by Elizabeth M. Ferrarini

CIOs in corporate America worry about how IT is going to make their organizations more competitive. In healthcare, demographics, not IT, help hospitals to, for example, expand into new markets. To this end, healthcare CIOs view IT as a critical underpinning for process improvements that can help patient care and safety.

Dennis L'Heureux has firsthand experience finding the right technology to fit a hospital's strategic initiatives, as well as its tight budgets. He wears two hats as both CIO and vice president of planning hat at Rockford Health System, a 400-bed tertiary healthcare provider and the second largest specialty health care group in Illinois. His exemplary technology leadership has earned him a place on Computerworld's list of Premier 100 IT leaders.

Enterpriseleadership recently sat down with L'Heureux to talk about some of the ways technology has improved some key functions and to discuss how he's dealt with an influx of new C-level peers.

EL: How do you deal with the challenges of spending on technology while  keeping the cost of healthcare down?

DL: I can't draw a direct line between those. There's always an incentive to keep the cost of healthcare down. We struggle with this all the time because of the new government mandate for more price transparency.

Our business is very complicated. For example, each insurance company we do business with might reimburse us differently for the same procedure. If someone wants to pay cash, the price will be different, to. This entire situation continues to vector downward as the government and insurance companies want to pay less. Meanwhile, the cash consumer wants to pay less.

We have constant pressure to provide the same types of services with better  quality and safety for less and less money.

EL: Can you talk about situations where IT has helped the hospital saved  money?

DL: A basic assumption in healthcare is that the use of IT over the long run will reduce costs. This is very hard to quantify across the board; however, I can cite some tangible cost savings. Because we've put in electronic medical records system, we've saved on file room clerks and don't have film expenses anymore.

And, I can say that technology is helping a radiologist come up with a diagnosis in less time than he or she did before, for example.

EL: What process improvements have you made at Rockford Health  System?

DL: We've eliminated the need to go looking through old film files trying to compare a patient's X-rays taken today with those taken three weeks ago.

We also centralized the scheduling of outpatient routines. Previously, physicians had to call a specific lab to make an appointment for an outpatient. The new system now allows physicians to call one number for all of these procedures. It also allows physicians to identify where any combination of those tests can be done for the patient. That's a pretty significant process improvement.

Finally, each year, our employees have to select their medical coverage for the following year. At one time, we mailed each employee a thick paper packet. Now, we have all of the information online.

EL: How automated are your medical records?

DL: We've automated a significant part of the records, including histories, physicals, all lab tests, all EKGs, all radiology tests, all surgical notes, all mammograms, and all cardiology tests. We haven't automated our nursing notes. That a big project.

EL: What are some of the best practices you have put in place for  IT?

DL: For the past 12 years, we've had a decent governance structure for how we use IT and the investments we make in it. Our Information Management Services Advisory Council consists of representatives from the physicians practice, nursing, administration, finance, and IT. This is a key best practice.

We also see our technology resource center as a best practice. If we'd had to outsource it, we wouldn't have pulled off the service levels that we now provide. We are proud of that.

EL: In some healthcare organizations, the CIO reports to the CFO. How do  you feel about that?

DL: The data suggests that if you report to a CFO, you have less flexibility and less investment in IT than if you reported to a CEO. You have the challenge of making sure you invest in the right things.

I'm fortunate to report to the CEO. In fact, I have survived five CFOs.

EL: How do you deal with the changing of the guard in C-level peer  positions?

DL: A new CFO may come in and ask questions -- why don't you do this and why didn't you do that? The answers can be simple. However, a lot of times, solutions and decisions have been made along a very complicated set of criteria. It's difficult to explain all that.

You have to retell your story constantly, not recreate history. You need to get the new CFO to understand where you are today and why. I like to sit down with the new person and go through all of my governance structure. Then, I list out all of the inventory of things we have, and talk about the investments we have made and what I think is still deficient. This tactic has worked very well for me.

You need to build good relationships with your C-level peers. These relationships help you to have an amicable conversation about crucial topics. If you don't have these good relationships, you'll cross swords every time you meet to discuss an important topic.

EL: How do you align IT with the hospital's business objectives?

DL: Because I was promoted to senior vice president, I am also in charge of strategic planning. It's easy for me to connect those dots. When we created our strategic plan for our company, we had six drivers. My schematic charts shows IT as the foundation for each one of them; IT doesn't sit as the seventh driver. We view IT as a support function, not as a way to create new markets.

New markets in healthcare come about by things such as demographics, unemployment, and employment. As we try to capture the market share for good paying customers, we try to leverage IT.

EL: What's the most pressing priority you have right now as far as a  project goes?

DL: Right now I'm working on using technology to provide better patient safety between the pharmacy and the nursing departments, which order, confirm, and dispense medications. We've mislabeled it as a "bar coding project," but it has many more components and processes than just bar coding.

At the time, the vendor we purchased the product from didn't have RFID. We're still months ahead of this implementation, so we've delegated someone to look into RFID and to see if it makes sense for us. I wrote the contract for bar coding, but if RFID is the way to do, then I'll have to reopen the contract and say I'd prefer RFID.

Prototyping often leads to two separate processes. That can be dangerous. We want to play it save and to stick with standard processes.

EL: What professional organizations help you to network with other  CIOs?

DL: I participate actively with the College for Healthcare Information Management or CHIME. About three times each time, I check with my CHIME colleagues to see how they are doing things, and what issues they are having.

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Elizabeth M. Ferrarini is a freelance technology writer based outside  of Boston, Massachusetts. Reach her at elizabethferrarini@yahoo.com.