A Model for Long-term Partnership

Background

Children's Hospital and Health Center of San Diego (CHHC) is a leader in pediatric patient care and research. It has the only designated pediatric trauma center in San Diego and is the only dedicated children's hospital in the region. It also houses a Research Center that administers federal funding for research in children's health and a new organization, the Center for Pediatric and Clinical Research, combining the strengths of clinical specialties with the infrastructure of CHHC and conducting over 200 trials per year in pediatric care. As CHHC has grown in size and become an innovative leader in care delivery and research, demands on its information management capabilities have also grown. Through this evolution, it has relied on Information Technology Optimizer consultants to provide information technology thought leadership, transformation and management.

Long-term Partnership

Since 1989, IT Optimizer consultants have played an integral role in the transformation of information management at CHHC. They helped to build the initial information management organization and led the information systems planning, architecture and implementation of the hospital's core system. According the CIO, Gayle Yeakle, over all of this time, the direction given by IT Optimizers has consistently been on target.

"We have used them for many projects and I have confidence that the results will consistently be high quality. They have valuable expertise in our industry niche (pediatric care) and don't provide cookie cutter solutions."

—Gayle Yeakle, CIO, Children's Hospital and Health Center

Organization Transformation: The Early Years

In the late 1980's information management was totally outsourced. There was no internal information management expertise. But Senior Management felt that it was paying too high a price for outdated technology. They were paying 45 cents out of every IT dollar for customization, and felt they lacked sufficient control. IT Optimizer consultants entered the picture and helped management build a strong internal organization while developing a strategic systems plan and assisting the organization through the process of vendor selection and a very successful systems implementation. They helped management think through difficult technical and personnel issues, without losing sight of the organization's core cultural values of loyalty, trust, and willingness to learn. That emphasis paid off.

Gayle Yeakle, the current CIO, was a lab assistant at the time. She recalls, "Thinking back, it's pretty amazing what we accomplished. We went from nothing to having 25 people and we successfully replaced our core system, bringing up 32 applications simultaneously without any disruption. And most of those people are still with us today."

For the initial systems selection and implementation, CHHC's team used the FULCRUM Series Methodologies®. Gayle claims that using FULCRUM was indispensable. "FULCRUM is a strong methodology to insure success; it guides the organization along the right stepping stones, and helps keep your eye on the ball."

Meeting New Challenges: Hospital Growth and Research Specialization in the 1990's

Later in the 1990s, IT Optimizers continued to help CHHC with information management challenges brought on by new growth, managed care and increased specialization. Among many other projects, they developed an IT plan to support increased focus and specialization on pediatric care and research.

In 1993, IT Optimizer consultants also played a key role in addressing all of the IT needs surrounding the development of a new hospital wing with over 100 beds. They assessed all of the information management needs of the new wing, with model nursing units and workstations and provided detailed networking engineering designs, standards and protocols.

They also provided education and indirect funding/ grant assistance through the creation of technical white papers. CHHC, as a leading research organization in pediatric care, relies on grants and other funding to provide state-of-the-art research. One of the white papers led to a major grant by Gateway Computer. Other white papers have addressed targeted issues in data warehousing, clinical data repositories, Enterprise Master Person Index (EMPI) and document imaging.

More Recent Projects

IT Optimizer consultants have provided IT thought leadership, strategy and management in a number of other key areas.

• Retrofit or Replace Major System
  An economic and functional assessment was conducted to determine whether the Meditech system should be replaced. As a result of a detailed economic and functional analysis using FULCRUM Feasibility and Cost-Benefit Analysis, the team decided to internet-enable the Meditech system.

• E-Health Strategy Formulation and Vendor Selection:
  IT Optimizers conducted a Senior Management Retreat to develop an E-Health Strategy for CHHC, led by Joe DeLuca, founder of IT Optimizers, and conducted the vendor selection using FULCRUM Vendor Selection. Medseek was chosen as the core internet services provider.
  
  According to Gayle, "They really helped us structure our thinking with respect to E-Health. Feedback from our online users, both physicians and consumers, is fabulous. Our focus groups indicate that we are providing what they really want, that we are proving our value…We also generated more funding because a first-time donor saw our site and gave us $100,000." Online innovations for CHHC include the provision of the "baby board" that has pictures of ill neo-natal infants that family can release to friends and a web-page service for the families of children with long-term illnesses to keep everyone informed of the health status of the child.

• Strategic and Tactical Support for Offering ASP Services to Physician Groups
  Physicians affiliated with CHHC outsource their information management needs to CHHC. CHHC provides online LSS/E-Z Cap/ Meditech services to these physicians and must charge them an appropriate price to avoid potential litigation. Using its FULCRUM Service Pricing Methodology, IT Optimizers is providing an easy-to-use pricing model.
  
  Gayle is enthusiastic about both the model for pricing physician services as well as the political support she has received during this process.

"When I am in a meeting with the CFO, the lawyer and the physicians and someone challenges a point (regarding the pricing of physician services), it's great to have Joe (DeLuca, founder of IT Optimizers) there to provide an objective view. I remain the good guy, the services provider with a positive working relationship with everyone."

"The services pricing model is a tool that's really easy to use. I can easily add or close a group and see what the pricing implications are; it's pretty hands-off and easy to maintain."

—Gayle Yeakle, CIO, Children's Hospital and Health Center of San Diego

• Other benefits from using FULCRUM Service Pricing Methodology for pricing physician services include:

• Incorporates fair market pricing
• Calculates capital and operating costs
• Provides pricing implications for various groups
• Reflects best business practice whether for-profit or not-for-profit
• Assures proper documentation in case of audit
• Complies with regulatory and legal mandates

Future Work

Gayle is currently considering the FULCRUM Project Management Office as a way to further leverage her organization and potentially save consulting dollars. "FULCRUM is a tool kit that helps me get more done with fewer resources."

Read more about FULCRUM Series Methodologies®

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