Becker's Hospital Review

24 HEALTH IT The CIO's Role in Cost Improvement By Liz Kirk, Senior Vice President, Cost Improvement, Strata Decision Technology F or the last decade, CIOs have been consumed with implementing and gaining adoption for EHRs. Now that they are implemented and wide- ly adopted, we've arrived in the "post-EHR era" — and the CIO's role is shiing. Now, the CIO's main re- sponsibility is to make all of the data collected day in and day out throughout an organization ac- cessible to decision-makers in an actionable, meaningful and us- er-friendly format. As the pace of change and degree of risk increas- es for providers, the need for quick, data-driven decisions grows. Getting data in the hands of operational and clinical leaders will enable improvements in quality, cost and strategy. Whether it's at the bedside or in the executive offices, it is the CIO's duty to get the right information to the right people to provide quality care and make timely, well-informed decisions so the health system runs as effectively and efficiently as possible. e CIO must be aligned with the strategic priorities of the C-suite. According the annual American College of Healthcare Executives survey, for the 11th year in a row, "financial improve- ment challenges" topped the list of CEO concerns for 2014, the most recent year available. Not surprisingly, it also tops the list for CFOs, according to several recent surveys. While CIOs haven't traditionally been financially focused, they are now key players in the cost improvement conversation. e CIO has two vital responsibilities specific to driving out costs: stewardship of the organization-wide IT spend and enabling cost savings initiatives to produce real savings. If a CIO is not viewing his or her role in this way, the organization is undoubtedly not re- alizing all of the savings available to them. Stewardship of the IT spend As healthcare providers become increasingly technology en- abled, the opportunities to spend more money on systems, im- plementation, maintenance fees, networks and consultants are endless. However, the IT stack can quickly become fraught with duplicative systems and functionality — read "excess cost." Aer years of cost reduction in front-line operational and clinical areas, it is necessary to look beyond these areas to generate the level of cost savings needed. e CIO should lead the charge to reduce the cost of IT operations. As shown in Exhibit 1, CIO-related cost savings opportuni- ties run the continuum from straightforward just-do-it actions to the more complex initiatives that require cross-functional collab- oration and well-defined processes and structures. The power of the platform in reducing cost One cost savings opportunity that falls directly within the CIO's domain and cannot be overlooked is the power of the plat- form. Oentimes, operational, financial or clinical leaders find a system they want that meets their particular needs. But to either feed this system data or use the output of this system, many manu- al processes are spawned. Smart people become the duct tape that tenuously holds the systems together. Take the finance operations of a large, academic health sys- tem. ey have one system for financial decision support, one sys- tem for clinical decision support, another system for budgeting, another for long-term financial planning, and yet a fih system for capital planning and tracking. ere are countless manual, of- fline processes in which a person is critical to moving data from one system to the next. Essential operational reports are routinely run in Excel because no single system supplies the information operational leaders need to manage their department. Unfortunately, the complexity in this health system is not unique. In fact, it's quite the norm. It is the CIO's responsibility to provide end users with a better, more efficient, less error-prone process. In the exam- ple above, efficiency can be drastically increased by replacing disparate systems with a single platform that provides that functionality all in one. Reducing customizations How many times have you heard people in your organization say "we have to customize it to make it work for us" when imple- menting new systems? Customizations typically result in higher implementation fees, longer implementation cycles, slower processing times, more support needs, more unplanned downtime and difficulty in up- grading functionality. While it can be difficult to accept off-the- shelf functionality, balancing customizations with standard or supported configurations can result in long-term cost avoidance. Exhibit 1

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