Customer Spotlight: Technology, It's All About People

A conversation with Gary Croteau, AVP & CIO, South County Hospital

Gary Croteau is the assistant vice president and CIO of South County Hospital (SCH) located in Wakefield, Rhode Island. SCH is an independent, non-profit, 100-bed acute care hospital offering the latest advancements in technology and a comprehensive range of medical and surgical services. SCH has more than 100 physicians in its community and 650 FTE total staff.

SCH prides itself in providing southern Rhode Island with the highest level of expertise, technology, and a comprehensive range of advanced inpatient, outpatient and home health services. We spoke with Gary about his approach toward connecting people and technology, and how he is using technology to improve processes in his organization.

Q: Gary, as CIO, information is your “middle name.” How do you view technology with respect to information in the hospital?

The first words that come to mind when someone says, “technology” are probably “efficient,” “productive,” “frustrating.” You wouldn’t hear “humans” or “people.” Although by its nature, technology should be tailored to benefit people. It is meant to make our lives and jobs easier. And it has for the most part.

Like any innovative MEDITECH hospital, at South County we always want to make sure we are providing high-quality, efficient patient care while maintaining smooth operations. This means the health of the hospital’s business side is just as important as the clinical side. As you would imagine, I take the information technology / information systems side of the house very seriously. But I also consider the human aspect of technology.

Overall, our users are not IT people, and they don’t necessarily need to learn the technical process of generating and accessing reports. They simply need to obtain the information they are looking for quickly and easily. Technology should not be their focus, but rather a critical tool to help them perform their jobs. In addition to accessing and recommending technology for the hospital, my staff provides IT assistance and training to all users throughout the hospital. We want to establish a partnership in their business operations by delivering technology solutions that compliment the department’s business expertise.

Q: In that light, how do you approach technology?

One basic view of our use of technology is the nature of information and access to information are interrelated. The hospital staff and its leadership must be able to find the information they need, when they need it. Technology doesn’t always lend itself to that. For example, email is a great tool for communicating, but it’s not always used most effectively or properly. It is perfect as an FYI, but it isn’t effective for having a meaningful dialogue or for communicating statistics, management reports or policies and procedures to users, staff and management.

Email may be fine for the people who receive the email in that given day but what about new people to the organization? How do they get the information that was sent by email before they joined the organization? A better approach is to publish this information in a way that is accessible to people when they need it, not when someone wants to provide it to you at one point in time. To me, that’s a very basic premise—information when you need it vs. when someone else wants to give it to you.

At South County, we use our Intranet as that basic medium to store and organize content, whether its policies and procedures, changes in the organization, or even those FYI nuggets. If it’s organized and searchable, then people can find it when they need it.

Q:  How do your users keep up with the volume of information they must work with?

We have many systems, and the process is different for every single one. There are different passwords, different screens, and different applications. If someone is new to the organization, it can be confusing and frustrating. How will she know what reports are available, and how to access and to produce them? Having report history available on the Intranet page, allows the manager to become acclimated to the environment, what’s expected of her, and what information there is to manage with.

In an effort to organize the back office, the IS staff implemented an automation technology called Boston WorkStation from Boston Software Systems to facilitate and automate many repetitive manual tasks, such as producing daily reports for various departments throughout the hospital, preparing downtime reports in case of a system failure, and ensuring the accurate transfer of online payments made on the hospital’s web site into MEDITECH. By automating workflow, we also maximized the use of our Intranet, giving managers easy online access to payroll and expense reports, and eliminating the hassle that accompanies the paper process.

By automating the reports, the IS staff only has to teach the management team or key users how to access the Intranet and find the reports in a consistent, logical way. Now all reports, be it a current report, last year’s or last month’s report, are archived within the Intranet.

Q: Can you talk about other projects you’re working on that strengthen the people/technology connection?

Another project we are committed to is building interfaces to biomed systems. In organizations that haven’t built these interfaces, staff writes critical patient information on a piece of paper, sticks it in their pocket, walks back up to the documentation systems department and keys in the data.

But the interfaces we have built allow for the transfer of information behind the scenes, without intervention from the staff. This eliminates redundant data entry and the chance for errors in the transcription process. Automating the flow of this information makes the staff more efficient and effective, improves patient safety and reduces medical errors. It also provides timely access to the information being captured at the bedside and pulls all these various systems’ data together for our patient records.

Using Boston WorkStation, we have established a mechanism for patients to access a patient portal to pay their bills online. Technology makes it convenient for patients to connect with the Patient Accounts Department and process payments. It is an automated environment where we use our primary billing system to extract patient statement information to post it as a record for the patient when he accesses the portal. As payments are received, the Boston WorkStation script retrieves the payments and posts them so they are accurate, updated and timely. It doesn’t require staff to enter data, and it provides for a smoother, more efficient process.

Q: What are some of the biggest differences about working in technology today versus when you began at SCH?

When I came to South County nine years ago, we had a mix of old technology, which was difficult to support in a small environment. We were installing new systems to deal with Y2K.  I pushed to replace those systems with MEDITECH because it offers us an integrated system, meaning it is designed by one vender and doesn’t require multiple interfaces to work. We push for standards and integrated products whenever possible. By reducing the variety of systems we need to support, we become more efficient. We have found that an integrated solution will be less expensive to buy, manage and support over time. My staff can build a foundation with the one product and not have to learn a new platform or get used to multiple vendors.

This idea of standardization is reflected in most of our decisions. We’re not a large IT/IS staff so we need to maximize our effectiveness. We try to create the most reliable environment and reduce the amount of variables that go into every solution. Whenever a new technology is introduced, we try to establish a best practice for implementing that technology. A good example is with our copiers and printers. We standardized on a vendor and the feature set and now, any employee can use any copier or printer in any part of the hospital. Having a variety of technologies that do the same thing reduces our effectiveness. Standardizing on technologies helps our users to be more comfortable with the tools they are using because they are familiar with them.

Q: Another major initiative at hospitals is electronic medical records. Will SCH be adding an EMR solution?

It is clear that electronic medical records are important for the survival of any hospital.
Along those lines, another one of South County’s goals is to improve communication between the providers and the hospital to exchange patient results. We’re instituting portals in the physicians’ offices, which will allow them to enter their orders online. They will be able to collect office specimens, label them, and, with the use of 2D barcode technology, automate the entry of patient information captured from the physician office system into the hospital registration system. The physician can then receive results back into an Inbox, closing the loop on the order entry/results reporting cycle. This solution will help the physicians track how well patients are complying with their orders and allows us to maintain accurate electronic records for each patient.

Q: Gary, anything else you’d like to add?

In this economic climate, we have to figure out how to get the same things done with fewer resources. We have moved to virtual servers, for example, allowing us to extend our capital investment. We must be diligent and not ignore what is happening around us. As new technologies develop, we need to assess their application to healthcare and use new tools to improve patient care. The new healthcare IT and the economic stimulus program will help us continue down this path.

I’ve seen a dramatic shift in focus for hospital IT. Over the last ten years, there has been a move toward concentrating on clinical systems vs. financial systems. Patient safety is the impetus, and technology plays a key role in improving safety in hospitals. We’re just beginning to understand how to use technology to improve patient safety. As IT people, we need to partner with our users, such as nurses, physicians and administrative staff, to be sure we’re adopting the right technology and implementing it to offer the most benefits to them.

Twenty-five years ago, it was all about the numbers. Now, it’s all about people.

Gary Croteau has 21 years of experience in the healthcare industry. For the past nine years, he has served as the assistant vice president and CIO at South County Hospital Healthcare System in Wakefield, Rhode Island. Croteau is also a steering committee member of the RI Health Information Exchange. He holds a bachelor of science degree in computer information systems from Western New England College.