Brigham and Women's Hospital CIO Sue Schade: Top Health IT Priorities

Seemingly constant advances in technology and health IT requirements mean hospital CIOs are busier than ever. When faced with a to-do list that includes meaningful use, electronic medical records, computerized provider order entry, e-prescribing and more, how should CIOs prioritize their time? Sue Schade, CIO of Brigham and Women's Hospital in Boston, shares some of her top priorities.

1. Demand management. Demand management has always been important for Ms. Schade, but is particularly so now because of the competing demands on her team’s time. Demand always outpaces the availability of resources, she says, so it is imperative to delegate resources to the most appropriate projects.

Most of the software at Brigham and Women's is internally developed. Thus, each request for enhancements, corrections and other changes goes to the hospital IT department. One of the great challenges for the staff is to manage these demands so the team can focus on fulfilling federal requirements, such as meaningful use. Ms. Schade has developed a formal IT governance structure and process for handling requests. "I can't emphasize enough the importance of formal objectives and processes to evaluate requests as an overall IT [team]," she says. The IT team conducts a value-risk assessment for each request, evaluating the potential impact on revenue, patient safety, employee satisfaction and other areas when deciding whether to pursue a particular project.

The requests that take priority are critical path projects. "We define critical path projects as those projects that support strategic initiatives and operational priorities as decided by the executive leadership. They trump others if there is a scheduling resource conflict," Ms. Schade says. Critical path projects at Brigham and Women's include, in no specific order, HIPAA 5010, ICD-10, meaningful use and acute care documentation. "If there was a resource contention between any of [the critical path projects], I would look at what the next key milestone dates are to determine trade-offs needed," she says.

2. Security. Improving data security and staff training on security has become increasingly important as more information is stored electronically. The hospital is working to limit the amount of data stored on mobile devices and ensure encryption for all devices, among other efforts. "Attacks and mistakes people can make cause potential exposures that we all have to work with and try to mitigate," Ms. Schade says.

3. ICD-10. Brigham and Women's will have to devote more resources to transitioning to ICD-10 than other hospitals, according to Ms. Schade, because their systems are internally developed. While other hospitals can wait until their vendor has an ICD-10 compliant system and install upgrades, Brigham and Women's will have to do a great deal of remediation work with their systems to meet ICD-10 requirements.

4. Interoperability. Ms. Schade says one of the hospital's current challenges is achieving interoperability and sharing information between organizations. Whether through a health information exchange or a separate partnership with organizations in the region, the hospital will need to made data accessible to other providers as part of meeting meaningful use criteria.

5. Staffing. "A lot of us are struggling with recruitment and hiring talented, experienced staff," Ms. Schade says. A shortage of healthcare IT workers coupled with high competition for skilled staff make recruiting an ongoing challenge, she says.

Related Articles on Health IT:

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How Hospitals Can Gain Support for Meaningful Use Initiatives

Top 7 Meaningful Use Myths Debunked

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