How one health system faces IT-driven challenges

Daniel Barchi, who's served as CIO at 2,300-bed Yale-New Haven Health System since 2010, says when he first started in his position, the system was not integrated and didn't operate together.

"It was like playing three-dimensional chess, but it worked out," Barchi told Healthcare Informatics in a recent interview. He added that in that first year, Yale-New Haven operated as if it were four separate organizations. "Above all, [we learned] to set aggressive timelines, and to let the aggressive schedule be your friend. Setting a goal, even a challenging one, let us accelerate the process much faster," he said.

According to Barchi, leading a 500-person IT team for a $4 billion enterprise with the focus almost entirely on people and process is akin to "moving an army forward." To that end, he said, communication and participation have been of the utmost importance.

In the next few years, Barchi said, Yale-New Haven plans to focus on delivering integrated care. His advice for other CIOs?

"In every situation in which IT is involved, there are some guiding principles," he said. "First, always put the patient first, because that will make clear what the answer is to any question; and have a close partnership with operational and clinical leaders."

Last fall, two healthcare specialists--arguing in a post to the Harvard Business Review--said that health IT is hindering, rather than enabling, integration of care across multiple settings and efforts to improve healthcare value.

"Most clinical information systems have been designed around specialties, procedures, or care sites, and focused on scheduling and fee-for-service billing," Harvard business professor Michael E. Porter and Thomas H. Lee, M.D., chief medical officer for healthcare management consultant Press Ganey, wrote. "Few systems were designed to keep track of individual patients over a full care cycle, and provide all the caregivers involved with comprehensive patient information."

Earlier this month, a report from the National Institute of Standards and Technology provided recommendations for electronic health record vendors and ambulatory care centers to improve the way EHRs are integrated into clinical workflow.

To learn more:
- read the full interview

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