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"Technology's completely revolutionized how we take care of patients," says Dr. Thomas Lathrop, the hospital's medical director for information systems, who spends half his time practicing internal medicine and the rest trying to find ways for technology to help doctors do their jobs. "Before, we had to plan to physically go to X-ray and pull the films and hope that someone else hadn't pulled them before you. You had to plan your day around finding these things to take care of patients. Everybody's record is now available everywhere all the time. That's an entirely new concept. That's amazing. But we had to change the way we think and do things."
And so will the entire health care industry, which is under pressure to heed the call from President George W. Bush for converting paper charts into EMRs, or electronic health records (EHRs), by 2014. But many midmarket medical organizations are struggling with the transition. A study published last year in the Journal of the American Medical Informatics Association, for example, predicted that universal EMR adoption would take a decade longer than the federal mandate. A Forrester Research Inc. study found that less than 20% of doctors use computers for clinical applications.
Gundersen Lutheran, on the other hand, has already completed the journey into the digital future. The nonprofit hospital's experience shows how executive leadership, close collaboration between business and technology, and a crafty approach to user resistance can add up to success for an early adopter.
Lathrop's partner in re-engineering the way doctors practice medicine at Gundersen is CIO Deb Rislow, a registered nurse with a degree in computer science. A decade ago, she helped nudge the century-old hospital toward a bold new future. Since Rislow joined Gundersen 17 years ago, the IT department has grown from 16 people to 150, while the capital budget has gone from $50,000 a year to $10 million.
Hospital CIOs around the country are discovering that they have to reinvent their IT shops. They've gone from managing mundane back-office systems such as accounting to running sophisticated clinical systems like PACS, which are not only technically demanding (terabyte storage capability is common) but mission-critical. Life hangs in the balance.
"In health care, IT was a support department," Rislow says. "There were practically no computers. There was very little development going on. But there was a vision and a strategy, and the hospital took the risk with us."
In some industries, CIOs have to struggle with replacing legacy systems. At Gundersen, Lathrop and Rislow faced replacing traditions that sometimes seemed nearly as old as the Hippocratic oath.
"Physicians are the CEOs of their own world," observes Eric G. Brown, the health care research director at Forrester Research. "Clinical information systems can make the health care system much more efficient. But the reality is, for that to happen the physician actually has to do more work. What's easier than grabbing a prescription pad and writing something? Technology benefits the rest of the ecosystem, but the physician has to carry the work. That's a hard sell."
At Gundersen, investing in the technology turned out to be fairly easy. Getting doctors to swallow it was the hard part.
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