isKey to Integrating IT into the Organization's Vision  By Mike Green A 2009 Modern Healthcare CEO IT Achievement Leader President and CEO, Concord Hospital  A Means to an End After years of being compared to other industries that have made impressive gains in quality and efficiency using information technology (IT), healthcare is finally catching up. Information-rich online portals for physicians and patients are becoming commonplace, and more and more hospitals are tapping into the safety benefits of solutions such as bar-code medication administration and computerized provider order entry (CPOE). But as we progress in this journey, we must keep in mind that IT is a means to an end, not an end in itself. "The end" is achieving the mission of better outcomes, patient safety and financial stability. As leaders, we need to integrate IT into what our organization does clinically and financially every day. IT can help us achieve excellence by instilling repeatable and sustainable clinical and financial outcomes. IT helps us systematize best practices and share guidelines across the enterprise. Engaging Stakeholders at All Levels Concord has always been an early adopter of health IT. We were one of the first hospitals in the nation to implement bedside computing in the early 1990s, and the first hospital in New Hampshire to implement CPOE. We've learned that the key to successful IT integration is engaging stakeholders at all levels of the organization. To succeed, you must have buy-in, adoption and shared responsibility, all coupled with accountability. Here are some of the strategies we've used to engage our key stakeholders:  Board of Trustees — I work with our Board of Trustees to establishpriorities, with IT consistently among the most important. Each IT investment must support our strategic objectives. My CIO attends the meetings and educates Trustees on the initiatives. Finance Committee — The committee reviews each IT project thatrequires an investment of more than $500,000. Any project endorsed by the Finance Committee is voted on by the full Board. Senior Management — I ensure that senior managementunderstands the benefits of the proposed IT opportunity, gain their agreement on the investment decision, and communicate accountability for successful implementation of the initiative. Key strategic IT initiatives are considered team initiatives in the senior management incentive compensation plan. In addition, some senior leaders have IT projects as a component of their individual compensation goals. Physician IT Leadership — We established a full-time role for aChief Medical Information Officer who provides leadership for medical staff adoption of IT. The CMIO is supported by four physicians six days per week. The physicians represent family practice, internal medicine, the family practice residency and pulmonology. Physician Steering Committee — For each health IT project, aphysician steering committee guides the implementation process. By involving multiple medical specialties, physicians contribute to the success of IT projects that affect medical staff. Physician Staff — To promote patient safety and care quality,Concord has established annual pay-for-performance quality targets for all employed physicians. Accountability at the Project Level Concord Hospital routinely prepares formal project charters for all IT-related projects. These charters identify the project objectives, metrics, executive sponsor and team, risks, scope, communication plan and post-implementation evaluation timeframes. For IT projects where the investment is greater than $50,000, formal reviews occur after completion to determine whether the objectives outlined for the project have been achieved. Effective leadership requires continual scanning of the horizon for new ways to improve performance. Our next major health IT project is focused on implementing McKesson's next-generation enterprise revenue management system to support our financial performance goals. Because of the successes we have achieved – and proved through our results – it has become easier to convince all of the stakeholders to commit the funds and effort to continue to invest in IT to support our strategies. Mike Green has been in healthcare management for more than 30 years in a variety of positions throughout New England and the East coast. He has served as President and CEO of Concord Hospital since 1992. Concord Hospital has won numerous awards, including multiple Most Wired awards from Hospitals & Health Networks, the journal of the American Hospital Association; a National Association of Medical Directors of Information Systems (AMDIS) award, and the top honors in McKesson's 2008 award for use of its CPOE.
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